Chicago Police Crisis Intervention Team NAMI of Greater Chicago NAMI of Greater Chicago

Chicago Police Crisis Intervention Team Program goals Enhance outcomes Enhance outcomes Officer safety Officer safety De-escalation De-escalation Diversion Diversion Crisis prevention Crisis prevention

Chicago Police Crisis Intervention Team Program goals Identify Mental Health calls Identify Mental Health calls Quantify Mental Health calls Quantify Mental Health calls Identify best practice methods Identify best practice methods

Training 40 hour State Certification course 40 hour State Certification course Voluntary Training Program Voluntary Training Program Mental Health Court Training Mental Health Court Training Office of Emergency Communication call taker training Office of Emergency Communication call taker training Mental Health Service System Training Mental Health Service System Training Focus groups Focus groups

Training History & Overview 1 hour History & Overview 1 hour Signs & Symptoms 4 hours Signs & Symptoms 4 hours Risk Assessment/Intervention 4 hours Risk Assessment/Intervention 4 hours Developmental Disabilities 2 hours Developmental Disabilities 2 hours Child/adolescent Disorders 2 hours Child/adolescent Disorders 2 hours Substance abuse/Co-occurring 2 hours Substance abuse/Co-occurring 2 hours Psychotropic medications 1 hour Psychotropic medications 1 hour Geriatric Disorders 1 hour Geriatric Disorders 1 hour Hearing Voices Exercise 1 hour Hearing Voices Exercise 1 hour Legal Issues (Petition) 2 hours Legal Issues (Petition) 2 hours Department Procedures 2 hours Department Procedures 2 hours

Training Consumer/Family Panel 3 hours Consumer/Family Panel 3 hours Community Resource Panel 3 hours Community Resource Panel 3 hours Mental Health Court Panel 1 hour Mental Health Court Panel 1 hour CIT Role-play 8hours CIT Role-play 8hours

Measurements Effectiveness of training Effectiveness of training Amy Watson – University of Illinois – Chicago (UIC) Amy Watson – University of Illinois – Chicago (UIC) Training content Training content Sue Pickett-Schenk – University of Illinois, Chicago (UIC) Sue Pickett-Schenk – University of Illinois, Chicago (UIC) Efficacy of training Efficacy of training Carrie Steiner – Illinois School of Psychology Carrie Steiner – Illinois School of Psychology Impact – Chicago Police Department Impact – Chicago Police Department

A rapidly diffusing intervention Over 400 hundred “CIT” programs (BJA, 2006) Over 400 hundred “CIT” programs (BJA, 2006) Identification of “Key Elements” (CSG) Identification of “Key Elements” (CSG) Evidence (limited but mounting) Evidence (limited but mounting) Reduced injuries (Dupont & Cochran, 2000 ) Reduced injuries (Dupont & Cochran, 2000 ) Reduced arrests ( Steadman, et al 2000; Teller et al 2006)Reduced arrests ( Steadman, et al 2000; Teller et al 2006) Increased transports to hospital (increase voluntary) ( Teller et al 2006) Increased transports to hospital (increase voluntary) ( Teller et al 2006) Increased perceptions of effectiveness (Borum, et al 1998)Increased perceptions of effectiveness (Borum, et al 1998) Improved attitudes (Compton, et al 2006)Improved attitudes (Compton, et al 2006)

Measurements Prior to training, most officers would elect to arrest Prior to training, most officers would elect to arrest After training, most officers would elect to divert After training, most officers would elect to divert The key to this turn-around lies in the training The key to this turn-around lies in the training Trained CIT officers recognize the signs and symptoms of mental illness Trained CIT officers recognize the signs and symptoms of mental illness

“CIT is more than just training” Thus, we need to model and measure the other elements & outcomes

Officer Characteristics CIT Training Organizational factors Saturation Champion Treatment Linkages Availability Perception of police officer Officer and Encounter Outcomes Skills with PSMI Use of Force Violence by PSMI Injuries Arrests Linkage to treatment as disposition Interaction of CIT and Mental Health Treatment linkages Community Characteristics Model of CIT Effectiveness (Watson, Morabito, Draine& Ottati)

Studying CIT in Chicago…….and beyond Evaluate effectiveness of CIT in Chicago Evaluate effectiveness of CIT in Chicago Test strategies for measuring key variables and outcomes Test strategies for measuring key variables and outcomes Provide groundwork for multi-site study of CIT in several cities Provide groundwork for multi-site study of CIT in several cities *work supported by NIMH R34 MH *work supported by NIMH R34 MH081558

Partnerships NAMI of Greater Chicago NAMI of Greater Chicago Illinois Law Enforcement Training and Standards Board Illinois Law Enforcement Training and Standards Board Illinois Office of Mental Health Illinois Office of Mental Health Cook County Circuit Court Cook County Circuit Court Mental Health Service System Mental Health Service System Office of Emergency Management and Communications Office of Emergency Management and Communications University of Illinois at Chicago University of Illinois at Chicago Illinois College of Psychology Illinois College of Psychology “

The Pilot Program 7 th District (Englewood) 23 rd District (Town Hall) 7 th District (Englewood) 23 rd District (Town Hall) 40 officers and supervisors per District 40 officers and supervisors per District 1 Sgt, 2 police officers per team 1 Sgt, 2 police officers per team Measurement instruments Measurement instruments FOR MORE INFO... Lt. Jeff Murphy, CIT Coordinator – Sgt. Bill Lange, CIT Team Manager –

Mental Heath Court

Since 1990’s Over 130 Courts Nationally Have Been Developed Most are adult criminal courts Most are adult criminal courts Have a separate docket dedicated to persons with mental illnesses Have a separate docket dedicated to persons with mental illnesses Divert criminal defendants from jail into treatment programs Divert criminal defendants from jail into treatment programs Some courts monitor the defendants during treatment and have the ability to impose criminal sanctions for failure to comply Some courts monitor the defendants during treatment and have the ability to impose criminal sanctions for failure to comply

The Cook County Model Target population: Target population: All voluntary admission to programAll voluntary admission to program Works exclusively with MI felony offendersWorks exclusively with MI felony offenders 24 month probation24 month probation Four phases of treatmentFour phases of treatment State of Illinois Division of Mental Health open casesState of Illinois Division of Mental Health open cases Generally non-violent, non-sex offendersGenerally non-violent, non-sex offenders Economically disadvantagedEconomically disadvantaged Co-occurring substance use disorderCo-occurring substance use disorder

Unique Program Features Primary Focus: Community Case Management Primary Focus: Community Case Management Crisis Intervention Team (CIT) – Chicago Police Department Crisis Intervention Team (CIT) – Chicago Police Department Clinical Emphasis-Multidisciplinary Team Clinical Emphasis-Multidisciplinary Team Sanctions-based system that keeps the mentally ill offender (MIO) out of jail/prison and in community services Sanctions-based system that keeps the mentally ill offender (MIO) out of jail/prison and in community services Open state mental health cases: services are paid through Medicaid Open state mental health cases: services are paid through Medicaid Focus on high-risk clients: felony probationers Focus on high-risk clients: felony probationers

The Process as of Now (What we are finding reality to be) The program individuals have: The program individuals have: Much more extensive criminal backgrounds (compared to a 7 year review of Cook County drug court participants)Much more extensive criminal backgrounds (compared to a 7 year review of Cook County drug court participants) Much more extensive psychiatric histories (including major Axis II Personality Disorders)Much more extensive psychiatric histories (including major Axis II Personality Disorders) Few, if any, community resources with adequate funding to service the level of care neededFew, if any, community resources with adequate funding to service the level of care needed

Criminal Justice History of Program Participants at Admission

Criminal Activity Pre- and Post-Admission

In Custody Days and Costs Average Days in Custody Average Jail Costs

Increase Public Safety For all 139 participants: 75% reduction in arrests 75% reduction in arrests 78% no felony arrests 78% no felony arrests 91% no felony conviction 91% no felony conviction Average days in custody went from 112 to 11.5 following a new arrest (annualized) Average days in custody went from 112 to 11.5 following a new arrest (annualized)

Graduates For the first two graduating classes: 100% no felony arrests 100% no felony arrests 100% no drug crime arrests 100% no drug crime arrests 93% decrease in total convictions 93% decrease in total convictions Average time in custody fell from 74 days to 3 hours (per year) Average time in custody fell from 74 days to 3 hours (per year) Related costs from $9,559 to $14 Related costs from $9,559 to $14

What we have learned about recovery Recovery takes time Recovery takes time It is not linear It is not linear 1 st 3-6 months crucial 1 st 3-6 months crucial People who do well seem to turn a corner at around months People who do well seem to turn a corner at around months The 24 month probation time frame is short for probationers to accomplish all we want them to The 24 month probation time frame is short for probationers to accomplish all we want them to CJS has made significant adjustments (also from the drug court model) CJS has made significant adjustments (also from the drug court model)

How does the Mental Health Court Team evaluate probationers’ progress? New arrests New arrests Drug test results Drug test results Compliance with probation conditions, including engagement in treatment Compliance with probation conditions, including engagement in treatment Progress toward work and/or school Progress toward work and/or school Attaining stable housing Attaining stable housing

What does CIT have to do with all of this? CIT officers are the “muscle” for the mental health court judges CIT officers are the “muscle” for the mental health court judges CIT officers strive to serve MH Court warrants within 48 hours of issuance CIT officers strive to serve MH Court warrants within 48 hours of issuance CIT officers appear in MH Court to testify after warrant has been served CIT officers appear in MH Court to testify after warrant has been served CIT officers call this “ongoing diversion” CIT officers call this “ongoing diversion”

New Initiatives HBT/SWAT HBT/SWAT School Patrol/SVU Officer training School Patrol/SVU Officer training Advanced CIT Training Advanced CIT Training Autism Autism Suicide Suicide Mental Health Court Warrant Procedures Mental Health Court Warrant Procedures Veteran PTSD/TBI/Justice Involved Veteran PTSD/TBI/Justice Involved

Chicago Police Department Crisis Intervention Team Lt. Jeff Murphy - CIT Coordinator Education and Training Division Suzanne M. Andriukaitis, M.A., LCSW Executive Director NAMI Greater Chicago