|Individuals suffering from psychiatric or substance use disorders sometimes display any one of a number of frightening behaviors: verbal outbursts, physical threats and even violence. Although call-takers at an Emergency Dispatch Center are under no immediate physical threat, they are often the focus of intense verbal violence. In this comprehensive guidebook, Ellis Amdur, with the assistance of consultants whose cumulative experience in emergency call-taking and emergency dispatch totals over one hundred and twenty years, walks professionals working in Emergency Dispatch Centers through a multitude of steps they can assist in keeping first responders, callers and other members of the public safe, while functioning at the highest level of professionalism.
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Amdur’s approach is based on behavior rather than diagnosis. The first section of this book discusses general principals required to prepare an emergency dispatch center for calls from emotionally disturbed individuals, as well as threat assessment: how to acquire essential information necessary to prepare first responders for any potential risk at the scene.
In the second major section of the book, he focuses on us: what we can do to achieve a state of integrity and powerful calm. Rather than abstract pronouncements, he offers specific strategies, including a method of breathing for the purpose of maintaining a one’s own center in crisis situations.
He then moves on to the heart of the book, discussing specific behaviors ranging from confusion and obsessive concerns to psychosis, mania and acute disorganization. In one very important section, he discusses interactions with anti-social and psychopathic individuals, people who present a danger to the psychological and physical well-being of anyone with whom they come in contact.
He moves on to suicidal callers, and then how to de-escalate aggressive and chaotic callers once a crisis begins. Given the ever-present concern for “suicide-by-cop,” these two subjects are inextricably intertwined. Amdur elucidates the various motivations that drive aggression and further delineates the different types of aggression that result. De-escalation tactics are specific– one learns how to immediately recognize what mode of aggression the person is displaying, and then, one can quickly and effectively implement the de-escalation tactics that are best suited to deal with the aggression one is facing.
The final sections of the book offer a macroscopic view: how to establish and maintain a culture of safety both within your agency and your personal life. The likelihood that one will have to use de-escalation skills or other self-protective strategies is far diminished when such a culture of safety is in place. Finally, in an essential appendix, he presents a protocol, specific to 9-1-1, on excited delirium (authored by Lieutenant Michael Paulus, ret.)