Endomarketing

o Expedient procedure at the CRC

X 4. System Integration o Agency communication o Dispatch/911 integration X X 5. Data collection

o Police CIT forms

o Officer Satisfaction/CRC Data Collection

o Client Satisfaction X X X 6. Strong Leadership o Financial Incentive o Police Culture X Further research required Training Quality

40 Hours of Police Training - The Memphis Police Department experimented with various levels of training to determine the number of training hours that would best prepare law enforcement officers for encounters with the mentally ill. Law enforcement personnel initially suggested that 8 hours of training would be adequate, though no changes in jail diversion of the mentally ill or reductions in police injury occurred (Dupont and Cochran, 2000). The mental health educators who originally devised the Memphis Model reinforced

the need to meet the required 40 hours of police training. When this intensive, quality, training was implemented positive outcomes were reported (Dupont and Cochran, 2000). These positive outcomes include the diversion of mentally ill away from jail and a reduction in the number of police injuries. Therefore the suggested 40 hours of police training is identified as an evidence based best practice (EBP). Following the Memphis Model, the training provided would include:

• 20 hours classroom instruction on topics such as overview of mental illness, effective communication, developmental disabilities, psychotropic medication, legal considerations, etc.

• 8 hours of field trips to sites including hospitals and intake centers serving people with mental illness, day programs, and after-care providers.

• 12 hours of role playing during which officers were required to role play situations in which they used the knowledge gained during the didactic presentations and field trips (Police CIT, 2004).

Currently Lakeside Alternative conducts all CIT training in Orange County. The required 40 hours of training are achieved.

Officer Protocols- EgonBittner argued in 1967 that police officers should possess a set list of protocols for when they interact with the mentally ill, yet these protocols should act as a guide and not transcend officer power or discretion. Nationally, CIT teams that operate under the Memphis Model provide officers a clear written policy for handling situations with mentally ill citizens though officers are also encouraged to use their discretion when solving problems and handle cases on their own (Teplin, 1990, p.31) Officer protocols is considered a best practice (BP).

Discussions with administrators indicate thatfollowing initial training CIT officers receive a resource manual that contains tips and resources. CIT officers also utilize Baker Act procedures for some of their decision-making. Each Orange County law enforcement agency has a different set of protocols and procedures – they are general in nature but should be similar to the CIT training procedures.

Due to the nature of mental illness and its frequent coupling with homelessness and substance abuse, police will often interact with the mentally ill not as a result of a call for service, but as the result of police witnessing the mentally ill person engaged is some violation or as part of some public encounter. This type of - on the spot encounter - does not allow a dispatcher to direct a CIT officer to the scene and diversion from the criminal justice system, if it occurs, is up that individual officer. For this reason it is important that all uniformed officers are knowledgeable about the Receiving Center and know the desired way to handle incidents with the mentally ill (or they should at least know when to call a CIT officer to the scene for assistance). There is no indication that Orange County functions this way.

CIT Officers Trained

Fifteen to Twenty Percent of Officers Trained- A best practice (BP) of the Memphis Model is the training of 15 to 20 percent of all officers within a precinct. Research by Dupont and Cochran (2000) indicate that the 15-20% benchmark avoids the expense of training all officers while simultaneously enabling a CIT officer to be on the scene of an incident involving the mentally ill within 5-10 minutes. Simply, the 15-20% is a best practice balance of cost-effectiveness and efficiency. The Memphis police department has maintained 225-240 trained CIT officers for a number of years. When we compare the number of trained officers to the total number of officers in the uniform patrol division (Memphis = 900) we find a justification for the 15-20% benchmark (Memphis Police Department, 2004) In Orange County the percentage of officers trained variesfrom department to department. Discussions with administrators indicate that the two largest departments (Orange County Sheriff and the Orlando Police Department) have about4-8 % of their uniformed officers

CIT trained, while smaller departments have about 10-20%.

Police Decision Making

Expedient procedure at the CRC - Research indicates that police decisions are often influenced by informal considerations like the degree of paper work and expediency of the procedure (Bittner, 1967). Additionally, police officers must always be concerned with their temporary responsibility for the offender. Therefore, frequently officers base their decisions on the ability to relinquish offender responsibility in a timely manner and return to duty (Dupont & Cochran, 2000). Traditionally, when officers do not have the option to transfer in a timely fashion offender responsibility for a mentally ill individual to a crisis center, they will simply arrest them (Teplin, 1984).

The Memphis Police Department experiences approximately a 15-to-30 minute best practice (BP) turnaround time forpolice at their crisis center (Steadman et al, 2000). In Orange County, the average time an officer remained at the CRC with a mentally ill client was 11.57 minutes, with an average range of between 10 minutes (January 04) to 14 minutes (April 04).

System Integration

Agency Communication- A key characteristic of effective jail diversion programs is an emphasis on coordination, cooperation and trust among partner agencies (NASMHPD Report, 2004). With regard to a pre-booking diversion program, the Memphis Model relies on successful communication between such agencies. Discussions with administrators indicate that Orange County law enforcement is characteristically a fragmented system. This fragmentation becomes relevant when the issues of 911/dispatch, data collection

methodology, and police leadership are reviewed.

Dispatch/911 Training – Jail diversion programs obviously operate in a complex and multi-agency setting. Although a complete systematic integration of services may be impossible, at a minimum “critical services” should be linked (Teplin, 1990). A successful diversion program will assist 911 dispatchers in developing a coordinating effort with CIT trained officers: this includes tools to determine whether mental illness may be a factor in a call for service and the use of that information to dispatch the call to the appropriate

responder (Memphis Police Department, 2004). The result should be qualified mental health officer arriving on the scene in a timely manner. A five to ten minute response time is a desirable and can be considered an emerging practice (EP).

Discussions with administrators indicate that the degree of coordination within Orange County fluctuates. It appears that coordination with 911 personnel varies from department to department in terms of how calls are referred to CIT officers. This issue is currently being addressed.

Data Collection

A successful jail diversion program records encounters with the mentally ill, the number of diversions achieved and the incidence of police injuries. Data are then used to indicate changes in the mentally ill jail population, the frequency of successful diversion placements and work hours lost to police injuries incurred when interacting with the mentally ill. According to Steadman (2000), ideal data collection measures would also include the

frequency of police interactions with the mentally ill, the number of clients screened by CIT, the number eligible for diversion, the number of clients placed in a mental health program and other relevant characteristics such as previous interaction with the client (recidivism). The Memphis Police Department is one of the few jail diversion programs that continually evaluates its program’s impact. Orange County tracks interactions between CIT officers and the mentally ill via two methods: (1) police CIT forms, and (2) CRC surveys.

Police CIT Forms - Pre-booking jail diversion research generally contains data collected by law enforcement agencies. In the case of Memphis Police, interactions between officers and the mentally ill are documented via officer reports and 911/dispatch data (Dupont

&Cochran, 2000). Without these data, outcomes cannot be evaluated with reliability. From discussions with administrators, the current data collection method in Orange County consists of a CIT tracking form. This tracking form is primarily a checklist that supplies information about the characteristics at the scene of police encounters and the resulting outcome. CIT officers are asked to provide the CIT forms to a designated supervisor who then forwards them to Lakeside Alternatives. Currently, the CIT form is not included in any of the agency’s paperwork and is not a mandatory document. As a result, administrators claim that the 1100 CIT interventions and 575 jail diversions (since February 2001) vastly under report the number of diversions.

Administrators also cite the officer surveys that take place at the CRC as a primary data collection methodology. However, these surveys present only a partial picture of what occurs

during police interactions with mentally ill persons. The surveys do not indicate how

frequently the CIT team is utilized, or the outcomes of subsequent interactions with mentally ill persons (number of diversion and/or officer safety). In addition, the reliability of the surveys can be questioned because of the environment (at the CRC) in which police complete the evaluation.

Officer Satisfaction & CRC Data Collection - Data collection is a common practice for all agencies participating in jail diversion. Although crisis centers must maintain strict confidentiality with regard to clients, it is crucial that data are collected on a macro-level in order to measure outcomes. The principal data collection technique at the CRC consists of a short survey that is completed by the officer who accompanied the mentally ill client. The CRC survey focuses on three concerns:

(1) What police/sheriff department the officer is from?

(2) Would the officer have arrested the client if the CRC was not an option? (3) Was the officer satisfied with the CRC encounter?

Looking at the CRC as a jail diversion program, police responses to question two above, in particular, provides evidence that police officers may be bringing inappropriate clients to the CRC. Between April 2003 and April 2004, the CRC screened 2,444 clients transported to the CRC by law enforcement officers. Responses to question 2 indicate that only 236 (or 9.6%) of these individuals would otherwise have been arrested (the major criterion for jail

diversion). Stated differently, the CRC data suggest that 2, 208 clients were transported to the CRC although they would not have otherwise been arrested. This finding suggests a disconnect between police training and police actions.

The CRC should attempt to capture data that will shed light on why the police are bringing individuals to the CRC. For example: was the officer is CIT trained? Was arrest an option? What charge would have been made? Other data that would be of interest from an

evaluation perspective would be to gauge the perceptions of Non-CIT trained officers as to their knowledge of the CRC and their knowledge of the criteria used to identify potential CRC clients.

Client Satisfaction - Successful diversion programs contain avenues for police officers and

clients to rate the intervention process (NASMHPD Report, 2004). This usually involves a satisfaction survey. While for police the focus is on safety issues (officer injury) and response time of the intervention team, for clients the focus is on the effectiveness of the de-

escalation and linkage to community resources. At this time there is no indication that Orange County evaluates client satisfaction.

Strong Leadership/Financial Incentives.

To encourage participation, strong and supportive leadership is required at the upper levels of the police organization. Police middle management in particular can identify and encourage officers to take part in the CIT training. Academic literature on officer

participation in supplementary programs (like jail diversion) stresses the importance of supervisor styles and enthusiasm (Engel, 2003). We currently have no data or anecdotal evidence identifying the degree of support for the CIT program and jail diversion from law enforcement. This represents an area of possible future research.

The Memphis Model often contains a small financial incentive for officers willing to participate in the CIT program. The financial incentive to be a CIT officer is typically minimal (usually around $45 dollars a month) (Dupont & Cochran, 2000). Discussions with administrators in the Orange County Sheriff Department suggest that CIT officers currently work on a volunteer basis and receive no compensation. Administrators in the Orlando Police Department state that CIT officers do receive some small additional compensation when “called out”, though there are varying options depending on the shift and the time at which the officer is called.

SECTION SUMMARY

When pre-booking jail diversion “best practices” (BP) that fall under the Memphis Model are compared with current local practice in Orange County, a mixed picture emerges. Orange County officers who volunteer to join the Crisis Intervention Team (CIT) are currently provided quality training in accordance with best practices (BP); they are supplied with appropriate guidelines and resources for encounters with the mentally, another best practice (BP). as well as access to the CRC where responsibility for the individual in temporary custody is transferred in an expeditious manner.

However, issues of concern in the operation of the pre-booking jail diversion program do exist including differences between police departments with regard to the staffing percentage of CIT trained officers which often falls well below the 15-20% best practices (BP)

benchmark. Lakeside Alternatives recognizes the problem of CIT staffing levels and training and is diligently working to remedy the situation. Currently, there is also wide variation in terms of training for police department dispatch teams which may result in CIT officers not arriving on the scene in a timely manner. Best practice (BP) research suggests that

coordinating efforts between dispatch and trained personnel is fundamental to the success of jail diversion. Issues of inconsistency appear to relate to the fragmented nature of the

criminal justice system in Orange County. In order to standardize such procedures, organized meetings and effective communication between departments is essential. In addition, the need for all officers to be aware of the CRC is of utmost importance. The nature of police work itself means that police will often interact with the mentally ill not because of a call for service (where dispatch might appropriately send a CIT officer) but on their own initiative (because they witness the individual involved in some wrong doing). These officers need to know the basics of identifying someone with mental illness and know when to request the help of a CIT officer. An accurate assessment of police officer

knowledge and perception of the CRC might be attained by surveying police officers in all Orange County police departments.

Finally, is the issue of data collection. Currently, the data collection methodology does not adequately provide an opportunity to reliably evaluate successful program outcomes or gaps that may exist in the system. While the CRC does pose several brief questions to officers who bring clients to the center, this approach is not adequate to analyze outcome measures of a pre-booking jail diversion program. Police agencies and CIT teams should be

encouraged to collect data on issues such as CIT response time to incidents involving the mentally ill, the frequency of interactions between police and the mentally ill, the number of jail diversions (clients taken to CRC), and police injuries. Accurate and relevant data is crucial for future research in order to evaluate the effectiveness of the jail diversion program and identify gaps in the system.

POST-BOOKING DIVERSION PROGRAMS