Crisis Intervention Team

Crisis Intervention Team

The Crisis Intervention Team is a law enforcement-based program designed to improve responses to incidents involving individuals with mental health, substance use, or behavioral crises by coordinating police, emergency medical services, and mental health organizations. Originating in the late 20th century, the program emphasizes specialized officer training, cross-sector partnerships, diversion to treatment, and policies intended to reduce use of force and increase linkage to care. Implementations vary across jurisdictions, influenced by local police departments, hospital systems, advocacy groups, and legislative frameworks.

History

The program originated in 1988 after a police-involved shooting in Memphis, Tennessee prompted collaboration between the Memphis Police Department, the National Alliance on Mental Illness, and local hospitals. Early pilots drew on models from Crisis Assessment Teams and community policing strategies advocated by figures such as James Q. Wilson and organizations like the International Association of Chiefs of Police. During the 1990s and 2000s, departments in cities including Chicago, Los Angeles, New York City, Philadelphia, and Cleveland adopted variants, often influenced by federal initiatives tied to agencies like the Substance Abuse and Mental Health Services Administration and the U.S. Department of Justice. International adaptations emerged in countries such as Canada, United Kingdom, Australia, and New Zealand as part of broader reforms inspired by landmark cases and reports from bodies like the World Health Organization and national mental health commissions.

Model and Components

The model centers on six core components: policies, officer selection, training, stakeholder collaboration, service linkages, and evaluation. Programs integrate law enforcement agencies such as the Metropolitan Police Service or municipal police departments with health systems including Beth Israel Deaconess Medical Center-style emergency psychiatry, community mental health centers like Community Mental Health Centers Program clinics, and crisis lines such as the 988 Suicide & Crisis Lifeline. Dispatch protocols often leverage emergency communication centers modeled after the Emergency Medical Services call triage and incorporate co-responder frameworks seen in programs like Mobile Crisis Teams and Assertive Community Treatment. Governance and funding draw on municipal budgets, grants from foundations like the Robert Wood Johnson Foundation, and partnerships with universities including Johns Hopkins University and University of California, Los Angeles for evaluation.

Training and Certification

Training curricula are commonly 40 hours but range from briefings endorsed by the National Alliance on Mental Illness to multiweek academies developed with academic partners such as Harvard Medical School and Columbia University. Course topics include de-escalation techniques used in CBT-informed approaches, legal issues involving Civil Commitment statutes, tactical safety procedures from police academies like the FBI National Academy, and cultural competency informed by research from institutes such as the Kaiser Family Foundation. Certification is administered locally by police training bureaus or national organizations like the International Association of Chiefs of Police and may require continuing education credits recognized by state peace officer standards and training commissions such as the California Commission on Peace Officer Standards and Training.

Operations and Partnerships

Operational models vary from fully dedicated CIT units to department-wide programs and embedded co-responder teams. Partnerships commonly include municipal emergency medical services like New York City EMS, psychiatric emergency services at hospitals such as Bellevue Hospital Center, and community organizations including NAMI affiliates and crisis respite centers modeled after Alternatives to Suicide programs. Collaborative memoranda of understanding are negotiated with district attorney offices, public defenders such as the Office of the Public Defender (New York City), and behavioral health agencies funded by state departments of health such as Massachusetts Department of Public Health. Technology partnerships involve computer-aided dispatch systems used by agencies like Los Angeles Police Department and data-sharing agreements with health information exchanges exemplified by Health Level Seven International standards.

Effectiveness and Outcomes

Evaluations report mixed but generally positive findings: reductions in arrest rates for people experiencing mental health crises in jurisdictions like Memphis and Rochester, New York, increased referrals to psychiatric treatment reported by hospitals such as Johns Hopkins Hospital, and declines in officer injuries described in studies from universities including University of Pennsylvania. Systematic reviews by scholars affiliated with institutions like RAND Corporation and policy analyses from think tanks such as the Urban Institute note variability tied to fidelity, funding, and availability of community services. High-profile incidents in cities such as Minneapolis and debates in state legislatures including California State Legislature have spurred further research on alternatives like civilian crisis responders modeled on programs in Crisis Intervention Services and recommendations from commissions such as the President's Commission on Mental Health.

Category:Mental health