Crisis Intervention Training in Law Enforcement

Increased awareness of mental health issues related to policing is a significant driver of the reform dialog in the United States. In 2015, the President’s Task Force on 21st Century Policing made several sweeping recommendations for greater research on the intersection of mental health and policing, and action addressing everything from law enforcement officers’ mental health needs to what training officers receive on mental health issues. Over the last three decades, agencies have trained Crisis Intervention Teams (CITs) to respond to calls related to mental health. As the latest research adds to our understanding of mental health and policing, CITs have continued to evolve to meet their missions’ demands better. This article explores the context in which they were initially created, how they serve their communities, and some of the critiques of the strategy.

Shifts in Mental Health Care

Crisis Intervention TrainingIn the United States, a significant shift in how mental health services were funded in the early 1980s led to major changes in how officers are trained to deal with mental health issues. In the simplest terms, funding at the federal level was diverted in the form of block grants to states, which according to the National Institutes of Health shifted the federal role to “one of providing technical assistance to increase the capacity of state and local providers of mental health services.” The merits and efficacy of this change to funding are the subjects of frequent debate. Still, one point of general agreement is that this policy shift has led to a patchwork system of mental health resources throughout the country, with evident disparities between states and between urban and rural areas.

This new funding model, coupled with changing attitudes towards institutionalization, led to a marked shift in providing mental health in the United States. In many cases, shortfalls in the availability of mental health care and related mental health crises came under the purview of law enforcement and the criminal justice system. Illustrating this point are recent statistics suggesting that while an estimated 5.2% of the US adult population lives with serious mental illness, that same population experiencing severe mental health issues makes up an estimated 16% of the prison population. This, combined with research suggesting as many as 20% of police calls are related to mental health issues or crises, makes the argument that law enforcement is being put into a role it isn’t always adequately equipped to handle.

Law Enforcement Adapts

Recognizing this gap in capacity versus need arising from mental health-related calls, agencies began to look for new ways to augment and improve their capabilities. In 1988, the Memphis Police Department (MPD) pioneered a first-of-its-kind formalized strategy to address an increased reliance on law enforcement to respond to mental health crises by creating the first CIT.

The department partnered with local mental health providers, the Memphis chapter of the National Alliance for the Mentally Ill (NAMI), as well as the University of Memphis and the University of Tennessee to lay the groundwork for training a new, specialized unit. This evidence-based approach incorporated research findings and proven mental health practices to more safely and effectively address mental health crisis calls for assistance. An initial group of volunteer officers received extensive and ongoing crisis intervention training to help them recognize situations involving mental illness and prioritized techniques like triage and de-escalation, helping officers connect those with serious mental illness with care providers rather than relying on arrest or detention as a means of resolution.

The MPD’s CIT program has shown significant positive results and served as a model for agencies nationwide. As of 2021, similar CIT programs drawing from the experience of MPD have been replicated in more than 2,700 communities throughout the country.

Successful Crisis Intervention Training Implementation

An effective CIT program creates tangible benefits for persons with serious mental illness. By avoiding arrest and incarceration and instead referring subjects to mental health resources, CIT programs can help the mentally ill avoid arrest records and convictions that can be barriers to employment, housing, and public services. There are also demonstrated benefits to departments that support CTIs. NAMI has collated and analyzed decades of research and identified three primary benefits.

Giving law enforcement officers better tools to do their job safely and effectively
Research suggests that officers who have undergone crisis intervention training are significantly more likely to report verbal engagement of negotiation as the highest level of force used in encounters with those experiencing mental illness. The same study showed that referrals and transport for care were more likely than arrests. Further research investigating the MPD’s CIT program found an 80% reduction in officer injuries during mental health calls involving crisis, suggesting a tangible benefit to officer safety.

Maximizing Officer Efficiency in the Field
Evidence suggests that, in some cases, CITs reduce overall time spent on mental health calls. Specialized crisis intervention training gives officers the tools to recognize scenarios involving mental health and respond appropriately. Additionally, the lower incidence of injury and use of force reduces officer time spent involved with rehabilitation, court, or internal affairs investigations.  This allows officers to get back into the field on patrol more efficiently.

Cost Savings for Governing Bodies
Put simply: jails and prisons are not mental health treatment facilities. NAMI explored the costs of incarceration versus mental health treatment and found that the cost of as few as 35 days of adult incarceration is roughly equivalent to that of an average course of inpatient psychiatric treatment. In the case of juveniles, who are much more expensive to house in detention, that figure drops to as few as six days.

Criticism of CIT

Though there is research to suggest a CIT program can produce benefits for law enforcement officers, the communities they serve, and those with mental illnesses – the findings are not conclusive. As with so many policing strategies and programs, the chances of success lie in the implementation. There is a danger that CIT training can be seen as another one-time box to tick off. Without follow-up and ongoing education, that training might not be adequately integrated into an agency’s overall strategy. Additionally, these strategies rely on the availability of mental health resources that may not be readily available in an era of municipal and state budget cuts, especially in rural and otherwise underserved communities. There is agreement among many in the field that, no matter how well-implemented a CIT is, it cannot entirely replace an effective mental health care system.

As CIT training and practice continue to evolve, they will rely on new research and evidence-based recommendations from mental health professionals and law enforcement leadership to build on the past successes and learn from missteps. Though these programs are not a one-step cure-all for limited mental health care resources, they will be vital in the mental health equation.

Look for a future post in which we’ll explore different CIT strategies and training methods in agencies across the country and how they are adapting to meet the needs of 21st century policing.