Crisis Intervention Teams (CIT) Information
With the closure of state hospitals beginning in the 1970’s and the shrinking resources in many communities, there is a large and disproportionate number of seriously mentally ill individuals under correctional custody and supervision. Researchers document a serious mental illness in 15% of incarcerated men and 31% of incarcerated women, rates in excess of three to six times those found in the general population.
The magnitude of the problem of untreated mental illness is revealed not only in the numbers, but also in the consequences. These individuals are more likely to experience suicide, victimization, violence, and unpredictable crises.
Typically, when a correctional and detention center is faced with a crisis, the first reaction is to call upon SORT/CERT, or its equivalent, for a swift response and resolution. Correctional and detention leaders, community members and mental health advocates all agree upon the premise that first responders’ swift response is a necessary component to facility safety and security. Disparity occurs and criticism arises when there are unfortunate consequences to the response such as inmate injury, staff injury and/or property damage.
CIT training is the bridge to narrowing the gap by providing front line staff with the needed skills and competencies to handle potentially dangerous individuals experiencing crisis situations. Additionally, it provides training for officers regarding behavioral health issues and educating community members about the role and needs of correctional and detention staff so both sides are more able to effectively utilize each other to benefit inmates and their families.
CIT for Law Enforcement began in Memphis, TN in the late 1980s after a tragedy involving a person with serious mental illness. The community came together with the Police Director and the Mayor of Memphis to find a more effective way for officers to respond to persons with mental illness in crisis. The partnerships that helped create CIT included the Police Department, Memphis University, The University of Tennessee Regional Medical Center, Veterans Administration Medical Center, Lakeside Hospital, other mental health centers, National Alliance on Mental Illness, family members and other advocates. This model takes a team approach and engages community stakeholders, including corrections agencies, local mental health agencies, family advocacy groups and others, in a collaborative and responsive effort to
manage and support justice involved persons with mental illness.
In 2010, The National Institute of Corrections realized that there was an opportunity to formally introduce the CIT Law Enforcement Model to corrections and detention agencies. The CIT Program for Corrections and Detention applies to jails, prisons and community agencies alike. It focuses on building an agency’s capacity to implement a locally owned and administered CIT program and the training for that program.
From December 2010 to March 2014, NIC implemented Phase I of its CIT Program for Corrections and Detentions. During this time staff, representing 19 jail systems, 20 state departments of corrections, and one team from U.S. Probation and Parole, was trained in the tenets of CIT. These three-person teams (mental health advocate, operations executive, behavioral health clinician) were encouraged to take the information learned at the National Corrections Academy in Aurora, Colorado back to their respective agencies to strategically plan the implementation of a locally-owned CIT program. In June 2014, NIC implemented Phase II(also referred to as a Partnership Training Program) of its CIT initiative. This 40-hour classroom based CIT program is held at a host state department of correction or jail.
The Partnership Training Program involves a simultaneous meeting and training schedule whereby the host agency’s Executive Steering Committee for CIT is briefed on the tenets of CIT, how to replicate and sustain the CIT Program while staff receives the 40-hour CIT classroom-based instruction.
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The tools, strategies, and techniques that will allow corrections staff, mental health service providers, and advocates to work together to develop and implement a crisis intervention team (CIT) are presented. CITs help reduce crisis situations, improve safety, and promote better outcomes for persons with mental illness. Participants will learn: about the core elements of a locally developed and owned CIT for managing mental illness in prisons, jails, and community corrections; how to develop collaborative partnerships and implement a CIT model that takes a team approach engaging community stakeholders, including corrections agencies, local mental health agencies, family advocacy groups, and others; and how to defend a CIT’s effectiveness in enhancing correctional staff’s knowledge and skills, aiding administrators in improved management and care for a special population, reducing liability and cost, improving community partnerships for increased access to resources and supports, and increasing safety for all. Overall, this training program focuses on building an agency’s capacity to implement a locally owned and administered CIT program and the training for that program. Sections of this manual include: crisis intervention teams—history, benefits, and successes; partnership and stakeholder development; organizational leadership and program sustainability; data collection and evaluation; planning and preparing for CIT training; and Program Development and Implementation Plan (PDIP).
(You can order the broadcast from the link above.)
CITs have matured from a law enforcement first responder model to new community partnerships with corrections. This team approach incorporates community, frontline law enforcement, and corrections agencies in a collaborative effort to address this growing problem. CITs are effective in enhancing correctional staffs’ knowledge and skills, aiding administrators in improved management and care for a special population, reducing liability and cost, improving community partnerships for increased access to resources and supports, and increasing safety for all.
(You can order the broadcast from the link above.)
Research shows that there are a disproportionate number of justice involved individuals suffering from chronic illness and/ or mental health and substance abuse disorders. We also know that a majority of the justice-involved individuals are young adults and unemployed or earn an income that is well below the federal poverty line leaving them without the ability to obtain health care. There is now an opportunity to enhance collaboration between the criminal justice/corrections and healthcare systems. Early estimates indicate a significant number of justice-involved individuals may be eligible for provisions under the Patient Protection and Affordable Care Act (ACA), specifically; enrollment in Medicaid or the ability to purchase health care coverage through state health insurance exchanges. Because of the many health care expansion possibilities for this population we are witnessing an unprecedented opportunity to help connect the justice population to healthcare coverage and the associated healthcare services.
Federal, state and local criminal justice systems are poised to change the way they do business with the advent of the ACA. It is now possible for millions of low income, justice- involved individuals to obtain healthcare or insurance coverage for their physical and behavioral health needs. This far reaching system change will impact every decision point in the criminal justice system from arrest to individuals returning to the community upon release.
This guide “will be broadly useful to U.S. jails in planning for crises, emergencies, and natural disasters and in developing the appropriate response capacities to cope with these events where they cannot be prevented” (p. vi). Six sections are contained in this publication: introduction; conducting an audit; Emergency Preparedness Self-Audit Checklist for Smaller Jails; Emergency Preparedness Self-Audit Checklist for Larger Jails; resource materials—leadership issues during crises, prevention of jail emergencies, and emergency teams; and case studies for the Maury County Jail fire, disturbance and escape at the Rensselaer County Jail (a new direct supervision jail in Troy, NY), Hurricane Andrew and the Florida Department of Corrections, and riots at Camp Hill (PA) State Correctional Institution.
Information regarding prison emergency preparedness is presented. This guide is comprised of the following sections: introduction; conducting an audit; self-audit checklists--emergency preparedness, natural disaster/HAZMAT/fire, and counterterrorism; Report on the National Survey of Emergency Readiness in Prisons; resource materials--leadership issues during crises, prevention of prison emergencies, emergency teams, and prisons and counterterrorism; and case studies.
The CIT officer will be able to secure a scene that involves an individual who is at risk of harming himself/herself or others due to mental illness, substance abuse or other brain disorder by utilizing de-escalation techniques that minimize the risk of injury to the consumer and law enforcement officers and maximize the probability of a voluntary response to receive treatment. The CIT officer will also be able to discuss the issue of stigma and the importance of a humane response to the person in crisis because of a mental illness, substance abuse problem or other brain disorder.
De-escalation Techniques - Basic communication skills - State of Georgia Crisis Intervention Team Training Program
Washington State Criminal Justice Training Commission
North Carolina Department of Crime Control and Public Safety - Governor's Crime Commission
University of Memphis, Department of Criminology and Criminal Justice
Nevada Department of Corrections
Presentation at Pennsylvania CIT Conference
Justice Research and Statistics Association (JRSA)
Melissa S. Morabito, Amy N. Kerr, Amy Watson, Jeffrey Draine, Victor Ottati and Beth Angell
Northeast Ohio Medical University
MS Department of Mental Health [Vimeo Video]