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

Columbia University2 sites in 1 country242 target enrollmentJanuary 1, 2023

Overview

Brief Summary

The goal of this clinical trial is to learn the effect, or lack thereof, of the Crisis Intervention Team (CIT) training among police officers. The main questions it aims to answer are:

Whether the 40-hour CIT training improves police officers' verbal crisis de-escalation skills / non-verbal physical behavior
Whether police officers with and without CIT training use different procedural justice and make different disposition-related decisions

Participants will:

Receive or not receive CIT training depending on whether they are randomized to the intervention group or the control group.
Participate in three assessments: baseline before the randomization, 3-months post-randomization, and 6-month post-randomization.

Researchers will compare police officers who were randomized to the control group with police officers who were randomized to the intervention group to see if receiving the CIT training make differences on the outcome measurements.

Detailed Description

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, the investigators will conduct a rigorous, multisite randomized controlled trial (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). The primary outcome is actual verbal crisis de-escalation skills / non-verbal physical behavior. Second, the investigators will determine the impact of CIT training on two secondary outcomes: use of procedural justice and disposition-related decision-making.

Registry

clinicaltrials.gov

Start Date

January 1, 2023

End Date

December 17, 2025

Last Updated

8 days ago

Study Type

Interventional

Study Design

Parallel

Sex

All

Investigators

Sponsor

Columbia University

Responsible Party

Principal Investigator

Michael Compton

Professor of Psychiatry

Columbia University

Eligibility Criteria

Inclusion Criteria

•18 years or older
•English-speaking
•Has not yet taken part in CIT training
•Willing and able to be tested, randomized to CIT training or no training, and re-tested at 3-months and 6-months
•Employment as a police officer from participating site

Exclusion Criteria

Not provided

Arms & Interventions

CIT officers

Police officers randomized to the experimental group will receive a 40-hour CIT training curriculum.

Intervention: Crisis Intervention Team (CIT) training

Non-CIT officers

Police officers randomized to the no-intervention group will not receive the 40-hour CIT training curriculum.

Outcomes

Primary Outcomes

Verbal Crisis De-escalation Skills / Non-Verbal Physical Behavior Rating (3 months)

Time Frame: 3 months

Verbal Crisis De-escalation Skills / Non-Verbal Physical Behavior will be assessed via blinded video ratings. The primary outcome is the total score. Domains include: (1) use of reflective statements, (2) use of summarizing/paraphrasing, (3) labelling of emotions, (4) use of encouraging statements, (5) maintaining a conversational tone, (6) seeking clarification from the subject, (7) speaking in a calm and level voice, (8) displaying empathy, (9) displaying honesty, (10) use of simple instructions, (11) asking directly about suicidal ideation, (12) use of space: maintaining appropriate physical distance from the subject, (13) using cover and objects for safety as appropriate, (14) aspects of body language that promote collaboration. Total score ranges from 0 to 100, with a higher score indicating a better outcome.

Verbal Crisis De-escalation Skills / Non-Verbal Physical Behavior Rating (6 months)

Time Frame: 6 months

Verbal Crisis De-escalation Skills / Non-Verbal Physical Behavior will be assessed via blinded video ratings. The primary outcome is the total score. Domains include: (1) use of reflective statements, (2) use of summarizing/paraphrasing, (3) labelling of emotions, (4) use of encouraging statements, (5) maintaining a conversational tone, (6) seeking clarification from the subject, (7) speaking in a calm and level voice, (8) displaying empathy, (9) displaying honesty, (10) use of simple instructions, (11) asking directly about suicidal ideation, (12) use of space: maintaining appropriate physical distance from the subject, (13) using cover and objects for safety as appropriate, (14) aspects of body language that promote collaboration. Total score ranges from 0 to 100, with a higher score indicating a better outcome.