Responding to Someone with Mental Illness

Mental illness should not be confused with an intellectual disability. People with mental illness are usually of normal intelligence but may have difficulty functioning at normal levels due to their illness. Many symptoms are not readily observable from outward appearances but are noticeable in conversation. As a first responder, you are not expected to recognize specific types of mental illness but to notice the basic symptoms and respond appropriately.

Indicators of Mental Illness

Intervening with Persons with Mental Illness

Considerations for First Responders:

  • Approach individual in a calm, non-threatening, reassuring manner. Introduce yourself with your name, rank and agency. Make the individual feel that he or she is in control.
  • Determine whether the individual has a family member or caregiver you can contact. Be aware that this person may be the offender or may try to protect the individual.
  • Avoid┬áthe following conduct in your actions and behavior with individuals:
    • Circling, surrounding, closing in on, or standing too close to the individual
    • Concealing your hands
    • Sudden movements or rapid instructions and questioning
    • Whispering, joking, or laughing
    • Direct, continuous eye contact; forced conversation; or signs of impatience
    • Any touching
    • Challenges to or agreement with an individual's hallucinations or paranoia
    • Inappropriate language, such as "crazy," "psycho," or "nuts
  • Interview individual in a quiet, distraction-free setting and ask simple and brief questions. Understand that a logical discussion may not be possible on some or all topics.
  • Back off and allow individuals time to calm down before intervening if they are acting excited or dangerous but there is no immediate threat to anyone's safety. Outbursts are usually short.
  • To bring compulsive talking under control, break the speech pattern of individuals with simple questions such as their birth date or full name.
  • Empathize with individuals and understand that their hallucinations are frighteningly real.
  • Be aware of non-verbal responses if someone is unresponsive. Do not ignore him or her or assume that he or she can't hear you.
  • Be honest. Getting caught in a well-intentioned untruth will increase suspicion and fear of you.
  • Assess the individual's emotional state continuously for any indications that he or she may be a danger to him or herself or others.
  • Do not overreact to offensive language or sexual, racial, or ethnic slurs directed at you.
  • Do not order, command, warn, or threaten.
  • Do not moralize, preach, or judge.

Source: United States Department of Justice (2010)