How officers can move people from crisis to compliance
Officers can help a person in crisis while achieving the goal of voluntary compliance by taking things SLOW
By Sergeant Christopher Bax
It is commonly accepted that there are four pathways to crisis: mental illness, substance use, medical conditions and situational stress. Any of these four pathways individually, or in combination, can create a state of crisis and lead to a person having contact with police.
Moving someone from a state of crisis toward compliance is not easy. By recognizing indicators of emotional distress, gaining information through active listening, communicating understanding, forming connections and making informed decisions, officers can help a person in crisis while achieving the goal of voluntary compliance.
When interacting with a person in crisis, officers might find the acronym SLOW helpful:
Let’s look at each of these areas in more detail.
1. Situational awareness
Officer safety is always a priority when interacting with a person in crisis. When used appropriately, the following communication techniques enhance officer safety by talking a person down through a behavioral change.
Working from the outside and moving in, officers can gain information from environmental, behavioral and verbal indicators. By recognizing indicators of emotional distress, officers can begin to make informed decisions as they slowly close the gap with the person in crisis, using time, space, cover and concealment to their advantage. The following techniques are offered for lower-risk situations. Keep in mind that in high-risk situations, commands and/or tactics might be needed first and once it is safe to do so, the following techniques can still be used from a position of safety.
2. Listening skills
Active listening is listening to understand. By listening 80% of the time and talking 20% of the time, officers can gain valuable information from a person in crisis. In order to get the conversation going, an introduction such as the following can be used substituting your own name, rank and agency:
"Hello, my name is Christopher Bax. I'm a sergeant with the Clarkstown Police Department. You can call me Chris. What's your name?"
The format of this introduction might seem like a departure from the way an officer usually introduces themselves, during a traffic stop for example, but that is entirely the point.
Interacting with a person in crisis is almost always a non-enforcement situation and so it can be handled differently. By leading with your full name, still identifying your rank/agency, and then offering the permission for the person in crisis to call you by your first name you can begin to form a connection with the person, build rapport, gain influence and then direct them toward services.
Also, by offering your name first you are modeling the behavior for the person in crisis to reciprocate, hopefully gaining their full name and the permission to use their first name to have a conversation. By establishing this foundation, you can then begin to build upon the conversation using minimal encouragers to get the person talking and respond with empathy. The following format, giving the person time to respond, can be used:
"Are you ok?
(Pause for response)
You seem (mad, sad, frustrated, upset).
(Pause for response)
I can hear it in your voice, you sound really (mad, sad, frustrated, upset).
Or if the person is not initially giving a verbal response:
I can see it in your face, something must really be bothering you.
(Pause for response)
How did you get so (mad, sad, frustrated, upset) today?"
Ideally, try to label the emotion you think the person is experiencing. Some common examples are listed in the parenthesis, but the list is endless. Even if you guess wrong, the person might then label their own emotion and you can run with that.
By responding with empathy, you can get the person talking. Subtle word choices can help accomplish that goal. For example, the last question above is opened up with the word "How" as opposed to "Why." "How" addresses the circumstances that lead to a response by the person. By asking the "how" question it encourages the person to explain what happened to them and how they reacted to it. "Why" is inherently accusatory. "Why did you do that?" is automatically implied by asking a "why" question and puts the person on the defensive at best or shuts them down at worst.
Outlining is the way that we communicate understanding. At this point, the person in crisis has conveyed information and by simply outlining, or repeating back that information, you can demonstrate that understanding. One way to do that is to say:
"Let me see if I understand what you are saying..."
Following this statement or any variation that accomplishes the same goal, you can then repeat back to the person what they told you earlier to make sure that there is mutual understanding.
At the end, a simple "Is that correct?" or any variation of that same question will ideally result in a "yes" response from the person in crisis. Getting the person to say "yes," even to small things such as getting permission to use the person's first name, or agreeing upon an outline of the situation, is important because it begins to condition the person in crisis to say "yes" throughout the conversation.
Ultimately, the conversation might be leading toward something the person does not want to do, such as going to the hospital, so gaining some "yes" answers along the way could help lead toward "yes" at the end. When used correctly, this technique not only conveys understanding but also forms agreements about what the person is experiencing and sets the stage for how you can help.
Rounding out the SLOW acronym is the concept of wellness. There needs to be some sort of disposition to the contact with the person in crisis and here we have some options. At the lowest level, documentation and a referral to a local resource, if available, can be effective if the person does not meet the criteria for an emergency evaluation. It is important to know what local resources are available and connect the person to those resources.
Besides getting the proper help for the person, connecting them to a resource could reduce future contacts. In some areas, mobile crisis teams (MCT) are available to assist officers at the scene. The composition of the team can vary, but when the team has a clinician on board, they can conduct an evaluation on scene reducing the number of transports to a hospital.
In areas where MCTs have been successful, the person in crisis or their family member might call the team directly, diverting low-risk calls away from 911 centers. As demand for MCTs has increased and this specific resource has been spread thin, telehealth programs are being utilized to remotely connect. Police agencies with telehealth agreements enable officers to bring a tablet to a scene and when it is safe to do so, have the person in crisis speak to a mental health professional via the remote connection.
In higher-risk scenarios, officers must know and be guided by their respective policies, procedures and training on how to handle these difficult situations. If the contact does result in transport to an approved hospital or facility, it is important to fully inform the staff member receiving the person in crisis as to what happened on the scene. In all cases, from simple documentation to involuntary emergency evaluations, proper documentation is the best shield from any potential liability.
Besides utilizing SLOW as a memory device on how to interact with a person in crisis, slowing down the entire contact is an effective tool for officers. The longer these scenarios play out, the more likely rational thought will replace emotional response for the person in crisis. Literally using the language of "slow down" can also be beneficial if the person in crisis is exhibiting pressured speech or agitation. "Slow down" tends to be better received than its past counterpart of "calm down." Telling a person in crisis to "calm down" can have the opposite effect and make things more adversarial. Anyone who has ever told their significant other to "calm down" during an argument already knows this to be true, but by simply changing the language to "slow down" while modeling the behavior through body language and cadence of voice, when safe to do so, can change the entire course of the interaction.
About the author
Christopher Bax is a sergeant with the Clarkstown Police Department in Rockland County, New York, a consultant for the NYS Office of Mental Health and an NYS DCJS Master Instructor. He started his career with the NYPD in 2005, becoming a third-generation police officer, worked for the Westchester County Police Department for two years, and then landed his hometown job in Clarkstown in 2008 and was promoted in 2019. Special thanks to Chief Jeff Wanamaker, Captain Glenn Cummings and Lieutenant Steve Chernick of the Clarkstown Police Department and mental health professionals Dr. Don Kamin, Rana Meehan, Carrie Wong and Mark Giuliano for their guidance, as well as his family for their support.