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

描述（由申请人提供）：在危机干预小组培训中，警务人员参加由本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小时专门培训。完成训练后，这些人员会在处理涉及严重精神疾病人士的电话时，担任专业的第一线应变人员。CIT模式还支持精神病紧急服务部门和警察部门之间的伙伴关系，增加了精神危机患者被送往医疗机构而不是监狱的可能性。拟议的研究是为了应对CIT研究的严重缺乏，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，将通过解决官员级CIT结果的关键问题，研究CIT培训最终可能导致改善患者和系统级结果的方式。这项研究将是理解这种协作模式如何运作的第一步，并将为研究奠定基础，这些研究可能对经常与执法/刑事司法系统互动的重度精神障碍患者产生重大影响。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）和新的CIT官员效应模型（MOLEC）。该研究的具体目的是：目标1：设计、调整和研究专门为警察使用的一系列措施的心理测量特性（即信度、效度）；目的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人员促进心理健康转诊和降级技能的意图方面的效用；目标3：通过比较6周内与疑似重度精神障碍患者的接触报告以及CIT人员与非CIT人员的转诊适当性，检验CIT项目在促进实际心理健康转诊方面的有效性。1-6个月将致力于仔细的仪器开发/适应，警察部门的参与，准备招聘和数据收集，以及仪器的可靠性/有效性测试。7-30个月将包括深入的横断面和6周的纵向数据收集，数据库开发和数据输入。第31至36个月将涉及数据分析和向各种有关对象散发调查结果。最终，这项研究可能阐明精神卫生和执法社区如何通过减少刑事定罪和增加获得精神卫生服务的机会来合作改善重度精神分裂症患者的健康。公共卫生相关性：鉴于将精神疾病定为刑事犯罪的全国性问题，导致患有严重精神疾病的人因轻微违法行为而被监禁，这延误或妨碍了以康复为导向的精神卫生服务的提供，拟议的研究具有重大的公共卫生重要性。通过研究危机干预小组（CIT）培训在官员层面的效果，可以加强执法部门与精神卫生部门之间的合作，严重精神疾病患者可能能够在精神卫生治疗服务的支持下过上更安全、更健康的生活，而不是被刑事司法系统纠缠。

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.