Crisis Intervention Teams in Corrections: Exploring the impact on officer use of force and the well-being of incarcerated people with mental illness

Project Summary/Abstract
People with mental illnesses are overrepresented in the criminal-legal system. Prisons are high-risk
environments for all people but are especially high risk for people with mental illnesses. Despite expansion of
diversion programs and an overall decline in prison populations, the proportion of people with mental illnesses
in prisons continues to rise. This is, in part, due to people with mental illnesses staying in prison longer.
Correctional officers (CO) are front-line workers who carry out prison policies and procedures and have
discretion in how they respond during behavioral disturbances. Given the high prevalence of mental illness
within the prison population, correctional settings are implementing an adapted Crisis Intervention Team (CIT)
model. CIT with police is well studied and considered an evidence-based practice for officer-level outcomes
and mental health service linkage. Research on the effectiveness of CIT in correctional settings is nascent. In
previous research, CIT trained correctional officers had significantly more knowledge and less stigma about
mental illness, more positive attitudes about people incarcerated with mental illness, and felt more prepared to
respond to mental health crisis events after completing the CIT training compared to pre-training scores.
Although this preliminary work is promising, there is no research examining how CIT skills are used in practice,
whether it changes officer use of force, or how it impacts response to mental health crisis events. Attribution
theory suggests that behavior change can occur through changes in attitudes and stigma but hypotheses
surrounding the impact of CIT on officer response in prisons has yet to be tested. The proposed study utilizes
existing data to examine whether CO response to mental health events, uses of force and segregation, staff
grievances, and attempted and completed suicides among the incarcerated population significantly changed
since implementation of CIT in one state prison system. The hypothesis is that altering CO knowledge and
biases in perceiving and responding to people with MI using CIT will minimize exposure to harmful sanctions,
increase safety in staff interactions, and improve response to mental health crisis events. The proposed
research addresses the specific objective of the NIMH Division of Services and Intervention Research to
conduct exploratory research to inform and improve the delivery and quality of interventions within real-world
service delivery systems. Prisons are highly complex systems and continue to be one of the largest institutions
to house people with mental illnesses. Effective intervention is critically needed to reduce harm while in prison
and the length of time people spend in high-risk, prison environments.

Grant Number: 1R03MH131969-01A1
NIH Institute/Center: NIH
Principal Investigator: Kelli Canada