Fundamentals of Transformation: The Crisis Intervention Team

August 01, 2008

Early in the life of the Mental Health Transformation Project, even as office supplies were requisitioned, staff hired, and requests for technical assistance launched, it became almost immediately evident that a host of diverse players across the field placed a high priority on training opportunities for law enforcement crisis intervention teams (CIT).

The queries came seemingly from everywhere: individual communities, mental health agencies, consumers, and law enforcement organizations alike.

In response, the Project created an infrastructure to uncover and address the specific needs of all these groups, and eventually contracted with the Criminal Justice Training Commission (CJTC) to create a standardized CIT training curriculum suitable for rolling out and implementing in any community in Washington State.

But what is CIT and why is it so universally considered important?

Defusing Crisis Situations: One Size Does Not Fit All

Essentially, crisis intervention teams are law enforcement units—in the Memphis Model, individual officers distributed strategically throughout the rank and file—trained specifically on how to recognize and deal with symptoms of mental illness or developmental disability in high-tension, confrontational situations.

This is not only harder than it sounds, it's also extremely important. That's because in many cases training for law enforcement officials calls on them to watch for signals and follow procedures that work well to control and defuse situations with most people, but often serve only to make them worse with those suffering from a mental illness.

The basic approach to most escalating episodes is for law enforcement officials to respond calmly and with a rational and deliberate assertion of authority, designed to track closely with the actions of the individual they are focused on. They start by requesting cooperation. Then they command cooperation. Then they enforce cooperation, with physical means if necessary.

Unfortunately, some individuals, with a wide array of conditions—autism, bipolar disorder, schizophrenia, even an amphetamine-fueled psychotic episode, and many more—do not respond well to this approach. They may become even more belligerent and confrontational. They may, in the moment, have little understanding of the consequences of their own actions. Perhaps most tragically, they may have decided they want to end their lives, and have chosen "suicide by cop" as their method.

Sadly, this is something that has had to be learned the hard way. Many communities, for any of a number of reasons, have witnessed rashes of police-shooting deaths of individuals with mental health issues, the result of these confrontations gone tragically wrong.

It's important to note that, contrary to the views of some, these incidents have lasting traumatic effects on law enforcement officials as well as the families and friends of the dead. It's one reason that the Washington State Mental Health Transformation Project so quickly heard from so many police organizations, stepping forward to request CIT training.

The Memphis Model

In the late 1980s, Memphis, Tennessee, became one of the first communities to proactively note the problem and take steps to address it. Their strategy involved working directly with mental health consumers and family members on high-level goals and strategies, and training a team of volunteer police officers from each precinct.

These CIT officers perform their regular duty assignments as patrol officers, but are also available to respond to crisis calls involving complex issues related to mental illness. With their training, CIT officers can, with confidence, offer a more humane and calm approach. What's more, these officers are scheduled strategically to maintain 24/7 coverage.

Others argue that training for all police officers in a community is the better way to go, and certainly there's a good case to be made there. But, in a world where resources are at a premium, the Memphis Model with its round-the-clock coverage has proven a successful way to significantly reduce the number of tragic incidents.

The CJTC curriculum offers Washington State communities of all sizes a turnkey strategy for beginning to implement this strategy and start seeing the benefits of CIT training in their own streets and neighborhoods.

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1. Stephen Williams ~ August 08, 2008, 11:16 a.m.

Though I find this to be very imformative and usefull there is one vital element missing in my opinion.The youth side of mental health, of which some asspects are approached differently than adults is not mentionend.This portion if properly addressed will not only help officers in responding to these calls but also will go a long way to dealing with the prevention aspects. I am working on youth spesific training and referals with two departments in Pierce County and would look forward to working with this group.