police and pbs interventions...police involvement with dd population once individuals are involved...
TRANSCRIPT
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Combining Forces in the Field Victoria Hatch, CBI Consultants Ltd. Sherry Adam, CBI Consultants Ltd.
Cpl Taylor Quee, RCMP (Police Mental Health Intervention Unit)
Police and PBS interventions for Clients with Critical Behaviours
One year later
Tellusaboutyou….
Presentation Overview
• Introducesystemforcasemanagementofsharedclientsbetweenemergencyresponsesystemsandcommunitybasedagencies
• Reviewandoverviewthesystemandhowitisimplemented
• Presentcasestudiesupdatestodemonstratetheprocess
• Reviewsomestrategiestohelpyoudevelopyourownpartnerships
A Little About CBI Consultants
• CBIConsultants(Communica@on,BehaviourandInstruc@on)hasbeenprovidingprofessionalsupportservicesforavarietyofindividualssince1988
• CBIhassupportedover5500individualsandtheirteamsinPosi@veBehaviourSupport,LifestyleDevelopment,Func@onalBehaviourAssessment,and/orCustomizedEmployment
• CBIalsoprovidesindividual,team,andagencywidetrainingandhasexpandedtoaddaTechnicalTrainingandAssistanceCentre
• CBISupportsindividualsacrosstheprovinceofBri@shColumbia,thecountryofCanada,andhasrecentlyexpandedworldwideprovidingdirectconsulta@onandtrainingtoChina,IndiaandJapan
Positive Behaviour Support (PBS)
• Anapproachthatblendsthevaluesandrightsofpeoplewithandwithoutdisabili@eswithprac@calscience
• Anevidence-basedstrategy
• Discusseshowlearningandbehaviourchangeoccur
• Founda@onisbasedonthefactthatbehaviouriscommunica@on
• Focusesonproac@vesupportsandstrategies
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Positive Behaviour Support (PBS)
Designedto:• Decreasechallengingbehaviour
• Increase:§ Qualityoflife§ Communica@on§ Self-regula@on§ Choice§ Communityinclusion§ Socialconnec@ons§ Skills
LDP Flowchart
(Malette, P., Miranda, P., Kandborg, T., Jones, P., Bunz, T., Rogow, S., 1992)
Police and Mental Health
Cpl Taylor Quee • Surrey RCMP – Police Mental Health Intervention Unit
Police Mental Health Liaison Officer
RevolvingDoor
HospitalDischarged
911
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Car67
HospitalDischarged
Police involvement with DD population
Withtheclosureofins@tu@onsbeginninginthe1970’s(Francis,Blue-BanningandTurnbull2014)
Thedevelopmentaldisabili@espopula@onhasbeenmovingfromins@tu@onalfacili@estocommunitybasedresidences(BigbyandBeadle-Brown2016;Francisetal2014)
Communitybasedresidenceforpersonswithintellectualand/orlearningdisabili@eswhilesuperiorforqualityoflifeoutcomesmayincreaseinstancesofchallengingbehaviourandtheneedforaddi@onalcommunitysupports(Joyce,DitchfieldandHarris2001)
Police involvement with DD population
CommunitybasedChallengingbehavioursmayincreaseinvolvementofpoliceand/orlawenforcement(ColemanandCo`on2015;HenshawandThomas2012;McNultyetal2010;Mar@n2015;Raina,Arenovich,JonesandLunsky2013)
PolicecontactwiththeLDpopula@onisgrowing(ColemanandCo`on2015;HollandandPersson2011;SpivakandThomas2013)
Currentpoliceinterven@onincludesmainlyreac@vestrategiesincludingrestraint(Taylor2002)andextremeforce(ColemanandCo`on2015)
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Police involvement with DD population
Onceindividualsareinvolvedwithbothcommunityandlawenforcementsystems,interven@onandsupportsbecomeproblema@cduetovarianceinservicedeliveryandmodelsofsupport(Lunskyetal2012)
Policeofficersarenottrainedinsuppor@ngthesespecificindividuals(Eadens,D.M.,Cranston-Gingras,DupouxandEadens,D.W.2016)
Thesetypesofinterven@onsaremorelikelytocon@nuetoinvolvepoliceandalsocreatefurthercriminaljus@ceinvolvement.Policearethereforebeingusedasaddi@onalsupportsforstafftoprovidesupportinhighneedscri@calincidents.(McNultyetal2010)
Police involvement with DD population
ModellandMak’s2008studyfoundbothknowledgeandpercep@onofthepersonswithadisabilityplayedaroleinbothinterven@[email protected]@nuestobedifficultforlawenforcementtoiden@fythispopula@oninthelineofduty.(HenshawandThomas2012)
Policewerefoundtousepreviousknowledgeofanindividualasthefirstlineofinterven@onbutthiswasnotthemosteffec@vestrategy(KellyandHasse`-Walker2016)
Police Mental Health Intervention Unit
Police Mental Health Liaison
• Policeofficerassignedtomanageclientswithmentalhealthneedswhohavehighriskcontactwithpoliceorhighresourcecontact
• PMHL§ EmbeddedwithinthePoliceMentalHealthInterven@onUnit§ Workswithcommunitypartnerstocreateacollabora@veapproachwhichinformscrisisresponse
§ Completeslongtermstrategiesforriskmanagement§ Communityandpartnereduca@ononpoliceresponse§ Policeofficereduca@ononmentalhealth
Plan Case Studies
• CaseStudies:§ Tash§ Anna§ Alex§ Jimmy
• Clientconsenthavebeenprovidedtosharethefollowinginforma@on
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Tash – Police Observations from Data Review
• TimeofcasereviewPolicecontacts(2001-2017)
• 252contacts2007-present• 215911callsbetween2008-2011§ Sheenjoyedpolicecontactsassocialinterac@on§ Staffstartedusingpolicetoassistindailyrou@nes§ Policecalledduetopropertydamageand§ Presenceofaweapon
Tash Police Data Tash – Emotional Thermometer
Tash – Safety Plan Anna – Police Observations from Data Review
• Timeofcasereview178Policecontacts(2001-2017)
• 59contacts12monthsprecedingreview§ EqualnumberofcallsfromcareteamasfromAnna§ Annatakentohospitalbypolice20@mesfrom2010-2014§ Bannedfromsheltersandbouncedtodifferentcarehomes§ Beganassocialneedcalls§ By2012therewasaggressionandthreats§ Shewasreportedashavingmentalhealthneedsbutnooneknewwhatorhowtheyaffectedher§ Sheenjoyedpolicecontactsandhospitalstays
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Anna: Police Data Alex – Police Observations from Data Review
• Timeofcasereview62policecallssince2012
• 2013-2016combinedtotal=56calls• OnecallsinceJune2016• Enjoyedthecookiesandjuicegivenathospital
• Theplanallowedstafftocancelpolicea`endanceifAlexwasde-escalatedwhentheyarrived.Policewould“be-friend”Alextode-escalatehim.
Alex: Police Data Jimmy- Police observations and Data Review
• TimeofcasereviewPolicecontacts(2012-2017)
• 32contacts6monthsprecedingreviewJanuary–June2016§ CBIinvolvedApril2014-June2015§ Re-involvementJuly2016present§ Jimmywouldbetakentohospitalbypolice§ By2012therewasaggressionandthreats§ Heenjoyedpolicecontactsandhospitalstays§ NocallssinceNov2016
Integrated Case Management
Whodoyoubringtothetable?
Crisis Cycle…. Response
Hospital
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Getting “buy in” from the team
• Foralotofpeoplethemostexci@ngpartoftheirjobis“success”andimplemen@ngasuccessfulstrategy
• Mee@ngsareyourprimarytooltofindsuccessininteragencyproblemsolving
• Whenusedcorrectlyyoucanmobilizethetalentofthediverseskillsintheroom
• Howeveritisachallengetoconnectwitharoomofpeopleversesoneperson
Meeting TIPS
• Mostpeoplejust“showuptomee@ngs”andtalkabouttheissues…thatiswhymee@ngsgetabadrap
• UsingRobHorner’s“ProblemadmiringversesProblemSolving”
• “Itreatmymee@ngslikeaformalinterview”CplQuee.Theyareplannedpurposefullyanddesignedtoaddressbarrierstosuccess.
Meeting Prep
Lookattheclient’sdailylifeandcycleofcrisisandconsiderwhointeractswiththem–iden@fyeachagency• Ambulance,police,hospital,crisismentalhealthworker,residen@alstaff,communitysupportworkersetc.
Consideryoursupportplanorpolicyaroundthisclient.Aretheagenciesincludedinyourplanawareofyourplan?
CreateanInter-AgencyMee@ng–inviterepresenta@vesfromtheaboveiden@fiedagencies
Reviewyourdataonyourclientandcomepreparedtopresentatthemee@ng.Asktheotherpar@cipantstodothesame.• Iden@fyyouragency’sroleinclientinterac@ons.Howdoestheclientrespondtoyourstaffandhowdoyourstaffrespondtotheclient?
Meeting Prep
Reachouttolocallawenforcementtoseeiftheyhaveanofficerassignedtoamentalhealthunit• Ifyoudonothaveanofficerassignedtomentalhealth,perhapsacommunityliaisonofficerorsomeonefromthecrimereduc@onunitwouldberecep@ve
Createbuyinbetweenagencies–considerhowtheseplansbenefiteveryone(e.g.,harmreduc@on,riskmanagement,be`eruseofresources,increasedclientcare)
Meeting Tips
• Beforeyourfirstmee@ngyourshouldhave;§ Createdastrategicpar@cipantlist§ Sentinvitesandanagenda§ Assignedpar@cipantsspecificdatatocomepreparedtopresentandcontribute§ Haveanideaofwhatyouwantsuccesslookslikeforthiscase§ Satdownanddeliberatelyconsideredbarriertosuccessandhowtoaddressthesewiththeroom
• Arriveearlyandnetworkwiththeroompriortothestartofthemee@ng(peopleneedtofeelateaseandwanttotalktoyou–thisstartswhentheywalkinthedoor–notatthebeginningoftheformalmee@ng)
§ Ifyou’renotgoodatthis-putsomethoughtintolightconversa@on
Meeting Tips
• Atyourfirstmee@ngbeginby;§ Iden@fyingthepurposeofmee@ng§ Thankeveryoneforcomingandrecognizethehardworkalreadyputintothiscase
§ Outlinethestructureofthemee@ng• Addresscommonfearsorbarriersintheroom• Beginbyaskingeachagencytopresenttheirroleandmandateintheclient’slife
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Meeting Tips
• ExploretheSafetyPlan/BehaviouralPlan/CarePlan-iden@fytheroleofeachagency§ Theagencyrepresenta@veshouldadaptthatcareplansothatitmergeswiththeirorganiza@onspoliciesandproceduresbuts@llworkstowardthebehaviouralprinciples.
§ IfthebehaviouralplancontradictsyourpoliciesthenworkwithyourConsultanttoalignbothplans.Forexample,ifthesupportstaffaretellingtheclient“Policewillarrestyouifyouhitthewallagain”,butpolicedonothavetheauthoritytoarrestinthesecircumstancesthenthismessagingisaproblem.Policeandthecareteamcanexplorewhataneffec@vepoliceresponselookslikeandwhattheappropriatemessagefortheclientis.Allpar@esinvolvedinsuppor@ngtheclientneedtounderstandtheplan.
• Leavemee@ngwithtasksandstrategies• schedulethenextmee@ngbeforeyouleave• Minuteswhichincludethetaskscommi`edtobyeachpersoncancreateaccountability
[email protected]@[email protected]
Our contact info:
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Bigby,C.&Beadle-Brown,J.(2016)Improvingqualityoflifeoutcomesinsupportedaccommoda@on
forpeoplewithintellectualdisability:whatmakesadifference.JournalofAppliedResearchinIntellectualDisabili7es,3,3-19.
Cummins.R.A.(1997)Assessingqualityoflife.AssessingQualityofLifeforPeoplewithDisabili7es:Models,Research,andPrac7ce,R.I.Brown,Ed.,pp.116–150.
Francis,G.F.,Blue-Banning,M.&Turnbull,R.(2014)Variableswithinahouseholdthatinfluencequalityoflifeoutcomesforindividualswithintellectualanddevelopmentaldisabili@eslivingincommunity:discoveringthegaps.ResearchandPrac7ceforPersonswithSevereDisabili7es,39,3-10.
Haruord,K.,Carey,R.,Mendonca,J.(2006).Pre-arrestDiversionofPeoplewithMentalIllness:LiteratureReviewandInterna7onalSurvey.JournalofBehavioralSciences&theLaw24,845-856.
Hayes,S.(2007)Missingout:offenderswithlearningdisabili@[email protected],35,146-153.
Henshaw,M.&Thomas,S.(2012)Policeencounterswithpeoplewithintellectualdisability:prevalence,characteris@csandchallenges.JournalofIntellectualDisabilityResearch,56,620-631.
REFERENCES .
Joyce,T.,Ditchfield,H.&Harris,P.(2001)Challengingbehaviourincommunityservices.JournalofIntellectualDisabilityResearch,45,130-138.
Kelly,E.&Hasse`-Walker,C.(2016)ThetrainingofNewJerseyemergencyservicefirstrespondersinau@smawareness.PolicePrac7ceandResearch,17,543-554.
McNulty,C.,Kissi-Deborah,R.&Newsom-Davies,I.(2010)Policeinvolvementwithclientshavingintellectualdisabili@es:apilotstudyinSouthLondon.MentalHandicapResearch,8,129-136.
Modell,S.J.&Mak,S.(2008)Aprimaryassessmentofpoliceofficers’knowledgeandpercep@onsofpersonswithdisabili@es.IntellectualandDevelopmentalDisabili7es,46,183-189.
Shalock,R.Brown,I.Brown,I.Cummins,R.Felce,D.Ma@kka,K.Keith,K.&Parmenter,T.(2002)Conceptualiza@on,Measurement,andApplica@onofQualityofLifeforPersonsWithIntellectualDisabili@es:[email protected],V40(6),457-470.
Townsend-White,C.PhamN.T.&Vassos,M.V.(2012)Asystema@creviewofqualityoflifemeasuresforpeoplewithintellectualdisabili@esandChallengingbehaviours.JournalofIntellectualdisabilityresearch,v56(3),pp270–284.
Wilson-Bates,F.(2008)LostInTransi7on:HowalackofCapacityintheMentalHealthSystemisFailingVancouver’sMentallyIllandDrainingPoliceResources.TheVancouverPoliceBoard.
www.pmhl.caCanadianna@onalcommi`eeforpolice/mentalhealthliaison.