Modeling Officer-Level Effects of Crisis Intervention Team (CIT) Training

描述(由申请人提供)：在危机干预小组(CIT)培训中，警察参加由当地心理健康专业人员、家庭成员/倡导者和心理健康消费者团体提供的40小时的专门培训。完成训练后，这些人员会担任专责的第一线接听电话服务，接听涉及严重精神病患者的电话。CIT模式还支持精神科急救服务和警察部门之间的合作，增加了精神危机中的人被送往医疗机构而不是监狱的可能性。这项拟议的研究是针对CIT研究的明显匮乏而开发的，尽管它正在美国许多城市广泛实施。这项研究将建立在PI正在进行的CIT研究的基础上，将考察CIT培训最终可能通过解决CIT官员级结果这一关键问题而最终导致改善患者和系统级结果的方式。这项研究将是了解这种协作模式如何工作的第一步，并将为可能对经常与执法/刑事司法系统互动的SMI患者产生重大影响的研究奠定基础。本项目将比较CIT和非CIT官员，并测试CIT效应的两个互补模型--计划行为理论(TPB)和CIT官员级别效应新模型(MOLEC)。这项研究的具体目标是：目标1：设计、调整和研究专门为警察开发的一些测量工具的心理测量学特性(即，信度、效度)；目标2：评估TPB、探索性MOLEC模型和组合模型在解释250名CIT人员与250名非CIT人员的心理健康转介和降级技能方面的效用；目标3：通过比较6周来CIT人员与疑似SMI患者的接触报告以及CIT人员与非CIT人员转介的适当性，来检验CIT计划在促进实际心理健康转诊方面的有效性。第1-6个月将专门用于仔细开发/改编工具、让警察部门参与、准备招募和收集数据以及测试工具的可靠性/有效性。7-30个月将包括深入的横断面和为期6周的纵向数据收集、数据库开发和数据输入。31至36个月将涉及数据分析和向各种相关受众传播调查结果。最终，这项研究可能会阐明精神健康和执法社区如何合作，通过减少定罪和增加获得精神健康服务的机会来改善患有SMI的个人的健康。公共卫生相关性：考虑到全国范围内将精神疾病定为刑事犯罪导致严重精神疾病患者因轻微违法而被监禁的问题，这项拟议研究的公共卫生重要性是巨大的，这延误或排除了提供面向康复的精神卫生服务。通过研究危机干预小组(CIT)培训对官员的影响，可以加强执法和精神健康之间的合作，严重精神疾病患者可能能够在精神健康治疗服务的支持下过上更安全、更健康的生活，而不是纠缠于刑事司法系统。

DESCRIPTION (provided by applicant): In Crisis Intervention Team (CIT) training, police officers participate in 40 hours of specialized training provided by local mental health professionals, family members/advocates, and mental health consumer groups. Upon completion of the training, these officers serve as specialized first-line responders for calls involving people with serious mental illnesses (SMI). The CIT model also supports partnerships between psychiatric emergency services and police departments, increasing the likelihood that people in psychiatric crisis will be taken to medical facilities rather than jails. The proposed study was developed in response to a prominent dearth of research on CIT, even though it is being implemented widely in numerous municipalities across the U.S. This research, which will build on the PI's ongoing CIT research, will examine the ways in which CIT training may ultimately lead to improved patient- and system-level outcomes by addressing the crucial issue of officer-level outcomes of CIT. This research will be a first step toward understanding how this collaborative model works and will set the stage for research that could have major implications for people with SMI who often interact with law enforcement/criminal justice systems. This project will compare CIT and non-CIT officers and test two complementary models of effects of CIT-the Theory of Planned Behavior (TPB) and the novel Model of Officer-Level Effects of CIT (MOLEC). The specific aims of the research are: Aim 1: To design, adapt, and study the psychometric properties (i.e., reliability, validity) of a number of measures developed specifically for use with police officers; Aim 2: To evaluate the utility of the TPB, the exploratory MOLEC model, and a combined model, in explaining intentions to facilitate mental health referrals and de-escalation skills of 250 CIT vs. 250 non-CIT officers; and Aim 3: To examine the effectiveness of the CIT program in facilitating actual mental health referrals by comparing reports of encounters with individuals with suspected SMI and appropriateness of referrals in CIT vs. non-CIT officers over 6 weeks. Months 1-6 will be dedicated to careful instrument development/adaptation, engagement of police departments, preparation for recruitment and data collection, and testing of instrument reliability/validity. Months 7-30 will include in-depth cross-sectional and 6- week longitudinal data collection, database development, and data entry. Months 31-36 will involve data analysis and dissemination of findings to various relevant audiences. Ultimately, this research may elucidate how the mental health and law enforcement communities can collaborate to improve the health of individuals living with SMI by reducing criminalization and enhancing access to mental health services. PUBLIC HEALTH RELEVANCE: The public health importance of the proposed research is substantial given the nationwide problem of criminalization of mental illnesses resulting in incarceration of people with serious mental illnesses for minor infractions, which delays or precludes the provision of recovery-oriented mental health services. By studying officer-level effects of Crisis Intervention Team (CIT) training, collaborations between law enforcement and mental health can be enhanced and people with serious mental illnesses may be able to lead safer, healthier lives supported by mental health treatment services rather than being entangled in the criminal justice system.