1. CIT - more than just training
We are the more…

2. 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.

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

4. 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.

5. 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

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

7. 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

8. 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.

9. 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.

10. 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.

13. Police
911
Crisis
Hospital
Crisis Hotline
Mobile Crisis Team
Jail

14. Police
911
Crisis
Hospital
Crisis Hotline
Mobile Crisis Team
Jail

15. Dutchess County Stabilization Center
Innovations in the Hudson Valley

16. 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.

17. 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.

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

19. 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.

20. 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.

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

22. 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.

23. 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.

24. 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.

25. Orange County CIT Response System
Innovations in the Hudson Valley

26. 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.

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

28. 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!

29. Questions? Contact: Mark Giuliano, MSW
Westchester County Department of Community Mental Health
Steve Miccio
PEOPLe Inc.
Police Officer Dawn Anemelos
Town of Poughkeepsie Police Department