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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 [email protected]
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
• Michele Saunders
• Don Kamin
• Pat Strode
OUR CONTACT INFORMATION
