1. revised: August 20121 “Why don’t you just take your meds?” CIT Officer Wendi Shackelford Anchorage (Alaska) Police Department

2. revised: August 20122 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

3. revised: August 20123 MEDI-SET INTRODUCTION Day 1

4. revised: August 20124  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

5. revised: August 20125 MEDI-SET PREPARATION

6. revised: August 20126 1. READING YOUR PRESCRIPTIONS

7. revised: August 20127 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”

8. revised: August 20128 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

9. revised: August 20129 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

10. revised: August 201210 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?

11. revised: August 201211 COMMON SUBSTANCES TO SELF MEDICATE  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

12. revised: August 201212  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

13. revised: August 201213  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 REMINDERS

14. revised: August 201214 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

15. revised: August 201215 INCREASING MEDICATION COMPLIANCE

16. revised: August 201216 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

17. revised: August 201217 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

18. revised: August 201218 MEDI-SET DEBRIEFING Day 5

19. revised: August 201219 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?

20. revised: August 201220  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

21. revised: August 201221 PRACTICAL APPLICATION driving the point home

22. revised: August 201222 18 minutes

23. revised: August 201223 THE MEDICATION CHALLENGE

24. revised: August 201224 I am looking for 48 people willing to “medicate” for the remainder of the CIT International conference

25. revised: August 201225 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 IF YOU ARE WILLING…

26. revised: August 201226 THANK YOU!!!

27. revised: August 201227 CONTACT INFORMATION  Officer Wendi Shackelford Voice mail: 907-786-2692 Email: wshackelford@muni.org