The crisis intervention team (CIT) model was developed in the United
States to align law enforcement goals with those of mental health advocates and
service users. Liberia is the first low-income country where CIT has been
implemented. After preliminary training of law enforcement officers and mental
health clinicians by U.S. CIT experts, the program is now entirely implemented
by Liberian personnel. In this column, the authors describe topics addressed in
the 5-day training-of-trainers process to prepare Liberian mental health
clinicians and law enforcement officers to conduct the program, along with
feedback received from participants. They hope that this model can guide future
initiatives aimed at fostering collaboration of law enforcement and mental
health services in global mental health.
Background
The Crisis Intervention Team (CIT) model is a law enforcement strategy that aims to build alliances between the law enforcement and mental health communities. Despite its success in the United States, CIT has not been used in low- and middle-income countries. This study assesses the immediate and 9-month outcomes of CIT training on trainee knowledge and attitudes.
Methods
Twenty-two CIT trainees (14 law enforcement officers and eight mental health clinicians) were evaluated using pre-developed measures assessing knowledge and attitudes related to mental illness. Evaluations were conducted prior to, immediately after, and 9 months post training.
Results
The CIT training produced improvements both immediately and 9 months post training in knowledge and attitudes, suggesting that CIT can benefit law enforcement officers even in extremely low-resource settings with limited specialized mental health service infrastructure.
Conclusion
These findings support further exploration of the benefits of CIT in highly under-resourced settings.
Problem-based learning (PBL) is a pedagogical framework that centers on a problem of interest and structures classroom tasks around teams formulating practical, evidence-based solutions. This approach is particularly well-suited for public health curricula, as it prepares students for a dynamic, interdisciplinary, professional environment. This study explores the piloting of a PBL approach with three student cohorts in a graduate-level public mental health course. Biweekly, interdisciplinary student teams were presented with a public mental health case provided by an expert in the field and asked to develop and present evidence-based solutions through a process grounded in knowledge acquisition, critical thinking, and faculty guidance. A mixed-methods evaluation was completed to examine student perceptions of PBL components and the benefits of PBL and to gather recommendations to enhance this approach. Among 37 students who completed self-administered surveys, more than 70% found case analysis, reviewing additional literature to support case solutions, and discussions with an expert to be the components “Most Helpful” to their learning. Four focus groups with 21 students were conducted to further examine perceived course benefits and suggested changes. Participants appreciated real-world simulations of public health issues and interdisciplinary teams and offered recommendations for future improvements, such as adding a culminating project. Findings support the benefits of a PBL approach in equipping graduate students with the knowledge and skills to successfully pursue professional public health work. Recommendations inform future efforts to implement this approach in other public health curricula as well as for other courses and settings.
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