The Crisis Intervention Team (CIT) model is designed to improve the outcomes of interactions between law enforcement officers and individuals living with mental illness. When an individual living with mental illness experiences a mental health crisis or acts out as a result of a mental illness, CIT works by diverting them to appropriate mental health services and supports rather than to the criminal justice system. CIT provides training to law enforcement officers on preventing psychiatric crises and deescalating a crisis when it occurs, while reducing the need for use of physical force.

However, CIT is not just a training program. CIT programs are only effective when law enforcement personnel, mental health providers, people living with mental illness and their families, and other community leaders collaborate to help ensure that when officers divert an individual, the treatment system is willing and able to provide appropriate services. CIT has three key components:

• A community partnership between mental health providers, law enforcement personnel, family and consumer advocates and other community leaders. Representatives from these groups form a steering committee. They examine their community to determine their community's needs, agree on strategies for meeting those needs and organize training for law enforcement officers. This committee also determines the best way to transfer individuals living with mental illness from police custody to the community mental health system and ensures that there are adequate services to effectively do this.
• A 40-hour training program for law enforcement personnel that includes basic information about mental illness, information about the local mental health system and local policies, interaction with consumers and family members to learn about their experiences, verbal de-escalation techniques and strategies and role-playing.
• Consumer and family involvement in the steering committee, coordinating trainings and leading portions of the training.

The first CIT program was established in Memphis in 1988 after a police officer shot and killed a man with a serious mental illness. This tragedy prompted a collaborative effort between the police, NAMI Memphis, the University of Tennessee Medical School and the University of Memphis to improve police training and procedures in response to calls involving individuals with mental illness. The Memphis CIT program has achieved remarkable success, in large part because it has remained a true community partnership. Today, the so-called "Memphis Model" CIT has been adopted by approximately 1500 communities in nearly all states, and is being implemented statewide in several states.

CIT has been successfully used with adults for decades in states and communities across the country, with outstanding results. As a result of the extraordinary success of CIT, innovative states and communities are working to expand CIT to effectively respond to youth in crisis in communities and in schools.

To learn more about CIT, visit NAMI's CIT Resource Center.

CIT is not a NAMI signature program. The first CIT program was founded in Memphis in 1988, through a joint effort between NAMI Memphis, the Memphis Police Department, the University of Memphis and the University of Tennessee Medical School. Since then the program has been replicated by hundreds of communities across the country. NAMI State Organizations and NAMI Affiliates have been instrumental in most of these communities.

No organization "owns" the CIT program and there is no one standardized curriculum. There are, however, agreed-upon standards for the CIT program and an international CIT organization.

CIT for Youth is not a distinct program, but is an extension of the CIT program. The overarching goal is the same: to improve interactions between law enforcement officers and individuals living with mental illness and to divert individuals living with mental illness to mental health services and supports and away from the criminal justice system (in the case of CIT for Youth, the juvenile justice system).

CIT for Youth focuses on the specific needs of youth with mental health needs and their families. As such, CIT for Youth involves new community partners, including school-based law enforcement officers, parents/caregivers and youth, school personnel and child and adolescent mental health providers. These partners work together to focus on the needs of youth with mental health needs and the services and supports available in the community to address these needs.

CIT training is a minimum of 40 hours; the length of CIT for Youth training varies, since it is often offered as a follow-up or in-service to officers who have already received CIT training. CIT for Youth training curricula vary in length from 40 hours to eight hours. CIT for Youth training specifically targets officers who are assigned to schools and/or frequently encounter youth in the community. CIT for Youth training may also be offered to school personnel. CIT for Youth training includes a specific focus on child and adolescent development, the manifestation of mental illness in youth, school policies and procedures and strategies for identifying and responding to youth in crisis. For more information on the different CIT for Youth training curriculums available and the topics they address, visit Training Information section of the CIT for Youth Resource Center.

In any CIT program, whether or not it includes a focus on youth, the involvement of individuals living with mental illness and their families is a vital component. In a CIT for Youth program, the families involved are usually parents/caregivers of youth living with mental illness and their children. They are involved in the planning and coordinating of CIT for Youth and in CIT for Youth training (as role players, instructors and presenters on the lived experience of mental illness).

If possible, communities considering implementing CIT for Youth should have a CIT program in place. The communities that we worked with in the three target states all had an existing CIT program. These communities found that an existing CIT program served as an important starting point for CIT for Youth. Leaders in communities without CIT should be willing to dedicate significant time and energy to building relationships with community partners, planning and coordinating and providing a minimum of 40 hours of CIT training. To learn more about CIT implementation, visit NAMI's CIT Resource Center.

CIT has been adopted by approximately 1500 communities in nearly all states. In most states, CIT is not in every community however there are a number of states with widespread CIT and well-organized state level CIT organizations, including Ohio, Maine, Utah, Georgia, Florida, Connecticut and others. To see where there are CIT programs near you, visit the University of Memphis CIT Center's CIT National Map.

CIT for Youth has only recently been developed and implemented in some states across the country, including Connecticut, Colorado, Illinois, Louisiana, Pennsylvania, Utah, Texas and others. CIT for Youth is quickly spreading to other states and we expect it to grow as information is shared and exchanged. There is not yet a central directory of CIT for Youth programs.

In addition, the MacArthur Foundation's Models for Change project is a multistate effort that is developing a national CIT for Youth program and implementing it in target states.

Communities with CIT for Youth have shared that the program can be implemented and sustained at low cost through community partnerships. The core community partners provide free resources, volunteers and in-kind donations.

• Coordination and Planning: Any partner organization may have staff members who can volunteer as a program coordinator to plan training sessions and steering committee meetings.
• Instructors: Community partners are often willing to donate their time as panelists, instructors and role players for the training.
• Facilities: Many programs host trainings at the local law enforcement training academy, schools or university facilities, for little to no cost.
• Materials: Law enforcement agencies may be willing to donate the cost of training materials and promotional materials. Other community partners may also provide funds to cover costs of other needed items.
• Salary: Law enforcement officers selected to attend a training should be volunteers who are invested in the program, rather than motivated by a pay increase. Some communities may choose to offer trained officers a token increase in pay in recognition of their specialized skills or certifications. Law enforcement agencies may be able to cover any additional staff costs incurred by taking officers off the street to attend the training. If not, law enforcement officers may be willing to attend the training during their own free time or vacation.
• Sustained Funding: Once a program is established, opening the classes up to officers from other communities and charging tuition can help create a sustainable funding stream.

In addition, some communities have financed their programs with grants. For more information about applying for grants, visit NAMI's CIT Advocacy Toolkit.

For more information on CIT for Youth implementation, visit the NAMI CIT for Youth Resource Center. NAMI's CIT Center and the University of Memphis CIT Center are available to provide general information and guidance on CIT implementation.

You should also connect with your NAMI State Organization or NAMI Affiliate to involve them in the process. Contact information for NAMI State Organizations and NAMI Affiliates can be accessed at www.nami.org/local.

In addition, the community leaders implementing CIT for Youth in NAMI's three target states agreed to offer technical assistance to communities who wish to implement the program. They are also happy to share their training curriculums. Here is their contact information:

Illinois

John Williams
Director of Youth Services
Oak Park Township
jwilliams@oakparktownship.org

Louisiana

Lieutenant David Anders
CIT Coordinator
Lake Charles Police Department
danders@cityoflc.us

Major Virginia ("Ginny") Higgins
Special Services Bureau Chief
St. Martin Parish Sheriff's Office
ghiggins@stmartinsheriff.org

Utah

Detective Ron Bruno
CIT Utah Program Director
Salt Lake City Police Department
ron.bruno@slcgov.com

NAMI also learned from and worked with leaders of the following programs:

Connecticut

Louise Pyers
Statewide CIT Program Coordinator
Executive Director of the CT Alliance to Benefit Law Enforcement (CABLE)
Criminal Justice Project Director of NAMI Connecticut
Lcp@cableweb.org or criminaljustice@namict.org

Chicago, Illinois

Kurt Gawrisch
Chicago Police Department
Bureau of Patrol
Special Functions Group, Unit 141
Crisis Intervention Team (CIT)
kurt.gawrisch@chicagopolice.org

San Antonio, Texas

Terri Mabrito
Community Liaison/TIFI Project Coordinator
Children's Crisis and Diversion
The Center for Health Care Services
San Antonio, Texas
tmabrito@chcsbc.org

Models for Change

http://www.modelsforchange.net