Testing a Systems Level Intervention to Improve Police Response to Persons with M

描述（由申请人提供）：监狱和监狱中大量的精神疾病患者引起了司法系统各个领域的政策关注。这包括警察的做法，在所有与公众接触的人中，大约有10%涉及精神疾病患者。在这些情况下集中执法反应的一种办法是设立危机干预小组。CIT正在全国各地的司法管辖区实施，希望减少对警察和精神疾病患者的伤害，减少逮捕，增加精神疾病患者向精神卫生系统的转移，并改善与精神卫生服务的联系。然而，研究CIT的有效性及其实施障碍的文献很少。芝加哥警察局目前在其25个地区中的两个地区试点了CIT项目，并将在未来18个月内在全市范围内实施CIT项目。在本申请中，我们建议启动一个研究项目，开发概念和方法框架，以支持CIT和其他基于警察的精神疾病干预措施的有效性研究。为此，我们将检查CIT在芝加哥的实施情况，测试其对警官和遭遇级别结果的影响的初步模型，以及地区和社区级别因素，如CIT饱和度（接受培训的警官数量）、心理健康资源的可用性、组织支持和领导力，以及影响这些结果的社区特征。因为，芝加哥警察局只是试点这个项目，我们有一个独特的机会来比较那些CIT饱和度有限的司法管辖区和那些已经完全实施了这个项目的司法管辖区。我们将应用定性和定量方法，并测试模型组件的不同概念化。将与地区一级的关键线人和两个时间点进行定性访谈。将在基线和1个月、3个月和6个月收集定量数据。横断面纵向分析将检查地区和个人层面的呼叫结果预测因子（伤害、强迫、逮捕、转移、心理健康服务联系），以及饱和超时时间的变化如何与结果的变化相关。这种分析将允许我们测试模型组件的不同概念和度量，测试模型相互作用和路径，并确定后续多站点研究的效应大小。在项目的最后阶段，我们将开始与四个城市的司法管辖区进行对话，讨论我们的发现以及我们的模型和方法对他们在CIT方面的经验的适用性，并随后为多地点研究发展合作。虽然只有有限的有效性证据，但CIT正在全国各地的司法管辖区被采用，以改善执法部门对精神疾病患者的反应。这项研究将使我们能够测试CIT的有效性，并开发出急需的方法和理论框架，以支持后续的基于警察的精神疾病干预研究。这一研究方案将为旨在改善官员、消费者和公众安全以及增加精神病患者获得精神保健治疗的机会和联系的政策和实践提供信息。

DESCRIPTION (provided by applicant): The large numbers of people with mental illness in jails and prisons has fueled policy concern in all domains of the justice system. This includes police practice, where approximately ten percent of all contacts with the public involve a person with a mental illness. One approach to focusing law enforcement response in these situations has been the implementation of Crisis Intervention Teams (CIT). CIT is being implemented in jurisdictions across the country that are hoping to reduce injuries to officers and persons with mental illness, decrease arrests, increase diversion of persons with mental illness to the mental health system, and improve linkages to mental health services. Scant literature exists, however, examining the effectiveness of CIT and barriers to its implementation. The Chicago Police Department currently has pilot CIT programs in two of its 25 districts and is in the process of implementing CIT citywide over the next 18 months. In this application, we propose the initiation of a program of research that develops conceptual and methodological frameworks to support effectiveness research on CIT and other police based interventions for mental illness. To do so we will examine CIT as it is being implemented in Chicago, testing a preliminary model of its impact on officer and encounter level outcomes and district and community level factors such as CIT saturation (number of officers trained), availability of mental health resources, organizational support and leadership, and community characteristics that influence these outcomes. Because, the Chicago Police Department is just piloting this program, we have the unique opportunity to compare jurisdictions with limited CIT saturation with those that have fully implemented the program. We will apply both qualitative and quantitative methods and test different conceptualizations of model components. Qualitative interviews will be conducted with district level key informants and two time points. Quantitative data will be collected at baseline and one, three and six months. Cross sectional longitudinal analysis will examine District and individual level predictors of call outcomes (injuries, force, arrest, diversion, mental health service linkage) and how changes in saturation overtime are related changes in outcomes. This analysis will allow us to test different conceptualizations and measures of model components, test model interactions and paths, and determine effect sizes for a subsequent multi-site study. In the final phase of the project we will begin dialogue with four urban jurisdictions to discuss our findings and the applicability of our model and methods to their experiences with CIT, and subsequently develop collaborations for the multisite study. Although only limited evidence of effectiveness is available, CIT is being adopted by jurisdictions across the county in an effort to improve law enforcement's response to persons with mental illness. This study will allow us to test CIT effectiveness and develop much needed methodological and theoretical frameworks to support subsequent research on police based interventions for mental illness. This program of research will inform policy and practice aimed at improving officer, consumer and public safety and increasing access and linkages to mental heath treatment for persons with mental illness.