Crisis Intervention Teams (CIT): First Responders on the Front Lines

Policing in this modern age presents first responders with ever increasing challenges and obstacles. Each day, thousands of police officers respond to people in crisis nationwide. Individuals struggling with mental health issues and various crisis situations frequently encounter law enforcement. In Harford County alone, the Sheriff’s Office handles hundreds of mental health related calls each month. The result is that at least 70-80 persons are transported to local ERs for evaluation; including the three municipal agencies, APG, and MSP, that number grows. Over and over, police are racing across the county to intervene with those in crisis. Many times, the callers are family, friends, co-workers, classmates and others. Few calls come from the person of interest. Officers find high numbers of people have been struggling with depression, suicidal thoughts, psychosis, substance use, and other issues simultaneously. Also, many are not in treatment or have stopped taking their prescribed medications. It is well known for those in need of treatment, failing to remain connected to care frequently results in a miserable existence, and increases the risk of crisis episodes. So, how do we help equip our first responders to recognize and respond to those in crisis?

Since 1988, the nation has slowly embraced the concept of “CIT.” It began in

Memphis, TN following the death of a mentally ill man armed with a knife. In a confrontation with police, he refused to drop the weapon and was shot and killed by officers. While the community was strongly impacted and enraged by this tragic outcome, cooler heads decided to take logical action steps. The local NAMI [National Alliance on Mental Illness] chapter reached out to Memphis Police Department to sit down together and open a dialogue about how to integrate crisis intervention and law enforcement. CIT was born! This is the foundation for teaching law enforcement basic crisis intervention and de-escalation skills to use in the field.

I have been working in the mental health field since 1990. Having spent 23 years with Sheppard Pratt, 14 years with the crisis team here in Harford County, reality was I spent nearly all my time working with police and responding to mental health calls with them. The volume of ‘psych calls’ was alarming. Despite our efforts, we lacked a solid method to teach officers about those suffering with mental illness and substance use. We finally learned about CIT in 2007, sending representatives to the CIT National Conference in Memphis, TN to learn all about it. Leadership moved quickly to start laying the groundwork for a countywide CIT program. Our first training was the summer of 2008. Since that time, hundreds of officers and others in public safety have joined. CIT is not a magic solution to the struggle law enforcement faces with crisis calls, but it is a solid skill set to add to their abilities.

Our county program is called “Harford County Public Safety CIT.” This is meant to reflect how we include many elements of public safety, beginning with ‘911’ call-takers, police dispatchers, police officers and corrections officers. We feel that this is the continuum of law enforcement response, from initial call to disposition. CIT training is a full week... 40 hours of lessons, role-plays, community visits and more. 40 hours is the standard for CIT worldwide. The goal is to maintain a minimum of 25% trained in each agency. We also teach Mental Health First Aid (MHFA) on the first day, a great foundation for the material we cover the rest of the week. MHFA also works great as a separate offering for larger audiences. We stress that CIT is much more than training; officers must take personal responsibility for their policing and use CIT to its full potential. It really is up to them to “Recognize and Respond” to someone in crisis.

In 2013, the State of Maryland Behavioral Health Administration released funding to all Maryland jurisdictions to either develop or expand CIT services in their communities. We already had our CIT program in place, so we chose to expand. Using this new funding, we opted to make the CIT Coordinator position permanent. As an employee of the Office on Mental Health, I serve here at the Sheriff’s Office as an on-site mental health consultant. In this role, I have access to the agency, can support CIT officers in the field, and make assessments and referrals to the appropriate treatment services. This includes the Mobile Crisis Team, hospital emergency rooms and local clinics, and providers. From this position, I can reach out to other law enforcement as well. We have had many agencies visit Harford County for the CIT course. Several have then begun their own in-county CIT trainings in their jurisdictions. The future is wide open for what can be done with these mental health and public safety relationships. We owe it to our communities to ensure our first responders are trained, equipped and positioned to respond to vulnerable persons, and strive for a safe and positive outcome.

Shawn Dundon, MA, CIT Coordinator

Office on Mental Health/Harford Co. Sheriff’s Office

Office: 443-409-3552

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Image courtesy of:

Lauren Carson http://www.lcarson.com/wellness/152/; https://goo.gl/images/KxaA1J;