Crisis Intervention Team Training in a Correctional Setting: Examining Compliance, Mental Health Referrals, and Use of Force

• Author: Christen Donley,Susan Mcneeley
• DOI: 10.1177/0093854820959394
• Published date: 01 February 2021
• Date: 01 February 2021
• Subject Matter: Articles

CRIMINAL JUSTICE AND BEHAVIOR, 2021, Vol. 48, No. 2, February 2021, 195 –214.

DOI: https://doi.org/10.1177/0093854820959394

Article reuse guidelines: sagepub.com/journals-permissions

© 2020 International Association for Correctional and Forensic Psychology

195

CRISIS INTERVENTION TEAM TRAINING IN A

CORRECTIONAL SETTING

Examining Compliance, Mental Health Referrals,

and Use of Force

SUSAN MCNEELEY

CHRISTEN DONLEY

Minnesota Department of Corrections

The Crisis Intervention Team (CIT) model was developed as a specialized police-based program in which officers are trained

to safely interact with individuals with mental illnesses. In 2011, the Minnesota Department of Corrections adapted this

program for corrections. This study compares prison incidents involving CIT officers to a comparison sample of non-CIT

incidents on a number of outcomes, including gaining compliance from people in custody (either immediately or as an inci-

dent unfolds), making mental health referrals, and using force against people in custody. We conducted a content analysis of

reports describing 500 incidents in an all-male, maximum security prison and estimated multivariate binary logistic models

to control for characteristics of situations, incarcerated people, and employees. The findings provide some support for imple-

menting CIT training in a correctional setting, but some less encouraging results show that improvements to the program are

still needed.

Keywords: correctional officers; mental illness; prisons; prisoners; use of force

INTRODUCTION

The closure of psychiatric hospitals across the United States beginning in the 1950s and

the subsequent influx of mentally ill individuals returning to communities has created an

increase in significant mental illness within prisons (Lamb & Weinberger, 2005). An esti-

mated 300,000 men and women with mental illness may be housed in jails and prisons

throughout the United States (Abramsky & Fellner, 2003). In 2011–2012, one in seven state

and federal prisoners met the threshold for serious psychological distress (Bronson &

Berzofsky, 2017). Rates of mental illness among incarcerated people are significantly

higher than in the general population (Al-Rousan et al., 2017). For example, 33% of males

AUTHORS’ NOTE: The contents of this article reflect the views of the authors and do not necessarily reflect

the views of the Minnesota Department of Corrections. Correspondence concerning this article should be

addressed to Susan McNeeley, Minnesota Department of Corrections, 1450 Energy Park Drive, Suite 200, St.

Paul, MN 55108; e-mail: susan.mcneeley@state.mn.us.

959394CJBXXX10.1177/0093854820959394Criminal Justice and BehaviorMcNeeley, Donley / CIT in Corrections

research-article2020

196 CRIMINAL JUSTICE AND BEHAVIOR

and 50% of females housed in the Minnesota Department of Corrections (MnDOC) have a

diagnosed mental illness and/or receive mental health services, compared with approxi-

mately 25% of the general population (Haigh et al., 2020).

When individuals engage in behaviors related to their mental health diagnoses, law

enforcement may respond inappropriately if not properly trained on the symptoms of men-

tal illness. In line with this, use of force by police is higher against those with mental illness

(Morabito et al., 2017; Rossler & Terrill, 2017). Because this may also be the case within

correctional facilities, it is crucial that correctional staff receive mental health training. For

this reason, Crisis Intervention Team (CIT) training—originally designed as a training for

police officers—was introduced in MnDOC facilities in 2011 (see Minnesota Department

of Corrections, 2015). The training is intended to expand correctional officers’ understand-

ing of mental illness, provide tools to support intentional communication between officers

and incarcerated people, and educate officers on interventions for those experiencing men-

tal health crisis (Dupont & Cochran, 2000).

CIT programs in police departments have shown improvements in outcomes such as med-

ical transports or referrals to mental health services (Bratina et al., 2018; Compton et al.,

2008, 2014b; Heilbrun et al., 2012; Kohrt et al., 2015; Lattimore et al., 2003; Ritter et al.,

2011; Scantlebury et al., 2017; Strauss et al., 2005; Teller et al., 2006; Tyuse, 2012; Watson

et al., 2010) and use of force (Compton et al., 2014b, 2015; Morabito et al., 2012; Skeem &

Bibeau, 2008). Only a handful of studies have examined outcomes associated with correc-

tions-based CIT training, with encouraging but limited results (Center for Health Policy,

Planning and Research, 2007; Davidson, 2016; Public Health Research Institute, 2005).

This study compares outcomes of prison incidents involving CIT officers to incidents

without CIT-trained officers, while controlling for relevant predictors. In particular, the study

examines whether CIT training is related to compliance (either immediately or later as an

incident unfolds), mental health referrals by staff, and use of force. To do this, we examine

reports written for 500 incidents within an all-male, maximum security prison. This study

makes several important contributions. First, we are aware of no other studies that measure

the relationship between CIT training and compliance or examine the relationship between

CIT training and mental health referrals within a correctional setting. Second, while there has

been one study to examine the association between CIT training and use of force in jails

(Center for Health Policy, Planning and Research, 2007), that study did not control for situ-

ational factors that likely influence officers’ behavior. Finally, the study provides valuable

information about the impact of mental health de-escalation training in correctional facilities,

and informs the literature on the effectiveness of CIT training more broadly.

CIT TRAINING

CIT—also known as the “Memphis Model”—was first utilized in 1988 in the Memphis

Police Department (see Dupont & Cochran, 2000). CIT training was designed as a diver-

sionary program to channel mentally ill individuals to the appropriate mental health facili-

ties or resources such as veterans’ services or chemical dependency services, rather than

involve them in the criminal justice system. The model was developed and provided in

collaboration with the National Alliance on Mental Illness (NAMI), community mental

health professionals, academic experts, hospital administrators, and church officials (Dupont

et al., 2007). It is estimated that CIT has been implemented in approximately 3,000 agencies