Law enforcement first responders and negotiators must understand individuals diagnosed with paranoid schizophrenia by learning the characteristics they may exhibit. These individuals will have two or more of the following characteristic symptoms, each of which exists for a significant portion of time during a 1-month period (or less if successfully treated): delusions; hallucinations; disorganized speech; grossly disorganized or catatonic behavior; and negative symptoms (no emotion). The article reviews violence risk among people with schizophrenia, case examples, crisis management strategies (verbal and nonverbal), physical tactics/alternative strategy considerations and incident assessment. The article includes negotiator/first responder guidelines. Notes