1. Not that kind of chatroom: A videoconferencing program CIT continuing education CIT International Conference August 15, 2018
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2. TODAY’S PANEL Detective Benjamin Melendrez Detective Lawrence Saavedra
Detective Matthew Tinney
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3. Learning objectives
Identify the need for continuing education for law enforcement in the areas of mental health and substance use.
Describe how the CIT ECHO is being used to train law enforcement throughout New Mexico and the country.
Describe the mixed methods approach being used to evaluate the CIT ECHO program and understand implications of the evaluation’s findings.
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4. Why do we need more accessible continuing education for CIT?
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5. Multiple Points of Interaction between Police and Individuals with Mental Illness and Substance Use Disorders
History of police arrest
25% of people with serious mental illness have histories of police arrest
25% 5%
12%
Calls for Service
5% of police calls for service involve people with behavioral health problems
Pathway to care
12% of individuals have police involved in their pathway to mental healthcare
MATT
Source: Livingston, J. D. (2016). Contact Between Police and People With Mental Disorders: A Review of Rates. Psychiatric Services, 67(8), 850–857.

6. There is tremendous variation in the type and amount of training police departments provide for their officers in how to respond to people in behavioral health crisis
Continuing education and specialized trainings do not receive the same degree of attention as entry level training
Funding opportunities for field officers remains a top concern for many departments
MATT
In 2017, the Council of State Governments Justice Center released a report on state standards for training law enforcement in mental health and crisis de-escalation training.
A survey was distributed to all state POST (peace officer standards and training) or other law enforcement training authority in 50 states and 3 territories
42 states responded
These three bullet points are from their primary findings
Source: Plotkin, M., & Peckerman, T. (2017). The Variability in Law Enforcement State Standards: A 42-State Survey on Mental Health and Crisis De-escalation Training. The Council of State Governments Justice Center.

7. The Number Of Behavioral Health Related Calls By Year for APD
MATT
We’ve seen an increase in the number of behavioral health related calls and we expect to see this number to continue to increase
Source: Winograd, Peter and Brown, Kylynn. The Albuquerque Police Department Crisis Intervention Unit Data Book: A Working Compendium. June 15, 2018.

8. Traditional CIT Training
40 hour class.
Limited upkeep. ?
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9. GRANT FUNDING & TIMELINE
$250,000 for a three year grant: 10/1/2015 – 9/30/2018
BJA FY 2015 Justice and Mental Health Collaboration Program: Planning and Implementation Grant
2014
APD attends Project ECHO Clinic
Received BJA Grant Funding
2015
Launch of First CIT ECHO
2016
116 ECHO Sessions Held
Present
MATT
Matt, you can use this timeline as a cue to explain the brief history of how CIT ECHO got started and what you all did to get up and running with the weekly sessions. You can also mention that in May 2018 we were awarded funding through the New Mexico State Targeted Response (STR) Initiative her or later.

10. Implementing the CIT ECHO
Partners:
Albuquerque Police Department
Project ECHO
University of New Mexico, Department of Psychiatry & Behavioral Sciences, Division of Community Behavioral Health
Crisis Intervention Team Inc.
Presbyterian Healthcare Services
Implementing the CIT ECHO
BEN
The program began hosting weekly sessions in January 2016

11. PROJECT ECHO CORE CONCEPTS
Video-Conferencing Network
Hub & Spoke Model
Case Based Learning
Demonopolizing Knowledge
Develops Subspecialty Expertise Over Time
BEN

12. CIT ECHO FACILITATION
BEN
Hub and spoke model

13. Traditional CIT Training The CIT ECHO Model
40 hour class.
Limited upkeep. ! ? ? !
BEN

14. Each CIT ECHO Session Consist of Two Parts
Brief
DIDACTIC
(45 minutes)
Debriefing
CASES
BEN

15. DIDACTICS Curriculum Modules: CIT Policing Psychiatric Diagnoses
Substance Use
De-escalation & Communication
Officer Self-Care
Resources
Special Trainings
BEN
Didactics last approx. 45 minutes
Curriculum topics must be related to 1 or more of these 7 identified curriculum areas
Pie chart shows a break down of the curriculum areas we have covered since implementing the CIT ECHO.
Pie chart starts with CIY policing and runs clockwise to correspond with the legend

16. DIDACTIC CURRICULUM 1. CIT POLICING 3. SUBSTANCE USE
Barricade Situations
Suicide by Cop
Communicating with Doctors
Certificates of Evaluation
2. PSYCHIATRIC DIAGNOSES
Bipolar Affective Disorder
Schizophrenia
Psychosis
Paranoia
Autism Spectrum Disorders
PTSD
3. SUBSTANCE USE
International Drug Trafficking
Suboxone vs. Methadone
Alcohol Use Disorder
Opioid 101 for Law Enforcement
Common Drug Street Names
Cannabis Myth Busting
4. DE-ESCALATION & COMMUNICATION
Basics of the PURE Model
Active Listening Skills
Verbal Judo
5. OFFICER SELF-CARE
Tactics for Officer Well-Being
Mindfulness
Exercise in the Treatment of Depression
6. RESOURCES
New Mexico Crisis & Access Line
NAMI: An Overview of Services
APD’S C.O.A.S.T. Program
7. SPECIAL TRAININGS
Transgender 101
Media’s role in Reporting Mass Shootings
Motivations of a Serial Killer
BEN

17. DEBRIEFING CASES Debriefing Template LAWRENCE
Case Debriefings give officers an opportunity to receive feedback and recommendations from their peers, experienced detectives, and a team of psychiatrists on on-going cases, or calls for service, involving behavioral health.
Debriefing template is completed by the psychiatrist and then notes and recommendations are sent to the presenting officer by the project coordinator.

18. Case Example
Collateral: Female, 94 y.o., good physical health, recent hospitalization, prior contact with family reference female’s erratic behavior Reason for contact: Subject refusing to exit taxi cab and wanted to be driven to a party for family member celebrating the death of an ex-spouse, this turned out to be a delusion. Family members called for police assistance and officers on-scene called the on-call CIU detective.
LAWRENCE

19. Case Example Clarifying Questions
How quick was the onset to her behaviors?
Has she been treated for any infections?
Was she on any medications and what were they?
History of dementia, violence, or drug use?
Availability of weapons?
LAWRENCE

20. Case Example Outcomes Short-term
Subject admitted to geriatric unit, received treatment and was given a discharge plan with prescribed medications
Long-term
Treatment Guardian
Admitted to long-term care facility
LAWRENCE

21. BENEFITS OF CASE DEBRIEFING
CIT ECHO works hand-in-hand with the Crisis Intervention Unit
LAWRENCE
Discussion of the benefits of presenting this case – how you were able to discuss the details of the case with both doctors

22. Evaluating the CIT ECHO
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23. Mixed Methods Approach
Online surveys to assess impact on knowledge related to the content presented in the session (weekly)
Online surveys to assess satisfaction with the technology and curriculum and impact on self-efficacy (3+ sessions)
Semi-structured interviews with stakeholders to obtain feedback about the face validity and practical utility
MATT
Here you can mention that Dr. Annette Crisanti is the PI (Principle Investigator) for the evaluation of the program. Jenn Earheart, Project Coordinator of CIT ECHO, also serves as the RA (Research Assistant) for the evaluation.
The objective of the evaluation is to determine the reach and effectiveness of the CIT ECHO with respect to: (1) satisfaction with training content and technology among stakeholders and participants, and (2) impact on knowledge among participants of Crisis Intervention Training policing and self-efficacy when interacting with individuals living with mental illness. Preliminary process [e.g. number of trainees] and outcome data will be presented and implications of the findings will be discussed.

24. Participating Agencies: January 2017 – July 2018
Albuquerque Ambulance Service
Albuquerque Fire & Rescue
Albuquerque Police Department
American University of Antigua
Aurora, IL Police Department
Bernalillo County, NM Sheriff’s Office
Chicago, IL Police Department
Comprehensive Healthcare Yakima, WA
Dayton, OH Police Department
Everett, WA Police Department
Gastonia, NC Police Department
Huntington, WV VA Medical Center
Jicarilla Apache Police
Johnston County, NC Mental Health Center
King County, WA Sheriff’s Office
Las Cruces, NM Police Department
McKinley County, NM Sheriff’s Office
New Mexico Law Enforcement Academy
New Mexico Probation & Parole
New Mexico State Police
New York EMS
North Richland Hills, TX Police Department
Ontario Canada Police College
Pinellas County, FL Sheriff’s Office
Portland, OR Police Bureau
Rio Arriba County, NM Sheriff’s Office
Rio Rancho, NM Police Department
San Juan County, NM Sheriff’s Office
St. Martin’s Mobile Crisis Teams
St. Paul, MN Police Department
Stevens Point, WI Police Department
Tulane University
U.S. Probation & Parole
Wicomico County, MD Health Department
MATT
We have participants from Washington, Oregon, Wisconsin, Illinois, Florida, Maryland, and Ontario, Canada

25. Process Data: January 2017 – July 2018
34 Agencies
203 unduplicated participants participants per session
hours of continuing education
51 calls for service debriefed
MATT
January 1, 2017 – July 31, 2018:
hours of continuing education
28.2 people per session
51 calls for service debriefed

26. PARTICIPANT DEMOGRAPHICS
MATT
The ‘N’ for the Fire Department is 2
Define COAST acronym – Crisis Outreach and Support Specialists
Other Category includes CIT Coordinators, Chaplain, Curriculum/Training Personnel

27. PARTICIPANT DEMOGRAPHICS
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Interesting that our participants are early in their career or veterans

28. EVALUATING OUR EFFECTIVENESS
To what extent did the information in this week’s session improve your knowledge of the presentation topic?
How likely are you to use the information that you learned in this week’s session in your job?
To what degree did this week’s session impact your knowledge of resources in the community?
After attending this week’s session how would you now rate your ability to interact with an individual in a mental health crisis?
MATT
In the weekly survey we also ask participants the following questions,
Based on the information you rec’d in this week’s session are there any changes that you would make in your interactions with people living with mental illness? If yes, they can elaborate.
Are there any challenges or concerns about implementing the information that you rec’d in this week’s session? If yes, they can elaborate.
What did you like best about this week’s session?
What did you like least about this week’s session?

29. Session Impact on Perceived Ability to Interact with Individuals with Mental Illness for all CIT ECHO Didactics
MATT
Highest rated curriculum area is psychiatric diagnoses
De-escalation is also highly rated, even higher than the traditional CIT policing module
You can talk about how the self-care module wasn’t originally a part of the curriculum and then we decided to incorporate based on need and officer response

30. What’s Next? Success Changes to SOPs and curriculum/training
Identification of best practices
Challenges
Officers debriefing cases
Meeting time doesn’t work for all officers
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31. THANK YOU! ANY QUESTIONS?
Contact Information:
Detective Benjamin Melendrez -
Detective Lawrence Saavedra -
Detective Matthew Tinney -
MATT
Maybe at this point also mention that we have a sign-up sheet at the front of the room that people can sign if they have more questions but don’t have time to stay or if they’d like to sign-up for the CIT ECHO.

32. Using Zoom
Run through these slides if time permits

33. Place your screenshot here
Zoom can be downloaded to smart phones, tablets, computers, and officers’ mobile tough books
Place your screenshot here

34. Important Zoom Features
MEETING ID: XXX-XXX-XXXX
Important Zoom Features