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ABSTRACT: The Crisis Intervention Teams model (CIT) was originally developed as an urban model for police officers responding to calls about persons experiencing a mental illness crisis. Literature suggests that there is reason to believe that there may be unique challenges to adapting this model in rural settings. This study attempts to better understand these unique challenges. Thematic analysis of focus group interviews revealed that there were both external and internal barriers to developing CIT in their respective communities. Some of these barriers were a consequence of working in small communities and working within small police departments. Participants actively overcame these barriers through the realization that CIT was needed in their community, through collaborative efforts across disciplines, and through the involvement of mental health advocacy groups. These results indicate that CIT can be successfully implemented in rural communities.
Community Mental Health Journal 07/2012; · 1.03 Impact Factor
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ABSTRACT: The primary aim of this retrospective study of death records was to determine whether there were significant differences in years of potential life lost (YPLL) between decedents with serious and persistent mental illness at a community mental health center (N=647) and decedents in the general population (N=15,517) after the analysis adjusted for sociodemographic factors and cause of death.
Clinical case management files from a community mental health center were matched to state death records from 1998 to 2004 to identify decedents being treated for a serious and persistent mental illness. Differences in leading causes of death and YPLL were calculated with descriptive and multivariate methods.
Mean+/-SD YPLL for the decedents with serious and persistent mental illness was 14.5+/-10.6, compared with 10.3+/-6.7 for the general population. Heart disease was the leading cause of death for both groups. Mean differences in YPLL after adjustment for gender, race, marital status, and education ranged from 1.7 years for chronic lower respiratory disease to 13.1 years for accidents and were significant for every leading cause of death. Differences in cause of death did not explain the difference in YPLL. Suicide, cancer, accidents, liver disease, and septicemia were differentially associated with YPLL for persons with serious and persistent mental illness.
Suicide, cancer, accidents, liver disease, and septicemia increased premature mortality among persons with serious and persistent mental illness. Along with ongoing suicide prevention programs, efforts to integrate primary and psychiatric care should focus on these preventable causes of early death.
Psychiatric services (Washington, D.C.) 07/2010; 61(7):663-8. · 2.81 Impact Factor
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ABSTRACT: This study examined the effects of mental health services and stigma on self-concept and quality of life among individuals with serious and persistent mental illnesses.
A broad array of inpatient and outpatient services, as well as perceptions of stigma, was assessed among 188 individuals who had been diagnosed as having serious mental illnesses. Quality of life and self-concept (that is, self-esteem and mastery) were also assessed at baseline and follow-up (approximately six months).
Receiving mental health services had an effect on changes in quality of life over time. Specifically, receiving counseling services had a positive influence on quality of life, whereas receiving inpatient services decreased quality of life. Stigma was not significantly associated with changes in quality of life over the study period. Self-esteem and mastery influenced the association between stigma and quality of life but did not influence the relationship between services and quality of life. Finally, although services had little effect on changes in self-concept, perceived stigma significantly reduced both self-esteem and mastery.
The extent to which services influenced quality of life was dependent on the type of service examined. Moreover, although the effects of services were more pronounced with respect to quality of life than self-concept, the opposite was true with respect to the effects of stigma. Efforts should be made to increase access to specific types of services, such as counseling, as well as to reduce negative perceptions of stigma that erode self-image among individuals with serious mental illnesses.
Psychiatric services (Washington, D.C.) 05/2010; 61(5):489-94. · 2.81 Impact Factor
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ABSTRACT: Survey data were used to assess how training affects changes in officers’ perceptions of persons with mental illness as well as perceptions of police and the mental health system's preparedness in addressing their needs. Officers’ confidence in their ability to handle calls involving people with mental illness in crisis increased most over time. Exploratory analysis indicated that this increase was positively associated with the pretraining degree to which people with mental illness in crisis present a problem for the police department. This increase was positively associated with the perception that the police department's overall effectiveness in meeting the needs of people with mental illness in crisis and negatively associated with the degree to which mental illness was believed to be caused by parental upbringing. These findings suggest that initial salience of the problem for the police department posed by those with mental illness is critical to CIT officer eventual “success.”
Journal of Police Crisis Negotiations 01/2010; 10(1-2):133-152.
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ABSTRACT: In recognition of the fact that police are often the first responders for individuals who are experiencing a mental illness crisis, police departments nationally are incorporating specialized training for officers in collaboration with local mental health systems. This study examined police dispatch data before and after implementation of a crisis intervention team (CIT) program to assess the effect of the training on officers' disposition of calls.
The authors analyzed police dispatch logs for two years before and four years after implementation of the CIT program in Akron, Ohio, to determine monthly average rates of mental disturbance calls compared with the overall rate of calls to the police, disposition of mental disturbance calls by time and training, and the effects of techniques on voluntariness of disposition.
Since the training program was implemented, there has been an increase in the number and proportion of calls involving possible mental illness, an increased rate of transport by CIT-trained officers of persons experiencing mental illness crises to emergency treatment facilities, an increase in transport on a voluntary status, and no significant changes in the rate of arrests by time or training.
The results of this study suggest that a CIT partnership between the police department, the mental health system, consumers of services, and their family members can help in efforts to assist persons who are experiencing a mental illness crisis to gain access to the treatment system, where such individuals most often are best served.
Psychiatric Services 03/2006; 57(2):232-7. · 2.38 Impact Factor
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ABSTRACT: The Crisis Intervention Team (CIT) model is a specialized police response program for people in a mental illness crisis. We analyzed 2174 CIT officers' reports from one community, which were completed during a five year period. These officers' reports described interactions with people presumed to be in a mental illness crisis. We used hierarchical logistic and multinomial regression analyses to compare transport to treatment to either transport to jail or no transport by how the calls were dispatched. The results revealed that both dispatch codes and officers' on-scene assessments influenced transport decisions. Specifically, calls dispatched as suspected suicide were more likely to be transported to treatment than calls dispatched as mental disturbance. Furthermore, calls dispatched as calls for assistance, disturbance, suspicious person, assault, suspicion of a crime, and to meet a citizen were all less likely than mental disturbance calls to result in transportation to treatment. Officer assessments of the use of substances, being off medications, signs and symptoms of mental or physical illness, and violence to self or others were associated with the likelihood of being transported to treatment. These results build on previous work that demonstrated differences in transport decisions between CIT trained and non-CIT trained officers.
International Journal of Law and Psychiatry 34(1):30-8. · 1.19 Impact Factor
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ABSTRACT: The Crisis Intervention Team (CIT) model is a specialized police response program for people in a mental illness crisis. We analyzed 2174 CIT officers' reports from one community, which were completed during a five year period. These officers' reports described interactions with people presumed to be in a mental illness crisis. We used hierarchical logistic and multinomial regression analyses to compare transport to treatment to either transport to jail or no transport by how the calls were dispatched. The results revealed that both dispatch codes and officers' on-scene assessments influenced transport decisions. Specifically, calls dispatched as suspected suicide were more likely to be transported to treatment than calls dispatched as mental disturbance. Furthermore, calls dispatched as calls for assistance, disturbance, suspicious person, assault, suspicion of a crime, and to meet a citizen were all less likely than mental disturbance calls to result in transportation to treatment. Officer assessments of the use of substances, being off medications, signs and symptoms of mental or physical illness, and violence to self or others were associated with the likelihood of being transported to treatment. These results build on previous work that demonstrated differences in transport decisions between CIT trained and non-CIT trained officers.
International Journal of Law and Psychiatry.
