Memphis/National
CIT Website

Coalition for the
Homeless

Treatment
Advocacy Center

Police Executive
Research Forum

Consensus
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City of Houston

National Institute
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Houston Police
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Houston Police
Officers Union

Harris County
Jail's Mental
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Time & Temp in Houston

Responding to the Mentally Ill - A Historical Problem

Responding to individuals in serious mental health crises has been historically problematic for law enforcement personnel. A lack of education and understanding of mental illness and de-escalation/crisis intervention techniques have led to the following consequences in many law enforcement agencies:

• Litigation. Responding to individuals in serious mental health crises has become one of the most litigious areas of law enforcement. Mental health consumers are injured and killed by law enforcement officers at a rate higher than the average population. Many law enforcement agencies across the nation have been sued for shooting individuals in serious mental health crises.
     
• Injuries. Officers and consumers are injured during these encounters at a rate significantly higher than the average population.
   
• Low Public Confidence. Many family members of individuals with mental illness are afraid to call the police because they fear the police may kill their family member.
   
• Incarcerations of the Mentally Ill. Jails and prisons have become the mental hospitals of the 21st century. Over 500,000 inmates in jails and prisons across the Untied States have mental illness. Yet there are fewer than 50,000 individuals with mental illness in state mental hospitals. The largest mental health facility in the United States is the Los Angeles County Jail, which averages 3,000 mentally ill inmates a day. Many of these individuals cycle in and out of jails and prisons on petty, nuisance-type crimes. One reason for this is the lack of alternative facilities for the mentally ill. A second reason is a lack of knowledge of mental illness among many law enforcement officers.
   
• Lack of Self-Confidence among Police. Many officers lack confidence in their ability to adequately respond to individuals in serious mental health crises. This is due to a lack of education about mental illness and de-escalation/crisis intervention techniques that have been proven to help de-escalate these situations.

The Development of CIT

The Crisis Intervention Team (CIT) program was developed in 1988 in response to a tragic incident. In 1987, police officers in Memphis, Tennessee fatally shot a suicidal person who was cutting himself with a knife and who approached the officers while holding the knife. There was a public outcry after the shooting. This outcry caused the mayor to establish a task force comprised of representatives of the police department, the medical center at the University of Tennessee, the board of education, local mental health facilities, local citizens, and the National Alliance for the Mentally Ill (NAMI). The task force created the CIT program in an attempt to prevent this type of tragedy from occurring in the future. The Memphis Police Department's program has become the model for law enforcement agencies across the nation.


The Memphis Model

Patrol officers volunteer to become CIT officers and attend a 40-hour school. Major topics of study include: recognition of mental illness, psychopharmacology, on-site visits to local mental health facilities, crisis de-escalation skills, defensive weapons training. Upon completion of the training, the officers return to their patrol assignments. When the department receives a call involving a person in a serious mental health crisis, the call is coded as a CIT call and dispatched to a CIT officer. CIT officers respond to routine calls when not responding to CIT calls.

An important aspect of the training is the involvement of each partner agency. Mental health professionals from area mental health facilities, representatives from NAMI, and mental health consumers are all involved in the training.

A second important aspect of the training is the inclusion of role-plays whereby officers put the theory of the classroom into practice.


The Key to the Program's Success

The key to the success of Memphis's program is the existence of a facility that quickly admits consumers brought in by the police who are in need of emergency psychiatric evaluation. The system in Memphis is designed to admit these consumers within 15 minutes. This streamlined system was made possible through the collaboration of the multi-agency task force formed by the mayor.

Effects of the Program

• Jail Diversion. Before the CIT program, many officers responding to disturbance and nuisance-type calls involving a person in a mental health crisis would take that person to jail. Today, most of these individuals are diverted to mental health facilities for emergency evaluation.
   
• Safety. The CIT program has resulted in reduced injuries to both law enforcement officers and mental health consumers.
   
• Improved Community Relations. Increasingly, family members have complete confidence in calling a CIT officer to respond to a loved one in mental health crisis.
   
• Improved Confidence of Officers. Officers feel more confident in their ability to respond to these difficult and often potentially volatile calls.
   
• Reduce Liability/Litigation. The program results in fewer injuries and shootings and thus reduces litigation.
  

For more information on the development of Houston's CIT program see our Timeline.