Published On:Tuesday, August 17, 2010

LIKE it or not, in the Bahamas there are citizens who have mental disorders. Some may be on the streets not taking their medications, while there are some who have not been diagnosed and are therefore not receiving treatment.

This was the introduction of the presentation given by senior nursing officer Betty Frazer of the Sandilands Rehabilitation Centre to senior officers of the Royal Bahamas Police Force.

However, Ms Frazer said that the positive side is that there are others receiving effective treatment, functioning and making a contribution to society, while living in society.

Ms Frazer is the coordinator of the Psychiatric Nursing Programme and the supervisor of the Continuing Nursing Education Unit at the Sandilands Rehabilitation Centre with 20 plus years of nursing experience.

Addressing the police officers, Ms Frazer said that unfortunately there are those persons in the Bahamas who are sufficiently well, but due to many factors, continue to reside in the Sandilands Rehabilitation Centre as well as half-way houses.

She said that many police officers as part of their job may come in contact with a mentally ill individual. Many may not feel comfortable handling mentally ill citizens as opposed to a criminal suspect because the criminal, they believe, are often more predictable and more clearly responsible for their behaviour than the mentally challenged.

There also remains the fact that the mentally ill are socially stigmatised by the mere fact that many people believe "that all mentally persons are violent", she said.

Ms Frazer said that this is one of the more prevalent and unrelenting myths about mental illness.

"The truth is that, in general, mentally ill citizens are far more likely to be the victims of violence than its perpetrators," she said.

Ms Frazer then asked and answered several questions after pointing out that surveys show that officers tend to view mentally ill subjects as more dangerous and less in control of their actions than other citizens.

Answering the question if people with mental illnesses are more likely than others to engage in violent behaviour, Ms Frazer said that while the mere presence of a psychiatric disorder does not necessarily increase a citizen's risk of violence, the risk is highest for persons diagnosed with schizophrenia, mania, and those who abuse drugs like marijuana, cocaine or alcohol.

Ms Frazer also gave brief overview of psychiatric illnesses are associated with violence:

* Schizophrenia, a mental disorder that makes it difficult to tell the difference between real and unreal experiences.

* Bi-polar disorder, a mood disorder that causes radical emotional changes and mood swings, from manic highs to depressive lows.

Aside from schizophrenic subjects, alcohol- and drug-intoxication disturbances comprise the bulk of potentially violent mental disorder-related police patrol interactions, Ms Frazer said.

In fact, the two diagnoses frequently overlap, as many mentally disturbed individuals are also abusing substances at any given time, she said.

Ms Frazer said that officers who encounter an irrational person creating a disturbance have three choices: Transport that person to a mental health facility or Accident and Emergency, arrest the person, or resolve the matter informally.

The single most important skill in dealing with the mentally ill is the ability to communicate, Ms Frazer said.

There are police officers and members of the public, she said, that believe that being the hard-nosed command-type is correct for all situations.

FBI studies have shown that an officer who lets his or her guard down and appears "weak" is more likely to get injured or killed. Despite these results, it is further recognised that taking the hard-nosed approach when dealing with a mental crises tend to backfire.

Unless an officer intends to either ignore or arrest every citizen he or she comes in contact with on the street, communication skills are vital for both solving mundane problems and defusing potentially explosive crises, she said.

Verbal communications skills are crucial for success in virtually every aspect of patrol policing efforts.

Those crisis situations that begin as hot calls can be more effectively de-escalated by officers who possess good verbal skills, potentially eliminating the need for physical force, restraint, and arrest.

Again, less risk of injury to officer or citizen and less paperwork, Ms Frazer said.