Recommended Best Practices
Recommendation 5.4: Implement crisis intervention programs and training.
Crisis intervention programs and training come in a variety of forms and address a variety of topics, some of which, such as the following, are essential. To address these issues, departments should work with communities to:
Train emergency call operators. Training should cover howto identify when people are in crisis so that officers are prepared to use crisis intervention tactics upon arrival. In departments with CITs, operators should be trained to dispatch and CIT officers.[i]and should prepare officers to use crisis intervention tactics. Dispatchers should have a script with specific questions so they can get needed information, including whether callers have weapons and whether they have mental health or developmental disabilities, or a substance use disorder.
Train all officersin basic techniques to identify mental health, developmental disability, or substance use disorder crises and to manage them. All officers should be trained to manage crises until officers with advanced training (i.e., CIT officers) and mental health professionals arrive. Basic crisis intervention training should be 40 hours and require additional (and continual) in-service training. The Houston Police Department, for example, requires all officers to take eight-hour refresher courses every two years after they have received 40 hours of basic training.[ii]
As noted above, training should be mandatory and should cover topics including implicit bias, cultural awareness and responsiveness, empathy, procedural justice, effective social interactions, tactical skills, verbal intervention and de-escalation, and negotiation.[iii]These skills strengthen officers’ ability to recognize when people are in crisis, defuse crises, and refer people to needed services. The President’s Task Force Report recommends that state Peace Officer and Standards Training boards (which set training requirements for law enforcement in regions across the country) include CIT training in basic recruit and in-service training requirements.[iv]
Pair officers withmental health and disability experts to respond to crises. “Co-responder” models are a middle ground: Officers respond to crises but they do so with mental health professionals and/or community-based service providers, who are better equipped to handle the situation.[v]Some departments use MCTs that exist outside of the department, where mental health and disability professionals respond to requests for service from officers and community members.[vi]Even under this model, officers must be trained in crisis intervention, and clinicians should be trained to lead the response when working with officers. The Los Angeles County Sheriff’s Department’s Mental Evaluation Team pairs mental health clinicians with officers to respond to people with mental health or developmental disabilities and other high-risk individuals. Although this co-response model has its own challenges, including cross-agency coordination, geography, staffing issues, training logistics, and transportation shortages, the Sheriff Civilian Oversight Commission’s ad hoc committee has recommended that LASD increase the number of MET teams from 23 to 60.[vii]
Establish a cadre of CIT officers with specialized training.[viii]Under the Memphis CIT model, officers volunteerto receive advanced training and are available for rapid response to mental health crises. They lead de-escalation efforts at the scene and assess the need to connect people with mental health services.[ix]The Chicago Police Department, for example, offers two 40-hour advanced trainings to help officers safely and effectively respond to youth and veterans in crisis.[x]
Instead of arresting people in crisis, CIT officers (with or without co-responders) should redirect or refer them to health professionals. This applies even when people have apparently violated the law — so long as they pose no immediate threat to public safety.[xi]Often, people who are acting erratically or causing a public disturbance but not committing an act of violence are placed under custodial arrest and/or issued a summons. If the summons turns into a warrant for failure to appear or pay fines, they can end up in jail for a minor initial offense and become ensnared in the criminal justice system.
[i]SeeRandolph Dupont, et al., Univ. of Memphis, Crisis Intervention Team Core Elements 10 (2007), http://cit.memphis.edu/pdf/CoreElements.pdf(“All dispatchers should be trained to appropriately elicit sufficient information to identify a mental health related crisis.”); Mark G. Peters & Philip K. Eure, N.Y.C. Dep’t of Investigation, Putting Training into Practice: A Review of NYPD’s Approach to Handling Interactions with People in Mental Crisis 31 (2017), http://www1.nyc.gov/assets/oignypd/downloads/pdf/Reports/CIT_Report_01192017.pdf(“A look at successful CIT programs around the country demonstrates that exposing dispatchers and call takers to CIT training is essential to the implementation of a successful CIT program.”); Kurt Vorndran et al., Police Complaints Bd., Enhancing Police Response to People with Mental Illness in the District of Columbia: Incorporating the Crisis Intervention Team (CIT) Community Policing Model17 (2006), https://policecomplaints.dc.gov/sites/default/files/dc/sites/police%20complaints/publication/attachments/Enhancing%20Police%20Repsonse%20to%20People%20with%20Mental%20Illness.pdf(“A crucial component of the CIT model is dispatch operations. To ensure that calls involving mental health issues are properly identified and that CIT officers are dispatched to those calls, dispatchers and 911 call takers receive specialized training on how to perform their duties in support of the CIT program.”); Carmen Best, Chief of Police, Seattle Police Dep’t Manual, 16.110 – Crisis Intervention, Seattle.gov (Aug. 16, 2018),https://www.seattle.gov/police-manual/title-16—patrol-operations/16110—crisis-intervention(noting that CIT-trained officers should be dispatched to calls that appear to involve a subject in behavioral crisis).
[ii]Police Exec. Res. Forum, Critical Issues in Policing Series: An Integrated Approach to De-Escalation and Minimizing Use of Force 15 (2012), https://www.policeforum.org/assets/docs/Critical_Issues_Series/an%20integrated%20approach%20to%20de-escalation%20and%20minimizing%20use%20of%20force%202012.pdf.
[iii]President’s Task Force on 21st Century Policing, Final Report of the President’s Task Force on 21st Century Policing 10-11, 56-57 (2015),https://cops.usdoj.gov/pdf/taskforce/taskforce_finalreport.pdf(asserting that “mitigating implicit bias should be a part of training at all levels of a law enforcement organization” and recommending that law enforcement departments “adopt procedural justice as the guiding principle for internal and external policies”).
[iv]President’s Task Force on 21st Century Policing, Final Report of the President’s Task Force on 21st Century Policing 3-4 (2015), https://cops.usdoj.gov/pdf/taskforce/taskforce_finalreport.pdf.
[v]See, e.g.,Melissa Reuland, Police Exec. Res. Forum, A Guide to Implementing Police-Based Diversion Programs for People with Mental Illness 10–11 (Jan. 2004), http://www.pacenterofexcellence.pitt.edu/documents/A%20Guide%20to%20Implementing%20Police-Based%20Diversion%20Programs.pdf;see also Henry J. Steadman et al., Comparing Outcomes of Major Models of Police Responses to Mental Health Emergencies, 51 Psychiatry Servs. 645 (2000), https://ps.psychiatryonline.org/doi/full/10.1176/appi.ps.51.5.645?url_ver=Z39.88-2003&rfr_id=ori%3Arid%3Acrossref.org&rfr_dat=cr_pub%3Dpubmed&(finding that a “specialized” response to mental health crises, partnering police with mental health professionals, was effective in reducing arrests); Council of State Gov’ts, Criminal Justice/Mental Health Consensus Project 41 (June 2002), https://www.ncjrs.gov/pdffiles1/nij/grants/197103.pdf(“Some law enforcement agencies hire licensed mental health workers as secondary responders. These civilians serve in units that are either located in the police department— where civilian workers are under the chief’s supervision—or reside outside the department because staffing is shared with other county or city mental health providers. These civilian workers may either ride along with officers in special teams or respond when called by an officer after the scene has been secured for various crisis calls, including those involving people with mental illness.”); U.S. Dep’t of Justice, Police Mental Health Collaboration, Co-Responder Team, https://pmhctoolkit.bja.gov/learning/types-of-pmhc-programs/co-responder-team(last visited Dec. 23, 2018).
[vi]U.S. Dep’t of Justice, Police Mental Health Collaboration, Mobile Crisis Team https://pmhctoolkit.bja.gov/learning/types-of-pmhc-programs/mobile-crisis-team(last visited Feb. 25, 2019); Council of State Gov’ts, Criminal Justice/Mental Health Consensus Project 37, 40-41, 45 (June 2002), https://www.ncjrs.gov/pdffiles1/nij/grants/197103.pdf; Melissa Reuland, Police Exec. Res. Forum, A Guide to Implementing Police-Based Diversion Programs for People with Mental Illness 4-9 (Jan. 2004), http://www.pacenterofexcellence.pitt.edu/documents/A%20Guide%20to%20Implementing%20Police-Based%20Diversion%20Programs.pdf.
[vii]See generally Sheriff Civilian Oversight Comm’n, Report of the Sheriff Civilian Oversight Commission Regarding the Mental Evaluation Team Program of the Los Angeles County Sheriff Department(2018), https://coc.lacounty.gov/LinkClick.aspx?fileticket=NOUC3DWcsps%3D&portalid=35;see also Sheriff Civilian Oversight Comm’n, Status Report of the Sheriff Civilian Oversight Commission Regarding the Mental Evaluation Team Program of the Los Angeles County Sheriff Department(2017), https://coc.lacounty.gov/LinkClick.aspx?fileticket=si_CVTMsBuA%3D&portalid=35.
[viii]Randolph Dupont, et al., Univ. of Memphis, Crisis Intervention Team Core Elements 12 (2007), http://cit.memphis.edu/pdf/CoreElements.pdf(“Officers within a patrol division should voluntarily apply for CIT positions. . . [E]ach of the CIT Officers maintains their role as a patrol officer and gains new duties and skills through the CIT training, serving as the designated responder and lead officer in mental health crisis events.”).
[ix]See Randolph Dupont, et al., Univ. of Memphis, Crisis Intervention Team Core Elements 14 (2007), http://cit.memphis.edu/pdf/CoreElements.pdf(“Police officers receive intensive training to effectively respond to citizens experiencing a behavioral crisis. . . . Officers are encouraged to maintain these skills throughout the course, while incorporating new de-escalation techniques to more effectively approach a crisis situation.”); Kurt Vorndran et al., Police Complaints Bd., Enhancing Police Response to People with Mental Illness in the District of Columbia: Incorporating the Crisis Intervention Team (CIT) Community Policing Model14 (2006), https://policecomplaints.dc.gov/sites/default/files/dc/sites/police%20complaints/publication/attachments/Enhancing%20Police%20Repsonse%20to%20People%20with%20Mental%20Illness.pdf(“The CIT model . . . consists of a select group of police officers who, although continuing to serve as regular patrol officers in a district or precinct, are certified to provide highly specialized mental health crisis intervention.”);Charles Dempsey, Beating Mental Illness: Crisis Intervention Team Training and Law Enforcement Response Trends, 26 S. Cal. Interdisc. L.J. 323, 324 (2017), https://gould.usc.edu/why/students/orgs/ilj/assets/docs/26-2-Dempsey.pdf(stating that one of the primary goals of CIT models is to “redirect individuals with mental illness from the judicial system to the health care system.”).
[x]William Harms, Police Need to Work More with Mental Health Professionals, 23 Univ. of Chi. Sch. of Social Serv. Admin. Mag. (Summer 2016), https://ssa.uchicago.edu/ssa_magazine/police-need-work-more-mental-health-professionals.
[xi]SeeCarmen Best, Chief of Police, Seattle Police Dep’t Manual, 16.110 – Crisis Intervention, Seattle.gov (Aug. 16, 2018(utilizing an intercept continuum that balances criminal charges with mental health interventions at different levels of crisis and provides for referral to a crisis solutions center in certain instances when resolving behavioral crisis-related misdemeanor property crimes).