Amy Watson

University of Wisconsin–Milwaukee | UWM

This paper outlines the development of standardized scenarios used to assess the efficacy of Crisis Intervention Team (CIT) training in a randomized, controlled trial. The objective was to create scenarios that accurately simulate mental health crisis situations for law enforcement officers, ensuring that each scenario tests specific CIT skills rel...

The Criminal Sentiments Scale-Modified (CSS-M) has been widely used as a measure of criminal attitudes. This analysis examined CSS-M scores in a large sample of outpatients with serious mental illnesses and a criminal legal system history. We compared total and subscale scores in our sample to scores from two other previously published U.S. studies...

Objective: The 988 telephone number was implemented in July 2022 as an easily accessible way to reach the National Suicide Prevention Lifeline and has been envisioned as one step in building a more robust crisis care continuum in the United States. This study aimed to describe how various stakeholders anticipated using 988 compared with the most w...

The overrepresentation of people with serious mental illnesses in the criminal legal system has spurred the development of crisis response models to improve or reduce police response to a mental health crisis. However, limited research has explored preferences for crisis response, and no research in the United States has examined the responses desi...

Background People with mental illnesses are disproportionately entangled in the criminal legal system. Historically, this involvement has resulted from minor offending, often accompanied by misdemeanor charges. In recent years, policymakers have worked to reduce the footprint of the criminal legal system. This paper seeks to better understand how m...

People with serious mental illnesses are disproportionately involved in the criminal legal system, often for low-level, non-violent misdemeanors. This paper examines how decision-makers at different stages of the criminal legal system articulate unique visions of the “best approach” for addressing this problem of over-representation. Focus groups a...

Aim: Given a lack of interventions to identify and engage individuals with early psychosis in jail and connect them to specialty care in the community upon release, we designed a Targeted Educational Campaign (TEC) for correction officers working in jails. We report on impacts of the TEC on officers' cognitive and attitudinal outcomes. Methods:...

The Theory of Planned Behavior posits that behaviors are predicted by one’s intention to perform them; intention is driven by attitude toward the behavior, subjective norm, and perceived behavioral control. We used this theory to predict Crisis Intervention Team (CIT)-trained and non-CIT officers’ intention to facilitate referral of persons with su...

Objective: Reducing the overrepresentation of individuals with serious mental illnesses in the criminal legal system requires a better understanding of the charges for which they are most commonly arrested. This study aimed to compare violent offenses, penal code classifications, Uniform Crime Reporting (UCR) codes, and specific charges in arrests...

Objective Prior research on Crisis Intervention Team (CIT) training for police officers has demonstrated improvements in knowledge, attitudes, self-efficacy, and stigma, but how these factors work together to influence behavioral outcomes like de-escalation skills and referral decisions remains unstudied. Method 251 CIT-trained and 335 non-CIT off...

Objective: The overrepresentation of people with serious mental illnesses in the criminal legal system has spurred information-sharing initiatives to transmit information between mental health service providers and criminal legal system stakeholders with the goal of improving resources and streamlining access to care. However, no research to date...

Objective: Individuals with serious mental illnesses are overrepresented in all facets of the legal system. State-level criminal histories of patients with serious mental illnesses were analyzed to determine the proportion who had been arrested and number of lifetime arrests and charges, associations of six variables with number of arrests, and th...

Purpose Very little is known about the frequency and nature of police contacts with individuals with intellectual or developmental disabilities (I/DDs). The purpose of the study is to examine the characteristics of police contacts with persons with I/DD and how they differ from other behavioral health-related encounters. Design/methodology/approac...

Over the past decade, police involvement in behavioral health crisis response has generated concern and controversy. Despite the salience and timeliness of this topic, the literature on service user experiences of interactions with officers is small and studies of youths and young adults are nonexistent. The authors aimed to investigate youths' and...

Calls to defund and reform police agencies have been emphasized in recent public discourse. Demands range from shuttering police agencies to shifting resources and responsibility for responding to noncriminal social and behavioral health vulnerabilities to the health and social services sector. This Open Forum discusses how police officers became p...

The Crisis Intervention Team (CIT) model has been implemented in over 3,000 communities across the USA. Research to date has shown beneficial results in terms of officers’ knowledge, attitudes, self-efficacy, stigma, and force preferences. This study aimed to broaden the lens on the implementation context of CIT to examine whether factors in the en...

Welcome to this special edition of the Journal of Psychiatric and Mental Health Nursing that seeks to explore the intersect between law enforcement and mental health care. Policing has always played a role in responding to individuals experiencing mental health crisis and or living with mental illnesses in the community. In recent decades, the poli...

Introduction: Data on fatal outcomes of police encounters, combined with evidence on the criminalization of people with mental illnesses, reveal a grave need to improve outcomes for individuals with mental illnesses who come into contact with police. Current efforts are hampered by a lack of in-depth knowledge about the nature of nature and contex...

People with mental illness (MI) are overrepresented in prisons, in part, because people with MI stay in prison longer. Correctional officers (COs) use discretion in force, violations, and segregation. Crisis intervention teams (CITs) are being used in corrections to reduce disparities in sanctioning and improve safety. This quasi-experimental, mixe...

In 2017, The Kennedy Forum Illinois partnered with the City of Chicago and community partners to launch the West Side Community Outreach Pilot Project, an initiative designed to bring free mental health trainings to underserved communities on Chicago’s west side. Participants self-selected from one of two broad training categories: an eight-hour Me...

Developed over 30 years ago, the Crisis Intervention Team model is arguably the most well-known approach to improve police response to individuals experiencing mental health crisis. In this article, we comment on Rogers and colleagues' review (in this issue) of the CIT research base and elaborate on the current state of the evidence. We argue that...

Objective: Individuals with serious mental illness are overrepresented in correctional populations. However, little is known about the representation of persons with serious mental illness at earlier stages in the criminal justice process. This research sought to measure the prevalence of arrestees in New York State who were treated for a major me...

Overview This guideline aims to improve the outcomes of situations where police respond to people who are experiencing mental health crises in the community. This guideline focuses on: i) enhancing police responses to managing mental health crises, and ii) improving partnerships with people with lived and living experience of mental health issues a...

The authors examined how police officers assess for mental illnesses and how those assessments vary by location. Researchers conducted semistructured interviews with 15 officers working in two police districts in one city. Findings from the study indicate that officers make assessments based on information from dispatch, collateral contacts, and be...

In recent decades, there has been sustained focus on police responses to persons experiencing mental health crises. The Crisis Intervention Team (CIT) model has been a seminal effort to improve safety, reduce arrests and enhance the use of emergency psychiatric assessment. With CIT well established, new discussions have emerged around how to furthe...

Officers' volunteering for Crisis Intervention Team (CIT) training—rather than being assigned—is assumed to be an important, beneficial self‐selection bias. This bias remains poorly characterized, though CIT officers are more likely to be female and to have had exposure to the mental health field. We determined whether or not self‐selection is bene...

As academic researchers, we are often asked to opine on whether the Crisis Intervention Team model (CIT) is an evidence-based practice (EBP) or evidence-based policing. Our answer is that it depends on how you define evidence-based practice and what outcome you are interested in. In this commentary, we briefly describe the CIT model, examine defini...

Purpose To propose a focus for mental health training efforts to better equip officers to provide interventions and supports to help facilitate improved outcomes for people experiencing mental health crises. Design/methodology/approach A reflection on key evidence relating to mental health training programs delivered to police, focussing on Aust...

Stigma is a significant barrier to recovery and full community inclusion for people with mental illnesses. Social work educators can play critical roles in addressing this stigma, yet little is known about their attitudes. Social work educators were surveyed about their general attitudes about people with mental illnesses, attitudes about practice...

While Assertive Community Treatment (ACT) is considered an evidence-based service model there is limited evidence regarding the effectiveness of an adaptation of the model, Forensic Assertive Community Treatment (FACT) for persons with serious mental illness who also have significant criminal justice system involvement. Using a multi-method approac...

There are calls across America for police to re-imagine themselves as “guardians” rather than “warriors” in the performance of their innumerable duties. The contentious history of police attitudes and practices surrounding encounters with people affected by mental illnesses can be understood through the lens of this wider push toward guardianship....

Although improving police responses to mental health crises has received significant policy attention, most encounters between police and persons with mental illnesses do not involve major crimes or violence nor do they rise to the level of emergency apprehension. Here, we report on field observations of police officers handling mental health-relat...

This article describes the innovative use of a pop culture source-song lyrics to augment the teaching of qualitative methods in social work research. The use of pop culture sources as learning tools in the MSW curriculum has the potential to enhance the learning experience for students. These techniques have not been applied in the content of MSW r...

Two surveys were conducted on the crisis intervention team (CIT) model, a police-based program designed to improve responses to individuals with mental illnesses. Data were collected between July and September 2013 from 171 police chiefs and sheriffs (42 had implemented CIT in their agency), and 353 law enforcement officers (273 had CIT training) i...

Drawing on attribution theory, research on police discretion, and public attitudes toward mental illness, we examine attributional processes in police decision making in response to domestic violence situations involving veterans and nonveterans with signs of mental illness. Using data from experimental vignettes varying veteran status, victim inju...

Stigma creates significant barriers to service access and recovery for persons with psychiatric disorders. In this chapter, we define stigma, examine its consequences for persons with mental illnesses, and discuss its implications for EI programs. We then describe approaches to reduce stigma that can be implemented by local communities. By incorpor...

Objective Police officers' decisions and behaviors are impacted by the neighborhood context in which police encounters occur. For example, officers may use greater force and be more likely to make arrests in disadvantaged neighborhoods. We examined whether neighborhood characteristics influence police encounters with individuals suspected to have a...

Objective: Individuals with serious mental illnesses are very likely to interact with police officers. The crisis intervention team (CIT) model is being widely implemented by police departments across the United States to improve officers' responses. However, little research exists on officer-level outcomes. The authors compared officers with or w...

Objective: The crisis intervention team (CIT) model is a widely implemented police-based program to improve officers' responses to individuals with behavioral disorders. The authors examined levels of force used by officers with or without CIT training and disposition decisions in a large sample of encounters with individuals whom they suspected o...

Purpose The purpose of this paper is to examine the predictors of officer attitudes toward Crisis Intervention Teams, a new innovation designed to improve police response to people with mental illnesses. Design/methodology/approach The current study uses data from a larger study of the Chicago Police Department (CPD) Crisis Intervention Team (CIT)...

There is mounting evidence that mental health courts (MHCs) reduce criminal recidivism and increase use of mental health services. Although not yet empirically tested, procedural justice has been proposed as one potential mechanism that promotes change and improves outcomes for MHC participants. In this article, we investigate MHC participants’ per...

As persons with mental illnesses and law enforcement become increasingly entangled, the collaboration of police and mental health service providers has become critical to appropriately serving the needs of individuals experiencing mental health crises. This article introduces the Crisis Intervention Team (CIT) Model as a collaborative approach to s...

Social work students (n = 60) in a master's-level course on severe mental illness participated in a quasi-experimental study examining the degree to which increased knowledge about and contact with individuals with schizophrenia during the course would impact their attitudes toward people with the disorder. Results revealed significant improvement...

In this episode of the inSocial Work Podcast, Dr. Amy Watson and Brian Kelly discuss their research into Forensic Assertive Community Treatment, an adaptation of traditional ACT that attempts to explore the unique challenges faced by previously incarcerated persons with mental illness as they re-enter communities. Dr. Watson and Mr. Kelly interpret...

The internalization of public stigma by persons with serious mental illnesses may lead to self-stigma, which harms self-esteem, self-efficacy, and empowerment. Previous research has evaluated a hierarchical model that distinguishes among stereotype awareness, agreement, application to self, and harm to self with the 40-item Self-Stigma of Mental Il...

Within social psychology, procedural justice theory has been used to understand variations in compliance with legal authorities such as police. Thus, it may help explain variation in cooperation and compliance in encounters between police officers and people with serious mental illness (SMI), which are often fraught with difficulty and risk. In thi...

The Crisis Intervention Team (CIT) program was first developed to reduce violence in encounters between the police and people with mental illness as well as provide improved access to mental health services. Although there is overwhelming popular support for this intervention, scant empirical evidence of its effectiveness is available—particularly...

The goals of Crisis Intervention Team (CIT) programs include improving safety during encounters between police and persons with mental illnesses, diverting persons with mental illnesses away from the criminal justice system, and increasing referral and access to mental health services. CIT is a systemic intervention, and as such, its implementation...

In response to challenges officers face with mental health-related calls, police departments are implementing specialized response programs like Crisis Intervention Teams (CIT). CIT is gaining support for its promise to promote safe, respectful interactions with police and individuals with mental illnesses. This paper outlines the results of a qual...

Collaborations between the law enforcement and mental health communities have become vital as law enforcement officers are often first-line responders in crisis situations involving individuals with mental illnesses. A nationally recognized example of a pre-booking jail diversion program, the Crisis Intervention Team (CIT) model, was developed in 1...

Collaborations between the law enforcement and mental health communities have become vital as law enforcement officers are often first-line responders in crisis situations involving individuals with mental illnesses. A nationally recognized example of a prebooking jail diversion program, the Crisis Intervention Team (CIT) model, was developed in 19...

Police agencies across the country are struggling to respond to significant number of persons with serious mental illness, who are landing on their doorsteps with sometimes tragic consequences. Arguably, the most widely adopted approach, the Crisis Intervention Team (CIT) model, is a specialized police-based program designed to improve officers’ ab...

During the past four decades, fundamental changes in mental health and law enforcement policies have brought criminal justice professionals into increasing contact with people with serious mental illness (PSMI). This contact occurs at every stage of the criminal justice process. The police, who are the gatekeepers of the criminal justice system, in...

Police officers encounter a sizable number of calls involving individuals who have mental illness. In response to the challenges that officers face with mental health calls, police departments nationally are implementing specialized response programs. In this paper, we present findings from qualitative interviews with police regarding the implement...

The Crisis Intervention Team (CIT) model of collaboration between law enforcement and mental health is widely recognized as being "more than just training" for police officers; the core elements of CIT include a number of other components. However, several system- and policy-level obstacles can make successful implementation of CIT difficult in man...

Police encounters are believed to be particularly dangerous for people with mental illness and police officers. Despite widespread concern among advocates, researchers and police professionals, little is known about the details of these interactions including the occurrence of injuries. In the current study, we explore injuries to people with menta...

Despite increased recent attention to improving the quality of encounters between police officers and people with serious mental illness, there are no measures available for assessing how consumers perceive their interactions with police officers. Drawing upon conceptual frameworks developed within social psychology, this study reports the developm...

Purpose: Alarming numbers of people with serious mental illness (SMI) in prisons have led to the development of specialized reentry services for this population, such as forensic assertive community treatment (FACT). While FACT is a promising model, its evidence base is not firmly established and controversy surrounds whether it should involve ment...

A large percentage of youth involved in the juvenile justice system experience mental health problems, yet many do not receive mental health care. In this study, we used a process-focused framework of mental health decision making to gain insight into the use of mental health services among these youth. In-depth interviews were conducted with nine...

The Crisis intervention team model (CIT) is possibly the most well known and widely adopted model to improve police response to persons with mental illness. A primary goal of CIT programs is to divert individuals with mental illness from the criminal justice system to mental health services. In this paper we examine the effectiveness of fielding CI...

Programs to improve police interactions with persons with mental illness are being initiated across the country. In order to assess the impact of such interventions with this population, we must first understand the dimensions of how police encounters are experienced by consumers themselves. Using procedural justice theory as a sensitizing framewor...

The large numbers of people with mental illness in jails and prisons has fueled policy concern in all domains of the justice system. This includes police practice, where initial decisions to involve persons in the justice system or divert them to mental health services are made. One approach to focus police response in these situations is the imple...

The Memphis model of the Crisis Intervention Team (CIT) program has established itself as a prototype of law enforcement-mental health collaboration for a large number of municipalities across the country, and several states are implementing statewide training programs that seek to train approximately 20 percent of their police forces. Given the en...

Many advocates have called for more anti-stigma programs targeting the attitudes of children towards people with mental illness as a way to forestall subsequent prejudice and discrimination as they age and develop. In order to better understand how children stigmatize people with mental illness, we reviewed the substantial literature on social cogn...

Persons with mental illnesses such as schizophrenia may internalize mental illness stigma and experience diminished self-esteem and self-efficacy. In this article, we describe a model of self-stigma and examine a hierarchy of mediational processes within the model. Seventy-one individuals with serious mental illness were recruited from a community...

The purpose of this study is to determine how the demographics of perceivers influence their stigma of people with mental illness or with substance abuse. A nationally representative sample (N = 968) was asked to respond to a vignette describing a person with a health condition (schizophrenia, drug dependence, or emphysema) and his/her family membe...

A way to promote eliminating stigma surrounding mental illnesses is targeting the phenomenon in children. This study's purpose is to validate models of mental illness stigma on children in Grades 6–8. Children completed the revised Attribution Questionnaire in a pretest of a larger study on a mental health education program. Data from this study pe...

Procedural justice provides a framework for considering how persons with mental illness experience interactions with the police and how officer behaviors may shape cooperation or resistance. The procedural justice perspective holds that the fairness with which people are treated in an encounter with authority figures (such as the police) influences...

This study examines the impact of two versions of anti-stigma programs-education and contact-presented on videotape. A total of 244 people were randomly assigned to education or contact conditions and completed pre-test, post-test, and follow-up measures of stereotypes. Results suggest that the education videotape had limited effects, mostly showin...

In this study, we examine newspaper coverage of mental illness in children and adults taken from 6 weeks during a 1-year period. Articles were coded for (1) type of article; (2) types of disorders named or described; (3) themes related to crime, attributions of the disorder, treatments, and critiques of the mental health system; and (4) "elements o...

Traditional theories of stigma and discrimination suggest that members of stigmatized groups internalize public stigma and suffer a loss of self-esteem and self-efficacy. More recent evidence suggests that this internalization, or self-stigma, is not a uniform response across members of stigmatized groups. Some people are not so negatively affected...

Self-stigma is distinguished from perceived stigma (stereotype awareness) and presented as a three-level model: stereotype agreement, self-concurrence, and self-esteem decrement. The relationships between elements of this model and self-esteem, self-efficacy, and depression are examined in this study. In Study 1, 54 people with psychiatric disabili...

Several studies have examined the breadth and depth of the impact of the stigma and discrimination associated with mental illness. This study examines perceived solutions to discrimination in housing and employment situations. We expected identification of solutions to be positively associated with disease insight and personal empowerment. One hund...

Family members of relatives with mental illness or drug dependence or both report that they are frequently harmed by public stigma. No population-based survey, however, has assessed how members of the general public actually view family members. Hence, the authors examined ways that family role and psychiatric disorder influence family stigma. A na...

While there is a growing literature on mental illness stigma and strategies for reducing stigma among adults, less is known about how children and adolescents view persons with mental illness. In this paper, we describe the Attitudes Toward Serious Mental Illness Scale-Adolescent Version (ATSMI-AV) and our initial examinations of its factor structu...

Previous studies using probability samples have found a noticeable, but small association between violence and psychiatric disorder. In this article, we analyze data from the National Comorbidity Survey (NCS) to further examine this question. Psychiatric diagnosis of survey responses was based on a modified version of the Composite International Di...

The use of legal coercion to compel individuals to participate in mental health treatment is expanding despite a lack of empirical support for many of its forms. Policies supporting mandated treatment are made by legislators and judges, often based on perceptions of public concern. Using data from the MacArthur Mental Health Module contained in the...

Structural stigma and discrimination occur when an institution like a newspaper, rather than an individual, promulgates stigmatizing messages about mental illness. This study examined current trends in the news media on reporting topics of mental illness. All relevant stories (N=3,353) in large U.S. newspapers were identified and coded during six w...

This article discusses examples of structural stigma that results from state governments' enactment of laws that diminish the opportunities of people with mental illness. To examine current trends in structural stigma, the authors identified and coded all relevant bills introduced in 2002 in the 50 states. Bills were categorized in terms of their e...

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Little direct research has examined the attitudes of police officers toward persons with mental illness. However, social psychological research on stereotypes and prejudice provides a basis for understanding officer attitudes and behavior in relation to individuals with mental illness. After discussing the growing numbers of persons with mental ill...

This study tests a social psychological model (Skitka & Tetlock, 1992). Journal of Experimental Social Psychology, 28, 491-522; [1993]. Journal of Personality & Social Psychology, 65, 1205-1223 stating that policy maker decisions regarding the allocation of resources to mental health services are influenced by their attitudes towards people with me...

This study examined how two types of public education programs influenced how the public perceived persons with mental illness, their potential for violence, and the stigma of mental illness. A total of 161 participants were randomly assigned to one of three programs: one that aimed to combat stigma, one that highlighted the association between vio...