Crisis Intervention Training

Becca Barrus

The ability of a police officer to de-escalate a volatile situation is invaluable and, in many instances, lifesaving. Not every situation calling for police intervention can be solved in precisely the same way, and it takes training to use discernment to decide which method will work best in a given situation.

That is why Crisis Intervention Training (CIT) was developed. It came about in 1988 in response to police killing a mentally ill person in Memphis, Tennessee (USA). The Memphis Police Department joined with the Memphis Chapter of the National Alliance on Mental Illness (NAMI), the University of Memphis, and the University of Tennessee to organize, train, and implement a specialized unit to respond to calls involving mentally ill people.¹ As of 2014, an estimated 2,700 police departments reported using CIT across the United States.² There is also a similar program in Toronto (Canada) called Mobile Crisis Intervention Team (MCIT) that sends a trained mental health professional with the police to scenes involving people with behavioral disorders.³

The training focuses on communication and de-escalation techniques such as: “continuously assessing the threat, being professional, modeling composure, being aware of body language, providing physical space as appropriate, using names and engaging, using calm and clear language, validating the person’s feelings/situation, encouraging relaxation, providing realistic assurances, and remaining patient.”⁴

The Core Elements of CIT are comprised of Ongoing Elements, Operational Elements, and Sustaining Elements. The program realizes that response to and treatment of mental illness calls go beyond the call and immediate reaction—it involves the community as a whole. It’s a conversation. Having officers with CIT experience is more impactful when coupled with mental health resources where those in need can get the assistance they need. Police departments are encouraged to form partnerships with the mental health advocacy community, such as individuals with mental illness and their family members as well as professionals (psychologists, therapists, social workers, etc.). Each police agency should also have policies that allow officers to refer patients to appropriate services, whether that’s inpatient or outpatient.⁵

When a crisis call is reported, the nearest CIT officer is sent, much like the nearest responder being sent to an ECHO call.

So what does this have to do with emergency dispatch? Dispatch is part of the Operational Elements of CIT’s Core Elements. The document states that “emergency dispatchers are a critical link in the CIT program” and that their ability to recognize a CIT call and ask questions to give the CIT officer information necessary to respond appropriately are key to the whole process. Emergency dispatchers involved in the CIT program should receive a minimum of 8–16 hours of classroom training and additional in-service training.⁶

For those who use CIT and the Police Priority Dispatch System^™ (PPDS^®), Protocol 121: Mental Disorder (Behavioral Problems) provides a script of research-supported questions and PDIs to de-escalate the situation before an officer even arrives on scene. Such PDIs include speaking softly and calmly to patients, writing down medications and/or drugs that the patient is taking, and protecting patients from themselves if necessary.

Additionally, the International Journal of Law and Psychiatry published a paper in 2011 citing, among other things, the effect that correct coding by the emergency dispatcher has on how the police officer handles the call. The study found that “the manner in which the call was dispatched” (i.e., the Determinant Code) “was, in fact, related to the decision the officers made at scene.”⁷

It’s important for emergency dispatchers to develop the skill of recognizing which calls are best handled with CIT and/or Protocol 121. Familiarize yourself with the signs and symptoms that are exhibited by mentally ill callers or patients to give them the best chance to have a positive interaction with the police and to get help.

For more information, see gocit.org.

Sources

1. “CIT History.” CIT. http://www.gocit.org/crisis-intervention-team-history.html (accessed March 19, 2019).
2. “Crisis Intervention Training for Police Officers Effective in Helping Respond to Individuals with Behavioral Disorders.” American Psychiatric Association. 2014; April 1. https://www.psychiatry.org/newsroom/news-releases/crisis-intervention-training-for-police-officers-effective-in-helping-respond-to-individuals-with-behavioral-disorders (accessed March 19, 2019).
3. Broadley L. “‘Psychiatrists in blue’: How police forces deal with people in crisis.” Global News. 2014; July 25. https://globalnews.ca/news/1472833/psychiatrists-in-blue-how-police-forces-deal-with-people-in-crisis/ (accessed March 19, 2019).
4. See note 3.
5. Dupont R, Cochran MS, Pillsbury S. “Crisis Intervention Team Core Elements.” The University of Memphis. 2007; Sept. http://cit.memphis.edu/pdf/CoreElements.pdf (accessed March 19, 2019).
6. See note 5.
7. Ritter C, Teller JLS, Marcussen K, Munetz MR, Teasdale B. “Crisis intervention team officer dispatch, assessment, and disposition: Interactions with individuals with severe mental illness.” International Journal of Law and Psychiatry. 2011; Dec. 7. https://www.researchgate.net/publication/49665118_Crisis_intervention_team_officer_dispatch_assessment_and_disposition_Interactions_with_individuals_with_severe_mental_illness (accessed March 19, 2019).