With increased reports of encounters with people who are mentally ill, especially in the downtown area, local mental health experts offered tips for what to do in such a situation.
The first and best thing to do is stay calm, said Steve Bradley, a therapist with Mid-Columbia Center for Living (CFL). He supervises the regional jail’s diversion program for people with severe mental illness.
It can be an uncomfortable situation, he said, and “if the other person is all worked up, our instinct is to get worked up too.” But the best thing is to manage your feelings of frustration, arousal, fear or uncomfortableness and stay calm.
It’s important to speak calmly, use deep breathing to relax in the moment, and speak in a conversational tone, he said.
Next, just listen to the person for a bit to find out what they’re saying. You don’t need to agree to any delusional beliefs, Bradley said, but you could respond with something like, “You seem upset right now.”
That lets the person feel heard and they are more likely to cooperate, he said. Also, if they’re doing something good, you can affirm it. It could be a compliment on what they’re wearing or something else positive.
Breana Hesse is a jail diversion mental health therapist. She said a simple acknowledgement of the person’s experience is sufficient. “You can say, ‘Oh wow, that sounds like a lot.’ Just acknowledging it’s happening for them is incredibly validating.”
Bradley suggested talking slowly, since the person in crisis may be hearing voices. They may or may not tell you they’re hearing them. “You’re competing with another conversation, and they need a little time to process through that.”
You might have to wait five or 10 seconds to get an answer to a question, he said.
People who say they are hearing voices are absolutely hearing them, he said. Bradley tries to convey that concept to people by explaining that he has tinnitus, and while nobody else can hear the ringing in his ears, he can, and people have to take it on faith that he hears it. The same holds true for those who hear voices.
If you’re feeling comfortable enough, you can ask the person how you can help them, Bradley said. It could be something as simple as giving them water or food.
If they might have physical pains, you could ask if they’d like you to call an ambulance.
He said its best to use literal language, not figurative language. Saying something like “why can’t you straighten up and fly right?” could be taken literally.
Also, if someone is in a psychotic episode, it is best to give them instructions one at a time. For example, telling them a multi-turn route to a bathroom might not work. It might be best to lead them there.
If you feel threatened, “it’s ok to call police and ask a person to be removed,” Bradley said.
He said of those who are mentally ill, “they behave and talk in ways that are bizarre and unusual and that makes us uncomfortable, but the vast majority of the severally mentally ill are not going to hurt you.”
Bradley said your movements around a person who is in crisis should not be sudden, and if you are going to get your phone out of your pocket, it is helpful to tell the person in crisis what you are doing.
He said it was also important to “be careful of personal touch. There’s not necessarily reason to touch somebody.”
Hesse urged people who encounter people with mental illness to be mindful of physical space. If you notice they are walking backwards from you, allow them to decide how much physical space they feel comfortable with.
Bradley said CFL has offered daylong mental health first aid classes to local entities for the last several years, and it’s free to those attending. For more information, contact Al Barton, interim director of CFL, at ABarton@mccfl.org, or call him at 541-296-5452 x 2204.
Things that are not helpful in encounters with a person who is mentally ill includes telling them to calm down, or saying that you understand where they’re coming from, Bradley said.
“When we say ‘I understand,’ sometimes its superficial or patronizing,” he said. It is better to be specific with observations, such as ‘You look mad, or you’re feeling upset,’ which shows empathy.
Also avoid interrogation language, such as “why would you do that?” Those run the risk of elevating erratic behavior rather than reducing it.
If a person has the time and patience and they’re comfortable, they can talk for quite awhile, but if a person is running a store and has customers to tend to, “they might have to be polite and end it,” Bradley said.
That might be something like “‘I’m glad you’ve got some water, thanks for coming in, have a nice day.’” Or, “I’ve got a lot of work to do, thanks for talking.”
Bradley said the suggestions being provided are not guaranteed to work, but they have a propensity to work.
He said business owners might not have the time it takes to make a situation work, where the ideal outcome is to have the person leaving in a good mood without causing a
scene.
Hesse said our culture doesn’t prepare us for how to interact with the mentally ill, and our society doesn’t have a way for people who are mentally ill to fit in and be contributing members of a community.
She encouraged people to recognize that people with mental illness deserve to be treated with respect and empathy, and that they didn’t choose to behave like this—it’s often something they’re born with.
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