CIT It’s More Than Just Training 1

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An innovative first-responder model of police-based crisis intervention with community, behavioral healthcare, and advocacy partnerships. CIT is a jail diversion program designed to improve the outcomes of police interactions with individuals whose behavior is influenced by mental illness, substance use, mental retardation and related conditions. Defined 3

1. Partnerships: Law Enforcement, Advocacy, Mental Health 2. Community Ownership: Planning, Implementation & Networking 3. Policies and Procedures Core Elements Ongoing Elements 4

4. CIT: Officer, Dispatcher, Coordinator 5. Curriculum: CIT Training 6. Mental Health Receiving Facility: Emergency Services Core Elements Operational Elements 5

7. Evaluation and Research 8. Recognition and Honors 9. Outreach: Developing CIT in Other Communities Core Elements Sustaining Elements 6

Before CIT: Us and Them Lack of Understanding about Mental Illness Lack of Understanding about Mental Health Services Lack of Understanding about Law Enforcement’s Role and Responsibility 7

More Reasons Not to Get Along Lack of Historical Cooperation Resistance to Change Territorialism Scarce Resources and Little Funding 8

Work Plan for Developing and Implementing a CIT Program 9

Organizational Identify and solicit key stakeholders that need to be involved Establish Oversight/Steering Committee and Chairperson Oversight Committee members attend CIT events in other communities Establish mission and goals for the committee Establish workgroup committees Determine structure of training program County Commissioners, Human Services Director, MH/MR, D&A, MCO, Providers, NAMI, Consumers, Warden, Probation & Parole, DA, Police Chiefs, etc 4 representatives from law enforcement, 3 from NAMI, 3 from provider agencies, 1 consumer, 1 county representative Memphis, Philadelphia, Johnstown, and Collingswood. April 2008 Curriculum, Outcomes, Public Relations 3.5, 6, (FTAC) and 40 hour 10

Curriculum Development Develop curriculum/training manual to meet local needs - content & time slots, field visits, resource material, role plays Review learning objectives & content outline for each module, set up final training schedule Identify instructors Review instructors' materials Use real life situations. Stay focused. Limit modules to about 1 hour Consumer & Family presentations Keep activity level moderately high Constantly evaluated and revised Trial and error. Evaluations for each module (morning & afternoon) Get PP presentations for each instructor 11

BUCKS COUNTY CRISIS INTERVENTION TEAM TRAINING SCHEDULE May 17th-21st 2010 Continental breakfast and Lunch provided Monday Title Day Start End Time Instructor Intro:CIT Overview/Success Story Mon. 8:00 9:00 1 Sevick Clinical Issues Related to Mental Illness Mon. 9:00 10:00 1 Dr. Friedman Suicide /Q.P.R Mon. 10:00 11:00 1 K.Thompson Lenape Valley Presentation Mon. 11:00 11:30 1/2 Curran/Sperry Hoarding Mon. 11:30 12:00 1/2 S.Curran Lunch Mon. 12:00 12:45 3/4 Provided Class Evaluations Mon. 12:35 12:45 Task Force Adult Prob./Parole Mental Health Unit Mon. 12:45 13:45 1 L.Hennessey Personality Disorders/hoarding Mon. 13:45 14:45 1 Sharon Curran Substance Abuse/ Co-occurring disorders Mon. 15:00 16:15 1 1/4 Ed Donahue Tuesday Class Evaluations Tues 8:00 8:15 1/4 Task Force PTSD Tues 8:15 9:15 1 Curran/Kingsdorf Suicide by Cop video Tues 9:15 10:00 3/4 Task Force Suicide by Cop Presentation Tues 10:00 10:45 3/4 Ofc. Ferraro Overview of Mental Health Law Tues 11:00 12:00 1 Tony Sevick Lunch Tues 12:00 12:45 3/4 Provided Class Evaluations Tues 12:30 12:45 Task Force Consumer Perspective Tues 12:45 14:00 1 1/4 NAMI Site Visits Tues 14:00 16:30 2 1/2 Task Force Wednesday Class Evaluations Wed. 8:00 8:15 1/4 Task Force Alzheimer's Disease Wed. 8:15 9:15 1 Steven Weiss 12

BUCKS COUNTY CRISIS INTERVENTION TEAM TRAINING SCHEDULE Psychiatric Meds and Side Effects Wed. 9:15 10:00 3/4 Steven Weiss Risk Assessment for Domestic Abuse Wed. 10:00 11:00 1 L.Thomas Veteran Issues (Roundtable) Wed. 11:00 12:30 1 1/2 Veterans Lunch Wed. 12:30 13:00 1/2 Provided Class Evaluations Wed. 12:30 12:45 Task Force Family Perspective Wed. 13:00 14:00 1 NAMI Strategies of De-Escalation Wed. 14:00 14:45 3/4 Aninsman Introduction to Verbal Techniques Wed. 14:45 16:30 1 3/4 Task Force Thursday Class Evaluations Thurs 8:00 8:15 1/4 Task Force Community Resources Thurs 8:15 9:45 1 ½ Task Force Juveniles Thurs 9:45 10:45 1 Marjorie Morgan Advanced Verbal Techniques Thurs 10:45 12:15 1 1/2 Task Force Lunch Thurs 12:15 12:45 1/2 Provided Class Evaluations Thurs 12:15 12:25 Task Force Site Visit BC Prison/B.A.R.N Thurs 12:30 16:30 3 1/2 Task Force Friday Class Evaluations/Program feedback Fri. 8:00 8:15 1/4 Task Force Hearing distressing voices exercise Fri 8:15 10:15 2 Phil Braun Complex Verbal Techniques Fri. 10:15 12:15 2 Task Force Lunch Fri. 12:15 13:00 3/4 Provided Graduation Fri. 13:00 14:00 1 Task Force Team building techniques Fri 14:00 16:30 2 1/2 T.F/students 13

Logistics Determine how to identify first group of officers for training and method to register them Select participants for first class (what jurisdictions) Notify participants of dress/schedule/expectations Reproduce other handouts - resource cards, articles on CIT, etc. Secure source of supplies / reproduction of materials Reproduce handouts for manual Secure training site (including A-Vs) Create registration forms, evaluation forms Order pins and diplomas Volunteer and selected by supervisor Lower Bucks County Provided to participants before training starts 14

Logistics Determine methods of evaluation and prepare evaluation forms Confirm time slots with each instructor Arrange for Field Visits Identify Role Players Secure food & refreshments Develop and send out Press Release Prepare rosters and nametags, on-site sign in sheets Plan for graduation - Meal? Press? Dignitaries? Guests? Speakers? Photographer? 15

Post Training Follow-Up Plan next 3.5, 6, or 40-hour class Hold Debriefing and review Process evaluations 16

System Enhancements $500,000 8:30AM-11:00PM 2 staff Fall 2008 Fall2009 $ enhanced the system Expanded hours Security Additional staff: Crisis, CPS, CRNP Implemented electronic 302 process Hired Crisis Director Mobil outreach & follow up Relationship with general hospital 17

Family Perspective NAMI PA – Bucks County Chapter (The National Alliance on Mental Illness) Mission – to improve the lives of the citizens of Bucks County who suffer from a serious mental illness or, as family members and caregivers, share the burden of these devastating illnesses. One of the few organizations that support family members and caregivers. All services are provided FREE. Support – family and consumer support groups Education – Family to Family, 12 wk, Peer to Peer, 9 wk, Classes Advocacy – CIT - how it all started... 18

Law Enforcement Acceptance Numerous hours spent early on talking to police chiefs 3.5 hour Introduction to CIT 6 hour Introduction to CIT 40 hour training Public Relations (face to face) Introductory sessions for management Introductory sessions for patrol officers Training leading to CIT certification 19

CIT Development for Bucks County CIT Task Force 3.5 hour Introduction to CIT for Law Enforcement Management and Emergency Dispatch February 17, September 8 & 10, 2009 October 6, hour CIT Introductory Training for Patrol Officers Completed: February and March 2009, 5 sessions. Completed: October and November 2009, 6 sessions. Completed: March 2010, 2 sessions. Completed: September & October 2010, 2 sessions 40 hour CIT Training leading to Certification. Completed: September Completed: January 2010 Completed: May 2010 Completed: November

Introduction to CIT Enhancing Officer & Community Safety: ▫ An Introduction to CIT 370 individuals trained as of Collaborative effort between Bucks County and FTAC 21

Graduates – 102 (as of November 2010) Bensalem Twp 19 Bristol Twp 13 Northampton Twp 10 Lower Makefield Twp9 New Britain Twp8 Lower Southampton Twp8 Falls Twp6 Adult Probation5 Warminster Twp4 Middletown Twp3 Plumbstead Twp3 Newtown Twp2 Corrections2 LVF Crisis2 Bristol Borough2 PA Probation & Parole1 Doylestown Borough1 Newtown Borough 1 Pennridge Regional 1 Paramedic 1 Penn Foundation 1 22

Officer Perspective and Acceptance of C.I.T. OR How to teach an old dog new tricks 23

Brick Wall *The system is broken *I am concerned about real crime. *I am not a social worker *I don’t like talking to those “people” *Let’s “lock em up” and keep society safe 24

Crisis Intervention Team Training CIT task Force, and Officer infused training. Common goals Sympathy vs Empathy Memphis Model vs your own community Realistic role playing Accepted presenters Resources 25

CIT Graduates 26

Change is Here Cpl. Tom Augustin, Lower Makefield Township Police Department years of police Experience talks about what CIT Training meant to him. 27

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Short/Long Term Goals & Outcomes The goals of the CIT program: The overall goal of the CIT training program is to treat mental illness as a disease, not a crime. Law Enforcement: ▫decreased number of injuries to the officers ▫decreased use of force ▫improved use of alternatives to arrest and jail ▫decreased time officers spend in the crisis unit (involuntary commitments) ▫reduced myths and stigma of mental illness among law enforcement ▫improved relationships for officers and community Behavioral Health System: ▫extended crisis response systems ▫increased opportunity for earlier intervention ▫improved treatment outcomes Consumers/Family Members: ▫decreased number of injuries to the consumer ▫better relationships between consumers and law enforcement officers ▫removed stigma of unnecessary incarceration in local jails ▫improved access to treatment ▫increased chance that the consumer will receive continuous care 29

Short/Long Term Goals & Outcomes Outcomes ▫Success Stories ▫Bucks County CIT Tracking Form 30

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Contacts Task Force Membership: Law Enforcement: Lieutenant Lois Kirgan, Bensalem Township Police Department, 2400 Byberry Rd,Bensalem, Pa 19020, Sergeant Andy Aninsman, Bensalem Township Police Department, 2400 Byberry Rd,Bensalem, Pa 19020, Detective Chuck Pinkerton, Northampton Township Police Department, 50 Township Road, Richboro, PA 18954, (215) Officer Steve Kingsdorf, Northampton Township Police Department, 50 Township Road, Richboro, PA 18954, (215) NAMI: Charles Bechtel, PO Box 355, Warrington, PA 18976, NAMI Carol Meholic, PO Box 355, Warrington, PA 18976, NAMI Agnes McFarlane, PO Box 355, Warrington, PA 18976, NAMI Behavioral Health Providers: MH - Sharon Curran, Lenape Valley Foundation, 500 N. West Street Doylestown, PA Nicole Wolf, Lenape Valley Foundation, 500 N. West Street Doylestown, PA D&A Ed Donahue, Addictions Specialist, General Manager/Consultant,The Next Step, House of Recovery, Certified Peer Specialist: Julie Harbison, Lenape Valley Foundation, 500 N. West Street Doylestown, PA County Representation: Tony Sevick, Bucks County Department of MH/MR (Chair), 600 Louis Drive, Suite 202, Warminster, PA 18974,

Thank You! 33