A Randomized, Controlled Trial of Crisis Intervention Team (CIT) Mental Health Training for Police Officers

Individuals with serious mental illnesses (SMI), as well as those experiencing suicidality or psychiatric crisis, encounter police officers frequently in the community. Almost a third of people with SMI have police involved in their pathway to mental health care. Although a variety of strategies to reduce law enforcement involvement in mental health crisis response are emerging, people with SMI and/or those in crisis will continue to encounter police when officers must serve as first responders, and importantly, during officers’ routine patrol duties. As such, officers need training to safely and effectively interact in these situations. The Crisis Intervention Team (CIT) model is a collaborative approach that includes a 40-hour training of officers. CIT has been implemented in thousands of U.S. communities, and some agencies are now mandating all of their officers complete CIT training. Despite widespread support and growing research, a randomized, controlled trial (RCT) has never been conducted to assess the effectiveness of CIT training on officers’ actual skills and behaviors. Prior research has relied on officers’ self-report of their de-escalation skills and has not directly measured actual performance in a rigorous, standardized, controlled fashion. Furthermore, multi-site studies are lacking, and potential officer-level factors that may moderate CIT training outcomes have yet to be systematically assessed. This study will partner with six sites across the country representing diverse geographic areas and constituency demographics. There are four Specific Aims of the study. First, we will conduct a rigorous, multi- site RCT of CIT mental health training. Each agency will provide 40 officers, for a total of 240. Among the 40 officers from each agency, half will be randomized to CIT training. Data will be collected using Standardized Scenarios, which will be rated centrally in a blinded fashion (blinded by site, study arm, and time). Primary outcomes are actual verbal crisis de-escalation skills and non-verbal physical behavior. Second, we will determine the impact of CIT training on two secondary outcomes: use of procedural justice and disposition- related decision-making. Third, we will test the influence of four targets/mediators on our primary outcome. These hypothesized targets/mediators are: knowledge of mental illnesses, attitudes, subjective norms, and self-efficacy/perceived behavioral control. Engagement of these targets is hypothesized to lead to the expected improvement in officers’ actual skills and behaviors. Fourth, we will evaluate three officer-level variables that might moderate any observed improvements at 3-months and 6-months: greater exposure to/familiarity with the mental health field, greater years of service as a police officer, and greater desire, interest, and motivation to perform the types of duties that CIT officers perform. Results from the RCT will inform decision-makers in jurisdictions across the U.S.