The Frontline Heroes' Crisis Toolbox: Mental Health Education and Practical Application

By Dr. Patty Poloka

This book is raw and dramatic in ways only public safety employees and military members may understand. Real and tragic events are told by Dr. Poloka and other specialists highlighted in sections called "Spotlight on Experts." Additionally, relationships developed over thirty-plus years with people from all walks of life, civilian as well as public safety and military, are the source of many stories that you will see throughout the book. This book is long overdue.

This text should be used in police academies, military leadership, and mental health training.

--Major General James R. Joseph, Retired, US Army

Mental Health Education and Practical Application is a very interesting and informative discussion of the psychological burdens that law enforcement officers must contend with, and an excellent educational review of how police officials can become better equipped to cope with such hazardous confrontations. This is a book that should be compulsory reading for every law enforcement applicant and active police officer.

--Cyril H. Wecht, MD, JD

• Language: English
• Publisher: Page Publishing, Inc.
• Release date: Aug 21, 2023
• ISBN: 9798886549669

Book preview

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The Frontline Heroes' Crisis Toolbox

Mental Health Education and Practical Application

Dr. Patty Poloka

Copyright © 2023 Dr. Patty Poloka

All rights reserved

First Edition

PAGE PUBLISHING

Conneaut Lake, PA

First originally published by Page Publishing 2023

ISBN 979-8-88654-965-2 (pbk)

ISBN 979-8-88654-966-9 (digital)

Printed in the United States of America

Table of Contents

Dedicated to those who lost their lives at their own hands because of the years of torment they suffered as first responders. Carrying the heavy burden of wearing the badge from the unaddressed trauma of seeing the worst things one person can do to another is not an easy life. Their dedication to serving others shall not be forgotten.

End of Watch

Wayne Wilson, 2004

Kevin Pushic, 2006

Carla Hubbard, 2009

Earl Woodyard, 2015

Foreword

Dr. Cyril Wecht

Introduction

Preface

Chapter 1

Cultural Competence

Implicit and Explicit Bias

LGBTQIA+

Elderly

Mental Health

Religion

Hispanic and Latino Culture

Eastern and Western Culture

Asian Culture

Addiction

Chapter 2

Acronyms and Important Terms

Highlight of Glossary Terms

Crisis Intervention Team (CIT)

Diagnostic and Statistical Manual (DSM)

Sequential Intercept Model (SIM)

Minnesota Multiphasic Personality Inventory (MMPI)

Positive and Negative Symptoms

Chapter 3

Mental Health Disorders

Person-First Language

Phobia

Social Anxiety

Anxiety

Panic Attacks and Panic Disorder

Agoraphobia

Premenstrual Dysphoric Disorder (PMDD) and Menopause

Major Depressive Disorder and Persistent Depressive Disorder

Bipolar and Manic Episodes

Schizophrenia and Delusions

Schizophreniform

Schizophrenia and Multiple Personality Disorders

Chapter 4

Youth and Mental Health Concerns

Youth and Development

Anxiety Disorders in Youth

Conduct Disorder

Pyromania

Kleptomania

Youth Self-Harm and Coping

Chapter 5

Prescription Medication and Illegal Substances

Psychotropic Medication

Medication Adjustments

Drugs and Mental Illness

Chapter 6

Science of the Brain

Autism Spectrum Disorder

Asperger's Syndrome

Nonverbal Autism and Language Devices

Intellectual Limited Capacity

Elderly with Dementia

Wandering

Search and Rescue

Spotlight on Expert

Dr. Kori Novak

Chapter 7

PTSD, TBI, and Mindfulness

Law Enforcement Culture

Hypervigilance

Military Culture

Breathing

Mindfulness

Spotlight on Expert

Dr. Richard King

Substance Abuse

Suicide Is the Ultimate Enemy

Resilience

Training in Repetition

Zero to Sixty

Diagnostic Criteria for PTSD

Risk Factors for PTSD

Traumatic Brain Injury (TBI)

Chapter 8

Polygraph Science and Investigation

Basic History of Detecting Deception

Body Systems

Polygraph Components

Personality Disorders and Polygraph

Chapter 9

Emergency Calls

Domestic Violence Calls

Deadly Domestic Calls

Hoarding and Public Safety

Chapter 10

Diversion from Incarceration

Justice-Related Services (JRS)

Talk Therapy

Day Programs

Diversion Programs

Veteran's Treatment Court (VTC)

Inpatient Hospitalization

Wraparound Services

Chapter 11

Police Culture and Crisis Management

Personality Traits (LEO Benevolence and Justice)

Negative Law Enforcement Encounters

Nurture or Nature

Wellness as a Holistic Approach

Chapter 12

Optimizing Education

Spotlight on Dr. Cyril Wecht by Dr. Poloka

End of Chapter Quiz Answers

Glossary of Terms

References

Biographies of the Experts who Contributed

About the Author

Dedicated to those who lost their lives at their own hands because of the years of torment they suffered as first responders. Carrying the heavy burden of wearing the badge from the unaddressed trauma of seeing the worst things one person can do to another is not an easy life. Their dedication to serving others shall not be forgotten.

End of Watch

Wayne Wilson, 2004

Kevin Pushic, 2006

Carla Hubbard, 2009

Earl Woodyard, 2015

Foreword

Dr. Cyril Wecht

It is most regrettable that our country's sociopolitical problems have become more and more disturbing in many ways. Law enforcement agencies, especially at local governmental levels, have not significantly improved their training of officers who must deal with these problems daily. Paradoxically, cases like Rodney King, George Floyd, and Breonna Taylor have led broad groups of citizens and political leaders to call for the defunding of police. While the actions of individual officers in these cases and many others are to be rigorously condemned, the solution to preventing them from recurring does not lie in decreasing expenditures for local, state, and federal law enforcement agencies.

Indeed, the only way to diminish and eventually eliminate police misconduct that results in unnecessary deaths of nonviolent civilians who do not pose a true danger to third parties and officers is to improve the training of law enforcement officers. Higher standards of education for applicants, in-depth psychological testing (introductory and repetitive), expanded training, and on-site meetings with various citizen groups (e.g., church groups, local clubs, community leaders, etc.) should be implemented. Lectures by psychiatrists, psychologists, and other mental health experts should be an integral component of the training programs for all law enforcement officers. Individuals suffering from various kinds of mental illness, people under the influence of alcohol and other drugs, noncriminal citizens suffering from extreme emotional distress or physical injuries pose serious threats to themselves and anyone else who encounters them.

How is it possible for law enforcement officers, who have had no medical training and who have not been instructed on how to deal with potentially dangerous individuals, to properly handle such potentially explosive situations? Dr. Patty Poloka, who has a wealth of experience superimposed on her outstanding academic career, has done a masterful job in identifying and analyzing these societal dilemmas. Dr. Poloka has acquired a vast amount of knowledge in dealing with these kinds of situations as a US military officer and police official.

Mental Health Education and Practical Application is a very interesting and informative discussion of the psychological burdens that law enforcement officers must contend with an excellent educational review of how police officials can become better equipped to cope with such hazardous confrontations. This is a book that should be compulsory reading for every law enforcement applicant and active police officer.

Cyril H. Wecht, MD, JD

Forensic Pathologist and Medicolegal Consultant

Past President, American Academy Forensic Sciences

Past President, American College of Legal Medicine

Introduction

It is important to know where the experts, particularly in social science, draw their perspectives. Traditional scientists have data from experiments to provide validity. Social sciences such as psychology, sociology, and even criminology have a great deal to do with context. Various factors such as opportunity, the presence or absence of emotional intelligence, and cultural norms for the society or group being considered in a situation apply. Socioeconomic status should not be a determining factor about whether someone has enough emotional intelligence to handle a situation in a manner society considers normal. However, the presence or absence of opportunity and access is something to consider.

Readers of this book should know the author's background. It is my perspective from training, education, and experiences reflected in the chapters to follow. I grew up lower-middle class with my widower father, a blood brother, and an adopted brother. Dad was an alcoholic with undiagnosed bipolar disorder, was a hoarder, and had agoraphobia in later life. My father, when he drank, was a very scary man who enjoyed fist fighting and had a heavy hand with his girlfriends and us children.

I vaguely remember my father in a police uniform. During most of my childhood, he was on disability and then retired from an on-duty injury in the early 1980s. I do not remember my mother who died of cancer when I was three years old. My brothers and I were left alone around the age of seven, ten, and eleven. Girlfriends my dad brought home physically abused us to include burning our fingers over the open flame of our stove, stealing our candy bar fundraiser money for drugs, and finding humor in getting us drunk. Prior to being left home without adult supervision, we were dressed in our pajamas and put to sleep in the family van parked next to the bar while my dad drank. Most of the time, my dad was known as the crazy cop but was trusted by our friends' parents and feared by those he drank with. It was often said, He's a great guy, but you don't want to be on his bad side. As children, we witnessed our father's fist fights several times, which was always frightening.

My father was absent for most of our school events and many sporting events. When my father was home to cook, he made enough food to last for the week. He made stews, sloppy joes, ham barbecue, or other food that we could reheat all week or until it was gone. Much of the time, we survived on toast, cereal, and pizza. We often gathered up loose change, or my older (adopted) brother stole money from my father's pants pocket when he was passed out, so we could get a sixteen-cut pizza for $4.00 (in the 1980s). I had my first examples of stealing for survival, and justifying it, at a young age. Ironically, lying and stealing were the two biggest infractions for which we would receive punishment, yet that was what we needed to do to survive. Two of us children became police officers, and one became a criminal. Despite an anxiety-filled childhood, I remember loving my father very much. He may have done the best he was able to on his own. He had demons and was unfamiliar with how to raise a girl, so he raised me like a boy.

I remember weeks of my father sobbing as he sat on the couch and thought about my mother who died in 1977. Dad referred to her as Little Red because of her long red hair and never got over her death. He wore his wedding ring until he died in 2006. Sadness would be followed by weeks of manic behavior with house parties that lasted days or even a week in the summer. Adults in all stages of undress and intoxication frolicked about with three children in the house as if there were no children present or as if there was nothing wrong with what was happening. In retrospect, perhaps for the 1970s, that lifestyle was not so outrageous, but rather uncharacteristic for our middle-class neighborhood.

The only memory of my mother is from the funeral home as she lay in the casket in her nursing uniform. The family was proud; she was a registered nurse (RN). No one spoke of her illness (cancer) or anything negative such as her having had several miscarriages. After the funeral, my brothers and I were split up for an undetermined amount of time to give my father a break. He eventually collected us because he said he could not stand being alone. That is when we started spending nights in the back of the family van outside of the bar and eventually left at home to fend for ourselves.

My father became a hoarder by the mid-late 1980s. Hoarding is often a result of someone literally filling up the physical space around them to fill the void and feeling of loneliness in their lives. Additionally, my father grew up poor and did the best he could to live in a better to have and not need than to need and not have manner. He once told me he wanted to have one of everything in case anyone ever needed anything. He meant anyone. He bought, in bulk, things we could never need more than one or two of such as a gross (144 count) of pocketknives. It is unclear if my father was a hoarder before my mother died or as a means of coping with her death.

There were many rough patches between my father and me, but he was soft-hearted and kind when he was not drinking. We exchanged I love you at the end of every phone conversation, but when he was angry or drunk, it was If you don't like my rules, when you turn eighteen, you can get the —— out! A few weeks prior to my eighteenth birthday, I moved in with my boyfriend during the spring of my senior year of high school. He became my first husband at the age of twenty-one and ex-husband at the age of twenty-two. With a divorce pending, I left for Army basic training, and my dad wrote to me almost every day. Advancing several years, he was a great Pap Pap to my daughter. When I took the test for the Pittsburgh Police, he was not happy. He expressed concern for my safety since he became disabled on the job. We were very close for the remainder of his life. He died at the age of sixty-one, which falls short of the average life expectancy of sixty-six for a police officer. He did not plan for retirement because he said he never thought he would live that long.

I survived as an adult on my own from the age of seventeen, had several marriages, evolved, and advanced in the military with the help of a few great mentors. I could have been swallowed up by the streets of the north side of Pittsburgh as many from my neighborhood have been. Of my two brothers, one is a cop, and the other is a criminal. That is how it goes with a cop's kids, and two out of three ain't bad, as my dad would say. A mature medical officer in my National Guard unit, Lt. Remmie, saw potential in me but that I was starting to spiral downward after my second divorce. He filled out an application on my behalf for Officer Candidate School. Over these past eighteen to twenty years since then, I have been successful in my education, military, and law enforcement journeys. I raised a successful Air Force technical sergeant/civilian respiratory therapist daughter and now have two great young men doing well in private high school and sports.

The decision to unveil many traumas in my childhood and throughout my adult life did not come without years of consideration. In the