CIT - more than just training We are the more…

The T is for Team not Training As the Crisis Intervention Team movement began to develop across the United States there was a common misperception that CIT is a police based training program to help people with mental health concerns in crisis. All of us in this line of work understand that the T is for Team not Crisis Intervention Training.

Who is on this Team? When were the tryouts? CIT Law Enforcement People with Lived Experience Family Members Behavioral Health Providers

Building a Team CITs do not operate successfully in isolation. These initiatives become truly effective when a partnership emerges between law enforcement, the treatment and recovery community, families and people with mental health concerns. In New York State the movement for CIT Development has been largely driven through the efforts of the Institute for Police Mental Health and Community Collaboration. The vast majority of the communities have begun with a system mapping of the first intercepts.

Mapping for CIT Development Examines the first intercepts (0 &1): Crisis Response System & Law Enforcement This focused look offers the opportunity to: Look critically at how the system works Identify opportunities for system enhancement Identify common goals Enhance relationships

Stakeholders Law enforcement agencies Jail Mental Health Staff 911/Dispatch EMS/Fire County Mental Health

Stakeholders Community based treatment providers: Care management Peer Support Programs Mobile Crisis Team Assertive Community Treatment Alcohol and Substance Services Families & people receiving mental health services Department of Social Services

Stakeholder Representatives Stakeholder representatives should have hands on experience & also the capacity to initiate system change. Some Stakeholders may be best represented by more than one person.

Attempt to establish a safe environment Develop a shared vision The Mapping Attempt to establish a safe environment Develop a shared vision Operate from the WIIFM principle (Steadman) Be prepared to look at the strengths of the system as well as where the system could be improved.

Intercepts 0 & 1 Functional examination of: Emergency mental health resources Call initiation Dispatch Response Hand off to jail based mental health supports if warranted (Intercept 2) Other alternatives, services & supports This critical look at the process offers opportunities for service enhancement and builds relationships.

Police 911 Crisis Hospital Crisis Hotline Mobile Crisis Team Jail

Police 911 Crisis Hospital Crisis Hotline Mobile Crisis Team Jail

Dutchess County Stabilization Center Innovations in the Hudson Valley

Dutchess County Stabilization Center In 2017, Dutchess County opened the Stabilization Center which operates 24 hours per day, 7 days per week.  It is a non-medical, voluntary, walk-in center for individuals experiencing crisis resulting from mental health or substance abuse issues.   The Stabilization Center provides law enforcement and the County’s Mobile Crisis Intervention Team with the ability to divert individuals with behavioral health or substance abuse issues so they can receive immediate assistance and services in order to de-escalate crisis and plan for ongoing services upon release.

Dutchess County Stabilization Center The Stabilization Center is an innovative partnership with several community health agencies that is unique in New York State.  This critical resource helps in the County’s efforts to divert individuals dealing with mental illness from hospital emergency rooms or from entering the criminal justice system.

Westchester County Police Mental Health Outreach Teams Innovations in the Hudson Valley

CIT In Westchester County Westchester has 48 Law Enforcement Agencies White Plains Police Department has trained CIT Officers as well as a Police Mental Health Co-Response Team Yonkers Police Department has trained CIT Officers and a Police Mental Health Co-Response Team in the 4th Precinct New Rochelle Police Department has a trained CIT Team Most of the Law Enforcement Agencies have trained CIT officers but don’t have dedicated teams.

Police Mental Health Outreach In those communities that we have dedicated mental health responders, the clinician engages the person in crisis and makes connections to the appropriate resources. Many times we found that the crisis was precipitated by the person’s inability to meet their basic needs. To that end we created a system with a warm hand off to a mental health worker at the local DSS office to help people access services.

Rockland County EMS Based Behavioral Response Team Innovations in the Hudson Valley

Rockland Paramedics Behavioral Response Team After the closure of County run clinic services Rockland County DCMH in collaboration with the New York State OMH awarded the contract for mobile crisis mental health services to Rockland Paramedics. The Behavioral Health Response Team became operational in 2015.

Rockland Paramedics Behavioral Response Team The team is comprised of one EMT and one clinician for each tour.  There are three tours that provide coverage 24 hours per day/7 days per week. Calls can come in to Rockland Paramedics directly or may be dispatched through 911. The mission of the team is to de-escalate, stabilize and provide services to the person in the least restrictive setting.  Ultimately they are looking to prevent unwarranted emergency room visits and hospitalizations.

Rockland Paramedics Behavioral Response Team When the team responds, they respond in a Rockland Paramedic’s car, no lights, no sirens and they are in plain clothes.  They can respond with law enforcements when appropriate. The team connects people with services. They have found that people are more likely to now request the team directly as an alternative to law enforcement intervention.

Orange County CIT Response System Innovations in the Hudson Valley

Orange County CIT Response System One of the first communities to receive funding to develop a police based Crisis Intervention Team in New York State was the City of Newburgh in Orange County. The team responds to people experiencing crisis, de-escalates the scene and refers people for services. The unique aspect of their system is that once the case is reviewed by the commanding officer of the CIT Team, the report is forwarded to a network of providers for follow up.

Orange County CIT Response System Newburgh Police CIT Orange County DCMH NAMI Independent Living Center Mobile Crisis

We are the more of CIT People with lived experience Family members Mental health providers EMS and other first responders Alcohol and substance use providers Homeless providers Local churches and faith organizations Local government Mental health authority Department of Social Services Department of Health And many more!

Questions? Contact: Mark Giuliano, MSW Westchester County Department of Community Mental Health mrg3@westchestergov.com Steve Miccio PEOPLe Inc. stevemiccio@projectstoempower.org Police Officer Dawn Anemelos Town of Poughkeepsie Police Department danemeloscit@projectstoempower.org