Question from staff member:  when faced with someone who is inebriated, do you approach them or call a security guard (they have someone part-time) first?  Do you approach them? Tell co-worker first.

If you have to approach them, tell a co-worker first. Never go it alone, there is safety in numbers, litigation might ensue; promotes professionalism, patron/staff less apt to do something that might be challenged in court

Give individual person space so they don’t feel threatened, be point blank with them

Set limits, identify appropriate behavior – many are institutionalized and/or homeless, social skills not great.  Say why their behavior is inappropriate and if this continues, you will not be (whatever your security plan says).  Follow with “do you understand this?”

Give them time to respond.  Important: you need to tell them the choice is theirs, they are in control of situation.  Gives choices and options for behavior.  

If there is a medical issue, call 911.  If combative – follow safety plan.  Don’t make them feel trapped.

Use re-statements – hey what’s going on? I’m here to help – offer resources?  Let’s sit and talk, come up with a plan. Engage them so they’re part of the conversation. If being a nuisance engage in exact manner.  

Remove patrons who were watching; if you try to remove the patron with behavior issues, it might escalate.  If total disruption – call police.

Offer solutions, not commands.  Offer to call their counselor on their behalf, or someone else they may want to talk with.

With staff, take care of each other in crisis, debrief afterwards. We need to process it, see what nerve it’s touched.  Is there an influx of patrons with behavioral issues? Should we revisit our plan/policy?

Not all mental health issues are the same; new drugs can lead to new issues?

Community health centers now pretty much statewide, some offer mental health care professionals in ride-alongs with police, counselors able to certify and enable mental health admissions.  

With the affordable health care act, group homes have to have residents leave 3 hrs./day.  They often choose to go to library. Developmental delayed individuals are different, and your approach would be different.  One library is offering staff training with the Trudeau ctr.  Most of developmental cases go through medical professionals, not mental health counselors.

Take away: set limits!!! Explain why patrons’ behavior is inappropriate; they might not have great social skills.  Give them choices in crisis situations; they have choices, offer rewards for choices, such as “we can talk every day about weather, etc. but not political views”.  Take a step back.  Not every situation is cookie cutter; lots of variables, and sometimes patrons are dually diagnosed with illness and substance abuse.