CIT (Crisis Intervention Team) and the emergency response to a crisis that involves the police

The ISBA Mental Health Law Section Council recently welcomed Alexa James, the Executive Director of National Alliance on Mental Illness (NAMI) Chicago, to speak about the emergency crisis responses by the police. A Licensed Clinical Social Worker with training in Child Development, James has worked with NAMI for six years. James led the Police Accountability Task Force De-Escalation Working Group. This group focused on the best police practices for de-escalating situations with different primary options other than the use of force.

NAMI strives to maintain an advocacy position that balances the interests of both the individual who faces mental health challenges and the family of the individual. Half of the members of NAMI’s staff self identifies as knowing a loved one who is mentally ill. NAMI maintains four Certified Recovery Support Specialists (CRSS) on staff. Ninety percent of the services NAMI provides are totally free.

James attended the ISBA Mental Health Section Council meeting to speak about police response to mental health crisis situations. NAMI Chicago has been focused on police training for 12 years. The Cook County Sheriff speaks frequently about these issues and explains that more people are in crisis and more people are much more acute. Police encounter particular difficulties when they respond to a mental health crisis. For instance, 911 call-takers have little training on how to handle or even identify mental health issues. There is a great need for 911 dispatchers to recognize a possible mental health issue in a phone call and to utilize officers who have specific training for de-escalation of situations involving patients who may be having a mental health crisis. Additionally, police officers need to be trained to de-sensitize a person who is undergoing a mental health crisis. As a result of the shortage of trained 911 dispatchers and police officers, high numbers of individuals go to Cook County jail rather than being treated in a more appropriate setting.

James went into further detail about crisis intervention teams (CITs). Some police districts have more officers trained in crisis intervention than others. Beyond that, CIT officers are not consistently dispatched. The de-escalation process is best served when the Office of Emergency Management Communications, the CIT within the Chicago Police Department, and the City of Chicago Services collaborate to recognize and respond to mental health matters.

She also touched on the decision points of whether to send a person experiencing a mental health crisis to a hospital or to take that person into custody when both the police and the fire department are present as first responders. In an ideal situation, a person in a mental health crisis would be cared for by her or his own mental health provider; the current system contains many barriers to getting a person in a mental health crisis connected with that individual’s provider.

James educated the Council about NAMI’s efforts to encourage training programs for police officers. Further, NAMI has waged a campaign within neighborhoods to educate people on the need to be aware of and request the police officers who are trained to handle mental health issues. NAMI also supports the creation of crisis centers which may be used to de-escalate situations and to assume responsibility for directing individuals to the hospital.

Future solutions may be similar to those used in other jurisdictions. Los Angeles, for example, has implemented a system wherein a police detective and typically, a nurse, respond to the calls that implicate a mental health matter. James also noted that in Portland, Oregon, the system utilizes the Emergency Medical Services, a social worker, and notably, a “Stat Lab,” in which individuals may undergo their first level of medical clearance. This final measure helps to eliminate the reliance upon the Emergency Department.

James concluded her presentation by distributing some materials which illustrate how the ultimate goals of de-escalation are to increase access to treatment, reduce injury and trauma in the community, and to provide better support for the police department. As such, both law enforcement (through CIT and otherwise) and mental health workers must join efforts to respond to incidents that implicate a mental health matter. 

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Dara M. Bass is an independent contractor attorney, based out of the Chicago area, who is licensed in Illinois and Missouri. She has been a member of the ISBA’s Mental Health Law Committee since 2006. She may be contacted at: darabasslaw@gmail.com.