A Criminal Justice System–Wide Response to Mental Illness

• Author: Megan L. Davidson
• Date: 01 February 2016
• Published date: 01 February 2016
• DOI: 10.1177/0887403414554997
• Subject Matter: Articles

Criminal Justice Policy Review

2016, Vol. 27(1) 46 –75

© 2014 SAGE Publications

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DOI: 10.1177/0887403414554997

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Article

A Criminal Justice

System–Wide Response to

Mental Illness: Evaluating

the Effectiveness of the

Memphis Crisis Intervention

Team Training Curriculum

Among Law Enforcement and

Correctional Officers

Megan L. Davidson1

Abstract

The present study sought to evaluate the effectiveness of the Memphis Crisis

Intervention Team (CIT) training curriculum among law enforcement and correctional

officers. A panel research design was used in which a sample of 179 law enforcement

officers and 100 correctional officers in nine Florida counties were surveyed on the

first day of training (pretest), the last day of training (posttest), and 1 month following

their completion of CIT training (follow-up). These surveys measured the extent

to which CIT training achieved several officer-level objectives, including increased

knowledge of mental illness, improved self-efficacy when responding to mental health

crises, and enhanced perceptions of verbal de-escalation skills. The results of these

surveys revealed that the training effectively achieved these objectives in the short

term, but a measurable decay was found in the follow-up time frame with regard to

self-efficacy and perceptions of verbal de-escalation.

Keywords

program evaluation, mental illness, crisis intervention introduction

1East Carolina University, Greenville, NC, USA

Corresponding Author:

Megan L. Davidson, Assistant Professor, Department of Criminal Justice, College of Human Ecology, East

Carolina University, East Fifth Street, Greenville, NC 27858-4353, USA.

Email: magersm@ecu.edu

554997CJPXXX10.1177/0887403414554997Criminal Justice Policy ReviewDavidson

research-article2014

Davidson 47

Mental illness is a public policy concern that pervades every facet of the public sector

in communities around the United States. Individuals with a mental illness often cycle

through various systems of care throughout their lifetime. The responsibilities of inter-

vening, managing, and treating this population are shared by numerous mechanisms of

formal social control, including the criminal justice system. Understanding how the

criminal justice system responds to persons with a mental illness is paramount to

developing the most effective and appropriate intervention strategies. The purpose of

the present study is to evaluate the effectiveness of a formal criminal justice response

to mental illness across nine counties in Florida. The Memphis Crisis Intervention

Team (CIT) model has been widely adopted across the country and around the world.

Therefore, gaining an understanding of the true effectiveness of this model contributes

to the literature surrounding this widespread criminal justice program.

While the criminal justice system was originally developed solely to enforce the

law and punish wrongdoers, the responsibilities of this system have expanded over

time. Due to dramatic policy changes in the mental health field over the last few

decades, agents of the criminal justice system are now frequently faced with the chal-

lenge of intervening and managing situations involving persons with a mental illness.

Specifically, deinstitutionalization, the tightening of civil commitment laws, and inad-

equate community treatment alternatives have collectively increased the visibility of

persons with a mental illness on urban streets around the country since the 1960s and

1970s (Erickson & Erickson, 2008; Teplin, 1984). This trend has not been accompa-

nied by a greater tolerance of this population by the general public. The dangerousness

stigma attached to the erratic and disruptive behavior that is often associated with

mental illness frequently compels citizens to invoke the criminal justice system to

manage incidents involving this population that occur in the community (Angermeyer,

Cooper, & Link, 1998; Erickson & Erickson, 2008; Horwitz, 2002; Phelan & Link,

1998; Schnittker, 2000; Teplin, 1984).

According to the Council of State Governments (2002) in the Criminal Justice

Mental Health Consensus Project, law enforcement officers typically encounter per-

sons with a serious mental illness in one of the following scenarios: (a) as a victim of

a crime, (b) as a witness to a crime, (c) as the subject of a call for assistance, (d) as a

suspected offender, and (e) as a danger to themselves or others. An estimated 7% to

10% of all police contacts involve a person with a mental illness (Borum, Deanne,

Steadman, & Morissey, 1998; Wells & Schafer, 2006). Results from a survey of law

enforcement officers from three different agencies indicated that approximately 92%

reported having responded to at least one mental health crisis in the month prior to the

survey, with 84% reportedly responding to more than one of these incidents during the

same time frame (Borum et al., 1998). Likewise, people with a mental illness often

report coming into contact with law enforcement, with many of them having been

arrested at least once (Borum, 2000).

Many communities lack dispositional alternatives to arrest for persons with a men-

tal illness engaging in maladaptive, criminal behavior. While this behavior may be a

manifestation of the individual’s mental illness, law enforcement officers must fre-

quently resort to arrest when responding to these calls for service. As a result, the