Police officer perceptions of the impact of Crisis Intervention Team (CIT) programs
Introduction
Law enforcement officers are often the first responders to crises involving individuals who are experiencing a mental health crisis (Canada et al., 2010, Munetz and Griffin, 2006, Watson et al., 2008), and play an important gatekeeping role in determining if an individual should be arrested, or if that individual may be better served by being referred for psychiatric treatment (Green, 1997, Lamb et al., 2002, Teplin and Pruett, 1992). This level of discretion requires an understanding and judgment of the nature of certain behaviors as either criminal, psychiatric, or indicative of some other concern (Teplin & Pruett, 1992). Law enforcement officers are often untrained or unprepared to adopt this position of providing this type of triage service (Patch & Arrigo, 1999). As such, community stakeholders are currently engaging in efforts to develop and implement police-based programs that enhance officer knowledge about mental health issues and community mental health resources, with the ultimate goal of better preparing officers to more effectively respond to such calls.
The Crisis Intervention Team (CIT) model is one such program that addresses the interface of individuals with mental illness and law enforcement (Cochran et al., 2000, Dupont and Cochran, 2000, Steadman et al., 2000). Since its inception in 1988 in Memphis, TN, CIT has spread rapidly and has been described as “the most visible prebooking diversion program in the U.S.” (Steadman et al., 2000). The goals of CIT are to reduce arrests of individuals who would more appropriately be diverted to the community mental health system, as well as to increase safety for officers and civilians (Compton et al., 2008, Dupont and Cochran, 2000). These goals are addressed by enhancing police officer knowledge about mental illness and the local community mental health system and by providing key communication skills and opportunities for personal contact with individuals with mental illness. Ideally, officers who participate in CIT are volunteers who either self-select into the program or are selected through an application process (Compton et al., 2008). In this way, officers who are compassionate towards individuals with mental illness may be more likely to be called upon to respond to such calls when needed.
CIT is a community-based program that results from a partnership among law enforcement agencies, the local community mental health system, individuals with mental illness and their families. Through training and experience working as a member of a specialized team of law enforcement officers, CIT is designed to strengthen officers' skills to de-escalate crises, recognize possible signs of mental health crises and, when appropriate, make referrals to the mental health system instead of making an arrest (Reuland, 2004, Ritter et al., 2010, Watson et al., 2010). Thus, CIT is a program, not just training, that develops a special team of officers who are meant to serve as first responders to calls involving individuals suspected of having a mental illness, are suicidal, or may be experiencing a mental health crisis (Reuland, 2004). Ultimately, CIT is designed to reduce the number of people with mental illness who become involved with the criminal justice system as a function of their illness rather than through any criminal intent.
The Sequential Intercept Model provides a conceptual framework for addressing the role of CIT in reducing the criminalization of individuals with mental illness (Munetz & Griffin, 2006). This model maps the interface of the criminal justice and mental health systems, identifying opportunities for jail diversion programs that may prevent individuals with mental illness from entering into the criminal justice system, or those interventions that may minimize time spent within the criminal justice system (Munetz & Griffin, 2006). The ultimate intercept is an accessible, effective mental health system that prevents individuals with mental illness from engaging in behaviors that may result in further criminal justice involvement. The first intercept consists of programs targeted towards law enforcement and emergency services, including CIT.
As CIT becomes more widely adopted, research is continuing to assess the impact of the program on the officers, individuals in crisis, law enforcement departments, and mental health systems (Broussard et al., 2011, Compton et al., 2006, Ritter et al., 2011, Ritter et al., 2010, Teller et al., 2006, Watson et al., 2004a, Watson et al., 2011, Watson et al., 2010).
The purpose of this study is to examine CIT officers' attitudes about CIT and how these attitudes relate to the officers' confidence in their abilities to respond to calls involving mental health crises. We also examine how attitudes about CIT relate to officers' perception of their department's effectiveness in meeting the needs of individuals in crisis. Further, we examine how the officers' personal experiences and familiarity with mental illness may relate to their attitudes about the impact of CIT, the officers' perceptions of his or her own abilities, and their attitudes about overall departmental effectiveness at responding to calls involving mental health crises.
Section snippets
Assessing the impact of CIT
Preliminary evidence suggests that CIT is an effective program that links individuals with mental illness who come in contact with law enforcement to appropriate community mental health services (Canada et al., 2010, Compton et al., 2008, Ritter et al., 2011, Teller et al., 2006). There is mixed evidence as to the effect of CIT on reducing arrests for individuals with mental illness, with some reporting a lower rate of arrest for communities that have CIT (Steadman et al., 2000), while others
Data and methods
We conducted a survey with officers who had participated in their local community's CIT program. The survey was administered at an Ohio (U.S.) statewide Advanced CIT conference and took approximately 10 min to complete. All respondents provided informed consent and the Institutional Review Board at Northeast Ohio Medical University approved this study.
Results
Descriptive analyses of our measures, including means, proportions standard deviations and alpha reliabilities for our sample (N = 57) are presented in Table 1. In addition to the sociodemographic characteristics of our sample as discussed previously, our respondents also provided information on their personal experience with mental illness. Most officers (81%) reported that they knew at least two or more people personally who have a mental illness, and 93% of our sample reported knowing a person
Discussion and conclusions
This study makes an important contribution of our understanding about how CIT officers perceive that CIT impacts their confidence in abilities, as well as various aspects of their own skills, knowledge, level of preparedness and the preparedness of others. Further, it has been suggested in the literature that officer characteristics, including familiarity and frequent contact with people with mental illness in officers' personal lives, will influence how CIT may impact officer attitudes and
Acknowledgments
This study is based on work supported by a grant from the Ohio Department of Mental Health and Addiction Services to support the Ohio Criminal Justice Coordinating Center of Excellence (BG-10-424-14-001). This funding agency was not involved in the study design or preparation of this paper. The authors would like to thank the officers who participated in this study, as well as the National Alliance on Mental Illness (NAMI) Ohio for their assistance with this project. We also thank Danielle Shaw
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