Crisis Intervention Team CIT BY: CORY ELAM

Mental Health  One in five American adults experience a mental health issue  One in 10 young adults experience a period of major depression  One in 25 Americans live with a serious mental illness such as schizophrenia, bipolar disorder, or major depression  Suicide is the 10 th leading cause of death in the United States. It accounts for more than 41,000 deaths a year. Which more than doubles the rate for homicide

Mental Health continued  Most people with mental illness are not violent  Only three to five percent of violent acts can be attributed to individuals living with a serious mental illness  On the other hand people living with severe mental illness are over ten times more likely to be a victim of a violent crime than the general population

Police and Mental Illness  A minimum of 1 and 4 fatal police encounters ends the life of an individual who has a mental illness  An example is people who are depressed and end up going suicide by police. Where the victim intentionally tries to provoke the officer into shooting them.  The most common thing to happen is when a person is having problems and a police officer shows up and misinterprets it as being aggressive or criminal rather than a mental illness

Examples  In Chicago a 19 year old male named Quintonio LeGrier who had a history of mental illness was shot killed by police  The police said that he came at them with a baseball bat and wouldn’t listen to commands  In Denver Paul Castaway 35 who also had a history of mental illness was shot and killed after he moved dangerously close to officers while holding a knife to his own throat

LAPD and Mentally Ill homeless man

Criminal Justice and Mental health  With severe cutbacks to mental health services it has pushed the criminal justice system to the front lines  Especially when it comes to police officers  With all the scrutiny on police currently involving race and use of force this is another major problem they are facing

Memphis Model Background  Memphis, Tennessee call to a public housing area  A young man was threatening people with a knife  A young black male was confronted by the officers  He refused to put the knife down and was shot multiple times  He would eventually die from the multiple gun shot wounds

Background continued  The young black male who was killed was known to have a history of mental illness  Cries of racism and police brutality erupted  The community had to develop a better way of handling and intervening with people who had a mental illness

Solutions  The mayor ended up turning to many different groups  National Alliance on Mental Illness NAMI  Enlisted police  Community mental health professionals  University leaders  Hospital Administrators  Church officials  With one goal to find a new and better way to help people with mental illness

NAMI  The National Alliance on Mental Illness is the largest mental health organization in the U.S.  They are dedicated on building better lives for the millions of Americans who suffer with a mental illness  They are in association with hundreds of local affiliates and state organizations  Volunteers help work and provide support and education to the community

NAMI continued  NAMI is made up of four councils who advise the board of directors  The NAMI National Consumer Council which is made up with people who live with mental illness. There is one representative in every state and one alternate  The Executive Directors Council is made up of current executive directors of all NAMI State organizations and NAMI affiliates

Other councils  The NAMI National Veterans and Military Council which is made up of members who are active duty or veterans as well as family members who could have lived with them and experienced it.  The State Presidents Council which is made up of the current presidents of NAMI State Organizations 

Discussion Question  Why do you think having a mental illness or even the term mental illness is viewed as negative or scary?

The beginning  What emerged from all the planning and involvement from the community was an initial task force.  Memphis Police Department Crisis Intervention Team CIT  Later would be known as Memphis Model  They would use their insights to revolutionize how police would handle people with mental illness

The plan  The CIT envisioned a selected group of officers who had specialized training to handle people who were mentally ill  Those selected officers would be throughout the city doing their normal patrols  But they would be ready for immediate dispatch if they were needed

Officer goals  The officers primary goals were  Deescalate the situation  Decrease the likelihood of violence  To prevent injury to family, patients, police, and neighbors  The officers would also decide whether or not to transport the patient for further evaluation

Help  If further evaluation was needed the receiving facility would offer referrals to resources  Community mental health services  Social services  Veteran’s services  When CIT was implemented it helped keep people with mental illness out of the criminal justice system  As well as increasing the chance of having the right health care referral

Volunteers  CIT was now becoming essential to have in Memphis  Effort had to come equally from the community as well  Mental health professionals and educators voluntarily joined to provide training and consultation to CIT officers with no charge to the police department  Example: Davenport, Iowa

Training  The officers had to have special training  Mental health diagnoses  Psychiatric medications  Issues of drug abuse and dependence  As well the officers would train in mental health law and cross culture sensitivity

Training Continued  To train the police officers they will first go through a 40 hour course going through different tactics and what needs to be done  Even after the original training there has to be follow up training  Training other law enforcement agencies  In service training on specialized areas like youth, veterans, and suicide prevention  Training other CJ fields like correctional officers, probation, and parole officers

Training Continued  Officers would also have to spend time with people who had mental illness to experience their illness first hand  Another big factor was officers getting intense training in verbal de- escalation skills with consistent attention to officer safety 

As a Community based model  With the success Memphis had the CIT program started to spread to other cities  So a group of leaders from different CIT programs decided to develop a document to identify the core elements of a CIT model  The document makes sure to stress the importance of community involvement  Steering groups into newly developed CIT programs would be critical

Community model continued  The group provides a forum for the partnerships as well as networking and eventually community ownership  They take on the role of advocacy for the various components of the program  A critical one is obtaining funding significant funding for psychiatric emergency system and other community based mental health efforts  The Efforts of the Memphis founders has led to a network of 2700 CIT sites throughout the nation

Discussion Question  Arkansas, West Virginia, Alabama, and Rhode Island are the only states in the U.S. to not have a CIT. Given the success that the Memphis program has had why do you think they don’t have at least one?

Houston  Houston started its program based on the Memphis model  They decided on training veteran volunteer officers and 25 percent of its patrol force  They faced a problem with only having 25 percent of the officers trained in CIT  So in March 2007 Houston provided CIT training to all of its cadets and they graduate as CIT officers

CIRT  Houston police department started this six month pilot program in March 2008  Crisis Intervention Response Team was very successful and was made permanent later that year  It is a co responder program based off of the original CIT program but it pairs a CIT skilled officer with a masters level licensed professional clinician  The clinician comes from the Harris Center for Mental Health and IDD

CIRT continued  The officer and the clinician will attend roll call together and actually end up riding together in the patrol car  CIRT is the highest level of response to individuals in serious mental health crises  The CIRT units are city wide but they are not included in the service call loop  Houston has the largest co responder unit in the nation with ten full time units and with plans to add three additional units

Objectives of CIRT  CIRT has ultimately four objectives that they have to achieve  They have to assist officers with CIT related calls  They Conduct pro active and follow CIT investigations  They respond to SWAT calls as a resource when available  Main goal is to handle the most serious CIT calls

Houston CIRT

Collaboration  In October 2011 Harris County Sheriffs and Houston Police Department decided to join together  Which formed to serve the entire city of Houston and Harris County  The Sheriffs started out with three units after overwhelming success they expanded to six units and by April 2014 they were up to nine units  The joint effort is one of the best examples of law enforcement working together with mental health officials

Summary Question  Even though CIT has been really successful what are some ways that it can improve and grow?