Crisis Intervention Team Model Research Articles

Examining Factors Related to Departmental Adoption of Crisis Intervention Team (CIT) Models: A Survey of Police Chiefs.

In an effort to improve police responses for handling incidents involving people with mental illness (PWMI), many police departments have adopted the Crisis Intervention Team (CIT) model. However, to date, there has been very little published research that has focused on examining factors related to the adoption of CIT models through the lens of police chiefs. To help fill this gap in the literature, the current study used data collected from a sample of 204 police chiefs in the Commonwealth of Pennsylvania to examine variables related to departmental adoption of the CIT model. Findings show that several factors (e.g., chief training, chief educational attainment, and departmental resources) were associated with departmental adoption of the CIT model. Policy implications and suggestions for future studies based on these findings are discussed within.

Cops, Clinicians, or Both? Collaborative Approaches to Responding to Behavioral Health Emergencies.

How a community responds to behavioral health emergencies is both a public health issue and social justice issue. Individuals experiencing a behavioral health crisis often receive inadequate care in emergency departments (EDs), boarding for hours or days while waiting for treatment. Such crises also account for a quarter of police shootings and >2 million jail bookings per year. Racism and implicit bias magnify these problems for people of color. Growing support for reform provides an unprecedented opportunity for meaningful change, but solutions to this complex issue will require comprehensive systemic approaches. As communities grapple with behavioral health emergencies, the question is not just whether law enforcement should respond to behavioral health emergencies but how to reduce unnecessary law enforcement contact and, if law enforcement is responding, when, how, and with what support. This policy article reviews best practices for law enforcement crisis responses, outlines the components of a comprehensive continuum-of-crisis care model that provides alternatives to law enforcement involvement and ED use, and offers strategies for collaboration and alignment between law enforcement and clinicians toward common goals. Finally, policy considerations regarding stakeholder engagement, financing, data management, legal statutes, and health equity are presented to assist communities interested in taking steps to build these needed solutions.

The Use of the Crisis Intervention Team (CIT) Model for Corrections Officers: Reducing Incidents within a County Jail

This study presents an adaptation of the Crisis Intervention Team Model (CIT) to a jail setting. Pre-post surveys and interviews assessed changes in corrections officers’ (CO) knowledge of and attitudes toward mental health. Cell Removal Team (CRT) services assessed the impact of CIT on the use of this specialized unit. Results indicate positive changes in CO attitudes, increased de-escalation skills, and an abrupt decrease in the level of CRT usage, with results sustained in the 8-month follow-up period.

What Research on Crisis Intervention Teams Tells Us and What We Need to Ask.

Developed over 30 years ago, the Crisis Intervention Team model is arguably the most well-known approach to improve police response to individuals experiencing mental health crisis. In this article, we comment on Rogers and colleagues' review (in this issue) of the CIT research base and elaborate on the current state of the evidence. We argue that CIT can be considered evidence based for officer level outcomes and call level dispositions. We then discuss the challenges that currently make it difficult to draw conclusions related to arrest, use of force, and injury related outcomes. More research, including a randomized, controlled trial is clearly needed. But we caution against focusing narrowly on the training component of the model, as CIT is more than training. We encourage research that explores and tests the potential of CIT partnerships to develop effective strategies that improve the mental health system's ability to provide crisis response and thus reduce reliance on law enforcement to address this need.

Police Crisis Intervention Teams: Understanding Implementation Variations and Officer-Level Impacts

Many police agencies utilize the Crisis Intervention Team (CIT) approach to facilitate effective responses when officers are called to address persons experiencing a mental health crisis. CIT training is predicated on verbal de-escalation tactics and includes situational assessment procedures, understanding the role and elements of the mental health system, and connections to mental health resources. The CIT approach, often called the Memphis Model, is generally recognized as beneficial for the community, persons with mental health issues, and the agency. The officer-level impacts of assignment to a CIT position have not been thoroughly explored. Additionally, differences in implementation of the original CIT model, resulting from community variations, have not been studied. The extant research employs several data collection modalities: surveys of CIT coordinators, interviews with leading CIT researchers, and interviews/focus groups with law enforcement personnel, to expand understanding of CIT efficacy, variations, and impact. Findings point to agency policy issues regarding the use and possible expansion of CIT teams.

The crisis intervention team (CIT) model: An evidence-based policing practice?

As academic researchers, we are often asked to opine on whether the Crisis Intervention Team model (CIT) is an evidence-based practice (EBP) or evidence-based policing. Our answer is that it depends on how you define evidence-based practice and what outcome you are interested in. In this commentary, we briefly describe the CIT model, examine definitions of evidence-based practice and evidence-based policing, and then summarize the existing research on what is known about the effectiveness of CIT to date. We conclude that CIT can be designated an EBP for officer-level cognitive and attitudinal outcomes, but more research is needed to determine if CIT can be designated an EBP for other outcomes. Using an evidence-based practice process approach, CIT may also be a justified strategy for many communities. Future directions to inform the field are discussed.

The nature and extent of police use of force in encounters with people with behavioral health disorders

Previous research studies have examined the treatment of people with mental illnesses by the police. Much available data support the adoption of the Crisis Intervention Team (CIT) model. A key issue in CIT development has been reduction in the use of force by CIT officers, and it is suggested that such adoption does accomplish such reduction. However, to date, scant research compares variation in police use of force by CIT officers across populations with mental illnesses, co-occurring disorders, and substance abuse disorders, as compared to their non-disordered peers. Using data from the Portland Police Bureau, a police agency in which all patrol officers have been trained in the CIT model, we analyze whether police use-of-force differs across these groups. Police use-of-force data were collected for 4211 incidents from the Portland Police Bureau from 2008 to 2011. Results indicate that people perceived as having comorbid behavioral health disorders were generally more likely to have force used against them, and more likely to be perceived as resistant, than people that were perceived as having only substance use disorder, only mental health disorders, or no apparent behavioral health disorders. People with co-occurring disorders are more likely to be perceived as violently resisting police officers and have force used against them. Further, people with no perceived disorders are more likely to have a firearm pointed at them in use-of-force encounters, but also the least likely to be perceived as resisting.

Crisis Intervention Teams: An Evolution of Leadership in Community and Policing

The primary intent of this article is to trace the historical context of Crisis Intervention Team (CIT) training and present the various elements of the Memphis CIT model as highlighted throughout the literature. We begin by operationalizing how the literature defines CIT training and the various elements that comprise its foundation. Next, we provide a review of extant literature with focus on evidence that support the impact of CIT across various police agencies in the USA. Then we demonstrate how research is translated into practice by introducing the case of Jefferson Parish Sheriff's Academy and its use and development of CIT training for law enforcement in the state of Louisiana, USA. A brief summary and conclusion are offered. Language: en

The Crisis Intervention Team (CIT) Model for Law Enforcement: Creative Considerations for Enhancing University Campus Police Response to Mental Health Crisis

Abstract Purpose of the article American university and college campus law enforcement, like their peers in American munipal law enforcement agencies, find themselves interacting frequently with civilians experiencing mental health disturbances. An innovative model for law enforcement, the Crisis Intervention Team (CIT) model, has been developed to address the difficulties law enforcement professionals and civilians in mental health crisis face during encounters. (Margolis & Shtull, 2012) This article explores how CIT can enhance police response to mental health crisis on the college campus. Methodology/methods Methods of applied research were conducted, borrowing from a benchmarking model and including interviews with multiple key informants representing law enforcement and mental health. Informants were affiliated with three universities and multiple municipal jurisdictions in Virginia, USA. Scientific goal The goal was to assess the relevance of CIT on the college campus and explore creative approaches to enhancing campus police response to mental health crisis. Findings The results supported the scholarly literature regarding the efficacy of the CIT model. Creative adaptations to the CIT model for campus possibly can be implemented to address concerns of mental health crisis on campus. Conclusions CIT is a highly innovative model requiring extensive collaboration between law enforcement, mental health agencies, and mental health advocates. As standard qualitative research was not conducted, the sample size of key informants may not have reached saturation. However, findings from the interviews support the body of literature on CIT. The implementation of CIT on the college campus could possibly help to alleviate difficulties on campus arising from mental health crisis, including reducing inappropriate arrest or disciplinary action, improving campus safety, addressing concerns related to threat assessment and management, and enhancing collaborative efforts on campus and with resources in the broader community.

The police-based crisis intervention team (CIT) model: I. Effects on officers' knowledge, attitudes, and skills.

Individuals with serious mental illnesses are very likely to interact with police officers. The crisis intervention team (CIT) model is being widely implemented by police departments across the United States to improve officers' responses. However, little research exists on officer-level outcomes. The authors compared officers with or without CIT training on six key constructs related to the CIT model: knowledge about mental illnesses, attitudes about serious mental illnesses and treatments, self-efficacy for deescalating crisis situations and making referrals to mental health services, stigmatizing attitudes, deescalation skills, and referral decisions. The sample included 586 officers, 251 of whom had received the 40-hour CIT training (median of 22 months before the study), from six police departments in Georgia. In-depth, in-person assessments of officers' knowledge, attitudes, and skills were administered. Many measures were linked to two vignettes, in written and video formats, depicting typical police encounters with individuals with psychosis or with suicidality. CIT-trained officers had consistently better scores on knowledge, diverse attitudes about mental illnesses and their treatments, self-efficacy for interacting with someone with psychosis or suicidality, social distance stigma, deescalation skills, and referral decisions. Effect sizes for some measures, including deescalation skills and referral decisions pertaining to psychosis, were substantial (d=.71 and .57, respectively, p<.001). CIT training of police officers resulted in sizable and persisting improvements in diverse aspects of knowledge, attitudes, and skills. Research should now address potential outcomes at the system level and for individuals with whom officers interact.

Crisis Intervention Teams Enhance Safety of Police, Patients

The Crisis Intervention Team model is based on a partnership of psychiatric emergency services, local mental health advocates, and police departments, facilitating treatment in lieu of incarceration.

Dealing with individuals who have mental illness: the Crisis Intervention Team (CIT) in law enforcement

Purpose – The current paper seeks to outline the Crisis Intervention Team (CIT) and review extant research regarding its efficacy in reducing criminalization of people with mental illness, as well as improving interactions between this population and law enforcement officers.Design/methodology/approach – The CIT model and theoretical underpinnings are discussed and an evaluative review of the current literature is presented.Findings – Research on the CIT model has generally shown improved officer and community safety; better mental healthcare for those in need; and decreased criminalization of those with mental illness. Methodologies have included the use of records reviews and officer surveys, primarily.Practical implications – Implications in the practice of law enforcement and psychology include decreasing criminalization of those with mental illness; reducing the frequency of police use of force; minimizing injury to consumers and law enforcement officers; and connecting people with mental illness to ...

Critical elements of the crisis intervention team model of jail diversion: An expert survey

The Crisis Intervention Team (CIT) model of jail diversion is a promising approach to addressing the over-involvement of people with mental illness with the criminal justice system. Despite its popularity and promising empirical support, the literature has yet to clarify CIT's critical elements. The aim of this study was to assess the degree to which experts agreement on the importance and perceived implementation of the critical elements of CIT. Study 1 used a literature review to cull potential elements. Three experts familiar with the CIT model reviewed these elements. Study 2 utilized an online survey of 55 CIT co-ordinators/officers and published experts to assess agreement regarding importance and degree the element is implemented. A preliminary list of 36 elements was identified with a high level of expert agreement on their importance regarding importance and implementation. This study developed a preliminary list of elements of the CIT's program. Further research should develop consensus, explore elements' association with outcomes, and differentiate elements from those common to all jail diversion programs.

Outcomes of Police Contacts with Persons with Mental Illness: The impact of CIT

The Crisis intervention team model (CIT) is possibly the most well known and widely adopted model to improve police response to persons with mental illness. A primary goal of CIT programs is to divert individuals with mental illness from the criminal justice system to mental health services. In this paper we examine the effectiveness of fielding CIT trained and supported officers for influencing call outcomes using data from patrol officers (n = 112) in four Chicago Police districts. Results from regression analysis indicate that CIT certified officers directed a greater proportion of persons with mental illness to mental health services than their Non-CIT certified peers. CIT did not have an immediate effect on arrest. Moderator analysis indicates that CIT had its biggest effect on increasing direction to services and decreasing "contact only" among officers who have a positive view of mental health services and who know a person with mental illness in their personal life. Additional moderators of the CIT effect on call outcomes include level of resistance and the presence of a weapon. Findings from this study have important implications for policy, practice and future research.

Crisis Intervention Team Training and Special Weapons and Tactics Callouts in an Urban Police Department

This study tested a hypothesized inverse correlation between the number of crisis intervention team (CIT) officers and the number of Special Weapons and Tactics (SWAT) callouts in an urban police department. Data for the number of accrued CIT-trained officers were combined with administrative data on the number of SWAT callouts during 27 four-month intervals. There were no significant correlations for the relationships examined, and implementation of CIT training was not associated with a decrease in SWAT callouts. Although the CIT model may yield important benefits in other domains, this study found no evidence of declining SWAT utilization as the number of CIT-trained officers accrued. The absence of association is likely due to the relatively low prevalence of SWAT use and the very different nature of CIT versus SWAT responses.

Application of a Model for the Development of a Mental Health Service Delivery Collaboration Between Police and the Health Service

Changing societal trends have revealed an increased prevalence of mental illness and diminished health resources from which to offer services. This has lead to a need to develop new and more efficient police and health service models of practice. Services offered by the police department in the management of mental health crisis in the community are essential in minimising the risk of individuals with mental health problems causing harm to themselves or a member of the public. In addressing the difficulties associated with police playing an important role in the management of mental health crisis in the community, but having little training in mental health issues, this paper discusses a proposed innovation for New South Wales police in Australia through the development of a Crisis Intervention Team model.

Applying Procedural Justice Theory to Law Enforcement's Response to Persons With Mental Illness

Applying Procedural Justice Theory to Law Enforcement's Response to Persons With Mental Illness

State Mental Health Policy: Statewide Implementation of the Crisis Intervention Team Program: The Ohio Model

State Mental Health Policy: Statewide Implementation of the Crisis Intervention Team Program: The Ohio Model

Frontline Reports

Frontline Reports

Police Use of the Taser With People With Mental Illness in Crisis

Police Use of the Taser With People With Mental Illness in Crisis