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Why the mentally ill continue to die


January 14, 2014
By Jim Bremner

by Jim Bremner

All the talk about deescalation of armed mentally ill individuals and the need for training has driven me, through frustration, to address the core issue – the flaw in current law enforcement training and why it repeatedly fails to be effective.

The bottom line all has to do with the hard wired, evolutionary adaptive survival mechanism of our mid brain’s fight and flight response.

{Instinct}

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The empirical data is in on the specific fundamental function of the mid brain limbic system – to keep humans alive and reproducing other humans.

The primitive brain (mid brain) housed in the limbic system – the hippocampus, amygdala and thalamus – drive the flight and fight response but also the desire for food and reproduction, freeze, flight (avoidance) and fight (fear based verbal and physical combat).

Early humans, like all other mammals, were totally reliant on instinctive reactions to their environment in order to survive. The mid brain limbic system and autonomic nervous system drove us to breath, eat, reproduce, flee and ultimately fight based on our perception of the world around us.

Relatively speaking the modern brain is a late arrival, developing only over the last two million years, as evidenced by the increase in skull and brain cavity size. This could be related to more nutritious food, which assisted in the development of the cerebral cortex and led to a cognitive process.

Not having a cognitive thought process two million years ago wasn’t as much of a draw back as one might think; after all, how much thinking would you do day to day?

Evolution has provided humans with a genetic gift of fear () of fire, water, heights and large animals. All other fears are learned through exposure to the environment and this is where the amygdala comes into play. It is our centre for primitive fear and short term memory, cueing the fight and flight response based on our exposure to a real or perceived threat in the environment. The thalamus then triggers the bodies neuro pharmacology, releasing a deluge of chemicals (adrenaline, nor epinephrine, dopamine, serotonin cortisol, etc.), which all prime the body for freeze, flight and flight.

Heart rate increases 200 BPM or better, vaiso constriction occurs, muscles tighten and the body maintains this state until the threat has passed. The hippocampus turns short term memory into long term memory and stores it in the modern brains cerebral cortex.

The amygdala is the emotional centre and evolution has provided that we feel before we think. Have you ever had an outburst while driving in rush hour traffic, which embarrasses you when you THINK about it?

The primitive brain does not understand language; it is only aware of threat cues in the environment based on our proximity to the threat. Humans feel before we think; it is not possible to do otherwise once we perceive or are confronted by a real threat.

{New threats}

What about our reaction to new threats? Through exposure, a person who has been bitten or hasn’t grown up around mans best friend will naturally be wary of dogs. They will avoid or flea areas where dogs are and, through negative or an uneducated experience, fear dogs.

That fear response is reduced through positive experience and education. Dogs are seen as mans best friend and this triggers a response from the thalamus that releases positive neuro pharmacology (dopamine). The individual becomes relaxed and comfortable in the situation and is able to access the modern brain and make rational decisions in the cerebral cortex.

A police officer’s reaction when confronting a mentally ill individual will be based on their last exposure and experience with a similar individual – good, bad or indifferent.

Officers must be exposed to the mentally ill in a positive setting and spend time in long term care facilities as care givers, not police officers, so they can see that the majority of mentally ill people, like the general public, are not violent.

{Deescalation}

Current deescalation techniques are based around verbal communication and negotiation skills (verbal judo and tactical communication are two popular methods).

Communication can be defined as the exchange of ideas between two people through a common language.

Negotiation is arriving at a mutually acceptable agreement between two parties, with give and take on both sides. Both are modern brain cerebral cortex functions but if the mid brain is primed by what an officer sees as a perceived conflict or threat, the cortex does not function at its peak, if at all.

Almost 80 per cent of communication is non verbal – para and body language. Actions reveal intent, real or perceived, not language. Both parties in a conflict are connected to their primal response to a threat – freeze, flight or fight.

If we look at nature, it is clear that distance is the true trigger of the fight response and officers must be trained to maintain it. This does not have anything to do with the 21 feet or edged weapons rule, although this is an added benefit; it has to do with primitive non verbal communication directly to the mid brain.

Officers must be taught the reality of primitive human behavior, including their own. Do not use threatening hand gestures and speak in calm tones; it is not the words but the tone. If parents yell, a child cowers.

{Predatory drift}

Humans have inherited, as an adaptive survival mechanism, hard wired predatory instincts which usually lie dormant. When normal behavior “drifts” over the line, predatory instincts kick in and take over. If something doesn’t happen to stop the behavior at the moment when this occurs, things can turn ugly.

Predatory drift can occur suddenly and unpredictably and is triggered by over-arousal (a situation where the officer perceives they are losing control). It can happen with the onset of situational anxiety and triggers a predatory reaction, which can ripple through an entire group of officers in an instant (fire contagion). It isn’t a conscious reaction; it’s visceral and instinctive.

Consider what happens to a mob of fans at a soccer game or a group of normally-civilized people standing on the sidewalk yelling “Jump!” to the poor, troubled person out on the ledge. Teenagers behave very differently when they’re in a group, as do gang members when they’re together in a “pack.”

Police officers must be made aware of this phenomena and use deep breathing, team work and disengagement to control the onset of predatory drift.

Police cannot address one side without addressing the other. The officer and subject both respond in kind based on an adaptive survival mechanism provided by nature; this is simply unavoidable without maintaining distance.

{Emotionally disturbed}

Emotionally Disturbed Persons (EDP) are not mentally ill and the phrase is not a catch all. Encountering such a person offers an opportunity to use the current methods of active listening, verbal judo and tactical communication but only after the individual has cycled down to engage their cognitive thought process.

{Suicide}

This is a most misunderstood topic; in the simplest of terms, suicidal individuals are looking for a rest from the unrelenting emotional turmoil of their individual circumstances and are not overtly violent. Suicides are rarely reported in the news (what North America calls suicide bombings are in fact martyrdom bombings).

What they have in common is a belief that life is not worth living, clear indications regarding their future, a plan, desire to contact former loved ones, a note in the form of an apology and a method of execution.

They have contemplated the act for some time on a daily basis and perhaps have done dry runs to build the fortitude to ultimately commit the act.

Having served on a SWAT team for many years, I watched as, despite our best efforts to intercede, individuals with the fortitude to carry out the act leapt from bridges or shot themselves (passive aggressive suicide).

I have watched several of the most recent videos of police shooting armed mentally ill individuals – and having shot one myself, it is clear in the light of day that they had all the precursors of suicide but lacked two finite criteria: a method of action (pills, bridge, weapon) and the resolve to carry through.

Their answer is to CLOSE THE DISTANCE with police, eliciting the fight response from officers. Under pressure police will always bypass less lethal force options for the highest force option – their firearm.

The danger of using fear conditioning as a training tool (21 feet rule) is that it is not a rule and not everyone at 21 feet with an edged or offensive weapon is dangerous. If you ate breakfast this morning the person across from you had a knife in their hands and you survived.

The response is based in the primitive brain and at this point in the confrontation the officer is helpless to respond otherwise ().

Once again we are back to distance and non verbal communication.

{Tools and training}

After 30 years in law enforcement, including almost 28 in special operations, I have seen the evolution of every force option available, used them all and acquired instructor status on some. I am constantly frustrated when I hear those with little familiarity speaking on the subject – or those who view one technology as a panacea to this universal issue (the law enforcement industrial complex).

Any tool is an extension of our hands; it compliments and assists the basic skill set to make us more efficient in our task but there has been a clear and ever growing departure from providing police officers with a competent basic skill set. The rush to technology as a way of compensating for a lack of skill has brought us to where we are today.

Technology is supposed to enhance the capability of those who possess a competent basic skill set. This is not measured by two day or week long courses that hand out certificates to all participants as proof of some type of expertise. Skills are earned and monitored and mentored by experienced officers.

The data tells the tale; since the introduction of semi automatic pistols police shoot more and hit less. The FBI estimates that law enforcement has anywhere between a 11 and 14 per cent accuracy rate in live fire engagements.

In keeping with distance as being the key to deescalation, officers must learn to contain an individual and not encroach on or penetrate into their perceived personal space unless extreme circumstance arise (based on officer perception). The tools and strategies that will enhance this methodology are:

  • Batons – Law enforcement has moved away from 26” wooden batons (visual deterrent, non-verbal means of communication received by the primitive brain) to collapsible 21 inch metal batons, in most cases for ease of carry. The disadvantage is that, in a confrontation, an officer needs a weapon that is longer than the opponents reach to keep them at a DISTANCE.

The new batons are also only used as striking implements. Control and come along strategies are no longer taught, limiting an officers’ response to a higher level of force that will inflict more damage on the subject.

  • Less lethal chemical munitions – OC, tear gas or a combination are used to detect, dislodge, disperse, deny and put individuals at a psychological and physical disadvantage to assist the officer in measured application of force to resolve a situation.

Many officers, again because of poor training methods and lack of experience with the technology, fear cross contamination and the minimal effects they may experience. This is the danger of requiring officers to be exposed to chemical munitions as part of their training. The experience for most is one of fear and anxiety – extremely negative. Such training is warranted at advanced levels for SWAT and special operations because they can be expected to work in contaminated environments for prolonged periods.

When a person loses respect for a weapon after exposure they are more likely to use it in a punitive measure (if it didn’t hurt me, it won’t hurt them). US and THEM are dangerous in law enforcement training as it dehumanises the public, making it more likely officers will resort to primal primitive measures ().

Officers may also distrust chemical munitions because they didn’t work as desired in a previous incident. All require time on target to be effective; if you do not receive the desired effect, another application is necessary but keep your DISTANCE.

  • Specialty impact munitions – When an officer cannot control the distance because there are no physical barriers, specialty impact munitions such as Safety Sock and other projectiles can be used at a minimum of 40 feet (and in some cases up to 50 meters or better) of stand off with 100 per cent accuracy. Again, these should be used as a measured response until the individual acquiesces.

  • CEW – This technology has also proven effective but is not without controversy. The major issue in encroaching on a subjects’ perceived personal space is that closing this gap endangers both officers and the subject. All less lethal technology must be accompanied by lethal over watch and when we close the distance, officers are more likely to resort to their firearm in response to the threat.

  • Shields – Though primitive they at least put a physical barrier between the threat and the officer. We train riot control officers to stand and take the onslaught of projectiles and fire bombs for hours on end without incurring physical harm. Corrections officers still use them effectively on a daily basis to subdue violent offenders.

Canadian law enforcement is following a trend to arm itself with carbines as a response to a perceived active attacker threat that, for the most part, is not a clear and present issue in this country. We have had only two or (arguably) three incidents in our history but we confront mentally ill individuals armed with offensive weapons daily.

Officers can be trained to shoot for less vital areas, just as we have been taught to shoot to vital areas; in some areas of the world this is their less lethal response to an offensive weapon; are we training to incapacitate or kill?

{To sum up}

Without addressing the core issue of our human condition I fear that we will continue to repeat the past, as we have for more than 20 years.

  • Officers must be exposed to and educated in the realities of a mentally ill subject and human behavior by physicians, psychiatrists, psychologists and long term care workers.

  • Officers must be given a skill set based in experience and competence, and the confidence that it will enable them to positively resolve a crisis.

  • There is no value based in fear conditioning for officers or the public.

  • Response teams of officers and psychiatrists should respond to events with a full spectrum of less lethal tools.

  • It is a software, not a hardware Issue (Lt. Col. D Grosman).

We are undeniably products of human biology and without addressing that we are unable to move forward.


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