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Crisis Intervention Team (CIT) Mental Health Training for Law Enforcement Officers: Protocol for a Multi-Site Randomized Controlled Trial

Michael T Compton*, Elisabeth Jackson, En Fu, Howard F Andrews, Ron Bruno, Erin Comartin,Hanga Galfalvy, Don Kamin, Leah G Pope, Eduardo Vega, Amy C Watson

Background: Although strategies to reduce police involvement in mental health crisis response are emerging, people with Serious Mental Illnesses (SMI) and/or those in crisis often encounter police during officers’ routine patrol duties. Officers need training to safely and effectively interact in these situations. The Crisis Intervention Team (CIT) model is a collaborative aaproach that includes a 40 h training of the officers who self-select and are screened to be CIT officers. CIT has been implemented in thousands of U.S. communities, but a Randomized Controlled Trial (RCT) has never been conducted to assess effectiveness of CIT training on officers’ skills and behaviors.

Purpose: To determine the effectiveness of CIT training on officers’ demonstrated skills and behaviors in three outcome areas: 1) Verbal crisis de-escalation skills, as well as non-verbal physical behavior (the primary outcome), 2) Officers’ use of four domains of procedural justice, 3) Disposition-related decision-making. Hypothesized mediators of the primary outcome, in addition to proposed moderators, will be assessed.

Participants and methods: 240 law enforcement officers from six sites across the U.S. will participate in video- recorded standardized scenarios with professional actors at baseline, with half then randomized to the 40 h CIT training within the following two weeks. Officers will then be re-assessed at 3 months and 6 months. The primary outcome will be measured using trained raters blinded to site, treatment arm and time point, viewing videos to rate officers’ demonstrated skills and behaviors; survey-based data will be collected on officers’ characteristics, the four hypothesized mediators and the four proposed moderators.

Conclusion: Innovative methods include using standardized scenarios with professional actors portraying psychosis with agitation, depression with suicidality and mania with refusal to leave to elicit officers’ demonstrated skills and behaviors. This multi-site RCT of CIT training will yield generalizable, high-impact results that will inform policy and practice, while filling critical gaps in research and knowledge.