post-intervention follow-up with consumers & families -reducing cit recidivism

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Post-Intervention Follow-up with Consumers & Families - Reducing CIT Recidivism

Sergeant Barry Armfield St. Louis County Police Department, Coordinator, St. Louis Area CIT Program

Richard Stevenson Director of Special Projects, Alliance on Mental Illness-NAMI St. Louis

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Presentation Objectives:

Background – CIT St. Louis Area. Obstacles to Success. Response to Obstacles. Conclusions.

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CIT Program Outcomes Nationwide

Access to services –

an important intended outcome

of CIT Programs nationwide!

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Background – St. Louis Area CIT

History Structure (council) Activities

– Trainings Basic 40-hour Course 8-hour In-service Education Programs Youth CIT Program

– Interventions– Reporting

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Background – St. Louis Area CIT

5 Counties 72 Law Enforcement Jurisdictions 38 Participating Organizations

– Hospitals– State Mental Health Department (DMH)– Community MH Centers– Advocacy Organizations– Courts

CIT Reports

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Outcomes – CIT Interventions: History of Mental Illness

65% of interventions are in response to individuals with known mental illness. yes

65%

no or unknown35%

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Outcomes – CIT Interventions: Psychotropic Medications

61% of interventions were to individuals known to have been prescribed psychotropic medications.

yes61%

no or unknown

39%

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Outcomes – CIT Calls: Compliance to Medication

9% known compliant;

48% known non-compliant.

yes9%

no48%

unknown43%

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Outcomes – CIT Calls: Treatment, Not Jail

89% of interventions result in transport to a treatment facility.

yes, 89%

no, 11%

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Lessons Learned

CIT Interventions – High percentage are to individuals who: – Have a severe mental illness – Are “frequent flyers” of police departments.– NOT currently linked to public sector services,

though they qualify.– Are the most difficult to treat.

CIT Clients who are willing to accept treatment are usually able to access treatment, eventually (not “frequent flyers”).

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Lessons Learned

To put CIT “out of business”,

we must include in our programs

strategies to gain access

to ongoing inpatient and

community-based mental health

and substance abuse services!

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Obstacles to Services –

Personal:– Diminished self-insight– Medications side-effects– Stigma

Non-compliance to treatment

Psychosis

Mental Health Crisis

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Obstacles to Services –

Systemic:– Misunderstandings by/about…

Law enforcement Families Providers

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Obstacles to Services –

Systemic– Hospitals – Law enforcement – attitude vs. illness– Awareness of resources– Family ignorance on police response– Provider ignorance on police response

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Response to Obstacles –

Communication, Council Three Case Studies

– A hospital discharge– An intervention with injuries – A tazing

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Access to Services –

…requires CIT Reports Services to families

– NAMI Support & education Navigating the mental health care treatment system

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Access to Services –

…requires CIT Reports Services to consumers

– Behavioral Health Response– Community Mental Health Centers

Community Alternatives Assertive Community Treatment (ACT)

– Life Crisis Services (suicide intervention)– CHADS (crisis involving youth)– Veterans Administration– Courts – Mental Health / Drug

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Conclusions

CIT can be the vehicle

to reduce police response to mental health crisis

through referrals to services

of participating agencies.

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Conclusions

Law enforcement is doing its job:– Good interventions.– Effective transports to treatment services.

Mental health must do its job:– Receive people into treatment– Keep them in treatment.

We must all work together.

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Questions

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Thank you!

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Contact Information

Sgt. Barry ArmfieldSt. Louis County Police Department, Coordinator, St. Louis Area CIT Program314/ 628-550barmfield@stlouisco.com

Richard Stevenson Director of Special ProjectsAlliance on Mental Illness-NAMI St. Louis314/ 966-4688rstevenson827@sbcglobal.net