After menacing passengers with a wooden staff and military sword on a commuter train in New York, 37 year-old Charles Stevens was dubbed, “The Long Island Railroad Swordsman.” Stevens, who was dressed in combat fatigues and wearing a mask over his nose, had been diagnosed with paranoid schizophrenia and had failed to take his psychiatric medication for the past two years.
While on the train, Stevens unsheathed the sword, which had a 3-foot blade. Police asked Stevens to drop the weapon, and when he refused, they sprayed him with pepper spray. Stevens lunged at the police officers while wielding the weapon, causing one officer to shoot him in the arm. Stevens still did not drop the weapon, and the police fired at him 7 more times before he fell to the ground. Stevens survived and was charged with First Degree Attempted Assault. He was later found to lack the capacity to understand the charges against him or to assist in his defense, and he was hospitalized in a psychiatric facility.
Crisis Intervention Team (CIT) Training
Although the names and details are different, the 1999 scenario above has played out many times over the years in cities across America with people of all ages. When police have an encounter with a person with a mental illness, we want there to be a safe outcome where no one is harmed. The type of training that has been implemented by police departments to decrease the chance of a violent confrontation with a person with mental illness and increase officer safety is called Crisis Intervention Team (CIT) training.
Based on a community policing model, CIT training is a collaborative effort between police, mental health professionals, hospital emergency departments, and individuals with mental illness and their family members. The goals of CIT training are to teach police officers how to safely engage with and respond to people in crisis, as well as to connect them to helpful resources in the community.
The Memphis Model of CIT
The Memphis CIT, developed at the University of Memphis, is a nationally known crisis intervention program that serves as a best practice model, and is commonly called the Memphis Model. The Memphis Model has successfully diverted individuals in crisis away from jail and connected them to appropriate community mental health resources. The implementation of the Memphis model helps to reduce negative stereotypes and stigma surrounding mental illness.
Some key topics in CIT training using the Memphis Model are:
- Recognizing signs of mental illness
- Learning first-hand about the challenges of mental illness by spending time with individuals with mental illness and doing site visits
- Community support and resources
- Cultural Awareness and Diversity
- De-escalation skills
- Scenario-based training to practice crisis intervention skills
Recognizing Signs of Mental Illness
Basic mental health information about how to recognize signs of mental illness is an important component of CIT training. The Memphis Model curriculum covers mental illness topics such as:
- Severe, persistent mental illness such as mood and thought disorders, like Bipolar Disorder, Depression, and Schizophrenia
- Cognitive disorders such as Dementia and Traumatic Brain Injury (TBI)
- Post-Traumatic Stress Disorder (PTSD)
- Suicide Prevention and Intervention
- Substance Abuse Disorders
- Disorders affecting children, youth, and adolescents such as ADHD and Autism
- Psychiatric medications
- Mental health law
Verbal and non-verbal de-escalation skills training is also a vital component of CIT training. Specific skills training includes being cognizant of tone of voice, using “I” statements, and basic courtesy. These skills and others are learned and practiced through discussion of previous scenarios, reviewing and critiquing strategies, and using role play.
It is clear to see how de-escalation skills and knowledge of mental illness are valuable for police officers who encounter individuals in crisis, however, we can also see the value for other professionals and situations inside and outside of law enforcement. For example, a teacher interacting with a difficult student in the classroom, a manager disciplining an angry employee, or a security guard at a hospital might utilize these same de-escalation skills and knowledge of mental illness to deal with someone who has the potential to initiate a violent attack.
CIT For Youth
The National Alliance on Mental Illness (NAMI) notes that many youth who do not receive necessary mental health treatment may end up in the juvenile justice system. Communities can expand their CIT programs to address the needs of youth with mental health concerns by working with schools, school resource officers (SROs), youth mental health providers, and parents.
Youth CIT Training is a valuable addition to any safety and security plan for schools, faith-based institutions, and agencies that serve young people.
National Alliance on Mental Illness (2017). What is CIT? Retrieved from https://www.nami.org/Law-Enforcement-and-Mental-Health/What-Is-CIT
The University of Memphis (2017). CIT Center: A Resource for CIT Programs Across the Nation. Retrieved from http://www.cit.memphis.edu/
Dr. Peggy Mitchell Clarke is a clinical psychologist and retired psychology professor who has lived in Denver, Colorado for almost two decades. In the aftermath of the 2012 Aurora theater shooting, Dr. Clarke was instrumental in developing and facilitating active shooter response and violence prevention training for all faculty and staff at Community College of Aurora (CCA). Dr. Clarke currently serves on CCA’s Behavioral Intervention Team and consults in the areas of mental health, classroom management, and safety.