The Use of Crisis Intervention Teams (CIT) Training for Corrections Officers: Reducing Critical Incidents within a County Jail

Background: Individuals with severe mental illness (SMI) are overrepresented in the criminal justice system and jails and prisons have become the primary care facilities for individuals with SMI. Studies of the Crisis Intervention Teams (CIT) model, which trains law enforcement officers to recognize symptoms of mental illness and engage in de-escalation, have resulted in positive outcomes for officers and individuals with SMI. This study presents an adaptation of this model for patrol officers to correctional officers (COs) within a county jail. To date, no studies have assessed the use of CIT training in correctional settings. This study asked: Does CIT training have an impact on outcomes in correctional settings?

Methods: This case study in one county jail used three data sources to measure proximal and distal outcomes. Proximal outcomes were measured in pre/post surveys from all corrections officers immediately before and after the training and in pre/post interviews with ten COs. The survey assessed their knowledge and attitudes about mental illness, with questions adapted from two validated assessments: The Attribution Questionnaire (Corrigan et al., 2002) and the de-escalation sub-set of the Behavioral Outcomes Scale (Broussard, et al., 2011). Pre/post interviews were conducted with ten COs on the Cell Removal Team (CRT). CRT COs are a subgroup of officers who receive a higher level of training in verbal and physical de-escalation to address conflicts within the jail. Selection of interviewees were stratified by gender and rank. The distal outcome tracked was the use of the CRT called to incidents in the jail. It was hypothesized that there would be a reduction in use of CRT once all COs learned about mental illness and are trained in de-escalation. Proximal outcomes were analyzed using paired-samples t-tests (surveys) and a case-ordered descriptive matrix (interviews). Interrupted Time Series (ITS) analysis assessed the change in use of CRT six months before and six months after the training was implemented.

Results: A total of 255 CO (83.1%) surveys were collected, with paired samples t-tests showing a significant positive change in attitudes regarding inmates who have mental illness (M=2.4, SD= 3.12; t(254)=11.851, p<.001) as well as knowledge in de-escalation techniques (M=.90, SD=2.36; t(254)=6.079, p<.001). Pre-post interviews highlighted increased understanding of mental illness and additional skills in de-escalation. The number of cell extractions decreased in the six months after CIT training (M=17.7 per month), when compared to the six months before (M=40.0 per month). ITS analysis suggests that CIT training resulted in an abrupt decrease in the level of CRT usage, and that over the six-month period following training, this change significantly persisted.

 

Conclusions: These findings show the transfer of positive proximal and distal outcomes of CIT training to a correctional setting. Incarceration of individuals with SMI are known to exacerbate their psychological symptoms; thus, it is essential that COs understand the signs and symptoms and are able to effectively de-escalate individuals in crisis. Implications exist for social workers to influence policy and practice within jails, along with resource allocation.