Law Enforcement and Emergency Services

Countywide implementation of crisis intervention teams: Multiple methods, measures and sustained outcomes

“…Recent calls for smart decarceration (Epperson & Pettus‐Davis, ) have placed a focus on the diversion of persons with mental health problems from the criminal/legal system to community mental health and social services. Since the 1980s, law enforcement agencies across the country have been addressing the increasing numbers of persons with mental health problems with specialized law enforcement responses (Reuland & Yasuhara, ). These specialized responses prioritize referral and transport to behavioral health service providers and family in lieu of arrest.…”

“…The CIT, sometimes referred to as the “Memphis Model” (Compton et al, ; Dupont & Cochran, 2000), is a collaborative effort within communities to improve interactions with individuals who have a mental illness (McGuire & Bond, ). Researchers have identified three critical elements needed to successfully implement specialized law enforcement response programs such as the CIT (Cross et al, ; McGuire & Bond, ; Reuland & Yasuhara, ), including: (i) philosophy and community collaboration; (ii) training (i.e., 40 hours for law enforcement); and (iii) the accessibility of mental health services (i.e., crisis center access). Although the CIT model has been widely implemented across the country, there is variation in fidelity to these critical elements (see CIT International; http://www.citinternational.org).…”

“…In order for these two systems to work collaboratively, they must come to an understanding of their differences and hold mutual respect for their differing philosophies (McGuire & Bond, ). Many communities that have successfully implemented CITs have created multidisciplinary groups to plan and coordinate the implementation, maintenance, and evaluation of CITs (Reuland & Yasuhara, ). The systems‐level, collaborative approach to CITs is designed to reduce the need for crisis response by law enforcement and to increase access to other services for this population; this approach demands a concerted effort from both professions for planning, implementation, and ongoing problem‐solving (Cross et al, ; Wood & Watson, ).…”

“…Often de‐escalation techniques learned in the law enforcement academies focus on demonstrations of authority and strength as a mechanism to ward off possible aggression. In CIT, officers learn that demonstrations of authority and strength may escalate a situation with someone experiencing serious mental health symptoms; effective de‐escalation techniques include a lowered voice, backing away from the individual, speaking calmly, and listening (Reuland & Yasuhara, ). Supplementary to the training for patrol officers is training for dispatchers, who can establish the need for CIT skills at the outset of a call (Compton et al, ).…”

“…Access to 24‐hour service or a crisis center with a “no‐refusal” policy (i.e., the center cannot turn away officer referrals) allows officers to drop individuals with mental health professionals and return to patrol more quickly (Cross et al, ). Organizational collaboration may require that administrators within the mental health system reorganize or increase services for individuals who come to the attention of law enforcement or those already involved in the criminal justice system (Cross et al, ; Reuland & Yasuhara, ).…”