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CIT: History, Mental Health

& Resources

Dave Moran LCSW, CAADC ~ Allyson Sproul, LCSW, CAADC

Role Play in CIT

  • The use of sociodrama and role-play techniques

  • Objective set to provide training

  • Adaptatied into training programs for other government agencies

History

Advocating for a new approach to domestic violence.

The role-plays included consideration to non-verbal behavior and adhered to a five-phase intervention model—

Resolution

Saftey

Communication

Most successful: Family Crisis Intervention Program, between psychodramatists at St. Elizabeth's Hospital & Metropolitan Police Department of Washington DC.

Also the most extensive training program in the United States at that time

(Hankins & Buchanan, 1987).

Referral

Diffuson

Afterward, participants engaged in a discussion about which interventions seemed most effective and their own action insights during the process.

Significant changes in police attitudes about domestic violence and their ability to respond to it

(Buchanan & Perry, 1985),

An increased ability to defuse conflictual situations

(Bandy, Buchanan, & Pinto, 1986),

Multiple studies concluded

Studies

Significant reduction of assaults on police who were trained by the program

(Buchanan & Hankins, 1983),

An overall improvement in communication skills, role repertoire, and spontaneity in responses

(Hankins & Buchanan, 1987).

Research on a similar police training program demonstrated a significant increase in recognition of:

  • Mental health issues, improved efficiency dealing with mental illness, decreased physical altercations and weapon-involved interactions with mentally ill individuals (Krameddine, DeMarco, Hassel, & Silverstone, 2013).

  • Study suggested that a one-day training for police cost about $120 per officer

  • More than $80,000 in savings over the next 6 months due to improved interpersonal skills of officers interacting with individuals in the community.

"No Wrong Door"

•Recovery Model of Integrated Treatment

•Collaboration between Criminal Justice, MH, Crisis and D&A systems

•SAMHSA, DOH, OMHSA are integrating systems under the COD Initiative

•Behavioral Health Criminal Justice Regional Forensic Service Coordination

Established links, between courts, probation, police departments,

corrections and the BH system include, but not limited to:

Forensic

Mapping

  • Rapid access to emergency inpatient services: MH/D&A services

  • 24-hour emergency/crisis services

  • Increasing participation of local police departments in specialized MH training

  • Development of specialized forensic liaison positions

  • Shared funding arrangements between CJ & BH

  • Development of MH court

  • Several ongoing meeting structures for information sharing and problem solving.

Map

What is Mental Health?

Mental Health

Adverse Childhood Experiences (ACEs)

ACE Study

Adverse Childhood Experiences (ACEs) are potentially traumatic events that occur when we are young.

ACEs and the associated toxic stress they create are the root causes of some of the most common, serious, and costly health and social challenges facing our state.

ACEs are strongly linked to 9 of the 10 leading causes of death in the United States

-www.acesaware.org

ABUSE

Physical, emotional or sexual

QUESTIONAIRRE

NEGLECT

ACE Breakdown

https://www.acesaware.org/wp-content/uploads/2022/07/ACE-Questionnaire-for-Adults-Identified-English-rev.7.26.22.pdf

Physical or Emotional

HOUSEHOLD CHALLENGES

Chronic interpersonal conflict due to MH/DA, Incarceration, separation and/or intimate partner violence

Stigma

Risk & Prevention

Risk & Prevention

Access

https://www.cdc.gov/violenceprevention/aces/riskprotectivefactors.html

Consistency

Trauma

Trauma

What helps the brain heal?

Rhythmic Brain

Meet Officer Ed...

Officer Ed

Bipolar Disorder

Mood

Bipolar DO

Schizophrenia

Thought

Schizophrenia

Substance Use & Addiction

  • Dopamine & Seratonin

  • Parts of the brain

  • Addiction vs Dependence

SUD

Dopamine & Seratonin

Neurotransmitters

Addiction vs Dependence

What is "Dependence"?

According to SAMHSA TIP 63

Here's the problem.....

When the body needs “something” to function at a baseline or state of “wellness”

Necessary for survival

“Physical dependence in and of itself does not constitute addiction, but it often accompanies addiction”.

–drugabuse.gov

Addiction

Dependence

Addiction vs Dependence

Nutrients

Physical-Based in the body

Chronic disease of brain reward

-ASAM

  • Inability to consistently abstain (substance or behavior)
  • Physical withdrawal symptoms

Nutrients

Neurotransmitters

Hormones

Body + Brain

  • Impairment in behavioral control
  • Tolerance

Blend of both criteria often

occur together in Substance Use Disorder

  • Craving
  • The body cannot

organically produce the

needed nutrient, hormone,

or neurotransmitter without

pharmacological or food based intervention

  • Diminished recognition of significant problems with one’s behaviors and interpersonal relationships

If people abruptly stop taking medications on which they’ve become physically dependent, they can experience withdrawal symptoms. This can be serious, even fatal.

Physical dependence on a prescribed, properly taken opioid medication is distinct from OUD and opioid addiction.

OUD is abehavioral disorderassociated with loss of control of opioid use, use despite adverse consequences, reduction in functioning, and compulsion to use.

  • Dysfunctional emotional

response

If the "thing" is missing, the body lets us know by exhibiting symptoms

-SAMHSA TIP 63

Addiction comes into play when the “thing” the body needs talks to the reward system of the brain.

  • The brain says: "Hey I REALLY LIKE this! Keep getting it"

  • We are less likely to do things that we do not find rewarding

  • We are more likely to do things that we enjoy
  • EX: Feeling good or not having to experience pain (physical and emotional)

Necessity for function + reward in brain + loss of control= Addiction

Meet Marla...

"I love ______, I'm a ______ junkie. When I start ______ I can't stop. I love the way it makes me feel, it's my comfort, but the ______ is killing me. It's keeping me from being a part of my kids lives. My kids are gonna come in and find me dead. I have to change or I'm gonna die"

Marla

The Brain

Alcohol and the Body

Alcohol

Needs & Prevention

Strengths

What factors into "health"?

Determinants of Health

Social Conditions

Community Collaboration

Stigma & Recovery

Recovery

Stages of Change

Stages of Change

Precontemplation

Contemplation

Preparation

Action

Maintenance

**Relapse

Recovery

Using/Active

Symptoms

Abstinence

Unhealthy Living

Goals, Hopes and Dreams

We're in this together

Wrap up

it is an ongoing journey

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