August 16, 2004 To establish policy and procedure regarding the interaction of employees with persons suffering from or suspected of suffering from mental illness, and with persons with disabilities.

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Atlanta Police Department

Policy Manual

 

 

 

 

 

 

 

 

 

Standard Operating

Procedure

 

Effective Date

November 24, 2009

 

APD.SOP.3084

Mentally Ill and Disabled Persons

Applicable To: All employees

Approval Authority:  Chief Richard J. Pennington

Signature:  Signed by RJP

Date Signed:  12/01/09

 

       
 

1.          PURPOSE  PAGEREF _Toc247527445 \h 1

2.          POLICY   PAGEREF _Toc247527446 \h 1

3.          RESPONSIBILITIES  PAGEREF _Toc247527447 \h 1

4.          ACTION  PAGEREF _Toc247527448 \h 1

4.1           Recognition of a Mental Illness  PAGEREF _Toc247527449 \h 1

4.2           Situations that require an immediate response  PAGEREF _Toc247527450 \h 4

4.3           Situations that do not require immediate attention  PAGEREF _Toc247527451 \h 4

4.4           Dealing with the Mentally Ill PAGEREF _Toc247527452 \h 5

 

4.5           Dealing with Blind or Visually Impaired Persons  PAGEREF _Toc247527453 \h 6

4.6           Dealing with Deaf or Hard of Hearing Persons  PAGEREF _Toc247527454 \h 7

4.7           Involuntary Admissions  PAGEREF _Toc247527455 \h 10

4.8           Training  PAGEREF _Toc247527456 \h 11

5.          DEFINITIONS  PAGEREF _Toc247527457 \h 11

6.          CANCELLATIONS  PAGEREF _Toc247527458 \h 11

7.          REFERENCES  PAGEREF _Toc247527459 \h 12 

 

 

1.               PURPOSE

 

To establish policy and procedure for interaction between employees and persons suffering from (or suspected of suffering from) mental illness, or between employees and persons with disabilities.

 

2.               POLICY

 

The Atlanta Police Department will cooperate and work with mental health facilities as necessary and appropriate as it concerns interacting with persons suffering from or suspected of suffering from mental illness.

 

The Atlanta Police Department will ensure that a consistently high level of service is provided to all community members, including those who may be suffering from (or are suspected of suffering from) mental illness or who are deaf or hard of hearing.  APD will honor its specific legal obligations under the Americans with Disabilities Act and the Rehabilitation Act. 

 

3.               RESPONSIBILITIES

 

3.1              Division, section, and unit commanders will monitor the implementation of this directive.

 

3.2              Supervisors are responsible for ensuring that employees are in compliance with this directive.

 

3.3              All employees are responsible for complying with this directive.

 

3.4              The Training Unit is responsible for providing entry level and refresher training for all employees.

 

4.               ACTION

 

4.1              Recognition of a Mental Illness

 

4.1.1           Mental illness refers to any of the various conditions characterized by impairment of an individual's normal cognitive, emotional, or behavioral functioning, caused by social, psychological, biochemical, genetic, or other factors, such as infection or head trauma.

 

4.1.2           Mental disorders are characterized by abnormalities in cognition, emotion or mood, or the highest integrative aspects of behavior, such as social interactions or planning of future activities.

 

4.1.3           Persons suffering from any of the severe mental disorders (illnesses) have a variety of symptoms that may include inappropriate anxiety, disturbances of thought and perception, dysregulation of mood, and cognitive dysfunction.

 

4.1.4           The most common and disabling manifestations of mental disorders are anxiety, psychosis, mood disturbances, and cognitive impairments.

 

1.    Anxiety is a state of apprehension, uncertainty, and fear resulting from the anticipation of a realistic or fantasized threatening event or situation, often impairing physical and psychological functioning. Anxiety disorders include generalized anxiety disorder, panic attacks, phobias, obsessive-compulsive disorder, and post traumatic stress disorder. Common signs of acute anxiety include:

 

a.    Feeling of fear or dread

 

b.    Trembling, restlessness, and muscle tension

 

c.    Rapid heart rate

 

d.    Lightheadedness or dizziness

 

e.    Perspiration

 

f.     Cold hands/feet

 

g.    Shortness of breath

 

2.    Psychosis is a severe mental disorder, with or without organic damage, characterized by derangement of personality and loss of contact with reality and causing deterioration of normal social functioning. Psychotic disorders include schizophrenia and manic-depressive illness. Common signs of psychosis include:

 

a.    Hallucinations

 

b.    Delusions

 

c.    Disorganized thoughts and behaviors

 

d.    Loose or illogical thoughts

 

e.    Agitation

 

f.     Flat or blunted affect

 

g.    Lack of concrete thoughts

 

h.    Inability to experience pleasure (anhedonia)

 

i.     Poor motivation, spontaneity, and initiative

 

3.    Disturbances of mood characteristically manifest themselves as a sustained feeling of sadness or sustained elevation of mood. Disorders of mood include major depression and bipolar disorder. Symptoms commonly associated with disturbances of mood include;

 

a.    Persistent sadness or despair

 

b.    Insomnia

 

c.    Decreased appetite

 

d.    Psychomotor retardation

 

e.    Anhedonia (the inability to experience pleasure)

 

f.     Irritability

 

g.    Apathy, poor motivation, social withdrawal

 

h.    Hopelessness

 

i.     Poor self esteem, feelings of helplessness

 

j.     Suicidal ideation

 

k.    Persistently elevated or euphoric mood

 

l.     Inappropriately high self-esteem

 

m.   Psychomotor agitation

 

n.    Decreased sleep

 

o.    Racing thoughts and distractibility

 

p.    Poor judgment and impaired impulse control

 

q.    Rapid or pressured speech

 

4.    Disturbances of cognition refer to an impaired ability to organize, process, and recall information. Disorders of cognition include dementia and Alzheimer’s disease. Symptoms associated with disturbances of cognition include:

 

a.    Short term memory loss or impairment

 

b.    Impaired attention span

 

c.    Impaired concentration

 

d.    Inability to perform higher intellectual functions

 

e.    Impaired language abilities

 

f.     Inability to perform activities of daily living

 

4.2              Situations that require an immediate response

 

4.2.1           Situations that require immediate attention and response include but are not limited to suicide threats, danger to others, and acute psychosis.

 

4.2.2           Community mental health resources that are available to the Atlanta Police Department and persons in Atlanta include:

 

1.    Grady Department of Mental Health

 

2.    Central Fulton County Mental Health Service

 

3.    Northside Behavioral and Mental Health Service

 

4.    Georgia Regional Hospital of Atlanta (does not accept Form 1013 from police officers)

 

4.3              Situations that do not require immediate attention

 

4.3.1           Situations that require prompt but not immediate attention include a person who does not appear to be a danger to himself or others but is incoherent or appears confused or unaware of his surroundings.

 

4.3.2           The Fulton County or DeKalb County emergency mental health offices available include:

 

1.    Behavioral Health Link operates the Georgia Crisis & Access Line.  This service provides a free telephone hotline for mental health or substance abuse crisis, including depression, anxiety, suicide, physical abuse, family conflict, alcohol or drug abuse crisis counseling.   The Georgia Crisis & Access Line may be contacted at any time at (800) 715-4225 and licensed mental health professionals (nurse, LCSW or LPC) will assist.   GC&A also dispatches the mobile mental health crisis team operated by The Fulton County Collaborative Crisis Service System (FCCCSS)
 

2.    DeKalb County Emergency Mental Health Services Crisis Line is a telephone hotline with trained counselors available to decide what needs to be done. They may be contacted at (404) 892-4646.

 

3.    Grady Hospital Adult Psychiatric Emergency Clinic is an emergency clinic where you can call or walk in at any time and receive help. They may be contacted at (404) 616-4762.

 

4.    Grady Hospital’s Community Outreach Support Services (COS) is referral based and includes clinical and social services, individual therapy, medication management, counseling, and geriatric services to individuals with mental illness, including homeless persons. Referrals to COS may be made by Grady Hospital Psychiatric Department, state mental hospitals, any inpatient psychiatric facility, or by calling (404) 616-4762 between 8:30 a.m. and 4:30 p.m. Monday through Friday.

 

5.    The Fulton County Collaborative Crisis Service System (FCCSS) provides assistance to persons that may need psychological help, with no service charge to that person, utilizing the four facilities mentioned in section 4.2.2. FCCSS will dispatch a Mobile Crisis Team to provide necessary and appropriate intervention, treatment, and resources.  Call the Behavioral Health Link Georgia Crisis & Access Line at (800) 715-4225 in order to access this service.

 

4.4              Dealing with the Mentally Ill

 

4.4.1           Contact with Persons Who Are Mentally Ill.

 

1.    The two federal laws which prohibit discrimination based on disability are the Americans with Disabilities Act of 1990 (ADA) and Section 504 of the Rehabilitation Act of 1973

 

2.    Both Title II of ADA and Section 504 require that first responders provide victims of crime who have a disability with an equal opportunity to benefit from and participate in all programs, services and activities of the law.

 

3.    As a first responder, a situation may arise where you are required to make reasonable modifications to accommodate people who have a mental illness.

 

4.    Provide for victims who are mentally challenged with care by a family member, guardian or mental health service provider before leaving the scene.

 

5.    Effective communication with a person who is mentally ill (or suspected of being mentally ill)  involved in an incident -- whether as a victim, witness, suspect, arrestee, or other persons connected to the situation -- is essential in ascertaining what actually occurred, the urgency of the matter, and the specifics of the situation.

 

6.    The input of people who are mentally ill (or suspected of being mentally ill) who are involved in incidents is just as important to the law enforcement process as the input of others.  Officers must not draw conclusions about incidents unless they fully understand -- and are understood by -- all those involved, including persons who are mentally ill (or suspected of being mentally ill).

 

4.4.2           Crime Victims: Alzheimer’s Disease

 

1.    Ask for Identification

 

2.    Treat the victim with dignity

 

3.    Remove the victim from crowds and other noisy environments

 

4.    Establish one-on-one conversation

 

5.    Explain your actions before proceeding

 

6.    Don’t leave the victim alone; they may wander away

 

4.4.3           Crime Victims: Mental Illness or Mental Retardation

 

1.    Anyone who is a crime victim may be traumatized but mentally challenged persons experience trauma more profoundly.  Listed are some guidelines that can help one respond to mentally challenged people.

 

2.    Approach in a calm, non-threatening and reassuring manner

 

3.    Contact a local mental health center immediately if victims are extremely agitated,
distracted, uncommunicative or displaying inappropriate emotional responses

 

4.    Ask the victims if they are taking any medication

 

5.    Conduct the interview in a setting free of people or distractions

 

6.    Keep the interview simple and brief

 

7.    Be honest with the victim – speak directly and slowly to the victim

 

8.    Keep questions that require the victims to do much reasoning or that can confuse victims to a minimum.

 

9.    Treat adult victims as adults, not children

 

4.5              Dealing with Blind or Visually Impaired Persons

 

4.5.1           The ability to see exists along a wide continuum from sighted to partially sighted to blind.  Blindness, whether complete or legal, and vision impairments become more common with advancing age.

 

4.5.2           In General:                  

 

1.    The two federal laws which prohibit discrimination based on disability are the Americans with Disabilities Act of 1990 (ADA) and Section 504 of the Rehabilitation Act of 1973

 

2.    Both Title II of ADA and Section 504 require that first responders provide victims of crime who have a disability with an equal opportunity to benefit from and participate in all programs, services and activities of the law.

 

3.    As a first responder, a situation may arise where you are required to make reasonable modifications to accommodate people who are blind or visually impaired.

 

4.    Effective communication with a person who is blind or visually impaired involved in an incident -- whether as a victim, witness, suspect, arrestee, or other persons connected to the situation -- is essential in ascertaining what actually occurred, the urgency of the matter, and the specifics of the situation.

 

5.    The input of people who are blind or visually impaired who are involved in incidents is just as important to the law enforcement process as the input of others.  Officers must not draw conclusions about incidents unless they fully understand -- and are understood by -- all those involved, including persons who are blind or visually impaired.

 

4.5.3           Responding to Persons Who are Blind or Visually Impaired

 

1.    Introduce yourself immediately as a law enforcement officer

 

2.    Do not speak loudly for most people who are visually impaired hear well

 

3.    Identify the person(s) to whom you are speaking when conversing in a group

 

4.    Avoid lapses of conversation in your interview without informing the victim

 

5.    Offer to fill out forms and read aloud written information for the victims

 

6.    Never pet guide dogs without permission

 

7.    Orient the victims to their surroundings

 

4.6              Dealing with Deaf or Hard of Hearing Persons

 

4.6.1           In general:

 

1.    People who identify themselves as deaf or hard of hearing are entitled to a level of service equivalent to that provided others.

 

2.    APD will make every effort to ensure that its officers and employees communicate effectively with people who have identified themselves as deaf or hard of hearing.

 

3.    Effective communication with a person who is deaf or hard of hearing involved in an incident -- whether as a victim, witness, suspect, arrestee, or other persons connected to the situation -- is essential in ascertaining what actually occurred, the urgency of the matter, and the specifics of the situation.

 

4.    Various types of communication aids – known as “auxiliary aids and services” –  are used to communicate with people who are deaf or hard of hearing.  These include use of gestures or visual aids to supplement oral communication; an exchange of written notes; use of a computer or typewriter; use of assistive listening devices (to amplify sound for persons who are hard of hearing); or use of qualified oral or sign language interpreters.

 

5.    The type of aid that will be required for effective communication will depend on the individual’s usual method of communication, and the nature, importance, and duration of the communication at issue.

 

6.    In many circumstances, oral communication supplemented by gestures and visual aids, an exchange of written notes, use of a computer or typewriter, or use of an assistive listening device may be effective.  In other circumstances, qualified sign language or oral interpreters are needed to communicate effectively with persons who are deaf or hard of hearing.  The more lengthy, complex, and important the communication, the more likely it is that a qualified interpreter will be required for effective communication with a person whose primary means of communication is sign language or speech reading.  For example:

 

a.    If there has been an incident and the officer is conducting witness interviews, a qualified sign language interpreter may be required to communicate effectively with someone whose primary means of communication is sign language.

 

b.    If a person is asking an officer for directions to a location, gestures and an exchange of written notes will likely be sufficient to communicate effectively and a sign language interpreter is often not required.

 

7.    To serve each individual effectively, primary consideration should be given to the communication aid or service that works best for that person.  Officers must ask persons who are deaf or hard of hearing what type of auxiliary aid or service they need.  Officers must defer to those expressed choices, unless there is another equally effective way of communicating, given the circumstances, length, complexity, and importance of the communication, as well as the communication skills of the person who is deaf or hard of hearing.

 

8.    APD is not required to provide a particular auxiliary aid or service if doing so would fundamentally alter the nature of the law enforcement activity in question, or if it would cause an undue administrative or financial burden.  Only APD head or his or her designee may make this determination.

 

9.    The input of people who are deaf or hard of hearing who are involved in incidents is just as important to the law enforcement process as the input of others.  Officers must not draw conclusions about incidents unless they fully understand -- and are understood by -- all those involved, including persons who are deaf or hard of hearing.

 

10.    Auxiliary aids or services are to be provided free of charge.

 

4.6.2.          Responding to Crime Victims who are Deaf or Hard of Hearing

 

1.    Signal your presence to the victims by waving your hand or gently touching the victim’s arm

 

2.    Determine how the victim desires to communicate

 

3.    Never use a child to communicate with adult victims

 

4.    Be careful not to assume that the victims hear well because they are wearing hearing aids

 

5.    Avoid shouting or speaking very slowly to make yourself heard and understood

 

6.    Never speak directly into a victim’s ear

 

7.    Do not assume that the victims are unable to speak or use their voice

 

8.    Observe the victim’s facial expression and other physical gestures

 

9.    Officers must utilize the following auxiliary aids as appropriate, when available, to communicate effectively:

 

a.    Use of gestures

 

b.    Use of visual aids

 

c.    Exchange of written notes

 

d.    Use of computers

                       

e.    Use of assistive listening devices

 

f.     Use of teletypewriters (TTY’s)

 

g.    Use of qualified oral or sign language interpreters

 

4.6.3           On-Call Interpreter Services

 

1.    The Atlanta Police Department will provide access to a sign language interpreting service that will be available 24 hours a day, on an on-call basis.

 

2.    The officer requiring the on-call sign language interpreter will notify his or her supervisor of the need for the service.

 

3.    The supervisor will notify communications that a sign language interpreter is needed, while keeping in mind:

 

a.    The need to provide effective means of communications between victims, witnesses, or suspects and the Atlanta Police Department, and

 

b.    That use of this service is on a cost-per-use basis and intended for serious law enforcement related matters.

 

4.    When a communications dispatcher or ACIC operator receives a request for a sign language interpreter, he or she will advise a communications supervisor who will make the request to Georgia Interpreting Services Network (GISN), if necessary.  GISN can be reached at 404-521-9100 (Daytime Number) or at 678-776-0704 (After Hours and Weekends).

 

5.    All additional notations pertaining to the use of GISN will be notated in the CADS.

 

4.6.4           Officers must review and have a working knowledge of Guide for Law Enforcement Officers When In Contact With People Who Are Deaf or Hard of Hearing.  This document reviews how officers should communicate effectively in the types of situations officers will encounter.  These situations include:

 

1.    Issuing a noncriminal or motor vehicle citation.

 

2.    Communicating with a person who initiates contact with an officer.

 

3.    Interviewing a victim or critical witness to an incident.

 

4.    Questioning a person who is a suspect in a crime.

 

5.    Making an arrest or taking a person into custody.

 

6.    Issuing Miranda Warnings to a person under arrest or in custody.

 

7.    Interrogating a person under arrest or in custody.

 

4.6.5           TTY and Relay Services

 

1.    In situations when a nondisabled person would have access to a telephone, officers must provide persons who are deaf or hard of hearing the opportunity to place calls using a text telephone (TTY, also known as a telecommunications device for deaf people, or TDD).  Officers must also accept telephone calls placed by persons who are deaf or hard of hearing through the Telecommunications Relay Service.

 

2.    TTY devices are available at the Public Safety Headquarters Building

 

4.7              Involuntary Admissions

 

4.7.1           When an officer receives a call or responds to a complaint concerning a mentally ill person, the officer’s immediate supervisor will proceed directly to the location.  In all cases where the subject does not possess a Doctor’s Certificate, the supervisor will make an evaluation and determine if it is necessary for the person to be taken into custody involuntarily.

 

4.7.2           Involuntary Admissions without Criminal Activity
 

1.    An officer will take into custody any person and transport the person to an emergency receiving facility if:

 

a.    There is a court order commanding a peace officer to remove and deliver the person;

 

b     There is a doctor’s certificate authorizing removal and delivery (Georgia Department Human Resources From 1013);

 

c     The person has committed or is committing a crime and the officer has probable cause to believe that the person is mentally ill and requires involuntary treatment (OCGA 37-3-42);

 

2.    If the officer takes the person to an emergency receiving facility, complete a Report of Peace Officer (Form 1013) and an incident report.

 

4.7.3           Involuntary Admissions with a felony arrest

 

1.    When an officer takes a person into custody for committing any felony or for committing a misdemeanor involving theft or injury, and he or she has probable cause to believe that the person is mentally ill, he or she will:

 

a.    Transport the person to the emergency receiving facility;

 

b.    Advise the staff that the person is under arrest, and the nature of the charge(s);

 

c.    Notify Grady Detention personnel, and leave the arrest ticket(s) with them;

 

d.    Complete an Incident Report.

 

2.    When an officer takes a person into custody for committing a misdemeanor or violating a City ordinance not involving theft or injury to the person or property of another, and has probable cause to believe the person is mentally ill, the officer will take the person to the emergency receiving facility and may, at his or her discretion, bring criminal charges.

 

a.    Charging the individual prior to taking the individual to an emergency receiving facility is not required.

 

b.    Complete an incident report; this report will be made part of the patient’s clinical record. (CALEA 5th Ed. Standard 41.2.7)

 

4.8              Training

 

4.8.1           The Training Unit will provide entry-level training on mental illness to all sworn personnel prior to their assuming sworn status that meets or exceeds the minimum expectations of the Georgia POST Council. (CALEA 5th Ed. Standard 41.2.7)

 

4.8.2           The Training Unit will provide refresher training on mental illness to all sworn personnel at least every three years.

 

5.               DEFINITIONS

 

5.1              Mental Illness – Having a disorder of thought or mood, which significantly impairs judgments, behavior, capacity to recognize reality, or ability to cope with the ordinary demands of life.

 

5.2              Court Order – A warrant issued by a court commanding a peace officer to take a person into custody and deliver him or her to the nearest emergency receiving facility to undergo a psychological examination or psychiatric treatment.

 

5.3              Doctor’s Certificate: A document executed by a licensed physician or psychologist of this state, stating that he or she had personally examined the individual within the preceding 48 hours and found that the person appeared to be mentally ill and required involuntary treatment or psychological examination.

 

5.4              Emergency Receiving Facility: Medical facility used for psychological evaluations and psychiatric treatment. 

 

1.    Fulton County (with or without charges)

 

2.    Grady Memorial Hospital (The Psychiatric Emergency Clinic on the thirteenth floor)

 

3.    Dekalb County (without criminal charges)

 

4.    Kirkwood Mental Health Center

       8am to 5 pm / Monday - Friday

       23 Warren Street, SE

       Atlanta, GA

       404-370-7474

 

5.5              Report of Peace Officer: A form to be completed by a police officer on every occasion that a mentally ill person is transported to an emergency receiving facility.  (This is the back of Georgia Department of Human Resources Form 1013).

 

6.               CANCELLATIONS

 

                  APD.SOP.3084 “Mentally ill and Disabled Persons”, effective August 16, 2004

     

7.               REFERENCES

 

                  Official Code of Georgia Annotated, Chapter 37

 

                  Commission on Accreditation of Law Enforcement Agencies (CALEA) 5th Edition Standard 41.2.7

 

                  DSM III Diagnostic and Statistical Manual of Mental Disorders Casebook: 1st Edition, New York:     

                   American Psychiatric Association, 1981.

 

                  Guide for Law Enforcement Officers When In Contact With People Who Are Deaf or Hard of Hearing, United States of America Department of Justice