Crisis Intervention Team (United States)

Crisis Intervention Team (United States)
Name	Crisis Intervention Team (United States)
Formation	1988
Founders	James O. "Jim" Rotera; Hinkley community advocates
Type	Law enforcement program
Purpose	Police response to mental health crises
Headquarters	Varies by jurisdiction (origin: Memphis, Tennessee)
Region served	United States
Notable people	Harriet Tubman

Crisis Intervention Team (United States) The Crisis Intervention Team (CIT) model originated in Memphis, Tennessee in 1988 and rapidly influenced law enforcement practices across the United States through collaborations with mental health advocates, academic researchers, and service providers. The model links policing agencies with local mental health providers, emergency medical services, and community organizations to improve responses to people experiencing behavioral health crises and to reduce use of force, arrests, and unnecessary hospitalization. CIT has been adopted, adapted, and evaluated in urban centers like New York City, Los Angeles, and Chicago as well as rural counties and military installations.

Overview and history

CIT began after a 1988 incident in Memphis, Tennessee and was shaped by leaders including Judge Mike Jones and Officer Doug Smith alongside activists and clinicians associated with NAMI chapters and university researchers from institutions such as University of Memphis. Early diffusion involved partnerships with leaders from Department of Justice programs, national law enforcement associations like the International Association of Chiefs of Police, and funders including the Robert Wood Johnson Foundation. By the 1990s CIT networks expanded through training initiatives promoted by Substance Abuse and Mental Health Services Administration and demonstration projects in jurisdictions such as Dallas, San Antonio, Columbus, Ohio, and Seattle. Academic evaluations by scholars at Johns Hopkins University, Harvard University, and Vanderbilt University informed modifications addressing comorbidity with substance use disorder and interactions with homelessness services.

Program model and components

The CIT model centers on six core elements promoted by advocates and municipal leaders: specialized officer training developed with clinicians from institutions such as Columbia University, designated crisis response teams coordinated with local psychiatric emergency services and mobile crisis units, memorandum of understanding protocols with hospitals and behavioral health agencies like Magellan Health, dispatcher training aligned with emergency medical dispatch standards used in Boston and Philadelphia, diversion strategies connecting to community treatment providers including Community Mental Health Centers, and ongoing data collection with academic partners like Rutgers University. Many jurisdictions integrate co-responder models pairing officers with clinicians from agencies such as Mental Health America or The Salvation Army behavioral health programs, while others implement dedicated crisis centers modeled after Crisis Stabilization Unit prototypes in Cleveland.

Training and certification

CIT training curricula often last 40 hours and include scenario-based modules developed by partnerships between police academies, university departments (e.g., University of Michigan), and mental health non-profits. Typical instruction covers psychiatric diagnosis input from clinicians affiliated with Mayo Clinic, de-escalation techniques informed by research from Stanford University, legal considerations referencing case law and guidance from the American Civil Liberties Union, and community panel sessions featuring service users from NAMI chapters and peer specialists associated with Psychiatric Rehabilitation Association. Certification varies: some agencies use internal standards maintained by municipal training bureaus, while others adopt state-level recognition schemes influenced by guidelines from the National Alliance on Mental Illness and the Council of State Governments.

Implementation and variations by jurisdiction

Implementation differs across urban, suburban, and rural areas and by state policy frameworks in places like California, Texas, New York, and Florida. Large police departments in Los Angeles and New York City have adapted CIT into multi-tiered systems with embedded mental health units, whereas counties such as Maricopa County and municipalities like Baltimore deploy mobile crisis teams linked to 24/7 crisis centers. Variants include co-responder teams in Portland, Oregon, embedded behavioral health clinicians in schools coordinated with Department of Education offices, and specially trained correctional CIT teams used in some state prisons to manage incarcerated individuals with serious mental illness. Jurisdictional variation reflects differing collaborations with hospitals such as Johns Hopkins Hospital, insurers like Anthem, and philanthropic partners including Kaiser Permanente.

Outcomes, evaluation, and critiques

Research from RAND Corporation, National Bureau of Economic Research, and university centers shows mixed but generally positive associations between CIT implementation and reductions in arrests for people with mental illness, decreased officer injuries, and increased linkage to treatment. Evaluations in cities like Memphis and Portland report declines in use-of-force incidents and improved officer confidence, while other studies note limited impact on overall hospitalization rates and system-level outcomes. Critiques from scholars at Yale University and advocacy groups such as Human Rights Watch focus on variability in fidelity, insufficient community mental health capacity, racial disparities in policing outcomes documented in analyses by ProPublica and the Brennan Center for Justice, and the risk of medicalization without adequate social supports.

Policy, funding, and partnerships

Policy initiatives at the federal and state levels involve grant funding from agencies including SAMHSA, technical assistance from the Office of Justice Programs, and policy guidance from entities like the National Center for State Courts. Funding streams combine municipal budgets, Medicaid reimbursements administered through state agencies such as California Department of Health Care Services, philanthropic grants from foundations like Bill & Melinda Gates Foundation and Robert Wood Johnson Foundation, and private insurer collaborations. Effective partnerships commonly include local hospital systems, university research centers, advocacy organizations such as NAMI, and national law enforcement groups like the International Association of Chiefs of Police that facilitate training, data sharing, and policy advocacy.

Category:Mental health