Behavioural Indicators Guide

Mentally incapacitated persons (MIPs) are a vulnerable group of people who need our care, respect and patience. MIPs commonly encountered by police include those with autism, schizophrenia, dementia or mild mental retardation. Although police officers are not expected to be able to diagnose individual mental health symptoms, it is important that their training enables them to recognize signs and indicators.

With the joint effort of police clinical psychologists, other medical experts and the welfare sector, we have come up with a “Behavioural Indicators Guide” which lists out some of the common characteristics of MIPs categorized into three areas namely personal circumstances, behaviour and conversational characteristics. Though the “Indicators” are neither exhaustive nor conclusive, they serve as a quick reference tool to police officers for early identification of MIPs. The Guide also includes advice on how to better communicate with MIPs.

Personal Circumstances

  • Place of Education (e.g. special school)
  • Employment (e.g. sheltered workshop)
  • Nature of residence (e.g. residential care homes for MIPs)
  • Some intellectually disabled or mentally ill persons may carry registration cards for persons with disabilities or medical appointment cards or hospital bracelets
  • Medication carried by the person


Behavioural

  • Sign of hallucination and delusion (e.g. superman delusion)
  • Socially inappropriate behaviours (e.g. giggling, being aggressive, inappropriate laughter, odd hand gestures)
  • Disorientation (e.g. confused about time, place and identity)
  • Rapid change of mood (e.g. being angry at one moment and becoming excited at another)
  • Poor eye contact (e.g. avoid eye contact or look blank)
  • Age-inappropriate behaviours (e.g. appear too childish, over affectionate, withdrawn)
  • Poor personal hygiene


Conversational

  • Non-responsive
  • Disorganized conversation (e.g. only brief answers, slurring, meaningless content, jumping from topic to topic)
  • Incoherent conversation (e.g. provide answer irrelevant to the question asked)
  • Repeat the last few words of what someone has just said (parrot talk / echolalia)
  • Socially inappropriate tone (e.g. speak in odd tones, make funny sound)



Tips on Effective Communication with a MIP

Things to Consider

  • Conduct the interview as soon as possible
  • Respect the subject as an adult
  • Reduce the stress of the subject
  • Allow the subject to finish his sentence or tasks in hand before communication
  • Get the subject’s attention before talking
  • Use concise sentence, one matter per question
  • Use simple languages
  • Speak slowly
  • Use body language, photos or other aids to facilitate communication
  • Appropriately use open ended questions
  • Clarify their meaning, use their language
  • Allow slow or no response towards instructions or questions
  • Address their physical needs, e.g. eating or drinking / using the toilet

Things to Avoid

  • Treat the subject as a ‘child’
  • Conduct the interview in an environment with distractions
  • Speak in a loud voice
  • Use long and complicated questions
  • Suggest to the subject what you guess in respect of a particular detail of an incident and press the subject to say “yes” or “no” to your suggestion
  • Push for an answer
  • Infer a meaning from the subject’s response