Traumatic Brain Injury Discussion 5

Explain the diagnostic criteria for Major Neurocognitive Disorder Due to Traumatic Brain Injury.

Explain the evidenced-based psychotherapy and psychopharmacologic treatment for Major Neurocognitive Disorder Due to Traumatic Brain Injury.

Identify the risks of different types of therapy and explain how the benefits of the therapy that might be achieved might outweigh the risks. Support your rationale with references to the Learning Resources or other academic resource.

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The following story is a fictional account of planning and preparation leading up to the mythical Democratic-Republican National Convention (DRNC) event in Miami, Florida. The story is loosely based on an amalgamation of real life occurrences in the lead up to the Free Trade Area of the Americas conference in Miami, Florida in 2003. The names of all the characters in the story are fictional.

As you read the story, keep in mind what contemporary criminal justice issues are likely to arise. At the end of the story, you will be asked to respond to several questions related to this scenario.

Miami-Dade Police has been designated as the lead local agency and lead operational planner for the event security. This policy differs significantly from the 2003 FTAA in which the City of Miami was designated as the lead local agency. Director Melanie Duncan is the head of the Miami-Dade Police Department. In turn, Director Duncan has designated Major Louis Warren as the Incident Commander and lead planner for the Department’s DRNC mobilization.

Since this event meets the criteria of a National Special Security Event (NSSE), the U.S. Secret Service has been designated as the lead coordinating agency with overarching statutory authority for the planning and execution of the event. Supervisory Special Agent Samantha Salerno has been appointed as the lead agent in-charge for the event.

Case Study – Innovation and Stagnation at the Miami-Dade Police Department

The police departments of the City of Miami and of Miami-Dade County have had their share of experience with civil disturbances over the last 40 years. There were the race riots in 1968 (Liberty City Riot), 1980 (McDuffie Riot), 1982 (Luis Alvarez Riots), and 1989 (Lozano Riots) in the Liberty City and Overtown areas. Then there was the Elian Gonzalez civil disturbance in April 2000.

In each of these incidents, segments of local minority communities (either African-American or Cuban) rioted as the result of some perceived injustice against their ethnic groups. The riots resulted from either police shooting young black men, or from the federal government deporting a young Cuban boy back to his home in Cuba.

One incident of civil unrest – the 1980 “McDuffie Riots” was particularly destructive. Three days of rioting in Liberty City, Overtown, Brownsville, and Coconut Grove, resulted in 18 deaths and over 180 serious injuries. The damage caused by the rioting was estimated at $100 million and was thought to have caused the permanent loss of over 3,000 jobs in the black communities of Miami. Morale among the rank and file of both major police departments in the County were at an all-time low. Traumatic Brain Injury Discussion 5

The McDuffie incident is also significant, in that it led to the innovation of the modern Mobile Field Force (MFF) model for police response to civil unrest. The “Miami-Dade” model, as it is commonly referred to, was actually a co-invention by officers from the City of Miami Police Department (MPD) and the Dade County Public Safety Department (now called the Miami-Dade Police Department – MDPD).

In effect, both police departments had sustained considerable injury and damage, both physically and to their reputations as a result of these civil disturbances. Much of the damage resulted from lack of aggressive response from the officers who had been shell-shocked from the community’s reaction to the killing of Arthur McDuffie, and the resulting not-guilty verdict of the involved officers.

Ironically, it was during the difficult times of the post-McDuffie period that many innovations, such as the Mobile Field Force concept were born. It did not take long before the MFF concept was put to a test with the 1982 “Luis Alvarez/Overtown” riots and again in 1989 with the “Lozano” riots. In both cases, the field forces worked marvelously, as both civil disturbances were quickly quelled.

By the time that the Mobile Field Forces were used to quell the Elian Gonzalez disturbances in 2000, the MDP and MDPD had become renowned for their innovative crowd control practices. The subsequent innovation of Special Event Response Teams (SERT) as an intermediary response to peaceful or marginally disobedient crowds further added to the MDPD’s expert standing among national and global police departments.

In 2001, the MDPD hosted a week-long Disorder Management Symposium that was attended by commanders and supervisors from departments throughout the United States, as well as a few from other nations. The MFF concept (and later the SERT model) has been adopted by police departments across the nation as the best way to deal with large and unruly crowds.

The Free Trade Area of the Americas Conference (FTAA)

The FTAA agreement between the United States and the majority of Latin American and Caribbean nations had come about as the result of global economic meetings between the heads of state of those countries during the Summit of the Americas Conference in Miami-Dade in 1984. Like the NAFTA agreement before it, the FTAA has drawn a considerable amount of opposition from the anti- globalization “fair trade” crowd.

The violent protests against global economic structures and free trade agreements first came about in 1999, during the World Trade Organization (WTO) conference in Seattle, Washington. These riots caught the authorities by surprise and signaled a shift in the paradigm of police civil disorder management. After Seattle, there were several other violent protests by an informal anti-globalization

alliance of unionists, communists, and anarchists. These included riots in Montreal, Canada; Genoa, Italy; Cancun, Mexico; and Washington D.C. Not only were the WTO conferences being targeted, but other worldwide economic forums such as the G-8 Conference and the World Economic Forum (WEF) were also being singled out by the radical groups.

The secretariat of the FTAA decided to bring the conference to Miami, Florida in November of 2003. High-level delegations from all the participating nations of the Western Hemisphere would be converging in Miami for the one-week conference. Being aware that the conference would attract the same type of violent protestors seen at Seattle, Montreal, Genoa, and Washington D.C., both the MPD and the MDPD commenced preparations for the likelihood of very large crowds and violent protests.

Early, preliminary planning at the MDPD started as soon as the department became aware of the conference. Many of the strategic and tactical concepts that were developed for the FTAA had already been conceptualized by a select number of mid-level managers (lieutenants) who had been aware of the problems in Seattle, Genoa, and Montreal for several years. It had become obvious, that the Mobile Field Force concept that had been born in Miami-Dade would no longer work against this new type of radicalized adversaries. So when the chiefs and directors of the two police departments ordered their planners to get ready for the FTAA conference, the lieutenants who were assigned the task already had a concept in mind.

It was clear to these lieutenants that there had been a major paradigm shift in civil unrest since the time of the race riots of the 1980s. The mobile field force concept that the Miami-Dade Police had innovated in the 80s and perfected in the 90s would no longer work against this new type of opponent. The new paradigm demanded that changes be made to the tactics and weapons used by the field forces. Unfortunately, as with all change, there would be many institutional barriers to the changes that the lieutenants were contemplating.

Simply stated, the new MDPD strategic direction conceived by the small cadre of lieutenants in response to the Anarchist/anti-globalization protestors expected for the FTAA was this:

· Emphasis on the offensive rather than reliance on defense alone (i.e., do not be passive)

· Inside and outside deployment (i.e., do not put all your forces behind a fence)

· Emphasis on unit mobility, rather than the static, linear tactics of the past

· Intelligence driven (know your opponent’s every move ahead of time)

· Proactive enforcement (i.e., strike early and strike hard – don’t wait until things get out of hand)

· Matching up with the adversary: “The right tool for the right job” (There were many different types of protestors, and protest behaviors, therefore different types of units were created to match up against each type)

· Emphasis on strict unit discipline (to prevent being goaded into a disadvantageous skirmish)

It would take a considerable amount of persuasion by the cadre of mid-level lieutenants before the upper command staff would “buy into” these new concepts. Ironically, the first (and unanticipated) Traumatic Brain Injury Discussion 5

barrier that the lieutenants encountered was resistance from the members of the Mobile Field Force Training Committee. This committee had been established in the mid-80s and was comprised mostly of sergeants, and a few lieutenants… many of whom had played roles in the early innovation of the original concept field force concept. These sergeants and lieutenants were once on the cutting edge of innovation, but for the past 20 years, very few new ideas had come to fruition. There had been a few suggestions to incorporate the use of Pepperball and other less lethal munitions into the field force tactics, but more often than not, the committee’s recommendations fell on deaf ears as the ideas were floated up the chain of command.

By 2003, the Mobile Field Force Training Committee had become a shell of its former self. It stopped innovating and had become a barrier to other peoples’ innovative ideas. That year, a sergeant from the Training Bureau made a presentation to the full committee on the incorporation of bicycle patrol officers into the field forces. Some of the lieutenants at that meeting loved the idea, but the old sergeants who had been in the committee for many years thought the idea of using bicycles was foolish. They didn’t see how bicycle patrol officers could function in the old “stomp and grind” tactics that field force was noted for.

The Mobile Field Force Training Committee had once been the cutting edge of innovation for the Miami- Dade Police Department. Now its members had become cynical and desensitized, in part because of the many rejections of its ideas over the years. The committee had become an old man’s debate society where nothing of much value ever came out. Worse yet, as the Training Bureau sergeant that proposed the bicycle idea came to find out, the committee had become a place where new ideas would come to die.

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