Do Crisis Intervention Teams Reduce Arrests and Improve Officer Safety? A Systematic Review and Meta-Analysis

• Published date: 01 February 2016
• DOI: 10.1177/0887403414556289
• Date: 01 February 2016
• Author: Sema A. Taheri
• Subject Matter: Articles

Criminal Justice Policy Review

2016, Vol. 27(1) 76 –96

© 2014 SAGE Publications

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DOI: 10.1177/0887403414556289

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Article

Do Crisis Intervention Teams

Reduce Arrests and Improve

Officer Safety? A Systematic

Review and Meta-Analysis

Sema A. Taheri1

Abstract

Until the 1950s, state mental health hospitals accommodated the majority of

individuals suffering from mental illness. Today, however, following the closing of

state mental hospitals, persons with serious mental illness without adequate private

care are 3 times more likely to be housed in a jail or prison than in a hospital. The

consequences associated with increased contact between the criminal justice system

and the mentally ill necessitates a comprehensive strategy that targets improvement

in interaction between the criminal justice system and the mentally ill. This article

reports on findings of a systematic review and meta-analysis of the Crisis Intervention

Team (CIT), a widely adopted program implemented in police departments, in an

effort to reduce reliance on incarceration as mental health institutions, and to train

officers about mental illness. The findings of this review and meta-analysis reveal

null effects of CITs on arrests of persons with mental illness (d = 0.180, p = .495)

and on police officer safety (d = −0.301, p = .191). These results do not suggest that

CIT programs should be discontinued. However, potential improvements to program

implementation and evaluation are discussed.

Keywords

Crisis Intervention Team, CIT, policing, mental illness, diversion

The use of jail diversion mechanisms are on the rise in the United States, with substan-

tial local agency and law enforcement funding and resources being invested in these

long-term programs (Reuland, Draper, & Norton, 2012). These programs are meant to

1Northeastern University, Boston, MA, USA

Corresponding Author:

Sema A. Taheri, School of Criminology & Criminal Justice, Northeastern University, 400 Churchill Hall,

360 Huntington Avenue, Boston, MA 02115, USA.

Email: s.taheri@neu.edu

556289CJPXXX10.1177/0887403414556289Criminal Justice Policy ReviewTaheri

research-article2014

Taheri 77

link specific groups of individuals, such as those with mental illness, with programs in

the community, and provide an alternative to criminal justice processing and institu-

tions that are often unable to provide adequate care and treatment (Lurigio, Smith, &

Harris, 2008). Interest in diversion programs like police-run Crisis Intervention Teams

(CITs) stems from the promise that they might reduce stigmatization, direct persons

with mental illness to needed treatment programs and away from arrest, and reduce

officer injury (National Alliance of Mental Illness [NAMI], 2012). With the exception

of the latter, these goals are in line with the resurgence of the rehabilitative ideal

(Cullen, 2013)—that the focus of criminal justice actors need not only be crime con-

trol but can also include an emphasis on treatment. It is within this ideal that CITs

ground their core goals of reducing arrest of the mentally ill, reducing officer use of

force, and minimizing injury to civilians and officers (Dupont, Cochran, & Pillsbury,

2007).

The main aim of this article is to report on the findings of a systematic review and

meta-analysis of the effects of CITs on its stated goals. The background and expansion

of CITs as a diversion mechanism is briefly outlined, with particular focus on the

Memphis model and its development. A synthesis of the empirical literature follows,

and moderator analyses are examined as a means of investigating differences across

studies in the outcomes observed. Implications of the findings for public policy and

future research are then discussed.

Background

Five decades ago, psychiatric hospitals or asylums (Cullen, 2013; Lurigio, 2013)

accommodated the majority of individuals with serious mental illness that came to the

attention of the mental health or criminal justice systems. When the practices of these

psychiatric treatment facilities were found to be detrimental to individuals facing long-

term stays, the United States experienced large-scale de-institutionalization.

Unfortunately, jails and prisons replaced hospitals in caring for the displaced individu-

als as they were released into the community (Wood, Swanson, Burris, & Gilbert,

2011). However, people suffering from a mental illness require specialized treatment

or care that the system cannot necessarily provide (Lurigio et al., 2008), and overrep-

resentation of these individuals in the criminal justice system only serves to increase

deficits in care and drain limited resources available to all offenders.

The process that moves a person with mental illness from the community to institu-

tions of formal control begins with arrest. Often these arrests are for minor offenses

and non-serious misdemeanors (Franz & Borum, 2011; Vickers, 2000). Police are

commonly the first to be called when an individual suffering with mental illness

engages in illegal behavior, or in some way threatens the community (Cordner, 2006;

Green, 1997). Frequently, officers are called to the same location or about the same

individual on multiple occasions. During crises, individuals experiencing psychosis,

or emotional distress made worse by a mental illness, may become violent or exhibit

erratic behavior (Reuland, Schwarzfeld, & Draper, 2009). The nature of mental illness

can produce ambiguity in these encounters, and the uncertainty that the situations