A MENTAL HEALTH NEWSLETTER FOR LAW ENFORCEMENT PROFESSIONALS
 

Mental Health Association of Greater St. Louis A United Way Agency

In this issue . . .

Sergeant Donna Ostendorf, an officer with the St. Louis County Police Department for approximately 19 years, is currently the Continuing Education Supervisor for the St. Louis County and Municipal Police Academy (CMPA). Information for this article was obtained from staff members of the CMPA and from the PPCT Management Systems, Inc. Defensive Tactics Training Student Manual, 2003.

This is the third in a series on stress in police work. 

Police officers have the same stress in their lives that the rest of the world has:  family, kids, bills, bosses, co-workers, houses.  Basically, “Too much to do, and too little time to get it done.” 

Law enforcement stress is unique. Imagine, on a daily basis being placed in harm’s way. The bad guys do not want officers around; the good guys are victims, hurt, or at the least, having a bad day.   

The term “routine” is not used in today’s law enforcement teachings because it assumes complacency and the “routine” can become the extreme at a moment’s notice. Officers can go from driving around checking buildings or watching traffic, to, with one call, a family disturbance, a fight in progress or a serious accident. The police cannot just walk away or ignore an uncomfortable or dangerous situation. The police must run in and help make it right. 

What happens to the body and the mind when it goes from 0 to 60 in mere seconds?   

According to PPCT Management Systems Inc., “Combat Anxiety” occurs. Mentally, there is an anticipation of danger. Combat anxiety can lead to a gradual deterioration of both mental and physical skills.   

Once the officer arrives at the call, “Survival Stress” kicks in. This is the perception of a threat, and it can cause a physical reaction such as increased adrenal activity. The reaction can be caused by many factors, including the anticipation or perception of a threat, by fear, or by a spontaneous unexpected surprise. The effects are increased heart rate and breathing, constricted blood flow and sensory reactions (sight, sound, taste, feel and smell). The typical heart rate of 60 to 80 beats-per-minute can increase to over 200 within seconds. (This is when your heart starts pounding.) Respiration increases to allow more oxygen to the body, causing rapid breathing, cottonmouth and sweating. The body is going into a “fight or flight” mode. Blood vessels start redirecting blood flow from the extremities to the vital organs of the body. Loss of blood flow can cause reduced dexterity of hands and fingers and have an effect on an officer’s fine and/or complex motor skills. Tunnel vision can occur, causing the officer to focus on a single object or person. In addition, auditory exclusion may cause the brain to stop processing information from the other senses, particularly hearing. 

The final stress mode is “Combat Stress.”  The officer has dealt with the situation, and must deal with the mental and physiological results. Symptoms of the body and mind attempting to de-escalate can appear as dizziness, paleness, nausea, excessive sweating, clammy skin, muscle tremors and in some cases, extreme exhaustion.  

What can be done to help control the physical and mental aspects of stress?   

Physical fitness and a healthy diet are important in dealing with stress. Eating healthy, staying hydrated and exercising regularly help to keep an officer physically prepared. With rotating shift work or long hours, developing a healthy sleep routine will keep the mind sharp and functioning. (Who has not been so tired they couldn’t think straight?)   

Mental preparation is essential and should begin before the tour of duty. A law enforcement officer must be committed to complete the job regardless of the risks involved. A “survivalist mentality” must exist. Officers have to understand they can NEVER give up and must not quit fighting. 

Proper and effective training helps eliminate a major stressor commonly known as “Fear of Failure.”  If the officer knows how to react to various situations by using safe and proper tactics, he/she will build confidence.  

Stress Management begins with the radio call. The use of tactical breathing can help reduce stress while enroute to the call. Try inhaling through the nose for a four count, holding the breath for a four count, breathing out through the mouth for a four count and wait for a four count, then repeat. Tactical breathing can help control heart rate, helping the officer remain calm and focused. The officer can visualize the situation and possible reactions to each scenario. For example, a family disturbance: Separate the parties where they cannot see each other, but where I can see my partner. Keep the subjects out of the bedrooms and kitchen because of accessibility to weapons. Play the “what if” game: “What if ______ happens?  I will respond by ______.” Once the officer believes he can control the situation, he loses the following “fear stressors”:  fear of the unknown, fear of making a mistake, fear of failure. 

An officer can do several things to de-escalate or decompress following a call. The officer can talk to fellow officers about the call. Officers often joke and laugh about a call as a coping mechanism, needing to always be mindful of others. For example, do not joke about a barbecue at a house fire with the victim’s family, neighbors or friends around.  Another coping method is for the officer to go to a secluded area and walk around, take deep breaths or do some minor stretching exercises. Sometimes taking a few minutes of “alone time” allows the officer to regroup and get his thoughts and emotions in order. 

Stress is an everyday factor, and in law enforcement, it’s a factor that needs to be managed before it affects an officer’s physical health, mental state or personal/professional attitude.  Options are just moments away. Be comfortable in your skills. Receive certified proper training. Take care of your health. Become more aware of physical effects from your adrenaline and how to respond. These are just a few suggestions to avoid some of the pitfalls of law enforcement stress.

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The John J. McAtee Police Recognition Award is presented to peace officers that have shown compassion, concern and understanding when dealing with persons with mental illness.  This year's award was presented at a luncheon  held on May 4, 2006. 

During the past year and over the past several years, Sgt. Daniel J. Zarrick (St. Louis Metropolitan Police Department) has continually demonstrated a remarkable level of compassion for and understanding of persons with mental illness. As a bike officer in the 4^th District, which includes downtown St. Louis, he frequently encounters people who suffer from mental illness, homelessness and chemical dependence. He knows many of these people on a first-name basis. No matter what their situation, Sgt. Zarrick treats them with dignity and respect. 

One example of Sgt. Zarrick’s compassionate service occurred in January, 2006. A homeless man was wandering the streets, wearing no shoes despite the cold temperature. He refused to speak to the police about who he was or why he was without shoes. Sgt. Zarrick (pictured at left with Jim and Steve McAtee, sons of John J. McAtee) took him to St. Patrick Center to see if he would speak to a social worker about his situation and needs. The man remained silent and would not accept help. Because Zarrick was concerned for the man’s safety, he transported him to Metropolitan Psychiatric Center, where he filled out an application and affidavit for 96-hour involuntary commitment. Sgt. Zarrick could have simply left the man in the care of a St. Patrick Center social worker, but instead he chose to take the time to ensure this man got the immediate treatment he needed. 

Another example of how Sgt. Zarrick goes above and beyond the call of duty in his service is by organizing and attending a monthly meeting with representatives from St. Patrick Center and the Downtown St. Louis Partnership. The purpose of these meetings is to help people who have mental illness and are homeless. Sgt. Zarrick has made an extraordinary effort to connect with community agencies and to assist the people he serves in getting the help they need. 

Even though Sgt. Zarrick has a long history of compassionate interaction with people suffering from mental illness, he volunteered to participate in the 40-hour Crisis Intervention Team (CIT) training to increase his knowledge about mental illness, crisis intervention, and mental health services for the individuals in his community. Under his leadership and role-modeling, all the officers under his supervision have completed the 40-hour CIT course. 

Not in just one specific instance, but throughout his career, Sgt. Zarrick has gone above and beyond the call of duty in serving persons with mental illness. The Mental Health Association is pleased to name Sgt. Daniel Zarrick as its Officer of the Year, 2006.

"Peace officers who have gone above and beyond the call of duty to show compassion, concern and understanding when dealing with persons with mental illness." 

These are the criteria used to select officers to receive the John J. McAtee Award, presented annually by the Mental Health Association of Greater St. Louis. On May 4, the 20^th anniversary of this award, 17 officers and one department were recognized. Sgt. Daniel J. Zarrick (St. Louis Metropolitan Police Department, 4^th District,) was named Officer of the Year.  (See story above.) 

Award recipients represented law enforcement agencies from Pevely, City of St. Louis, Union, Overland, Sullivan, U.S. Probation – Eastern District, Olivette, Creve Coeur, Jefferson County Sheriff’s office, Chesterfield and Pacific. 

Judges Robert and James Dowd, Jim McAtee (son of John J. McAtee) and representatives from Crider Center for Mental Health, the Missouri Department of Mental Health – Eastern Region, and the Mental Health Association congratulated and thanked the officers for their fine work. Steve McAtee, another of John’s sons, and Jim Dowd, brother of Judge Robert Dowd, also joined the head table.  

Attorney General Jay Nixon (pictured right) delivered the keynote address. Nixon applauded the work of officers who, on a daily basis, face the challenge of serving the public in a climate of diminishing resources. “Officers on the front line are serving as the shock absorbers for our society. And unfortunately, in the state of Missouri today, they are absorbing a lot of shocks. The officers here today must deal with more and more citizens facing crises on many fronts, including the need for mental health services.” He went on to comment, “Officers are being called upon to do even more at a time when communities have fewer and fewer resources for treatment.” 

The McAtee Award is named after Judge John J. McAtee, a long-time advocate for improving the quality of life for persons with mental illness. He served the St. Louis community in numerous capacities, including 18 years as a board member at the Mental Health Association. 

The Mental Health Association hosts the annual event and accepts nominations from police departments, mental health agencies, hospital emergency rooms and emergency shelters.

 
Recipients of the 2006 John J. McAtee award are Detective Kenneth Baur, Officer Charles Moutray,
Sgt. Daniel Zarrick, Sgt. Kevin Anderson, Officer Steve Still, Sgt. Mark Schupp,
U.S. Probation Officer Marty Thurman, Senior U.S. Probation Officer Teresa Telford, Chief Hank Davenport,
Officer Kyle West, Officer Ed Davis, Sgt. Rich Will, Deputy Brian Misner, Cpl. Randy Vaughn,
Officer Michael Mainieri, Officer Steven DeGhelder, Officer Desiree Howard, and Officer Andy Vaughn.
Also pictured are Attorney General Jay Nixon, McAtee family members, the Judges Dowd
and Joe Yancey – MO Dept. of Mental Health.

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CIT Corner appears regularly in Street Talk. CIT-trained officers will contribute articles to the column for the purpose of sharing information about the successes and expansion of CIT (Crisis Intervention Training) in the metropolitan area. 

In the April edition, I discussed CIT training and the benefits of the program. I need to emphasize CIT is more than just training. It is a program consisting of a partnership between law enforcement, mental health agencies/professionals, consumers, and families of consumers.  

St. Louis City, St. Louis County and municipalities in St. Louis County make up the St. Louis Area CIT program. Any agencies outside this area need to get together to form a CIT Council for their area. I have received several requests from officers in Franklin, Jefferson and St. Charles Counties to attend the 40-hour basic CIT training. My response is that it requires the formation of a CIT Council in their area, and that I and the other members in our council would be excited to assist in getting their program started.

CIT is a law enforcement program and the best way for the program to be implemented is for a law enforcement agency to take the lead in setting a meeting with other law enforcement agencies along with mental health providers in their jurisdiction. An officer with authority to make decisions should be appointed as chairperson of the council and to appoint committee chairpersons for different committees: training, reporting, provider relations, court procedures, and standard operating procedures. The St. Louis Area Council’s Chairperson is Major Robert Trittler, St. Louis County Police Department, who oversees the council and makes decisions on the direction of the program. When our council was established, we sent representatives from law enforcement and mental health to the Kansas City Area CIT Training program where we were able to bring back ideas on how our training should be organized. Obviously, changes had to be made to fit our area. The St. Louis Area CIT Council invites any interested agency to attend our 40-hour basic CIT training to assist in organizing their training. Our training is based on the Memphis, TN., program, as are most CIT programs of which I am aware.   

The CIT Council should consist of a very proactive group of professionals who are interested in having the best possible CIT program. They are charged with problem-solving and improving communications between police and the mental health community. 

Another way to get ideas and to understand CIT is to attend the National CIT Conference that will be held in Orlando, FL. on September 25, 26, and 27. Information on the program, registration and accommodation is available at http://cit.fmhi.usf.edu.  I encourage anyone interested in establishing a CIT program to attend. 

For more information on CIT, contact me at barmfield@stlouisco.com or call 314-628-5509. We are looking to expand the CIT program and I am available to assist.

A “survivor of suicide” is a family member or friend of a person who has died by suicide.  Survivors frequently experience overwhelming shame and embarrassment, preventing them from seeking help and putting them at greater risk for suicide themselves.  Survivors of suicide are the living “casualties” of suicide.  

Each year, as many as 200 people die by suicide in the greater St. Louis metro area.  For each completed suicide, it is estimated that at least six people – family members and friends -- are intimately affected, making them “survivors” of suicide. Thus, each year at least 1,200 St. Louisans join the ranks of survivors of suicide.  

Survivors often struggle for years with the guilt and grief that death by suicide leaves in its wake. Many survivors agree that a “peer-postvention” service would have been helpful, offering immediate comfort, preparedness information, and hope that they too can survive their loss. 

How can you, an officer on the scene of a suicide or a domestic disturbance rooted in the aftermath of a suicide, help?  What resources exist to help these family members and friends?   

We are pleased to advise you of a new community resource - the St. Louis Area Survivors of Suicide Response Team – available to you and the persons you serve, who find themselves dealing with the suicide of a loved one. 

The Survivors of Suicide Response Team (SSRT) is a collaborative effort by St. Louis area survivors of suicide and mental health service organizations to advance support services for those who have experienced a loss to suicide. Partner organizations are KUTO (Kids Under Twenty One), Life Crisis Services, Mental Health Association of Greater St. Louis, NAMI-St. Louis, and Unmasking Suicide, Inc., a local partner of the National Organization of People of Color Against Suicide (NOPCAS).   

Elizabeth Makulec, Executive Director of KUTO, says, “The mission of the SSRT is to reduce the risk of suicide in survivors by instilling hope through listening, sharing experiences, offering encouragement and linking them with community resources that will better help them survive their loss.”  Team members are trained peer survivors, counselors, social workers, and community service providers who are available to meet with newly bereaved families and individuals.   

SSRT is peer-facilitated and is intended to supplement, not replace, clinical therapy or  counseling.  The Team strives to identify, engage, support and educate survivors as soon as possible following their loss. SSRT members are trained peer survivors, counselors, social workers, and community service providers who, under mutual agreement with survivors, visit with newly bereaved individuals and families.

SSRT members:

• share the message that surviving the tragedy of suicide is possible.
• promote resiliency through caring, availability and understanding.
• explain the grief process, stages of mourning, and what to expect emotionally.
• help survivors cope with the difficulties and unique challenges that follow suicide.

If you or someone you know could benefit from the SSRT, call KUTO (314-963-7571) to learn more about the service and how to coordinate a team visit. If, in your professional role, you encounter persons struggling with the suicide of a family member or friend, let them know the SSRT is an available community resource for help.

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Ruth L. Abramson, a Licensed Clinical Social Worker, is a graduate of St. Louis University School of Social Services. She has been in private practice for 30 years, working with individuals and families on a variety of mental health concerns. Two areas of clinical expertise are self-mutilation and eating disorders.

Officers, especially those in schools, will no doubt encounter a person who self-mutilates. While the officer cannot always ascertain the motivating factor for the behavior or immediately know if suicide was intended, he/she can demonstrate knowledge about the seriousness of the situation and the need for mental health services. Obviously, when mutilation is severe and life-threatening, calling for medical assistance is the only option. Officers can also make key referral suggestions to parents, school officials, other family members and/or the individual for follow-up mental health services. (See accompanying Referral Information box.) 

Insight into the self-mutilator 

Today, “cutting” is a behavior found all too often among persons with emotional disturbances or mental illness. Self-mutilation is a frightening barrier that keeps others from seeing a person who is lost, in pain, and in desperate need of help. 

The person who “cuts” seeks relief from mental pain and anguish through self-inflicted physical pain. The person finds solace in the letting of his/her own blood. Police officers may wonder why some people would deliberately inflict pain on themselves, and whether that behavior makes them dangerous to others.  This behavior is so foreign to most of us that it could be easy to confuse our own feelings and motives with those of the cutter.

While many cutters feel abandoned emotionally, each self-harming person has a different history, a different motive, and a different state of mind before, during and after harming him/herself. As helpers, we must overcome our own feelings of discomfort. 

For the self-mutilator, the physical pain has a calming or distracting effect on an even more painful psychological state. The self-mutilator is very sensitive to his/her own emotional pain and often doesn’t trust others. She prefers to be the one in control of the pain she experiences and the feeling of numbness it leaves behind.  That is the usual goal of the cutter.  Unfortunately, the cutting provides only short-term relief from the psychological/emotional pain, resulting in a buildup of negative feelings and an addiction to self-mutilation for its short-term relief. 

There are two characteristics in all self-mutilators: 

·                    a feeling of mental disintegration and/or an inability to think

·                    a rage that can’t be expressed toward a powerful parent or authority figures 

The self-mutilator typically has low self-esteem; females typically seek abusive relationships, often because security and pain have been fused. This fusion causes her to “treat” her feelings of insecurity, loneliness, and fear of abandonment with self-inflicted pain because she connects it with “home.” 

Cutting is an act of anger and of self-medicating. When the body is injured, hormones called endorphins are released to fight anxiety, agitation and depression. 

Can treatment help? 

Treatment can be successful when the clinicians adopt a highly authoritative, yet warm and supportive posture in order to develop trust. Police officers, by their statutory authority and training can often fulfill that need in the short term.  Those officers who are on the scene following a serious cutting incident, cannot exhibit fear, or they will be dismissed by the client. Because of what the patient needs for the therapeutic process to be successful, the police officer or mental health professional must exhibit certain traits: confidence; empathy; ability to appear knowledgeable; an understanding of the client’s despair; nurturing posture, and optimism.   Despite the use of a blade of some sort, self-mutilators are rarely dangerous to others.

Police officers, when confronting self-mutilators, should locate the weapon and confiscate it to protect the cutters from inflicting more serious harm on themselves.  Beyond immediate medical assistance for the wounds, self-mutilators and their families should be referred to mental health services as soon as possible.

The table below is a resource for contacting agencies that can help you deal with self-mutilators.

Crisis Hotlines  Behavioral Health Response 24-hour crisis hotline 314-469-6644  Kids Under Twenty One (KUTO) “Warm” line/peer support for teens and young adults 314-644-5886  Life Crisis Services 24-hour crisis hotline Free, crisis counseling clinic 314-647-4357	Information and Referrals  Mental Health Association Education; Information; Referrals 314-773-1399  NAMI-St. Louis Education and Support for Family/Friends 314-966-4670
Sliding Scale Counseling Agencies
Care & Counseling   314-878-4340  Catholic Family Services 314-544-3800  Jewish Family & Children’s Services 314-993-1000	Lutheran Family & Children’s Services 314-787-5100  Provident, Inc. 314-533-8200

 

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Open Mind is a column produced by the Mental Health Association, which appears weekly in many Suburban Journals. Click here for the reprint above and access to the entire Open Mind Archive on this website.

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We have archived past issues of Street Talk on this website.  All back issues also include a Mental Health Directory and a link to a relevant Open Mind column.

April, 2006

• Family Effects of Police Work
• 20th Annual McAtee Award Nominations
• Street Talk Survey: Tell Us What You Think
• Open Mind: Stress Management
• CIT Corner/March 2006 CIT Graduates
• Street Talk Archives
• Street Tips: Eating Disorders
• Mental Health Directory

January, 2006

• The Stress of Shift Work
• At Your Service: NAMI St. Louis
• Street Talk Survey: Tell Us What You Think
• Open Mind: Stress Management
• CIT Corner
• Street Talk Archives
• Street Tips: Guardianship and Conservatorship
• Mental Health Directory

October, 2005

• A Police Officer's Guide to Mental Retardation vs. Mental Illness
• At Your Service: Productive Living Board
• NPSF Survey: We Need Your Help
• Open Mind: St. Louis Mental Health Resources
• CIT Corner
• Street Talk Archives
• Street Tips: Recognizing BiPolar Disorder
• Mental Health Directory
• Current Issues: Mental Health Court

July, 2005

• Police Recognition Awards
• At Your Service: Life Crisis Services
• Officer of the Year: Lori Bethmann
• Do You Know?  Effects of Stress
• CIT Corner
• Open Mind: Inheriting Schizophrenia
• Street Report: Police Suicide
• Street Talk Archives
• Street Tips: Mental Health Glossary
• Mental Health Directory
• Current Issues: Effects of PTSD

April, 2005

• Police Recognition Award Luncheon
• Current Issues: Police Could Bear Brunt of Budget Cuts!
• CIT Corner: CIT at Work - Case Examples
• At Your Service: National Council on Alcoholism and Drug Abuse
• Law In Action: March, 2005 CIT Graduates
• Open Mind: St. Louis Resources
• Street Tips: Medication Non-compliance
• Street Talk Archives
• Tip Sheet: Common Psychiatric Medicines
• Mental Health Directory

January, 2005

• Post-Holiday Blues
• At Your Service: CenterPointe Hospital
• Law In Action: Nov. 2004 CIT Graduating Class
• Q&A: Not Guilty by Reason of Insanity
• CIT Corner: CIT Training Pays off on the Street
• Street Report: Cops Have Feelings, Too
• CIT Appreciation Dinner
• Open Mind: St. Louis Resources
• Street Tips: Keys to Tactical Communication
• Street Talk Archives
• Current Issues: State Budget Affects Mental Health Services
• Mental Health Directory

October, 2004

• Living with Killing
• Current Issues: Important Ballot Issues
• Law In Action: July 2004 CIT Graduating Class
• CIT Corner: Update on CIT
• Street Tips:Encountering the Homeless
• At Your Service: Family Support Program
• Street Report: The Brotherhood
• Q&A: Not Guilty by Reason of Insanity
• Open Mind: Supporting a Friend with Mental Illness
• Street Talk Archives
• Mental Health Directory

July, 2004

• 2004 John J. McAtee Award Winners
• Q&A: Schizophrenia - What Officers need to Know
• In the Limelight: Officer Emily Mancuso
• ASIST Training
• Law In Action: March 2004 CIT Graduating Class
• Open Mind: Schizophrenia and the Brain
• Street Tips: Dealing with Mentally Ill or Suicidal People
• Tips from NAMI: Responding to a Mental Health Crisis
• Mental Health Directory

April, 2004

• 2004 John J. McAtee Award
• State Budget Cuts Affect Law Enforcement
• St. Patrick Center Programs
• Homeless People are Not All the Same
• Mental Health Directory
• Say YES to Homeless Youth
• Youth In Need Provides Services to Young People
• Roll Call
• P.O.S.T Approved Training
• Open Mind: Homelessness

January, 2004

• CIT: Safety, Understanding, and Service
• Street Tips: When Someone is "Acting Strangely."
• CIT: Training Makes it Happen
• Law in Action: Jail Diversion Program
• Do You Know? Obesity
• Q&A: Criteria for Involuntary Commitment
• At Your Service: Hawthorn Children's Psychiatric Hospital

October 2002

July 2002

April 2002

Following is a dated index of previous articles that have appeared in Street Talk.  To get a copy of any article or a previous issue, please call LaDonna Haley at 314-773-1399.

"It Worked for Me" (Officer Gorman)

Holiday blues vs. Seasonal Affective Disorder (SAD)

What should I know about Bipolar Disorder?

"When it finally hit home – part 1" (FBI agent Burt Jensen)

Public policy, mental health, your work

Liability issues for officers and departments

In the Limelight: Hazelwood PD

At Your Service: St. Patrick Center

I’d like you to know (helpful hints)

Dealing with frequent callers

"When it finally hit home – part 2" (FBI agent Burt Jensen)

Officer and Department of the year awards

At Your Service: Provident Counseling

Q&A: All about EAP’s

Know your mental health options

What does confidentiality really mean?

Rethinking our strategies (John Bozarth)

Anger management

Helping peers in distress

In the Limelight: Ballwin and Hazelwood PD’s

January 2002

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