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STARTING OR IMPROVING YOUR CIT PROGRAM

Using the Core Elements

Presented by: Major (ret.) Sam CochranMichele Saunders, LCSW

Don Kamin, Ph.D.Pat Strode

CIT International Annual ConferenceSeattle, Washington

August 25, 2019

Agenda & Overview

• Community Engagement of the CIT Program: More than “Just” Training

• Introduce & Discuss CIT Core Elements

• Partnership Development & Steering Committees

• CIT Training & Implementation

• Sustainment & Growth

• Q & A

• Ongoing Elements• Partnerships: Law Enforcement, Advocacy, Mental Health

• Community Ownership / Identity: Planning, Implementation & Networking

• Policies and Procedures

Operational Elements• CIT: Officer, Dispatcher, Coordinator

• Curriculum: CIT Training

• Mental Health Receiving Facility: Emergency Services

• Sustaining Elements• Evaluation and Research

• In-Service Training

• Recognition and Honors

• Outreach: Developing CIT in Other Communities

http://www.citinternational.org/resources/Documents/CoreElements.pdf

CIT Core ElementsPartnerships: Building Sustainability

ONGOING ELEMENTSPartnerships and Committees

OPERATIONAL ELEMENTSTraining

Implementation

SUSTAINING ELEMENTSEvaluationIn-service

Recognition

Imp

rove Yo

ur C

IT Pro

gram

ONGOING ELEMENTSPartnerships and Committees

Questions & Discussions…

1) Who should be Considered “KEY” (necessary) Partners?

Answers: Law Enforcement (1st Responders)Mental Health (Community Services & Support)and Advocacy (NAMI / MHA / other…)

Answers: Probation, School Resource, 911 Telecommunications,Corrections, VA Police, University Police, State Police, Hospital Security, …… Other CIT Connections...

2) Who might be considered “additional” Partners ?

• The When and Why and The Who – Also…

• The What … understanding “the agendas” within engagements

✓What’s in it for them?✓What motivates them?✓What do they have in common?✓What are their desired outcomes?

Understanding Engagements

of CIT

• The most Important --• Examples: Successful engagements (Law Enforcement)➢Schedule Appointment with Chief / Sheriff➢Develop a “meeting plan” – (do your homework / research

about CIT)➢Know your community resources (strengths & weaknesses)➢Compliment your local law enforcement & Chief -- do

research -- know specifics ➢Promote to assemble a CIT Committee or Taskforce

(Partnerships)➢Introduce your Goals & Objectives & Share information about

other CIT programs

Understanding Engagements of CIT

How to Engage

Examples: Successful engagements (Mental Health Providers and Advocates)

➢Develop list of public and private mental health providers (don’t forget school counselors)

➢Develop list of advocacy organizations, i.e., NAMI, BSA

➢Develop “talking points” of partnership and CIT benefits

➢Develop a “tentative training schedule” to give idea of CIT class topics

➢Identify CIT Committee or Taskforce members from MH/Advocate partners

➢Introduce Goals & Objectives & Share information about other CIT programs

Understanding Engagements of CIT

How to Engage

https://nami.org/cit

NEW RESOURCE: Available for Download or Purchase August 26, 2019

http://www.citinternational.org/bestpracticeguide

A CIT Steering Committee…

L E

Building and Sustaining CIT as a Community Program

CIT Steering Committee

What are some Steering Committee Roles?

✓Strategic Plan – develop short and long-term goals

✓Draft Time-Tables: What is a Time-Table

✓Fact Finding & Research about CIT – How• Read/Study: CIT CORE Elements

• Visit Existing CIT Program

• Familiarity with “state laws” – What role or influence does state law play within present systems / services

✓Keep Partnerships Active (Commitment) to CIT

✓Plan and commit for the Steering Committee to continue…

➢Adages help … “CIT is more than training”

✓Arrange “mental health system & crisis service mapping”

CIT is MORE…

The Basis for Systems Mapping

Sequential Intercept Model

Sequential Intercept

Model

“…a series of points of interception at which an intervention can be made to prevent individuals from entering or penetrating deeper into the criminal justice system.”

I. Law Enforcement

Crisis

Mobile Crisis Team

911 Police

Hospital

Jail

Crisis HotlineCrisis

Drop-off

Crisis

Mobile Crisis Team

911 Police

Hospital

Jail

Crisis Hotline Crisis

Drop-off

CIT Steering Committee

What does a “Troubled” Steering Committee look like?

1. Domineering Leader

2. Member(s) may drop-off from the committee

3. Leader may leave (not engaged)

4. Lack of clear, shared purpose or mission/goal understanding

5. Lack of focus to task or shared tasks

6. Personality issues

7. Time constraints (tasks and/or meetings)

8. Money issues (discouragement)

9. Discouragement from lack of (or no) crisis services

10. At least one “weak” partnership

CIT Steering Committee – Overcoming Barriers

1. Plan to keep Committee & Community Leaders engaged and informed

2. Develop clear, shared purpose with goals

3. Have an agenda – make meetings meaningful

4. Assign purposeful tasks (committee / sub-committee work)

5. Give recognition and credits to committee members

6. Have rules to minimize personality conflicts

7. Be respectful of everyone’s time and commitment

8. Think smart – plan for “distractions” …… “just train everyone”

9. Continuously promote CIT as a Community Program / Not $$

10. Plan to nurture-develop-engage new “champions / partners”

Stay Focused

CIT

OPERATIONAL ELEMENTS

TrainingImplementation After Training

CIT Training

• Forty (40) Hour training

• Uses multiple trainers with subject matter expertise

• Recommend a co-trainer model

– Mental Health/Law Enforcement/Advocacy

• Selecting and Preparing trainers

Selecting Trainers• Subject Matter Experts• Understand work and culture of LEO• Can relate to officer, not talk down or over• Training/Teaching experience• Good engagement with audience• Knows the community

Preparing trainers• Review their role• Review their presentation/rehearse• Educate on philosophy of CIT

• Safety, resource connection, increase knowledge and skills

• For understanding – Ride-alongs• Ensure trainers feel connected to other

trainers (Team) and to each topic• Encourage use of varied activities for learning• Real life examples• Provide feedback to trainers

Challenges with Trainers

Challenges• Not prepared• Not understanding the audience• Not reliable• Too academic• Not able to connect with audience• Good ones move on• Having a back up plan

CIT Training

• CIT training must be relevant to the deputy/officer

• CIT training must emphasize Safety

• CIT training must show a relationship with the community crisis system

• Each part of the CIT training must build on each other

Purpose?

Why are they important?

Site Visits

Purpose

• To interact with consumers in recovery

• To engage in conversation for learning

• To educate consumers of your role

• To connect with community resources

Whey are they important

• Learn more about mental illness

• Allows for better understanding

• Builds relationships

• Builds trust

• Build empathy

• Reduces stigma

OPERATIONAL ELEMENT:

DE-ESCALATION TRAINING

Yes, sometimes De-escalation is MORE Than Just Talking

De-EscalationIt’s More Than Just Talking

• The two highest CIT Training Evaluation Ratings:

(1) Talking with people – “Face-to-face discussions” / Engaging (talking) officers & people living with Mental Illness (talking & sharing information)

(2) De-escalation Skills with Scenario Practicums

➢ Recommending minimum of 10-hours verbal de-escalation training

Verbal De-escalation “Training”

CIT Verbal De-escalation –

✓ Teaching officers to think outside the “academic verbal de-escalation training box” (skills & scenarios)

✓ Officer safety training (performance and skills) must be protected & engaged throughout verbal de-escalation trainings.

More than “textbook skills”

CIT Verbal

De-escalation…

Selecting Verbal De-Escalation Trainers

✓ Trainers:

❑ experience

❑ consider Train-The-Trainer

✓ Co-Trainer Model – teaching as a “team”

✓ Mixing didactical training with scenario practicums

(close to 50/50 training split -- didactic & scenario)

✓ Verbal De-escalation may be introduced within some of the many various training topics...

Skills, Guardrails, Strategies, Stages of Crisis, Advance or Complex Crisis Performances

Skills

Verbal Communication Skills

2-hours

De-escalation Strategies: The Four Plays

2-hours

12 CIT Guardrails

2-hours

Verbal De-escalation in Action

4-hours

Verbal De-Escalation Learning by “Steps”

Learning Points are incorporated within each “Step”

Training Others

Dispatch

Corrections

EMS

Hospital Security

Others

Be part of the Crisis Intervention Team!

Participate in a 2-day training for dispatchers.

Advanced training is optional for those taking the 2-day course, and is

a refresher for those who have been through the training in the past.

Advanced Training will focus on:

PTSD, Active Shooter, and Practice Scenarios

Monday, September 21 &

Tuesday, September 22

Portage County Sheriff’s Office

Contact Laura at

330.673.1756 ext 201 or laurab@mental-health-recovery.org

Learn about:

a Mental Health Conditions

a De-escalation Skills

a Active Listening Skills

a Pink Slip Procedures

a Trauma

a Suicidal Callers

a Practice Scenarios

Sponsored by

Portage County Crisis

Intervention Team

Portage County

Sheriff’s Offic

e

Wednesday, September 23

at the Portage County Sheriff Office

Registration:

Contact Laura 330.673.1756 ext 201

What does a Dispatcher Need?

A roster showing current CIT Officers on duty

A laminated sheet showing medications for mental illness

Telephonic de-escalation skills training – cheat sheet

An understanding of what a CIT officer is capable of

What else?

Considerations for Training Others

Relevancy to other professions -Purpose/Goal

Capacity/space

Is it best to have a mixed class or separate professions (i.e., corrections, probation)?

OPERATIONAL ELEMENTSCIT IMPLEMENTATION

The law enforcement Coordinator (Commanding Officer) is a police officer and is the liaison between law enforcement and all program partners.

CIT LAW ENFORCEMENT COORDINATOR

The mental health coordinator is a leader / administrator in the mental health community and is the liaison with the advocacy and law enforcement communities.

CIT MENTAL HEALTH COORDINATOR

The advocacy coordinator is the liaison between advocacy (advocates, family members, and individuals with mental illness) and all program partners.

CIT ADVOCACY COORDINATOR

Albany, New York CIT Coordinators

Mental Health, Law Enforcement & Advocacy Coordinators

Multi-agency CIT programs may have a need for a Program Coordinator who is largely responsible for the day to day logistics of inter-departmental communication, data collection and management, records keeping and scheduling training.

CIT PROGRAM COORDINATOR

SUSTAINING ELEMENTSEvaluation In-service

Recognition

Recognition

and

Honors

Data Collection

and

Evaluation

CIT

Advanced/Inservice,

Coordinator

Meetings

and

Newsletters

Data Collection

and

Evaluation

What are some “DATA” of interest ?

What data and Where and How collected ?

Positive CIT Outcomes1

• Increased officer knowledge & confidence

• Lower arrest rates

• Increased referrals for treatment

•Decreased use of force

1 Watson, A. C., Compton, M. T., & Draine, J. N. (2017).

The crisis intervention team (CIT) model: An evidence-based policing practice?

Behavioral Sciences & the Law. 1-11.

Is Your Program Getting These

Same Outcomes?

Examples of collectable information

• Pre & Post training measures of knowledge & attitudes• Ratings of each module (instructors)

• Law enforcement overall call volume➢#/% related to mental health crises➢#/% responded to by CIT officers

• Outcomes of ‘CIT calls’➢Diversion; resolved @ location, transported➢Force used (injuries)➢Arrest

• Jail census for individuals with mental illness

https://store.samhsa.gov/product/Crisis-Intervention-Team-CIT-Methods-for-Using-Data-to-Inform-Practice-/sma18-5065

Where do you discuss data / evaluation results?

Hint: It was mentioned about 40 slides ago

What, Where, How…. ?

CIT

Advanced/Inservice,

Coordinator

Meetings

and

Newsletters

Top 10 Advanced CIT Courses1

1. Communication / De-escalation2. Youth3. Community Resources4. Veterans5. Diagnoses6. Suicide7. Legal Issues8. Developmental Disabilities / Autism9. CIT Program-Related 10. Officer Wellness

1 Among those programs reporting in-service / advanced courses, from CIT International survey conducted in 2016.

Top 10 Desired Advanced CIT Courses1

1. Communication / De-escalation2. Diagnoses3. Community Resources4. Officer Wellness5. Legal Issues6. Youth7. Trauma8. Developmental Disabilities / Autism9. Suicide10. Veterans

1 From CIT International survey conducted in 2016.

FEEDING & NURTURING

Everyone wants to know that they are valued and appreciated!

• Show them: • Annual Awards Banquet

• Civic Recognition (news articles, public acknowledgement)

• Plaques/certificates/a box of chocolates

• Donations (gas cards, movie tix)

Recognition and Honors

CIT Law Enforcement, Mental Health Provider, Advocate of the Year Awards

Course Graduation Pictures

.

Recognizing CIT Partners

Got great ideas on awarding and recognizing CIT officers, your program, and your department?

NEW RESOURCE: Available for Download or Purchase August 26, 2019

http://www.citinternational.org/bestpracticeguide

• Sam Cochran

Sam.Cochran@shelby-sheriff.org

• Michele Saunders

msaunders416@comcast.net

• Don Kamin

dkamin@nyscit.org

• Pat Strode

GACIT1pat@gmail.com

OUR CONTACT INFORMATION