The CIT (Crisis Intervention Training) Program is described by CIT International as “an innovative first-responder model of police-based crisis intervention training to help persons with mental disorders and/or addictions access medical treatment rather than place them in the criminal justice system…” It is a community partnership that includes law enforcement, behavioral health professionals, individuals with lived experience with mental illness or addiction disorders, their families, and other community advocates.
The program’s beginnings date back to 1998, when a Memphis police officer fatally shot a man with a history of mental illness and substance abuse. A community task force was initiated at that time comprised of law enforcement, mental health and addiction professionals, and mental health advocates.
The task force collaborated to develop what is now known as the Memphis CIT model. The model’s primary goals consist of increased safety in crisis encounters and, when appropriate, diversion from the criminal justice system to treatment. In September 2007, the Core Elements document was created that established components central to the program’s success.
Since that time, it is estimated that over 2,700 CIT programs have been implemented nationwide. In addition, the program has been adopted internationally in Canada, the United Kingdom, and Australia. As the number of active programs continues to increase, the question is often asked: “Does CIT training actually work?” The following article will examine the answer to that question.
What is CIT Training?
Due to our country’s lack of mental health crisis services, law enforcement officers serve as first responders to behavioral health crises. Most often, however, they are not formally trained to recognize, assess, or treat mental illness. Crisis intervention training (CIT) can link law enforcement, behavioral health professionals, and individuals experiencing a mental health or substance use crisis.
The training can improve communication, provide appropriate behavioral health resources, and ensure officer and community safety.
What exactly is CIT training? Simply put, it is a program that helps people learn how to respond to and support individuals in crisis. CIT training for law enforcement consists of 40 hours of comprehensive study that provides tools and resources to officers to effectively assist people with mental illness and substance use disorders who are in crisis.
The training is designed to increase safety for law enforcement and those in crisis and reduce the stigma often associated with mental illness. It also ensures that individuals with mental health and substance use disorders receive treatment instead of incarceration when possible.
Training typically consists of classroom instruction covering mental health topics, developmental disabilities, and addictive illnesses and site visits to local receiving facilities. In addition, officers are taught de-escalation techniques, active listening, crisis intervention skills, and safe restraint and use of force tactics, often in role-play scenarios. Some programs also include education on medication and side effects.
Why Do We Need Crisis Intervention Training?
Every day, law enforcement officers face dangerous situations, including those associated with behavioral health issues. Yet, for far too long, they were forced to focus on penalizing people’s behaviors in crisis rather than understanding why they were in crisis.
CIT training provides a better way for them to deal with the unique stresses of situations involving individuals with mental health or substance use disorders. In addition, it provides them with greater insight when responding to the scene and allows them to de-escalate the situation quickly.
The need for CIT training is becoming increasingly evident across the nation. Lt. Richard Cavanaugh, a CIT officer with the Montclair, New Jersey police and board member of CIT International: “We think every officer should have training and awareness in mental illness…We look at CIT-trained officers as specialist officers, like you have SWAT officers or bomb technicians.”
Cavanaugh relates a recent example of how valuable the training can be when he was called to a scene where a woman attempted to commit suicide by slashing her wrists and had refused help. He made eye contact with the woman and said: “It looks like you are having a bad day.”
He then says that she allowed him to put gauze on her wrists. They began talking, and Cavanaugh asked her about baseball and her romantic relationship. “We talked about everything,” he says. “It was about building rapport.” He continued to talk with her and apply pressure to the wounds. The woman finally agreed to go to the hospital. Cavanaugh has gotten to know family members of people he has helped and has been able to recommend mental health resources and suggestions for legal issues.
What Are the Benefits of Crisis Intervention Training?
CIT is recognized as a safe practice model by multiple organizations, including NAMI (National Alliance on Mental Illness), Department of Justice, Department of Health and Human Services SAMSHA, American Association of Suicidology, National Association of People of Color Against Suicide, and the John Jay College of Criminal Justice. The program has a history of safe interventions with persons in crisis. In addition, CIT officers have been recognized as having the empathy and skills necessary to resolve behavioral health crises successfully.
It has also proven to be a potent agent for overcoming the stigma and stereotypes often associated with mental illness. For example, a recent survey indicates that CIT-trained officers perceive themselves as less likely to escalate to the use of force during a behavioral health crisis encounter. That has proven to be true in Memphis, where CIT resulted in an 80% reduction in officer injuries during mental health crisis situations.
A study completed by the Council of State Governments (CSG) identifies the following benefits of Crisis Intervention Training have identified the following benefits:
- Increased officer and individual safety
- Increased frequency of jail diversion to treatment
- Reduced time spent by law enforcement on crisis calls
- Reduced use of force by officers
- Improved officer understanding of mental illness
The study examined the policies and practices of law enforcement encounters with people with mental illnesses. The information collected was provided to communities to help them design, implement, or modify crisis intervention programs to best fit their need. Resources created through the research include “The Essential Elements of a Specialized Law Enforcement-Based Program.”
The document outlines ten critical features needed for a successful law enforcement-led response. Other resources include case studies of statewide efforts to improve law enforcement responses to those with mental illnesses and a guide for overcoming common barriers to law enforcement training on mental health responses.
How Do We Determine Whether CIT Training Works?
Now that we have examined CIT training, why we need it, and what benefits it provides, how do we determine whether CIT training works? SAMHSA (Substance Abuse and Mental Health Services Administration) has stated that evaluation and research are fundamental components of an effective CIT program. When vital data is available, programs can be better positioned to show their impact and solidify CIT’s role in a community.
Data collection and analysis are critical to understanding if the program is being implemented as planned and identifying gaps or other issues. In addition, having accurate documentation can assist in determining outcomes and accurately calculating the costs of sustaining the program and future modifications or expansions.
To achieve this, a robust technology solution is a must. Julota’s cloud-based software platform allows each organization to access shared information and create custom reports. It provides the community with better management of the program’s features, such as tracking diversions and identifying frequent utilizers. Because it is a SaaS (software as a service) technology, there will never be a concern about systems breaking down or crashing.
Julota’s dynamic data collection and analysis capabilities can help stakeholders confidently assess the program’s effectiveness in jail diversion, number of repeat encounters, and referrals to care. Stakeholders can easily determine whether a proper transition from crisis contact to care is occurring and whether positive collaboration between agencies is occurring. Accurate data collection through Julota’s platform is an invaluable tool to demonstrate the positive impact that CIT can have on a community.
For example, the San Jose Police Department showed a 32 percent decrease in officer injuries in the year following the CIT program’s implementation. In addition, in Memphis, where the original CIT program began, the Police Department reported that during the first four years of the program’s implementation, the rate of referrals by law enforcement officers to psychiatric emergency services increased by 42 percent. These numbers indeed indicate the positive impact of CIT programs.
Examining the questions posed in this article provides a glimpse into how CIT programs can contribute to greater safety and better long-term results for law enforcement responses to individuals in behavioral health crises. As we review the evidence presented above, we can answer the question: “CIT training: does it actually work” by stating emphatically: “The answer is Yes!”