Written Testimony In Support of 2SSB 5311,
Crisis Intervention Training
Seth Dawson, National Alliance on Mental Illness (NAMI Washington)
[email protected] 360-754-3290
As documented in the studies cited and summarized below, there are positive
fiscal considerations associated with Crisis Intervention Training –
particularly in terms of reduced:
*psychiatric hospitalizations,
*inpatient referrals from jails,
*jail bookings/time served,
*police officer and citizen injuries,
*police time spent per incident, and
*SWAT responses
Although not covered by these studies, civil liability prevention is
definitely another fiscal advantage in properly training law enforcement for
these kinds of incidents.
South Med J. 2014 Jun;107(6):391-5. doi:10.14423/01.SMJ.
0000450721.14787.7d.
Costs and savings associated with implementation of a police crisis
intervention team.
El-Mallakh PL1, Kiran K1, El-Mallakh RS1.
Author information
•
1From
the College of Nursing, University of Kentucky, Lexington, and the Mood
Disorders Research Program, Department of Psychiatry and Behavioral Sciences,
University of Louisville School of Medicine, Louisville, Kentucky.
Police crisis intervention teams (CIT) have demonstrated their effectiveness
in reducing injury to law enforcement personnel and citizens and the
criminalization of mental illness; however, their financial effect has not been
fully investigated. The objective of the study was to determine the total costs
or total savings associated with implementing a CIT program in a mediumsize city.
METHODS:
The costs and savings associated with the implementation of a CIT program
were analyzed in a medium-size city, Louisville, Kentucky, 9 years after the
program's initiation. Costs associated with officer training, increased
emergency psychiatry visits, and hospital admissions resulting from CIT
activity were compared with the savings associated with diverted
hospitalizations and reduced legal bookings.
RESULTS:
Based on an average of 2400 CIT calls annually, the overall costs
associated with CIT per year were $2,430,128 ($146,079 for
officer training, $1,768,536 for hospitalizations of patients brought
in by CIT officers, $508,690 for emergency psychiatry evaluations,
and $6823 for arrests). The annual savings of the CIT were
$3,455,025 ($1,148,400 in deferred hospitalizations, $2,296,800 in
reduced inpatient referrals from jail, and $9825 in avoided
bookings and jail time). The balance is $1,024,897 in annual cost
savings.
J Ky Med Assoc. 2008 Sep;106(9):435-7.
Evaluation of consequences of implementation of police crisis
intervention team in Louisville.
El-Mallakh RS1, Spratt D, Butler C, Strauss G.
Author information
•
1Department
of Psychiatry and Behavioral Sciences, University of Louisville
School of Medicine, Louisville, Kentucky 40202, USA. [email protected]
Arrest rate for CIT runs is lower than non-CIT runs (2.1% vs 6.2%,
respectively, P < 0.01). Hostage negotiation team callouts dropped by half.
While the occupancy of the mental health unit in Jefferson County Jail has
stayed relatively constant at around 1,100 patients/year, the referrals to
intense psychiatric services (eg, Central State Hospital) has greatly dropped
(from 53% in 2001 to 26.8% in 2004, P < 0.01).
CIT helps keep people with mental illnesses out of jail, and gets them
into treatment.
• Studies show that police-based diversions, and CIT especially,
significantly reduce arrests of people with serious mental illnesses.1, 2
Pre-booking diversion, including CIT, also reduced the number of rearrests by 58%. 3
CIT reduces officer injuries, SWAT team emergencies, and the amount
of time officers spend on the disposition of mental disturbance calls.
• After the introduction of CIT In Memphis, officer injuries sustained
during responses to “mental disturbance” calls dropped 80%.7
• After the introduction of CIT in Albuquerque, the number of crisis
intervention calls requiring SWAT team involvement declined by 58%.
8
• In Albuquerque, police shootings in the community declined after the
introduction of CIT. 9
• Officers trained in CIT rate their program as more effective at meeting
the needs of people with mental illness, minimizing the amount of
time they spend on “mental disturbance” calls, and maintaining
community safety, than officers who rely on a mobile crisis unit or inhouse social worker for assistance with “mental disturbance” calls. 10
References
1. Steadman, H., Deane, M.W., Borum, R., & Morrissey, J. (2001). Comparing outcomes
of major models of police responses to mental health emergencies. Psychiatric Services,
51, 645-649
2. Sheridan, E., & Teplin, L. (1981). Police-referred psychiatric emergencies: advantages
of community treatment. Journal of Community Psychology, 9, 140-147.
3. TAPA Center for Jail Diversion. (2004). “What can we say about the effectiveness of
jail diversion programs for persons with co-occurring disorders?” The National GAINS
Center. Accessed December 19, 2007 at: http://gainscenter.samhsa.gov/pdfs/
jail_diversion/WhatCanWeSay.pdf.
4. Compton, M., Esterberg, M., McGee, R., Kotwicki, R., & Oliva, J. (2006). “Crisis
inter-vention team training: changes in knowledge, attitudes, and stigma related to
schizophrenia.” Psychiatric Services, 57, 1199-1202.
5. Strauss, G., Glenn, M., Reddi, P., Afaq, I., et al.(2005). “Psychiatric disposition of
patients brought in by crisis intervention team police officers.” Community Mental Health
Journal, 41, 223-224.
6. Teller, J., Munetz, M., Gil, K. & Ritter, C. (2006). “Crisis intervention team training
for police officers responding to mental disturbance calls.” Psychiatric Services, 57,
232-237.
7. Dupont, R., Cochran, S., & Bush, A. (1999) “Reducing criminalization among
individuals with mental illness.” Presented at the US Department of Justice and
Department of Health and Human Services, Substance Abuse and Mental Health Services
Administration (SAMHSA) Conference on Forensics and Mental Illness, Washington,
DC, July 1999.
8. Bower, D., & Pettit, G. (2001). The Albuquerque Police Department’s Crisis
Intervention Team: A Report Card. FBI Law Enforcement Bulletin.
9. Dupont R., & Cochran, S. (2000). “A programmatic approach to use of force issues in
mental illness events.” Presented at the US
Department of Justice Conference on Law Enforcement Use of Force, Washington, DC,
May 2000.
10. Borum, R., Deane, M.D., Steadman, H., & Morrissey, J. (1998). “Police perspectives
on responding to mentally ill people in crisis: perceptions of program effectiveness.”
Behavioral Sciences and the Law, 16, 393-405.
Excerpts from “Crisis Intervention Teams in Florida,” by
Crystal M. Staples, Saint Louis University
http://www.academia.edu/922239/Crisis_Intervention_Teams_in_Florida
Ballas, Paul. 2007. “Schizophrenia and the Criminal Justice System: The Benefits
of Crisis Intervention Team Training”. Retrieved May 10, 2011
from www.healthcentral.com/schizophrenia/c/76/9665/crisis_team/
The author finishes the article by explaining how an effective CIT program
can help officers and reduce more costly alternatives such as incarceration.
It was helpful in the research of this project because it gave
a background argument for saving the state of Florida money which is a
point made in the conclusion of this project. [Emphasis supplied].
Steverman, Sarah and Tara Lubin. 2007. “Avoiding Jail Pays Off”. Retrieved May 12,
2011from www.ncsl.org/Portals/1/documents/magazine/articles/
2007/07SLApr07_AvoidingJail.pdf
This article is about how diverting people with mental illnesses before they
are put in the criminal justice system will save money for the community.
The authors offer figures for how much it costs to help people in mental
health programs and in jail. They show that it costs less to help mentally ill
consumers in mental health facilities than it does to keep these people in jail.
The article provided evidence for this project’s argument that Florida
would save money by implementing CIT programs statewide. [Emphasis
supplied].
Teller, Jennifer, Mark Munetz, Karen Gil and Christian Ritter. 2006. “Training for Police
Officers Responding to Mental Disturbance Calls”. Retrieved May 10, 2011
from psychservices.psychiatryonline.org/cgi/reprint/57/2/232
This is a report focusing on CIT training for police and emergency call
takers and how it can reduce the number of arrests and incarcerations
for people with mental illnesses. [Emphasis supplied].
[NOTE: If you’d find more detailed fiscal impact
information such as this paper helpful please see SSB
5915, also assigned to House Appropriations.]