Crisis Intervention Team Mental Health Training for Law Enforcement Officers: Protocol for a Multi-Site, Randomized, Controlled Trial.

Objective: Although diverse strategies to reduce police involvement in mental health crisis response are emerging, people with serious mental illnesses and/or those experiencing a mental health crisis routinely encounter police. Officers need training to safely and effectively interact in these situations. The Crisis Intervention Team (CIT) model is a collaborative approach that includes a 40-h training of officers who self-select to become CIT officers. Despite widespread adoption across thousands of U.S. communities, no randomized, controlled trial (RCT) has assessed CIT training's effectiveness. Our objective is to determine the effectiveness of CIT training on officers' demonstrated skills and behaviors in three outcome areas: (1) verbal and non-verbal crisis de-escalation skills (the primary outcome), (2) officers' use of four domains of procedural justice, and (3) disposition-related decision-making. Hypothesized mediators and moderators will also be assessed. Methods: A total of approximately 240 officers from seven or eight U.S. sites will engage in video-recorded standardized scenarios at baseline, with half being randomized to receive CIT training within the following 3 weeks. Officers will then be reassessed at 3 and 6 months after the CIT training week. Trained raters, blinded to site, treatment arm, and timepoint, will evaluate the primary outcome. Survey-based data will capture officer characteristics and hypothesized mediators and moderators. Results: This study employs innovative methods, including standardized scenarios with professional actors portraying psychosis with agitation, depression with suicidality, and mania with refusal to leave, to measure officers' skills and behaviors. Conclusions: The multi-site RCT will yield generalizable, high-impact findings to inform policy and practice, addressing critical gaps in research on CIT training.