In-Field Mental Health:

The Playbook
How Mental Health Influences Our Real
Time Decisions

Matt Rogers
Mountain View Police Department
 About Me
• Bachelors Degree in Psychology
• Cal Poly San Luis Obispo
• Specialized classes in Abnormal
Psychology, De-Escalation
• Corrections Deputy with the Santa
Clara County Sheriff’s Office
• 2015-2016, Main Jail in San Jose
• High and Maximum Security
Inmates
• Time spent in 8A – the acute
psychiatric facility
• Patrol Officer with Mountain View PD
• 2017 to Present
• Assignments include Gang
Suppression Team (GST), CSI, Drone
Team, and CNT.
• Named CNT Hostage Negotiator in
2018 (Crisis Negotiation Team)
Mental Health – It’s tricky!
 Take the data with a grain of salt
 Mental Health data varies from source to source
 It’s protected health information.

 True numbers of affected persons are rarely

accurate
 Social stigma prevents people from seeking help
 Cultural factors
 Shame or embarrassment
 Does not include the toll it takes on families,
caregivers
Goals:
1) To improve the ability to recognize
common mental health issues
 You are not diagnosing per the DSM
 DSM: Diagnostic and Statistical Manual of
Mental Disorders (Now on Edition 5, 2013)

2)To improve the ability to react to

common mental health issues

Both will aid in improving officer safety and avoiding

litigation.
Keep this in mind during your
contact:

TIME
The “LE Big Three”

1) Bipolar Disorder

2) Depression

3) Schizophrenia
Bipolar Disorder
Basics
 Commonly associated with tumultuous emotional
health with ups and downs
 5.7 million Americans (2.6%) diagnosed.
 Manifests 16-25 years old, often undiagnosed
 Likely heritable, as 2/3 have at least one relative with BPD1
 Formerly referred to as “manic depression”
 Each person is different, making it difficult to
immediately recognize. There is no blanket solution or
treatment
 Will often overlap symptoms with other disorders
(especially depression, anxiety)
Bipolar Disorder
What You May See
 Manic/Mania (High)  Depressive (Low)
 Hyperactivity  Loss of interest in
activities
 Extremely Talkative
 Feeling hopeless,
 Racing Thoughts
worthless
 Illusions of Grandeur  Fatigue, lethargy
 Big Plans
 Giving away
 ‘Over the Moon’ enthusiasm belongings
 Easily Distracted  Indecisive
 Poor decision making, risk-  Suicidal
taking behavior thoughts/plans
Bipolar Disorder
Reacting
 If manic
 Where they are on the
 ‘Take a deep breath for me’
spectrum (manic or
depressive) changes  ‘Let’s take a step back’
how you will react  ‘Explain ____ to me’
 Ultimately, you want  Keep them talking
to get them to a stable
“medium” where they
 If depressed
can maintain until  Make eye contact
professional help  ‘Let’s work together to get
 Band-aid for you some help’
transport, if necessary
 Gives them purpose, a goal
to aim for
 Depression
Basics
 Comes in temporary and chronic varieties
 Manifests in adolescence
 More common in women, but this could be due to stigma
for seeking help/treatment
 Approximately 17.3 million Americans have chronic,
clinical depression (Major Depressive Disorder).
That’s 7.1% of the USA!1
 Often paired with anxiety, bipolar
 Widely untreated and undiagnosed due to
social stigma
 NOT a chemical imbalance in the brain
 Depression
Basics
 Common Chronic  Temporary
 Major Depressive  Common after a
major traumatic life
 2 weeks or more of a
event
depressive episode
 Not diagnosed as a
 Diagnosed, often treated
“long-term” issue
with medication
 Will still display long
 Persistent Depressive
term symptoms, but
 Symptoms that last 2+ does not mean you
years have a long-term
 Postpartum issue
 ‘Down in the dumps’
 Seasonal Affective Disorder
 Treated with therapy,
 Treated with medication,
support, time
therapy
Depression
What You May See
 Common symptoms include:
 Social withdrawal
 Giving away of belongings
 Lethargy, poor personal hygiene
 Lack of interest in once loved hobbies
 Lack of motivation
 Helpless and hopeless
 “I don’t know what to do”
 Lack of eye contact, slumped shoulders
 Sleeping more than usual
 Depression
Reacting
 They are seeking relief from something they do not see the end of.
 Your job is to show them a positive light at the end of the tunnel. To get
there, you must give them a goal to aim for.

 “We both want you to feel better. Let’s get you to someone who can
help you the best”
 Make eye contact, shows you’re not just lip service
 “How would you feel about talking to a doctor?”
 Build on small wins, such as asking for help, or having a support
system.
 “Most people don’t have the courage to ask for help. You’re already a step
ahead. You’re already showing me that you can do it.”

 For anything you propose, make it sound like a joint venture. If they
feel control, you will have better short and long term results.
Schizophrenia
Basics
 Extremely serious, wide range of symptoms,
severity, and functionality
 Hallmark symptom is the hallucinations of
auditory and visual stimuli
 They will see and hear things they genuinely believe
are real, but are not.
 Manifests itself between adolescence and early
30’s.
 For men, adolescence to mid 20’s.
 For women, typically 20’s to 30’s
 Lifelong, but can be managed effectively.
 Paranoia is common
Schizophrenia
What You May See
 There are a many, many symptoms that differ for each person
and each case.
 Twitching, delusions, scattered speaking or thinking.
 General difficulty with information processing

 The most relevant (and most dangerous) of the symptoms you

will see in the field are hallucinations.

 Often, this is in the form of hearing voices or other sounds

(clicking, thumping)

 In the US, between .5 and 1.0% percent of the population are

diagnosed with schizophrenia
 Schizophrenia
Voices and Hallucinations

In the movies

In reality
Schizophrenia
What You May See
 Hallucinations can be recognized if you know what to
look for. Behavior such as:
 Talking to people who are not there
 Having full conversations with oneself
 Mumbling or chanting to oneself
 Delay when responding to questions
 They are filtering the voices they hear and deciding which
(yours) to respond to. They are matching your face with
the voice
 Looking the wrong direction when you speak to them
 They may genuinely believe the stimuli (your voice) is
coming from elsewhere
 Staring at a fixed position in a room
Schizophrenia
Reacting
 There is no “one size fits all” solution. But there are
things to consider when it comes to handling someone
with hallucinations.

 Understand that they could be seeing or hearing things

that lead them to believe that you are a threat.

 If they ask you if you see/hear things that are not

there, it’s recommended you don’t agree you see
them too.
 At the same time, don’t dismiss what they see
 “I believe that you see that, but I don’t see it. What do
you see?”
Schizophrenia
Reacting
 Try to make eye contact and allow them
to see your face when speaking
 It will help them match your voice to your
face via lip reading.
 If there is a delay on reaction, it’s
because they are filtering in their head
and trying to figure out how to respond.
 Be patient, they may not immediately follow a
command. They might be getting 6 different
statements at once.
 Watch their eyes.
 When in doubt…
 Angle the conversation to add value to the
other person.
 It may buy you enough time to obtain a helpful
statement or complete a hold.
 Mental health is stigmatized and many
feel they are alone, that no one cares,
that help is too difficult, too
embarrassing, or too scary to get.
 If you can show, even momentarily, that you
want to help them it will go a long way.

My suggestions today DO NOT replace your agency’s own policy and procedure.
 For more information…

Works Cited
Depression and BiPolar Support Alliance. (2020, 12 09). Bipolar Disorder Statistics. Retrieved from DBS Alliance:
https://www.dbsalliance.org/education/bipolar-disorder/bipolar-disorder-statistics/
Depression and Bipolar Support Alliance. (2020, 12 09). Depression Statistics. Retrieved from DBS Alliance:
https://www.dbsalliance.org/education/depression/statistics/
Healthline. (2020, 12 09). Depression: Facts, Statistics, and You. Retrieved from HealthLine.com:
https://www.healthline.com/health/depression/facts-statistics-infographic#Types-of-depression
Healthline. (2020, 12 09). Schizophrenia. Retrieved from Healthline: https://www.healthline.com/health/schizophrenia
National Institute of Mental Health. (2020, 12 09). Bipolar Disorder. Retrieved from NIH:
https://www.nimh.nih.gov/health/statistics/bipolar-disorder.shtml
National Institute of Mental Health. (2020, 12 09). Depression. Retrieved from NIH:
https://www.nimh.nih.gov/health/topics/depression/index.shtml
National Institute of Mental Health. (2020, 12 09). Schizophrenia. Retrieved from NIH:
https://www.nimh.nih.gov/health/statistics/schizophrenia.shtml
Wikipedia. (2020, 12 09). Bipolar Disorder. Retrieved from Wikipedia: https://en.wikipedia.org/wiki/Bipolar_disorder