The Police-Based Crisis Intervention Team (CIT) Model: II. Effects on Level of Force and Resolution, Referral, and Arrest

Compton, Michael T.; Bakeman, Roger; Broussard, Beth; Hankerson-Dyson, Dana; Husbands, Letheshia; Krishan, Shaily; Stewart-Hutto, Tarianna; D’Orio, Barbara; Oliva, Janet R.; Thompson, Nancy J.; Watson, Amy C.

doi:10.1176/appi.ps.201300108

Cited by 117 publications

(97 citation statements)

References 16 publications

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“…Six studies evaluated interventions involving police and their impact on access to crisis care. 32,[107][108][109][110][111] Of these, three studies involved police officers receiving intensive mental health training (usually a 40-hour period), two studies examined the impact of triage provided by mental health professionals, and one study compared outcomes for different models of collaboration between police and mental health professionals being provided in different local areas. One study was conducted in the UK, 32 three in the USA, [108][109][110] one in Australia 111 and one in Canada.…”

Section: Other Process Interventions In the Emergency Departmentmentioning

confidence: 99%

“…Three studies [109][110][111] evaluated the benefits of police officers receiving mental health training; none were conducted in UK. No convincing evidence of benefit was found in any of these studies, and the extent to which the findings could be applied to the UK is also unclear.…”

Section: Police Officers Receiving Training In Mental Healthmentioning

confidence: 99%

“…Compton et al 109 mostly found no differences in the level of force used by police with mental health training and those without, but police officers with mental health training were more likely than police officers without that training to describe their highest level of force as verbally engaging and negotiating with a person with mental health problems.…”

Section: Police Officers Receiving Training In Mental Healthmentioning

confidence: 99%

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Improving outcomes for people in mental health crisis: a rapid synthesis of the evidence for available models of care

Paton

Wright

Ayre

et al. 2016

Health Technol Assess

105

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BackgroundCrisis Concordat was established to improve outcomes for people experiencing a mental health crisis. The Crisis Concordat sets out four stages of the crisis care pathway: (1) access to support before crisis point; (2) urgent and emergency access to crisis care; (3) quality treatment and care in crisis; and (4) promoting recovery.ObjectivesTo evaluate the clinical effectiveness and cost-effectiveness of the models of care for improving outcomes at each stage of the care pathway.Data sourcesElectronic databases were searched for guidelines, reviews and, where necessary, primary studies. The searches were performed on 25 and 26 June 2014 for NHS Evidence, Cochrane Database of Systematic Reviews, Database of Abstracts of Reviews of Effects, NHS Economic Evaluation Database, and the Health Technology Assessment (HTA) and PROSPERO databases, and on 11 November 2014 for MEDLINE, PsycINFO and the Criminal Justice Abstracts databases. Relevant reports and reference lists of retrieved articles were scanned to identify additional studies.Study selectionWhen guidelines covered a topic comprehensively, further literature was not assessed; however, where there were gaps, systematic reviews and then primary studies were assessed in order of priority.Study appraisal and synthesis methodsSystematic reviews were critically appraised using the Risk Of Bias In Systematic reviews assessment tool, trials were assessed using the Cochrane risk-of-bias tool, studies without a control group were assessed using the National Institute for Health and Care Excellence (NICE) prognostic studies tool and qualitative studies were assessed using the Critical Appraisal Skills Programme quality assessment tool. A narrative synthesis was conducted for each stage of the care pathway structured according to the type of care model assessed. The type and range of evidence identified precluded the use of meta-analysis.Results and limitationsOne review of reviews, six systematic reviews, nine guidelines and 15 primary studies were included. There was very limited evidence for access to support before crisis point. There was evidence of benefits for liaison psychiatry teams in improving service-related outcomes in emergency departments, but this was often limited by potential confounding in most studies. There was limited evidence regarding models to improve urgent and emergency access to crisis care to guide police officers in their Mental Health Act responsibilities. There was positive evidence on clinical effectiveness and cost-effectiveness of crisis resolution teams but variability in implementation. Current work from the Crisis resolution team Optimisation and RElapse prevention study aims to improve fidelity in delivering these models. Crisis houses and acute day hospital care are also currently recommended by NICE. There was a large evidence base on promoting recovery with a range of interventions recommended by NICE likely to be important in helping people stay well.Conclusions and implicationsMost evidence was rated as low or very low quality, but this partly reflects the difficulty of conducting research into complex interventions for people in a mental health crisis and does not imply that all research was poorly conducted. However, there are currently important gaps in research for a number of stages of the crisis care pathway. Particular gaps in research on access to support before crisis point and urgent and emergency access to crisis care were found. In addition, more high-quality research is needed on the clinical effectiveness and cost-effectiveness of mental health crisis care, including effective components of inpatient care, post-discharge transitional care and Community Mental Health Teams/intensive case management teams.Study registrationThis study is registered as PROSPERO CRD42014013279.FundingThe National Institute for Health Research HTA programme.

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Section: Other Process Interventions In the Emergency Departmentmentioning

confidence: 99%

Section: Police Officers Receiving Training In Mental Healthmentioning

confidence: 99%

Section: Police Officers Receiving Training In Mental Healthmentioning

confidence: 99%

See 1 more Smart Citation

Improving outcomes for people in mental health crisis: a rapid synthesis of the evidence for available models of care

Paton

Wright

Ayre

et al. 2016

Health Technol Assess

105

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“…As described in a companion article (16), each department had implemented CIT training of officers with local instructors and a standardized 40-hour curriculum, which was developed and made available through a statewide CIT initiative (14). Selfselection (volunteering) for CIT specialization is commonly considered a core element of the CIT model.…”

Section: Participantsmentioning

confidence: 99%

The Police-Based Crisis Intervention Team (CIT) Model: I. Effects on Officers’ Knowledge, Attitudes, and Skills

Compton¹,

Bakeman²,

Broussard³

et al. 2014

Self Cite

101

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“…Unfortunately, despite studies evaluating aspects of CIT training's effectiveness [4][5][6][7], little empirical validation has been conducted to investigate just how effective CIT training is at improving officers' ability to respond to persons in crisis. This is in part due to the difficulty of measuring training impact on officer behavior using outcome measures such as reduction in use of force, decreased arrest rates, or referral to mental health services (which may not allow officer discretion).…”

Section: Introductionmentioning

confidence: 99%

Crisis Intervention Team (CIT) metrics: a novel method of measuring police performance during encounters with people in crisis

James¹,

James²

2017

Ment Health Addict Res

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The Police-Based Crisis Intervention Team (CIT) Model: II. Effects on Level of Force and Resolution, Referral, and Arrest

Cited by 117 publications

References 16 publications

Improving outcomes for people in mental health crisis: a rapid synthesis of the evidence for available models of care

Improving outcomes for people in mental health crisis: a rapid synthesis of the evidence for available models of care

The Police-Based Crisis Intervention Team (CIT) Model: I. Effects on Officers’ Knowledge, Attitudes, and Skills

Crisis Intervention Team (CIT) metrics: a novel method of measuring police performance during encounters with people in crisis

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