Introduction

Members of Fairfield, Connecticut, Police Department’s Crisis Intervention Team (CIT) showed (and continue to show) a great deal of dedication, initiative, forward-thinking, and professionalism as they helped to build and shape, from the ground up, a truly advanced and progressive CIT program.

CIT is integrated within the department’s patrol division; team members often balance an increased workload, in addition to patrol responsibilities. Fairfield CIT officers are expected to respond to and resolve all crisis incidents involving mental health or substance abuse issues that occur during their shifts. Fairfield CIT officers also perform a proactive function by following up with patients, victims, and families to provide information and access to a myriad of mental health and substance abuse resources. This requires strict time management skills and discipline to efficiently complete CIT tasks while maintaining exceptional levels of productivity as patrol officers. Fairfield CIT officers also take on special projects aimed at improving the reach and efficiency of the program. They continuously establish and foster close relationships with representatives from an ever-expanding network of mental health and substance abuse agencies.

Fairfield CIT officers have, in an unprecedented manner, fortified the growing nexus between law enforcement and mental health professionals. The Fairfield CIT program, Fairfield L.I.F.E., is quickly becoming the model for other law enforcement agencies to aspire to. The model has improved the quality of service to Fairfield’s community and has furthered the Fairfield Police Department’s goal of “Making Fairfield Safer” through professionalism, honor, and excellence.

Implementation

The Fairfield Police Department Crisis Intervention Team is a specialized unit within the department. CIT officers are trained to respond to any type of mental health or substance abuse incident. The training for the CIT officers includes recognition of a variety of mental health disorders, de-escalation and conflict resolution techniques, and awareness of available mental health and substance abuse resources. Incidents they respond to can range from minor to severe and include, but are not limited to those involving patients with Alzheimer’s disease, people who chronically abuse alcohol or narcotics, children with autism, people with mood disorders who have frequent violent outbursts, and people with severe depression who threaten or attempt suicide. According to Louise Pyers, MS, B.C.E.T.S, founder and executive director of the Connecticut Alliance to Benefit Law Enforcement (CABLE),

An individual who comes into contact with a CIT Officer has the opportunity to see a different way of policing; for family members and people living with mental illness, this is a real gift. We know it saves lives.[1]

Basic goals of any CIT program include the following:

• Reduce injuries to the subject displaying signs of mental health and/or substance abuse issues, the responding officer(s), and any bystanders.
•  Shift the focus away from the arrest and more toward the need to provide the necessary mental health resources when appropriate (jail diversion).
• Reduce the amount of repeat police response and repeat hospital visits.
• Reduce the number of completed suicides and “suicide by cop” incidents.
• Reduce in-custody deaths from “excited delirium.”
• Promote feelings of trust and faith in police departments by persons and families coping with a mental health or substance abuse diagnosis.[2]

The traditional CIT model is applied in the field by a CIT-trained patrol officer equipped with a higher degree of training in recognizing, responding to, and resolving matters involving mental health or substance abuse. The challenge of the traditional model is that it is reactive in nature; in most cases, the police officer’s role is completed when the initial matter is safely resolved, either by enforcing mandatory ambulance transport for a psychiatric evaluation or by an arrest. The CIT officer is trained to attempt to gain voluntary compliance in order to reduce risk of injury to the patient, responding officers, medical personnel, and any bystanders. The question remains, what happens after the hospital visit or after the arrest? How do police fulfill the remainder of the goals of the CIT program?

In the first few weeks of the initial implementation of the Fairfield CIT program, officers observed patients being quickly released from the hospital without any long-term plan for treatment. Those who were suffering in silence continued to suffer. Those who were prone to criminal activity reoffended. These challenges forced Fairfield CIT officers to reconsider the traditional CIT model and modify their approach to suit the needs of the community. The CIT Unit believed it could strengthen Fairfield’s CIT program in three ways: (1) by designing a follow-up phase, (2) by creating uniquely forged partnerships, and (3) by devising a system of tracking CIT activities and responses. These enhancements had a direct effect on the way the Fairfield CIT Unit functioned. They increased the level of the officers’ involvement with individuals coping with mental illness or substance abuse, helped to incorporate outside agencies into a follow-up phase, and helped to monitor progress and compile statistical data. This thought process was the beginning of the creation of the Fairfield L.I.F.E. Model. The letters in L.I.F.E. describe the process in which Fairfield CIT officers enhanced the traditional CIT model to further assist and support individuals in crisis: Learn, Intervene, Follow-up, and Evaluate. More specifically, learning how to identify and respond to individuals in crisis; intervening in those crisis situations; following up with the subject after the situation; and evaluating the techniques, progress, and effectiveness of the program.

There were several challenges to consider regarding the design and implementation of the L.I.F.E. program. The challenges needed to be navigated for smooth operation from the initial response phase through the follow-up phase. Ultimately, the challenges were resolved by pursuing procedural, hierarchal, and technological modifications. Common challenges included

• Lack of buy-in: Non-CIT trained officers and supervisors did not fully understand the role of the CIT officer and the benefits of the program.
• Dispatch: When and how is a CIT officer dispatched to a “CIT call” outside of his or her patrol?
• Unity of command: When a CIT officer is the initial responder, who is the officer’s supervisor for that incident? Is it his or her patrol sergeant or the CIT supervisor?
• Communication: When the initial responder is not a CIT officer, how does the CIT supervisor get notified of the incident in order to schedule a follow-up visit?
• Computer reporting software, “LEAS”: Could LEAS support the needs of the proposed CIT program objectives?

Conquering the lack of buy-in and dispatching and unity-of-command challenges required several steps. First, non-CIT trained personnel and dispatchers needed to be educated on the types of calls that should receive a CIT response. Further, new procedures needed to be proposed and agreed upon regarding proper response to these calls. Finally, the patrol force needed to be educated on the goals, uses, and benefits of utilizing CIT officers for these calls. To accomplish this, each shift was first addressed during roll call and then officers regularly received department-wide emails to address specific issues that arose.

Fairfield CIT officers created two tools, which could be used in either the initial response phase or the follow-up phase and assist the responder with proper documentation. The “CIT Field Response Form” is a guide to collect basic pertinent data such as name, date of birth, diagnosis, medication compliance, current support system, condition of home, and other essential information. The “CIT Risk Assessment Form” is a guide to gather in-depth information necessary to paint a full picture of a person’s past and current mental state, past and current living environment, future plans, and key risk factors to help CIT officers determine the likelihood of the individual posing a continued danger to self or others. In order to comply with HIPAA restrictions on personal health information, each form requires the patient’s signature consenting to sharing protected information with appropriate mental health or substance abuse professionals.

As far as computer software capabilities, LEAS allowed CIT officers to solve the majority of the follow-up phase challenges. CIT officers were further able to utilize LEAS as a tracking system for CIT calls and data. A specific “CIT Unit” designation was added to LEAS—and, when using drop-down menus in certain fields of the LEAS reporting function, “CIT Unit” can be selected for the purposes of tracking CIT activity or routing the subsequent report to the proper CIT personnel. When “CIT Unit” is selected, LEAS allows for quick searches of CIT activity. Activity can be searched by overall responses or specifically by initial response, follow-up, or incident type. Being able to quickly generate statistical and comparative data has been useful in keeping administrators apprised of CIT productivity, anticipating future needs of the program, and identifying trends by various demographics.

LEAS has a case management function that has the capability to route reports interdepartmentally, either for the purpose of simply sharing the information or to request follow-up action. Utilizing the “CIT Unit” function in this field allows patrol sergeants to forward incident reports following mental health or substance abuse reports to the CIT supervisor. For example, when a CIT officer is the initial responder to such calls, the subsequent report is forwarded to the CIT supervisor via the case management function for informational purposes. The CIT supervisor then checks for the patient’s documented consent to the sharing of information with appropriate outside agencies; assesses the need for further referral to such agencies; and, ultimately, facilitates such referral. When a non-CIT trained patrol officer is the initial responder on such calls, the patrol sergeant forwards the report to the CIT supervisor via the case management function and requests follow-up action. The CIT supervisor then uses the case management function to assign a CIT officer to follow up with the individual at a later time.

The purpose of the follow-up visit is tri-fold: (1) to provide the individual with mental health and substance abuse disorders resource phone numbers and websites; (2) to gather CIT Field Interview, Risk Assessment data, and consent for further referral to outside agencies; and (3) to promote positive relations between the police department and the individual. Often, a person in crisis views his or her initial interaction with police in a negative light so following up after the moment of crisis can be far more productive for both the person and the CIT officer. It is also important that the CIT process does not further traumatize the person already in crisis. The Fairfield CIT approach involves the provision of a fixed, monthly amount of compensatory hours to support CIT officers who come in on their days off for the specific purpose of performing the follow-up phase of the CIT process. These officers come to work wearing professional civilian attire and are assigned an unmarked police car for the purpose of responding to the residence of the person formerly in crisis. Use of an unmarked car reduces the perceived stigma of having a police vehicle parked outside of the home, and the officers’ civilian attire helps the individual feel more at ease while speaking with the officer(s). In the end, CIT officers often leave the person with positive feelings about the service they received from the police department at the end of the follow-up phase.

 Fairfield L.I.F.E.—Innovations and Evolving Practices

As the Fairfield CIT Unit progressed through the implementation of the L.I.F.E. Model, several innovations and evolving practices emerged. The following segments describe innovations and practices in the Fairfield Police L.I.F.E. Model, which, when combined, are unique to its function. Those innovations include the CIT Go-Pack, CIT brochures, the ride-along program, the referral process, the SafeReturn Network, and the CIT Crisis Manual.

Go-Pack and CIT Brochure

The Fairfield CIT brochures were created by the Fairfield CIT Unit. Each brochure lists several resources in relation to each category of citizen served (veterans, juveniles, etc.) listed in the brochure. Next to each resource is a check box, which the officer can check if he or she recommends it for the subject who is receiving the brochure, a brief description of the resource, and the contact number for the resource. The resources listed are a compilation of local, state, and federal resources that specialize, focus, or otherwise work with individuals falling under the categories of adult and general, senior citizen, juvenile, substance abuse, and veterans. Websites are also listed on the brochure because some people prefer to perform Internet research as opposed to calling services. The purpose of the brochure is to empower individuals, to provide them with a physical reminder of the resources, and to ensure they have the police department’s contact information.

 Ride-Alongs

Talking about resources on scene is beneficial to some citizens, but Fairfield CIT officers found that other individuals needed further assistance in getting help. The L.I.F.E. Model implements a ride-along component that is offered to mental health contacts in the area. The ride-along component allows mental health professionals to ride with CIT officers during day or evening shifts. Ride-alongs allow the officers to develop or enhance their rapport with local mental health professionals and create an environment in which both sides learn more about the other’s roles and responsibilities. Through the ride-along component, the mental health professional is able to provide insight and often assist, when safe to do so, in crisis situations that arise during his or her ride-along. Mental health professionals also ride along with CIT officers for follow-ups. These interactions allow officers and mental health professionals to develop connections in which they feel more like coworkers or partners working toward a unified goal of helping those in need. Deborah Barton, a licensed clinical social worker from Greater Bridgeport Community Mental Health Center, described her interaction with officers with the following words:

I love working together as a team. The officers and I are able to bring different skills and perspectives, which complement each other, with the common goal of assisting a citizen in crisis.[3]

The ride-along component of the L.I.F.E. Model has proved to be very valuable for all parties involved. The amount of knowledge and understanding gained by officers and mental health professionals can never be adequately measured. Mental health professionals shared insight into mental illnesses, various forms of therapy, medications, trends, and statistics; some even assisted with police training or attended CIT meetings. Simultaneously, CIT officers provided insight into the complex and dynamic situation of dealing with people actively in crisis in uncontrolled environments. Deborah Barton found great professional benefit in riding with officers.

It has been a privilege to ride-along with the police. I learned about the stress of being a police officer. Additionally, I have learned the ins and outs of the legal system and have become somewhat of an “expert” within my agency.[4]

Whether the ride-along is a one-time thing or a weekly commitment, conversations are generated, and, instead of police and mental health professionals seeming like intangible entities to one another, both groups came to recognize each other as human beings.

Referral Process

Another way Fairfield CIT officers seek to connect people with resources is by forwarding information about individuals in need to those who can assist them further. In the traditional policing model, the goal was to simply stop a problem that was actively occurring; there was no follow-up to see if the interventions helped or if further assistance was needed. Before the inception of the Fairfield’s CIT Unit, incidents were generally handled in the following way:

1. dispatch received a call for a problem,
2. officers were dispatched to the scene,
3. officers de-escalated or handled the situation that was actively occurring, and then
4. the individual in crisis was sent to the hospital, separated, or arrested.

At that point, police involvement ceased, unless there were future calls to police. In the L.I.F.E. Model, a fifth step is added. If a mental health or substance abuse issue is noted or recognized in the first two steps (dispatch and original response), and a CIT officer is available, he or she responds to the scene to assist and provide resources. In this fifth step, reports for incidents involving mental health or substance abuse issues are forwarded to the CIT supervisor who determines whether the report should be followed up by a CIT officer or if information should be shared with other organizations for further assistance or follow-up. Mental health professionals are then able to follow up on their own by calling, visiting, or arranging a meeting with the individual with the assistance of law enforcement. The follow-up and referral process of the L.I.F.E. Model further aids in connecting people with resources that may help them.

SafeReturn Network

The SafeReturn Network is a computer database developed to assist emergency personnel in locating and safely returning community members who have conditions that make them susceptible to “wandering.” The design for this database was created by the Fairfield Police Department and put into effect by Dr. Wook-Sung Yoo, professor of software engineering at Fairfield University. Graduate students Ebenezer Rodriguez Vidal and Michael Marrero were selected to take on the endeavor of creating the SafeReturn Network as part of their capstone project. The SafeReturn Network was completed by Vidal and Marrero in May 2013 and implemented by the Fairfield Police Department in January 2014.

Once an individual is registered with the SafeReturn Network, officers have the ability to search the database using a variety of variables such as name, physical characteristics, and age. Individuals can be registered by family members, caretakers, or law enforcement. In addition, the database contains photographs of each individual. If an officer encounters someone who is unable to communicate, the officer is able to open a gallery of photographs and filter those photographs based on physical characteristics. If a match is found, the officer is then able to retrieve the individual’s profile and emergency contact information. The SafeReturn Network is accessible from the mobile computer terminal within an officer’s patrol vehicle as well as at police headquarters.

Crisis Manual

The manual contains a checklist of responsibilities, staging points, chain of command, contacts, and a span of control functions. The contacts listed in the manual are from agencies that have created their own call-trees for psychological response to incidents. Once the officer makes contact with the individual listed, that individual would then activate their call-tree, thus sending mental health professionals to the determined staging zone. Several contacts in charge of those call-trees are listed in the manual, and all expressed interest in participating in the system 24/7. Once on-scene, the mental health professionals are organized by CIT officers who maintain accountability, organization, limited access, and scene safety. The manual also provides forms regarding hostage and scene assessment. It is important to note, due to the unpredictable nature of crisis scenes, this manual should be used only as a guideline. Ultimately, discretion, policy, and state and federal laws should be utilized.

Community Relations

CIT programs at police departments have shown to have a positive effect on community-police relations. Louise Pyers describes how CIT programs influence citizens,

People who observe a CIT Officer at work are often inspired and surprised to see an officer calm a crisis by listening with respect and compassion.[5]

The Fairfield Police Department’s L.I.F.E. Model helped to enhance the public and community relations of its organization. Fairfield CIT officers have spoken at and conducted presentations for various groups including the National Alliance for Mental Illness, Fairfield’s Citizen Police Academy, Fairfield Public Schools, Autism Speaks, and Abilis, Inc. Media interviews and social media have also furthered the reach of the positive effect of CIT on the community. In addition, Fairfield CIT officers spoke at the 2013 CIT International Conference and 2014 Connecticut CIT Symposium to share Fairfield’s L.I.F.E. Model with other law enforcement and mental health organizations. The presentations serve as an avenue to inform people about CIT benefits and the ways police seek to help people. Interactions such as these humanize police officers and display the positive impacts made by police on a daily basis

Conclusion

The entire L.I.F.E. Model may not be practical or compatible within all organizations, but most agencies are able to scale or adapt the program or take the elements they find useful and actionable in their communities. Fairfield L.I.F.E. has revolutionized the way Fairfield police handle situations involving individuals in crisis. It is difficult to quantify success in terms of numbers this early in the program; however, after tracking Fairfield’s L.I.F.E. Model over time, it is hoped that evidence may show a measurable reduction in injuries to individuals, officers, and bystanders involved in mental health– or substance abuse–related calls. Fairfield police are already seeing a reduction in the number of times “repeat customers” require police involvement as a result of access to a wide variety of resources, a nexus between law enforcement and mental health services, and follow-ups. Tracking the progress of the Fairfield L.I.F.E. Model and modifying the program enable its continued success. The Fairfield Police Department is also seeing a reduction in the number of mental health–related arrests with the responding officers’ foci shifting to assessing the need for proper treatment rather than an arrest.

Success of Fairfield’s L.I.F.E. Model thus far also has been marked by the growing positive feedback from the community through news articles, letters to the police chief, emails, calls to supervisors, and positive face-to-face interactions with the public. Through continued support for the Fairfield L.I.F.E. Model, CIT officers can continue to enhance the program, strengthen relationships with existing resources, and foster new networking relationships. This type of dedication and the creation of these types of programs reflect the fundamental goals of law enforcement officers to support, protect, and serve their communities.

Notes:

[1] Louise Pyers (founder and executive director, Connecticut Alliance to Benefit Law Enforcement), personal communication, May 6, 2015.

[2] Randolf Dupont and Sam Cochran, The Memphis Model CIT Program (PowerPoint presentation, 2009), http://www.cit.memphis.edu/aboutCIT.php?page=3 (accessed November 1, 2016).

[3] Deborah Barton (clinical social worker, Greater Bridgeport Community Mental Health Center), personal communication, May 2, 2015.

[4] Ibid.

[5] Pyers, personal communication, May 6, 2015.