Archive for the ‘mental illness’ Tag

Intervention Strategies to Prevent Behavior Escalation

Brenda Putman presented an audio conference on Intervention Strategies to Prevent Behavior Escalation a while back.  In light of yesterday’s find – the essay by Chip Ward about homelessness – I thought it might be appropriate to include my notes from this conference here.  They will serve as a reminder for me and perhaps will also be helpful to someone else.  Putman’s conference is one that I would take again if it were offered and I recommend others do the same.

Here are my notes:

Putman suggests that it is important to realize that life does not happen in a vacuum but through interaction with one another.  She defines anxiety as “a noticeable change or increase in behaviour” and places it as the first indicator of a crisis.  And she suggests that the best response in such a situation is to be supportive and non-judgemental with the intent of decreasing the anxiety.

Putman says that the library client may not have the skills to manage whatever it is that is making them anxious so the librarian needs to try to illicit a good response.  Possible ways to achieve this include:  asking them “How can I help you?”  If, for example, they have returned a library book late and are upset because of fines, telling them that they would not have incurred fines if they had brought the book back on time only places the responsibility for their predicament back in their hands.  We need to be supportive and non-judgmental without enabling them.  The teachable moment should be the moment AFTER the problem is solved, i.e., how can I avoid that problem in the future?

In order to communicate a non-judgmental approach you need to:  respect people’s personal space; have a relaxed and open facial expression with an appropriate amount of eye contact that says, ‘I’m here to listen’; don’t cross your arms across your chest; stand at an angle to the person so they don’t feel hemmed in; keep your voice tone level – not too soft and not too loud.

If they respond to you defensively you need to adjust what you’re saying.  It hasn’t been well received so you need to respond in a different way.

Defensiveness can be the beginning of a loss in rationality.  You need to recognize that the individual has a problem and try to help them find some conclusion.

Dealing with verbal escalation:

First stage is questioning – questioning policy, info seeking question, then perhaps a more challenging question – questioning your authority or motivation.  Ignore the challenge NOT the question.

When people refuse to comply with the rules you need to ask, how am I or my organization contributing to the non-compliance?  Sometimes policies need to be updated.  You need to ask yourself, ‘what is it that we could do to encourage compliance?’

It is important to recognize when people are feeling frustrated and are not getting what they want that their anxiety has escalated.

Debriefing questions to ask yourself:

What did we do?

How did we respond?

How might we do it differently next time?

How can we support each other in such a situation?

We need to recognize that an individual’s anxiety has something to do with some kind of precipitating factor – not you – maybe the traffic was bad, or maybe they had an argument with their spouse, etc.  Be sensitive to the fact that people come in with a variety of precipitating factors.  Be supportive, non-judgemental, listen.  Recognize that their anxiety has nothing to do with you – develop empathy.

The difference between sympathy and empathy:

Sympathy – I feel bad for you;

Empathy – identify what you see and validate that they are experiencing this problem.  Sometimes people are anxious when they think nobody understands them.

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What they didn’t teach us in library school

The linked essay was written some time ago by Chip Ward, a retired Librarian from the Salt Lake City Public Library.  Even with a health care system in place, the issue of helping the homeless also comes up in libraries in Canada.  It is Ward’s note that homelessness is usually associated with mental illness that is of particular interest to me at this time.  While I have worked in the past in a public library where I met many individuals who were homeless and suffering from mental illness, I now find myself working in a community college library where I am not dealing with the homeless to the same degree, but still dealing with the mentally ill.  We have (in my short time here) had one homeless gentleman come into the library asking the students for money and I apologized to him when I told him he could not do that here.  We also, however, have at least two regulars who suffer from mental health issues but do not appear to be homeless.  One is angry and loud.  As an alumni he has a right to be here and he comes in and let’s you know under no uncertain terms that this is so.  The other is depressed and sad.  He has a new research project every time I see him (which is almost every day) and requires reference assistance to complete it.  I am happy to have the reference practice.  He was looking for some materials the other day that he could not have access to from here because they were available through the databases which, by virtue of our agreements with the vendors are intended only to be accessed by registered students with their passwords, so I checked the public library’s web site and told him what was available to him there.  He indicated that he did not want to go to the public library because they – well – they don’t help him in quite the same way.  Ward discusses this issue with compassion.   See more in his blog.  Message to Chip Ward – we did discuss this in library school, but it doesn’t hurt to be reminded that people suffering from mental health issues exist in and are a part of every community and should be treated with the same respect as everyone else.  Thank you.