December 13, 2019

Prior to 1988, police officers in this country had no training to teach them how to handle a mental health crisis. When officers are untrained on how to de-escalate someone in crisis, the possibility of them using force goes up drastically. This is why crisis intervention team (CIT) program and training was created in Memphis, Tennessee, after a tragic incident where a police officer shot a person with mental illness. 
Even 31 years later, most communities in this country still do not have CIT for their officers. And sadly, some officers aren’t even aware of what CIT is. 

What is CIT?

CIT is a community based program that brings together a variety of stakeholds to change how communities are responding to mental health crises. A significant part of CIT is a 40-hour training meant to educate officers on recognizing when individuals have mental illness and are symptomatic, de-escalating the crisis situation and navigating people toward resources and help. The curriculum was a collaborative effort between the Memphis Police Department, NAMI, the University of Tennessee and the University of Memphis. 
The training can be tailored to suit the individual needs of an agency based on the level of available resources. However, most 40-hour CIT trainings consist of:        

  • Active listening and de-escalation
  • Legal considerations
  • Mental illness basics
  • Various conditions including bipolar disorder, schizophrenia, depression, anxiety, PTSD, etc.
  • Suicide detection & prevention; police officer suicide; suicide by cop
  • Excited delirium
  • ​Local resources
  • Jail diversion
  • Role plays

For too long, officers have been more focused on penalizing the behaviors of people in crisis rather than attempting to understand why they are in crisis in the first place. And this training teaches officers how to de-escalate and where to navigate people in a crisis – including understanding the benefits of treatment rather than incarceration. These techniques have been used to divert thousands of people from jail and prevent thousands more from making potentially fatal decisions. 

Implementing CIT

Here are a few things we recommend considering when developing a CIT program in your area. 

  • A good CIT program highlights the idea of jail diversion.
  • If you don’t have quality local resources available for the officers to divert their individuals into treatment, consider how this could negatively impact the CIT program.
  • ​Understand that jails and emergency rooms are not quality treatment options for mental health crises.
  • When developing your program, consult with experts or those with experience to gain insight. 
  • Simply putting an officer in front of a group and reading 40 hours of PowerPoints is not going to have enough impact to shape internal culture.
  • The more collaborative your program, the better. Rely on local subject matter experts to teach courses. Get out and talk to people and ask questions about what is available and how partnerships/relationships can be developed.

Creating a Mental Health Unit

In 2003, the San Antonio Police Department in San Antonio, Texas, adopted the 40-hour CIT and in 2008, developed a full-time mental health detail. Sitting through the CIT training is valuable for each individual officer, but the results are quite profound  when an agency takes the next step to create an actual mental health unit. When you have a full-time unit, 100% of the calls these officers respond to are individuals during their darkest times. It is some of the best and most rewarding on-the-job training an officer can receive. 
Responding to people suffering on a daily basis creates the deepest level of empathy — if you have the right officers filling the role. The San Antonio Police Department is fortunate to have just that. And hopefully, with the spread of CIT, more agencies will follow suit. 
CIT is an integral part of developing an officer, simply because of the alternative perspectives it can provide. As Abraham H. Maslow stated, “If the only tool you have is a hammer, everything will look like a nail.” Let’s embrace the notion that just because things have always been done a certain way, doesn’t mean it is the best way. We can be better. We can do better. Quality crisis intervention team training is one simple place to start. 

Officers Joe Smarro and Ernie Stevens are members of the San Antonio Police Department Mental Health Unit. They are featured in the HBO documentary “Ernie & Joe: Crisis Cops.”


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We’re always accepting submissions to the NAMI Blog! We feature the latest research, stories of recovery, ways to end stigma and strategies for living well with mental illness. Most importantly: We feature your voices.


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text “helpline” to 62640, or chat online. In a crisis, call or text 988 (24/7).