October 22

Desperate for Change – Crisis Response Training

Now that we know people with mental illness are 16 times more likely to be killed by police, you may be asking yourself, what can we do to fix it? The biggest and most common response to mental health crises today is a model created in Memphis called the Crisis Intervention Team (CIT). The CIT’s main purpose is to improve the safety of police encounters involving mental illness. CIT is a model that involves multiple steps for law enforcement to take, including a 40-hour training for police officers, breaking the stigma around mental illness that are commonly held in the criminal justice system. This model focuses highly on collaboration across all agencies, meaning that officers must communicate with the emergency department and any other mental health responders so the Crisis Intervention Team can be activated. Lastly, when the opportunity arises, police officers are allowed to go meet with families who do have mental health issues, instead of only coming across them during emergency situations. This process is important in order to help police officers who don’t have much knowledge of mental illness become more understanding and hopefully accepting of individuals affected by these challenges. 

Currently, there are around 3,000 Crisis Intervention Teams across the country, and many more departments are forming. According to the International Journal of Law and Psychiatry, in order to adopt this model, departments have to make marked changes to their

A tweet from just a few days ago where officers in Wisconsin are being trained in crisis response.

processes. However, these changes hold profound effects once the Crisis Intervention Teams are active. Memphis has already reported a decrease in the number of arrests and increased diversion to mental health services. A study done by the Akron Police Department found that officers with CIT training are more likely to identify mental illness during events, and respond by bringing the patient to mental health services, over officers without CIT training. Another study, this one by the International Journal of Law and Psychiatry, concluded that many of the decisions officers make during an incident change the outcome of how a mental health crisis is handled. Firstly, this study found that the way the call is dispatched can change the whole outcome of how it is handled. Another factor has to do with police perception of mental illness. Lastly, the assessment areas that are used in CIT training (substance abuse, adherence to medication, signs, and symptoms of mental or physical illness, and violence towards self or others) drastically change what type of services a mental health patient receives in a crisis. 

The CIT model does not work for everyone; therefore, alternative forms of mental health crisis prevention must continue to be studied. One particularly promising model, relatively new to the United States, originated in Australia. The Mental Health First Aid for Public Safety (MHFA-PS) model involves improving officers’ interactions with people struggling with mental illness, specifically, including more de-escalation techniques, skills to safely address mental health cases, and reducing the stigma of mental illness. The findings of this model have shown that there is increased confidence in the way officers respond to a person with mental illness as well as changed beliefs about mental health crisis response. When these typical models don’t work, there is still an even simpler option that departments can implement in order to help their crisis intervention. This method involves a 16-week training, where they get over 13 hours of instruction on mental illness. They also receive scenario training where they practice scenarios of mental health cases for four hours. At the very minimum, training is imperative.

Public voice is an important element to increasing care and concern in the methodologies our police force relies on to deal with individuals with mental health issues. Please take advantage of any opportunities to interact with law enforcement and urge them to train and talk about how to deal with mental health incidents in compassionate ways. In addition, I encourage you to share which mental health crisis training you like best to implement across the country. Click on any of the links or watch the video below to learn more about the CIT model.

 

 

References 

Ellis, H. A. (2011). The Crisis Intervention Team—A Revolutionary Tool for Law Enforcement: The Psychiatric-Mental Health Nursing Perspective. Journal of Psychosocial Nursing and Mental Health Services, 49(11), 37–43. https://doi.org/10.3928/02793695-20111004-01

 

Ritter, C., Teller, J. L. ., Marcussen, K., Munetz, M. R., & Teasdale, B. (2011). Crisis intervention team officer dispatch, assessment, and disposition: Interactions with individuals with severe mental illness. International Journal of Law and Psychiatry, 34(1), 30–38. https://doi.org/10.1016/j.ijlp.2010.11.005

 

Watson, A. C., Compton, M. T., & Draine, J. N. (2017). The crisis intervention team (CIT) model: An evidence‐based policing practice? Behavioral Sciences & the Law, 35(5-6), 431–441. https://doi.org/10.1002/bsl.2304

 

Watson, A. C., Ottati, V. C., Draine, J., & Morabito, M. (2011). CIT in context: The impact of mental health resource availability and district saturation on call dispositions. International Journal of Law and Psychiatry, 34(4), 287–294. https://doi.org/10.1016/j.ijlp.2011.07.008

Wise, M., Christiansen, L. & Stewart, C. Examining the Effectiveness of Mental Health Education on Law Enforcement: Knowledge and Attitudes. J Police Crim Psych 36, 49–55 (2021). https://doi.org/10.1007/s11896-019-09319-4