A Randomized, Controlled Trial of Crisis Intervention Team (CIT) Mental Health Training for Police Officers

患有严重精神疾病（SMI）的人，以及那些经历自杀或精神危机的人， 在社区里经常遇到警察。几乎三分之一的SMI患者有警察参与 他们的精神健康之路尽管有各种减少执法部门参与的战略， 心理健康危机应对正在出现，患有SMI的人和/或处于危机中的人将继续遇到 当警务人员必须担任第一反应者时，以及重要的是，在警务人员执行例行巡逻职务时，作为 因此，警察需要接受培训，以便在这些情况下安全有效地进行互动。危机干预小组 (CIT)该模式是一种协作办法，包括对警官进行40小时的培训。CIT已实施 在数千个美国社区，一些机构现在要求所有官员完成CIT 训练尽管有广泛的支持和越来越多的研究，随机对照试验（RCT）从未 以评估创新科技训练对人员实际技能和行为的成效。 先前的研究依赖于军官自我报告的降级技能，并没有直接衡量 以严格、标准化、受控的方式进行实际表现。此外，缺乏多地点研究， 和潜在的军官层面的因素，可能温和的CIT培训成果尚未系统地 评估。这项研究将与代表不同地理区域的全国六个地点合作， 选区人口统计。本研究有四个具体目标。首先，我们将进行严格的，多方面的， CIT心理健康培训的研究中心RCT。每个机构将提供40名干事，共计240名。在40 来自每个机构的官员，一半将被随机分配到CIT培训。将使用标准化的 场景，将以设盲方式（按研究中心、研究组和时间设盲）进行集中评级。初级 结果是实际的语言危机降级技能和非语言的身体行为。二是 确定CIT培训对两个次要结果的影响：程序正义和处置的使用- 相关决策。第三，我们将测试四个目标/介质对我们的主要结果的影响。 这些假设的目标/中介是：精神疾病的知识，态度，主观规范， 自我效能/知觉行为控制。假设这些目标的参与会导致预期的 提高人员的实际技能和行为。第四，我们将评估三个官员级别的变量， 在3个月和6个月时可能会缓和任何观察到的改善：更多地接触/熟悉 心理健康领域，作为一名警官的更长的服务年限，以及更大的愿望，兴趣和动力 执行CIT官员执行的职责类型。RCT的结果将为决策者提供信息， 美国各地的司法管辖区。

Individuals with serious mental illnesses (SMI), as well as those experiencing suicidality or psychiatric crisis, encounter police officers frequently in the community. Almost a third of people with SMI have police involved in their pathway to mental health care. Although a variety of strategies to reduce law enforcement involvement in mental health crisis response are emerging, people with SMI and/or those in crisis will continue to encounter police when officers must serve as first responders, and importantly, during officers’ routine patrol duties. As such, officers need training to safely and effectively interact in these situations. The Crisis Intervention Team (CIT) model is a collaborative approach that includes a 40-hour training of officers. CIT has been implemented in thousands of U.S. communities, and some agencies are now mandating all of their officers complete CIT training. Despite widespread support and growing research, a randomized, controlled trial (RCT) has never been conducted to assess the effectiveness of CIT training on officers’ actual skills and behaviors. Prior research has relied on officers’ self-report of their de-escalation skills and has not directly measured actual performance in a rigorous, standardized, controlled fashion. Furthermore, multi-site studies are lacking, and potential officer-level factors that may moderate CIT training outcomes have yet to be systematically assessed. This study will partner with six sites across the country representing diverse geographic areas and constituency demographics. There are four Specific Aims of the study. First, we will conduct a rigorous, multi- site RCT of CIT mental health training. Each agency will provide 40 officers, for a total of 240. Among the 40 officers from each agency, half will be randomized to CIT training. Data will be collected using Standardized Scenarios, which will be rated centrally in a blinded fashion (blinded by site, study arm, and time). Primary outcomes are actual verbal crisis de-escalation skills and non-verbal physical behavior. Second, we will determine the impact of CIT training on two secondary outcomes: use of procedural justice and disposition- related decision-making. Third, we will test the influence of four targets/mediators on our primary outcome. These hypothesized targets/mediators are: knowledge of mental illnesses, attitudes, subjective norms, and self-efficacy/perceived behavioral control. Engagement of these targets is hypothesized to lead to the expected improvement in officers’ actual skills and behaviors. Fourth, we will evaluate three officer-level variables that might moderate any observed improvements at 3-months and 6-months: greater exposure to/familiarity with the mental health field, greater years of service as a police officer, and greater desire, interest, and motivation to perform the types of duties that CIT officers perform. Results from the RCT will inform decision-makers in jurisdictions across the U.S.