Memphis Crisis Intervention Team Overview

1 Memphis Crisis Intervention TeamOverviewRandolph Dupont, PhDUniversity of MemphisSchool of Urban Affairs and Public PolicyDepartment of Criminology and Criminal Intervention Strategies (901) 678-5523 copyright 2008 Please Note:The information provided is intended for use in public policy briefings. It is designed to assist in providing information about the Memphis CIT Model to community leaders and key stakeholder reasons related to copyright restrictions, this information is not for publication or use without the written permission of the author. Contact Dr. Dupont for further information. Thank Intervention TeamMemphis Model This is policing for the 21stCentury Police Chief Charles Moose (1997) This program should be imitated in every This program should be imitated in every city in America E. Fuller Torrey (1996) .. the most visible pre-booking diversion program in the Hank Steadman and colleagues (2000)Best Practice Model NAMI (1996) National Alliance for the Mentally Ill American Association of Suicidology (1997) National Association of People of Color Against Suicide (1999) Amnesty International (1999) Race, Rights and Police Brutality White House Conference on Mental Health (1999) Department of Justice (2000) Department of Health and Human Services SAMHSA (2000) CUNY, John Jay College of Criminal JusticeLaw Enforcement News(2000)First Responder Model Advantages excellent immediacy of response (Deane et al, 1997) changes nature of Intervention reduces injuries, use of force (Dupont & Cochran, reduces injuries, use of force (Dupont & Cochran, 2000) changes attitudes/perception (Borum et al, 1998) lowers arrest rates (Steadman et al, 2000) increases healthcare referrals (Dupont & Cochran, 2000))

2 Clarifies lines of responsibility (immediately) IInntteeggrraatteedd CCrriissiiss SSeerrvviicceess FFoorr BBeehhaavviioorraall EEmmeerrggeenncciieess A Community Partnership Since 1988 Memphis Police Services Patrol Division Crisis Intervention team (CIT) Mental Health Community University of Memphis University of Tennessee Regional Medical Center VA Medical Center Lakeside Hospital Community MHC and others NAMI National Alliance For The Mentally Ill NAMI Memphis Goals Improve Officer and Consumer Safety Immediacy of Response In-Depth Training team Approach Change Police Procedures Redirect Consumers from Judicial System Health Care System Single Source of Entry No Clinical Barriers Minimal Officer Turnaround TimePlanning GroupGovernmentLaw EnforcementJudiciaryAdvocatesCitizens/Co nsumersHealth CareMental HealthMental HealthLocal ResourcesCIT ModelCrisis Intervention team ModelDispatch Officer Citizen Event DispositionIntroductory TrainingIdentify CIT OfficersNew ProceduresVolunteerPatrol RolePatrol RoleNew RoleSelectionSpecialized TrainingMaintain Safety SkillsDe-Escalation Skills New ProceduresLead InterventionDe-escalation Skills Officer

3 DiscretionReceiving FacilityUser FriendlyMental Health Emergency System Considerations Diagnosis and Referral(Honesty versus Expediency) Referral Sources(Open-end/On Demand) Community Interface (Professional and Advocacy) Training Environment (Burnout) team Approach (Multifaceted Needs) Barriers Lack of Mental Health Funding Turf Issues Political Disinterest Legal Issues Risk Assessment Police CultureMental Health Models University Hospital Emergency Room Regional Medical Center ER Community MHC Crisis Triage/Hospital Community MHC Crisis Triage/Free Standing State Hospital TriageCIT Training- Scenario Based-Exposure-Exposure- Specialized Knowledge- Officer ExpertiseCrisis Escalation Cycle Uncertainty Questioning Refusal Demanding Demanding Generalized Acting Out Specific Acting out Recovery Rapport CooperationPolice Response to Emotionally Disturbed PersonsModels of Police Interactions with the Models of Police Interactions with the Mental Health SystemPolicy Research Associates (PRA) Principal Investigator: Henry Steadman, PhD Co-investigator: Joseph Morrissey, PhD Co-investigator: Randy Borum, PsyD Project Coordinator: Marty Deane, MA Funded by.

4 National Institute of Justice (NIJ) Presented at: American Public Health Association (APHA) Annual Meeting (1997)Maintain Community Safety? Officer RatingsBorum et al (1998) Moderate to Very Effective010203040 Community Service OfficerMental Health Mobile Crisis TeamMemphis Crisis Intervention TeamMetropolitan Police SystemsPercent Moderate to Very EffectiveMinimize Officer Call Time? Officer RatingsBorum et al (1998) Moderate to Very Service OfficerMental Health Mobile Crisis TeamMemphis Crisis Intervention TeamMetropolitan Police SystemsPercent Moderate to Very Response TimesDeane et al (1997) Percentage00 to 0506 to 1011 to 1516 to 20 Time to Response in MinutesCITCSOMCU120140160180 Maximum Response TimeDeane et al (1997)020406080100 Time to Response in MinutesCITCSOMCUI ntervention ProgramHealth Care Referrals,Impact on Arrest and Officer SafetyRandolph Dupont, PhDProfessorProfessorUniversity of MemphisSchool of Urban Affairs and Public PolicyDepartment of Criminology and Criminal Justice12001400160018002000 CIT ER Referrals 02004006008001000 Jan-April Referrals1988198919901991199219931994199 5 YearJail Arrest Evaluation Data National Estimates Sheridan & Teplin, 1986.

5 Borum et al, 1998 20% CIT Steadman et al, 20002% Reports to County Government Reports to County Government Daily Census Count Zager (1990) ; Dupont (1998) Monthly Arrests Screened for MI Dupont (1998) , CMS (1999) Individuals Eligible for ROR Pretrial Services (1999) Per 1000 EventsOfficer Injuries During MI Per 1000 Barricade per 1000 Events84-8788-9192-9596-99 YearsSAMHSA The following research was funded by the Department of Health and Human Services Substance Abuse and Mental Health Service Administration Criminal Justice Jail Diversion Administration Criminal Justice Jail Diversion Project Grant SM 53274. Appreciation for their assistance in this project is gratefully Health TX (P<.0001) : Symptoms (P<.0001) Probabilities at 3 Months: During Past 30 Days (P<.05) onCIT Diversion -Compared to Jail(after 90 days)-better connection to community treatment-improved mental status symptoms-lower rate of re-arrest* SAMHSA: Final Report, Dupont (2003) Criminal Justice Jail Diversion ProjectR efe ren cesA m ne st y Internatio nal (1999).

6 U nited States o f Ame rica: R ace, R ig hts and P o liceB rutalit y. A m nesty International R eports A M R 51/147/99, N ew Yo o rum, R ., D eane, M ., Steadman, H . & M o rrisey, J. (1998). Po lice perspe ctives o nrespo nd ing to menta lly ill peo p le in cr isis: percept io ns o f pro gram effect ehavio ral S ciences and the Law : 16, o rum R , S w anso n J, S w artz M , H ida y V : (1998). S ubstance abu se, vio le nt beha vio rand po lice enco unters amo ng peo p le w it h severe mental d iso rders. Jo urna l o fC o ntempo rar y C rim inal Just ice: 12, ush, S . C. (2002). U sing co nd it io nal relea se as a strategy fo r effective linkage toco m m u nit y m e ntal healt h ser vices: the M em p his P u blic D efenders O ffic e M o o m m u nit y M ental H ealt h R epo rt, 2, 81-82, eane M , Stead man H , B orum R , V esey B , M o rrissey:, (1999). E merg ing partnershipsbetw een menta l healt h and law e nfo rcem e nt.

7 P sych iatric S ervice s: 50, eane, M ., Stead ma n, H ., B orum, R . & M o rrisey, J. (1997). E ffe ctive me ntal healt hpartnerships w it hin co m mu nit y po licing init iat ives. P aper presented at the 126thA nnual M eet ing o f the A m er ic an P ublic H ealt h A sso c iat io n, W ashingto n, .D upo nt, R . & C o chran, S . (2002). Po lic e and m e ntal health linked pro grams: P ro m isingP ractices T he C IT M o del. In G . Landsberg, M . R ack & L . B erg (E ds.), Servingm enta lly ill o ffenders: c hallenges and o ppo rtunit ies fo r menta l healt h pro fessio na ew Y o rk, S pringer P upo nt, R . (2001). Ho w the C r isis Interve ntio n T eam M o de l E nhances P o licing a ndD upo nt, R . (2001). Ho w the C r isis Interve ntio n T eam M o de l E nhances P o licing a ndImpro ves C o m mu nit y M e nta l H ealt h: T he C IT M o del as a B r idg e to C o m m u nit yM ental H ealth S ervices. C o m m u nit y M ental H ealth R epo rt, 3, 3-4, upo nt, R.

8 & C o chran, S . (2000). Po lice R e spo nse to M ental H ealth E m ergencies B arriers to C hang e. Jo urna l o f the A m erica n Academy o f P sychiatr y and the L aw ,28, oo se, C . A. (1996). Co m m ents at the Po rtland P o lice S ervices C r isis Interve nt io nT raining. Po rtla nd, O R .P ractitio ner P erspective s (2000). M emp his, T N , P o lice D epart ment s C r is is Intervent io nT ea m. U .S. D epartment o f Just ice: B ureau o f Ju stice A ssistance, Ju hite H o use C o nference o n M ental H ealt h (1999). W o rking fo r a H ealthier A m ashingto n, .S AM H S A N ew s (2000). Ja il D iversio n P ro gram s E nhance C are. U .S . D epartment o fH ea lth and H u m an S ervices: S u bstanc e A bu se and M e ntal H ealth S ervic esAd m in istratio n. 7(2), 1-5. Steadm an, H ., D eane, M ., Bo rum, R . & M o rrissey, J. (2000). Co mpar ing o utco mes o fm ajo r mo dels o f po lice respo nses to mental hea lt h em ergencies.

9 P sychiatr ic S ervices,51, orrey, E . F. (1996). Co mm e nts at the annual m eeting o f the N atio na l A lliance fo r theM entally Ill, N ashville, T N , hite H o use C o nference o n M ental H ealt h (1999). W o rking fo r a H ealthier A m ashingto n.