Published results confirm that symptoms of anxiety and depression have increased for teenagers between the ages of 12 and 17. The U.S. Department of Health and Human Services estimate that in 2014, over 12 percent of teens in the United States experienced at least one major depressive episode, as compared to 5 percent of teens in 2006. Depression, anxiety and other mental health symptoms such as psychosis can interfere with a juvenile’s ability to think logically, concentrate, make clear decisions or communicate feelings directly. Any one of the mental health symptoms can be exhausting, causing agitation and frustration throughout the day or night.
Symptoms can interfere with academic, social and family life as well as basic functions such as eating and sleeping. Severe symptoms, if left untreated, can cause chronic negative thinking, hopelessness and irritability. Irritability can build up, causing the teen to lash out aggressively toward others (face-to-face or online), or engage in self-harming behaviors. A recent Seattle Children’s Hospital study quantified an increase in self-harm searches by collecting data from Instagram related to searches for the hashtag, #selfharmmm. Findings indicate that searches for this hashtag increased from 1.7 million in 2014 to over 2.4 million in 2015.
Given the prevalence of mental illness of teenagers between the ages of 12 and 17, it is likely that police officers will encounter such individuals during a traffic stop or a domestic dispute. In addition, officers may interact with these individuals when they are deemed possible witnesses to or suspects of a crime. Individuals suffering with symptoms of mental illness pose a complex challenge to police because their symptoms often prevent them from understanding or responding rationally to questions or directions. Irrational thinking may result in criminal behavior, self-harm or a threat to the police officer and others. Crisis de-escalation techniques can be helpful when engaging with juveniles experiencing symptoms of mental illness. Techniques used to “calm down,” “slow down” or “disengage” can be effective.
Tempering emotions is more difficult in a crisis than intensifying the emotions of those involved in a crisis situation. After scene safety has been established and all involved are physically controlled, approach calmly. Approaching the situation with a calm and controlled tone (as opposed to yelling or taking a commanding stance) may help calm the angry, agitated and emotionally charged juvenile. Remaining calm enables the officer to ask questions, give simple directions and observe how the juvenile responds to the officer, assessing how well the teen can communicate, follow directions and comprehend the situation.
Verbal cues can calm an agitated individual experiencing a mental health crisis. Here are two examples:
- A juvenile who is kicking or hitting something
(Officer): “There is no reason to kick the wall, because I’m here to listen.”
Active listening can slowly help the juvenile calm down, gain some control and realize the officer is willing to listen. Often this individual just wants to be heard. Let the juvenile vent and keep in mind that what they say is not a personal attack against you.
- A juvenile who is experiencing auditory hallucinations (hearing voices)
(Officer): “It’s OK … I’m here to help. I need you to listen to my voice.”
Asking the juvenile to focus on your voice instead of the ones the juvenile is hearing in his or her head may help the young person focus, concentrate and see that you are real. Focusing on one voice often diminishes fear, while alleviating confusion created by psychotic episodes, until medical help arrives at the scene. Keep your radio at a low volume so sounds and additional voices heard over the speaker does not add to the confusion.
Crisis situations are intense and can become dangerous. Slowing down buys time. Time helps officers evaluate the situation rather than box themselves into a highly charged incident with only seconds to make a critical judgment. Slowing an incident down increases the safety of all officers involved, even if hands-on-tactics are utilized. Calling for backup within the first 15 minutes of a crisis helps to avoid the tendency to think that immediate action must be taken to resolve a situation. Time allows officers to observe mental health symptoms such as thought confusion, self-harming behaviors, tremors and/or repetitive physical behaviors such as rocking, hand-flapping and eye-blinking, all commonly related to autism or other developmental disorders.
Not all situations require police action. When there are no signs of hostility or aggressiveness, a situation can be resolved without making an arrest. Using his or her discretion, the officer can decide whether the juvenile has calmed down and cooperated. Upon determining that the individual is safe and the situation is under control, the officer can complete the de-escalation process by reassuring the juvenile and then simply walking away.
Utilizing de-escalation techniques in a mental-health crisis situation (when possible) can help to avoid officer injuries, or injuries to the juvenile and others involved.
Nancy Musarra Ph.D., LPCC