“Why don’t you just take your meds?”

1. “Why don’t you just take your meds?” CIT Officer Wendi Shackelford Anchorage (Alaska) Police Department revised: August 2012

2. OBJECTIVES • Participants will gain practical application and working knowledge regarding medications which they can use to train their CIT officers • Participants will begin to understand issues regarding medication compliance • Participants will engage in hands-on activity that increases empathy for mentally ill regarding medications revised: August 2012

3. MEDI-SET INTRODUCTIONDay 1 revised: August 2012

4. The best time to introduce the medi-sets exercise is about thirty minutes before lunch on the first day of class • lunch hour to load their medi-sets • GOAL: maintain medication compliance, as directed, for four full days of class revised: August 2012

5. MEDI-SET PREPARATION revised: August 2012

6. 1. READING YOUR PRESCRIPTIONS revised: August 2012

7. EXAMPLE • Seroquel 100 mg, po q iTID i prn for agitation • TRANSLATION: • “Take your Seroquel 100 mg pills by mouth (po) at the rate (q) of one pill (i) three times (TID) a day plus one additional pill (i) as needed (prn) if your symptoms of agitation increase or become intolerable” revised: August 2012

8. 2. MENTAL ILLNESS SELECTION • Allow people to pick their mental illness of choice (from six common diagnoses) • Distribute relevant mental illness sheet to each person • Schizoaffective disorder bi-polar type • Bipolar I disorder MRE manic • Schizophrenia paranoid type • Bipolar II disorder • Major depression • Borderline personality disorder revised: August 2012

9. 3. DISTRIBUTE MEDI-SETS • Medi-sets should have selected prescription information already secured to the bottom • Skittles represent psychotropic and other prescribed medications • Some illnesses may need two packets of Skittles based on the number of medications to be taken and size of the medi-set • Use the Skittles that have mixed up flavors for best impact revised: August 2012

10. 3a. SELF MEDICATION • Jelly Belly candies represent all other substances people might use to manage their symptoms AKA “self-medication” Discussion: • Why do people self-medicate? • What are some of the common substances they might use? revised: August 2012

11. Benadryl Cocaine Nicotine Marijuana Alcohol Inhalants Other people’s prescription meds Morphine Ecstasy Methamphetamine Viagra Steroids Ambien Heroin Dextromethorphan DM Psilocybin mushrooms K2/spice caffeine COMMON SUBSTANCES TO SELF MEDICATE revised: August 2012

12. Allow students time to interpret their prescriptions and then load their medi-sets with prescription medications (Skittles) • Allow students to add self medications to their medi-sets at their discretion (Jelly Bellies) • Provide unlimited access to self medications throughout the entire course and remember to keep them fully stocked revised: August 2012

13. REMINDERS • As the course instructor, provide regular, all day reminders of… • “Remember to take your medications!” • “Are you medicated?” • “Have you taken your meds today?” • You simulate their caseworkers, doctors, care providers, family members, nurses, neighbors, first responders, and anyone else who has a vested interest in their medication compliance revised: August 2012

14. 4. DAY 1 HOMEWORK • Go to www.nami.org Have students read about the following: • Common symptoms of your illness • Common medications used to treat your illness • Common side effects of those medications revised: August 2012

15. INCREASING MEDICATION COMPLIANCE revised: August 2012

16. COMPLIANCE BY REWARDS • On day 2, ask who has been med compliant. Reward with… • Play money • On day 3 or 4, ask who has been consistently med compliant. Consider rewarding with… • Play credit cards • Special trips i.e. to the zoo, shopping mall • Other special rewards • On day 4 or 5, ask who has been consistently med compliant. Consider rewarding with… • Pets • Their own room or apartment revised: August 2012

17. COMPLIANCE BY PUNISHMENT • On day 3, 4, or 5 publicly admonish one or two students for failing to comply and then withhold the reward that is publicly bestowed on others • On day 4 or 5, take a reward from one or two previously compliant students who have not maintained continuous compliance revised: August 2012

18. MEDI-SET DEBRIEFINGDay 5 revised: August 2012

19. DEBRIEFING WITH YOUR STUDENTS • What is the purpose of this exercise? • Why were you rewarded for compliance? • Why were you punished for lack of compliance? • What did you experience as you tried to maintain medication compliance? • How hard was it to take your medication as prescribed? revised: August 2012

20. No money for medications I ran out of medications I substituted them for another pill, substance, or drug I took them to please the instructor, doctor, counselor, etc I don’t know how to take them I forgot them I lost them I swapped them with someone else for theirs I gave them to someone else My kids ate them I didn’t feel like taking them I don’t know how to read the prescription I didn’t take them as prescribed I took them all at once I don’t think I need them Someone stole them Medical issues that are complicated by meds i.e. diabetes I dropped them under the fridge, in the parking lot, on the floor I didn’t like the way they tasted I didn’t like the way they made me feel My dog ate them revised: August 2012

21. PRACTICAL APPLICATIONdriving the point home revised: August 2012

22. revised: August 2012 18 minutes

23. THE MEDICATION CHALLENGE revised: August 2012

24. I am looking for 48 people willing to “medicate” for the remainder of the CIT International conference revised: August 2012

25. IF YOU ARE WILLING… • Pick up the following supplies at the back of the room: • One medi-set with prescription • One package of Skittles • One package of Jelly Bellies • One mental illness sheet that matches your medi-set prescription revised: August 2012

26. THANK YOU!!! revised: August 2012

27. CONTACT INFORMATION • Officer Wendi Shackelford • Voice mail: 907-786-2692 • Email: wshackelford@muni.org revised: August 2012