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Articles   |    
The Police-Based Crisis Intervention Team (CIT) Model: II. Effects on Level of Force and Resolution, Referral, and Arrest
Michael T. Compton, M.D., M.P.H.; Roger Bakeman, Ph.D.; Beth Broussard, M.P.H.; Dana Hankerson-Dyson, M.P.A., M.P.H.; Letheshia Husbands, B.A.; Shaily Krishan, M.P.H.; Tarianna Stewart-Hutto, M.S.; Barbara M. D'Orio, M.D., M.P.A.; Janet R. Oliva, Ph.D.; Nancy J. Thompson, Ph.D., M.P.H.; Amy C. Watson, Ph.D.
Psychiatric Services 2014; doi: 10.1176/appi.ps.201300108
View Author and Article Information

Dr. Compton and Ms. Broussard are with the Department of Psychiatry, Lenox Hill Hospital, the North Shore–LIJ Health System, New York City (e-mail: mcompton@nshs.edu). When this study was conducted, they were with Emory University, Atlanta, and The George Washington University, Washington, D.C. Dr. Bakeman is with the Department of Psychology, Georgia State University, Atlanta. Ms. Hankerson-Dyson, Ms. Husbands, Ms. Krishan, Ms. Stewart-Hutto, and Dr. D’Orio are with the Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta. Dr. Oliva was formerly with the Georgia Bureau of Investigation, Atlanta, and is now retired. Dr. Thompson is with the Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta. Dr. Watson is with the Jane Addams College of Social Work, University of Illinois at Chicago.

Copyright © 2014 by the American Psychiatric Association

Abstract

Objective  The crisis intervention team (CIT) model is a widely implemented police-based program to improve officers’ responses to individuals with behavioral disorders. The authors examined levels of force used by officers with or without CIT training and disposition decisions in a large sample of encounters with individuals whom they suspected of having a serious mental illness, a drug or an alcohol problem, or a developmental disability.

Methods  A total of 180 officers (91 with CIT training and 89 without) in six departments reported on 1,063 encounters, including level of force and disposition (resolution at the scene, referral or transport to services, or arrest).

Results  CIT training status was generally not predictive of level of force, although CIT-trained officers were significantly more likely to report verbal engagement or negotiation as the highest level of force used (odds ratio [OR]=2.00, p=.016). For CIT-trained officers, referral or transport was a more likely outcome (OR=1.70, p=.026) and arrest was less likely (OR=.47, p=.007) than for officers without CIT training; these findings were most pronounced when physical force was necessary. Analyses of disposition differences by officers’ perceptions of subjects’ primary problem (for example, mental illness only versus a drug or an alcohol problem) found some effects of CIT training status.

Conclusions  CIT training appears to increase the likelihood of referral or transport to mental health services and decrease the likelihood of arrest during encounters with individuals thought to have a behavioral disorder. Research should address subject- and system-level outcomes that complement this early evidence of successful prebooking jail diversion.

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Figure 1 Number of encounters by level of force and disposition reported by officers with or without crisis intervention team (CIT) traininga

a Officers coded 1,035 encounters by level of force and 1,063 by disposition. Percentages may not sum to 100 because of rounding.

Figure 2 Percentage of encounters reported by officers with or without crisis intervention team (CIT) training by level of force and dispositiona

a CIT-trained officers coded 503 encounters by level of force and 517 by disposition. Officers without CIT training coded 532 encounters by level of force and 546 by disposition. Percentages within level of force and disposition may not sum to 100 because of rounding. Odds ratios (ORs) indicate the magnitude of the difference (reference group: officers without CIT training).

b The 95% confidence interval does not include 1.

Figure 3 Percentage of encounters reported by officers with or without crisis intervention team (CIT) training by level of force for encounters resulting in resolution, referral or transport, and arresta

a For CIT-trained officers, 406 encounters involved no or low force and 97 involved physical force. For officers without CIT training, again 406 encounters involved no or low force and 126 involved physical force. Odds ratios (ORs) indicate the magnitude of the difference (reference group: officers without CIT training).

b The 95% confidence interval does not include 1.

Figure 4 Dispositions of encounters reported by officers with or without crisis intervention team (CIT) training, by officers’ perception of subjects' conditiona

a Numbers to the left of each pair of bars are odds ratios indicating the effect of CIT training status for the adjacent disposition (reference group: officers without CIT training).

Anchor for Jump
Table 1Characteristics of the six participating law enforcement agenciesa
Table Footer Note

a This information was collected from an officer with crisis intervention team (CIT) training from each agency who served as a liaison to the study team.

Table Footer Note

b Cherokee County is a sheriff’s office; all others are police departments.

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