Implementing Crisis Intervention Teams in Small Cities

In many areas in the U.S., police officers serve as first responders to mental health crises, making them “gatekeepers” to the mental health and criminal justice systems. To improve officers’ response to individuals experiencing a mental health crisis, the Crisis Intervention Team program was developed in 1988 in Memphis, Tennessee. Since then, the CIT model of collaboration between law enforcement and mental health professionals has been widely recognized as being “more than just training” for police officers. This was a step in the right direction however implementing crisis intervention teams in small cities has since then been proven difficult.

For example, the CIT model supports community partnerships between law enforcement, mental health providers, advocacy groups, and social services.

Although numerous cities in the country have implemented CIT programs, some system and policy-level obstacles have made successful implementation difficult in smaller jurisdictions. Issues that have proven challenging are obtaining officer buy-in, expanding CIT beyond police personnel, challenges involving decentralized policing, and creating and funding the co-responder model.

 This article will look at each of these challenges of implementing Crisis Intervention teams in small cities.

Obtaining Officer Buy-In to CIT Program

The importance of CIT training for police officers cannot be underestimated. After all, these are the individuals we turn to in times of crisis. In most communities, the goal for CIT-trained officers is 20-25% of the law enforcement agency.

The training is most effective with officers who have volunteered, as they are more amenable to applying the learned tools upon returning to their units. In addition, the CIT training provides them with the ability to evaluate crisis situations properly, using their discretionary powers to divert individuals away from the criminal justice system to the behavioral health system. Studies show that CIT-trained officers are less likely to resort to force in behavioral health crises.

One of the challenges to CIT training is often initial officer resistance to the training. The need to shift the standard police approach from authoritative and forceful to an emphasis on de-escalation, empathy, and a nonjudgmental attitude can seem daunting at first. Because of this, obtaining officer buy-in to CIT programs typically hinges on several questions:

  1. Will CIT training improve officers’ knowledge, perception, and attitude toward mental illness?
  • Will CIT training improve officer and individual safety?
  • Will CIT training improve the outcomes of mental health encounters?

An answer to these questions can be found in a study conducted by the Journal of the American Academy of Psychiatry and the Law (AAPL). The study shows that upon completion of CIT training, officers indicated an improvement in attitude, reduction of stigma, and officer satisfaction and self-perception of a reduction in the use of force.

Expanding CIT Beyond Police Personnel

The media often depicts large teams of police officers racing to a mental health crisis scene. But unfortunately, the reality is that most police departments across the nation have fewer than ten police officers.

Thus, adaptations must be made to meet these numbers’ unique limitations. Some agencies have replicated existing models, such as the Memphis CIT model, with adaptations to serve their communities better.

One such adaptation is the expansion of CIT beyond police personnel such as EMS responders. Research suggests that CIT training for EMS personnel can improve mental health emergency response, increase the confidence level of responders, and provide greater safety for individuals in crisis and emergency responders.

53.8% of EMS participating in the research stated they would be willing to complete the training. While extending CIT training to EMS personnel is rare, it has proven effective and necessary.

In Akron, Ohio, paramedics are routinely dispatched to all 911 calls involving individuals experiencing a psychological episode. In six years, Akron EMS and law enforcement received a combined total of 10,004 mental health calls. In addition, EMS was responsible for 54% of calls that involved non-CIT trained police officers and 42% of the calls that involved trained CIT officers.

Challenges Involving Decentralized Policing

Just what is the definition of decentralized policing? In a centralized policing system, one police force connects all the independent police forces.

Countries that use a centralized policing system include Great Britain, Israel, Italy, and France. A decentralized policing system is one in which there is no national policing force, and each police force acts under its supervision and is independent of other agencies.

In addition to the United States, countries that use a decentralized system include Mexico, Canada, and Japan. In addition, the decentralized system allows for autonomy from outside influences, such as political parties.

The decentralization of policing has both advantages and disadvantages. One advantage is the ability of police agencies to be more responsive to local community needs.

Challenges involving decentralized policing include the possible duplication of effort and lack of coordination between agencies. These challenges most frequently occur when federal or state officials determine they have authority over local investigations.

Though the extent to which entities like the FBI refuse to coordinate with local police is often exaggerated in modern police dramas, that lack of coordination does exist. In recent years, however, the relationship between the FBI and local law enforcement has improved. Bruce J. Gebhardt, who served as the Deputy Director of the FBI from 1974 – 2004, stated: “The time when a police department or a sheriff’s office or the FBI can act on its own is gone…Officers are on the front lines, defending our citizens…”

Creating and Funding the Co-Responder Model

Often CIT trained officers are often paired with clinicians in a category known as the co-responder model. A co-responder model pairs law enforcement with behavioral health specialists to intervene and respond to behavioral health-related calls.

These teams use the combined expertise of police and behavioral health specialists to de-escalate situations and help link individuals to appropriate services. Therefore, when creating a co-responder program, it is essential to have a robust and dedicated commitment from law enforcement, behavioral health providers, community leaders, and community partners such as social services and peer specialists.

Clear policies and procedures and quality mental health crisis intervention training should be developed. In addition, a careful study should be completed to determine what services and supports are currently available and what resources need to be added or improved.

Initial funding for the program frequently comes from organizations such as the Substance Abuse and Mental Health Services Administration (SAMHSA) or local or state governments. Often, funds are approved for a pilot program, and the data collected is used to measure the critical outcomes of the program.

Those outcomes will prove the value of the co-responder program and can be used to procure additional funding through grants or funds from local or state entities. That’s why it is essential to have a robust technology solution with the demonstrated dynamic data collection and analysis ability.

Julota’s platform helps co-responders track and evaluate data across multiple sources with its robust interoperability features. For example, monitoring impact metrics for call responses allows the crisis intervention teams in small cities to focus on appropriate data and provide the proper documentation to relevant stakeholders.

There is often a significant amount of pressure to prove results, and the availability of relevant data can result in bigger budgets for the future of your program.

Implementing crisis intervention teams in small cities may also require technology that will allow them to collect the data necessary for continued program evaluation to determine needed changes and improvements. Though you may be sure that your program is making a difference, demonstrating that to stakeholders and funders may sometimes prove difficult.

With Julota’s powerful platform, access to vital data is quick and easy. Data collection fields and reports can be customized to meet your program’s specific needs. Collecting valuable data can also empower your community in decision-making regarding issues like homelessness and incarceration/diversion.


In this era of changing views toward policing, communities are responding to the challenges by implementing crisis intervention teams in small cities. In addition, law enforcement and community partners all recognize the need for a better response to mental health crises.

Officer buy-in to the crisis intervention team program has proven to be a critical factor in the model’s success. Those who volunteer for the training are the most successful in displaying empathy and understanding of individuals experiencing a mental health crisis.

Expanding CIT training beyond law enforcement is also showing positive results. In many cities, EMS regularly respond to calls alongside law enforcement. Their ability to interact positively and de-escalate potentially volatile mental health situations is a valuable asset to crisis intervention teams.

Crisis intervention teams are expanding across the country. It is estimated that more than 2,700 teams are currently in place and experiencing proven success. CIT International’s research shows that communities that prescribe the CIT model have higher success rates in resolving serious crisis situations. These teams are effectively implementing CIT’s first goal: to develop the most compassionate and effective crisis response system that is the least intrusive in a person’s life.