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Articles   |    
The Police-Based Crisis Intervention Team (CIT) Model: I. Effects on Officers’ Knowledge, Attitudes, and Skills
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.201300107
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  Individuals with serious mental illnesses are very likely to interact with police officers. The crisis intervention team (CIT) model is being widely implemented by police departments across the United States to improve officers’ responses. However, little research exists on officer-level outcomes. The authors compared officers with or without CIT training on six key constructs related to the CIT model: knowledge about mental illnesses, attitudes about serious mental illnesses and treatments, self-efficacy for deescalating crisis situations and making referrals to mental health services, stigmatizing attitudes, deescalation skills, and referral decisions.

Methods  The sample included 586 officers, 251 of whom had received the 40-hour CIT training (median of 22 months before the study), from six police departments in Georgia. In-depth, in-person assessments of officers’ knowledge, attitudes, and skills were administered. Many measures were linked to two vignettes, in written and video formats, depicting typical police encounters with individuals with psychosis or with suicidality.

Results  CIT-trained officers had consistently better scores on knowledge, diverse attitudes about mental illnesses and their treatments, self-efficacy for interacting with someone with psychosis or suicidality, social distance stigma, deescalation skills, and referral decisions. Effect sizes for some measures, including deescalation skills and referral decisions pertaining to psychosis, were substantial (d=.71 and .57, respectively, p<.001).

Conclusions  CIT training of police officers resulted in sizable and persisting improvements in diverse aspects of knowledge, attitudes, and skills. Research should now address potential outcomes at the system level and for individuals with whom officers interact.

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Figure 1 Effect sizes for differences between officers with or without crisis intervention team training in responses to key construct measuresa

a Effect sizes for knowledge and opinions about mental illnesses (top two bars) were not linked to the vignettes used in the assessment. Other bars pertain to variables linked to the psychosis or suicidality vignette. Only ten of the 13 vignette-linked variables that significantly differentiated the groups are shown. Effect sizes between .20 and .50 (vertical lines) are regarded as weak, and those between .50 and .80 as moderate.

Anchor for Jump
Table 1Measures of six key constructs among officers with or without crisis intervention team (CIT) training
Table Footer Note

a P, psychosis vignette; S, suicidality vignette

Table Footer Note

b Cohen’s d is the standardized difference between the means.

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