An Ounce of Prevention is Worth…

By Marc Rios-Klein

Prevention is defined as “the act of stopping something from happening or arising.” Examples include:  “This vaccine is prevention against a disease,” or “Keeping a fire extinguisher in your kitchen can aid in the prevention of a serious fire.” I believe that the art of prevention and early detection are the keys to minimizing, if not eliminating, the impact of any illness be it physical, psychological, or a psychiatric condition or issue.

In my last blog, I raised the dilemma about how to break through the internal resistance of an individual who is experiencing paranoid delusional thoughts or undergoing the throws of mania. I did not mean to present it rhetorically – it is, potentially, a grave concern for the person’s wellbeing and / or their significant other’s welfare and safety. The pressure of the battle waged in the minds of an individual dealing with these symptoms is, to say the least, intense and, generally, all-consuming. Suicidal, aggressive, and even homicidal thoughts can flood anyone in that moment and leave them feeling extremely vulnerable. Often, they perceive that their loved ones or the entire planet’s welfare is at stake! At that point, moods can shift very quickly with one’s thoughts, and an action based on distortions of reality is possibly only one-second away. Family members, friends, and sometimes strangers can become victims in an instant.

I feel a great deal of empathy for those who have to endure these extremes of thought and emotion, which become fictionalized in a distorted mind or otherwise. Often, the person believes to their very core that they are on the defense when, in actuality and within the realm of true reality, they sadly and tragically acted from an offensive place. I wish to help in the prevention of these highly avoidable events. Challenging the distorted notions head-on usually leads to a person taking an even further entrenched position, and, too often, a person becomes agitated by the challenge.

We all see the horrific outcomes of these types of events almost daily on the national news. Matter after matter in which a person struggling with their mental illness is shot and wounded by police officers or killed right on the spot as they posed a risk to the safety of the police and / or the community. I do not wish to cast any disparaging remarks regarding who is at fault as each of these events are unique to the circumstances. Law enforcement agents do have the right to protect themselves from “imminent” violence aimed directly at them. However, I have to believe, in my clinical opinion, that much more mental health education and training, including role-playing exercises, need to occur to greatly enhance their ability to manage these events more effectively. It’s impossible to expect all to become mental health experts, but their overall responses can improve through this enhanced educative experience across all law enforcement in the country. An all-day 8 or 16 hour training is not enough. Nor would that amount of investigative training turn me into a police detective!! After 200 hours of training as a Child Protective Services Worker in San Diego County, I was qualified to handle the responsibilities involved in investigating cases of suspected abuse and neglect. When I was unsure, I consulted with those with more knowledge in my field as well as District Attorneys and Public Defenders. My current local area, Solano County, offers a training for anyone in the community entitled “Mental Health First Aid.”

So, getting back to my original issue, my experience has shown me that once a person is “deep into their symptoms” and overwhelmed by the intensity of what they are dealing with in their minds, it is almost impossible to convince them of much at that point. Medication becomes critical, and a compassionate, non-confrontational approach is best. In extreme cases, restraint may become necessary during a hospitalization to prevent self-harm or violence toward others. This is why I believe that mental health education is needed from junior high school forward in academic curriculum with role-playing built into the education process. Anything that can aid in desensitizing the stigmatization aspects of talking about mental illnesses helps diminish the potential of matters that I described earlier from occurring in the first place. Bring Change 2 Mind is creating an entire program for high schools and colleges to assist in the formulation of mental health awareness, help start the dialogue, and reduce shame / stigma. Again – really, really sweet and gentle people living with mental illness can find themselves involved in a violent, tragic event when under extreme internal pressure. They could be hurt or killed by the police, or hospitalized multiple times. Paranoid delusional thinking, command auditory hallucinations, and / or mania can flare when one is either not medicated or under-medicated (ineffective response). Education and helping those learn healthier coping skills and techniques toward a place of true recovery and improved self-control are the keys to success.

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