Frequently Asked Questions

Training by itself does not constitute a PMHC program. Training is certainly one of the 10 essential elements, and officers will be far more effective when they acquire the knowledge and skills to respond to mental health calls for service. Yet, simply training officers without implementing the other essential elements is inadequate and may even be counterproductive. For example, responding effectively to mental health calls requires a different approach than what is used for most calls for service. Officers typically need additional time to develop a rapport to effectively deescalate the encounter and reach an appropriate disposition. Absent the support of supervisors to slow the pace of the response, officers may ineffectively respond to the call.

This is just one example of how calls are handled differently, and it highlights the need for an agency to make the PMHC program a priority and provide the operational and administrative infrastructure to enable the PMHC program to succeed. For a comprehensive list of the 10 essential elements, see Improving Responses to People with Mental Illnesses Strategies for Effective Law Enforcement Training.

Every state, either through legislation or administratively by the state Peace Officer Standards and Training (POST) agencies, establishes the basic number of hours and the curriculum for recruit and in-service training for law enforcement officers.

The following examples illustrate how each state's requirements for mental health and de-escalation training at the recruit level vary:

• Indiana requires every law enforcement recruit to complete six hours of mental health training
• Utah requires a cadre of certified Crisis Intervention Team-trained officers in all jurisdictions. CIT training is a 40-hour curriculum, to be completed in a one-week 35 period, based on the Memphis Police Department Crisis Intervention Team mode
• The State of Washington mandates that every new full-time law enforcement officer employed after July 1, 9 2017, complete eight hours of CIT training
• In 2015, California enacted legislation that requires recruits to complete 15 hours of training on "Persons with Disabilities," and requires that all recruits successfully complete the associated scenario or risk failing the academy

In addition to establishing standards, POSTs also certify training programs that officers can participate in to build knowledge, develop skills and to meet annual training requirements. The courses are typically developed by individual agencies, training academies or statewide organizations. For example, Missouri CIT and Kentucky Kentucky CIT are independent CIT Councils that provide POST-certified training courses.

The Commission on Accreditation for Law Enforcement Agencies, Inc. (CALEA) is the national accrediting body for those law enforcement agencies that choose to be accredited. CALEA requires standard that requires all participating agencies to provide entry-level training to all officers and refresher training every three years to officers who come into to contact with people with mental illness. While this is a mandatory standard that applies to all agencies, it does not specify the number of hours or the curriculum to use.

For additional information see:

• CALEA Mental Health Training

Law enforcement agencies and the mental health system (i.e., state and local mental health agencies, community mental health providers, and hospital emergency departments) can work together to develop strategies to meet the mental health demands in their community. It is about building​ trust and an appreciation for each other's expertise, but that can be a challenge.

The police play an important role to connect individuals with services and supports that will reduce problematic behavior and promote public safety. Likewise, mental health agencies and providers can steer officers to resources for people with mental illnesses when crisis services are responsive to law enforcement needs.​

To do so, police and mental health agencies and providers will need to understand and appreciate each other's roles, responsibilities and resource constraints. Building a collaborative partnership takes time and patience, and law enforcement and mental health agencies and providers may need to first address long-standing challenges. For example, it is not unusual in many communities for each system to believe that their counterparts are not accepting full responsibility for their role in handling mental health calls for service. Taking the time to discuss points of friction will ease misunderstandings, but it will also identify opportunities to clarify roles and improve efficiencies between the systems ​

For more information, see:

• PMHC Law Enforcement Mental Health Learning Sites
• Building Bridges: 10 Essential Elements for Effective Community Partnerships between Law Enforcement and Mental Health

This is a community issue that requires a holistic approach to be successful.  Although law enforcement agencies are the initial responder to many people with mental illnesses, they are not equipped to provide the resources and services this population needs.  Law enforcement must seek to partner with both mental health professionals and advocates and the families of those with mental illnesses to emphasize collective ownership of the issue along with solutions. Law enforcement must seek to partner with both public health officials, mental health professionals, and advocates and families of those with mental illnesses to emphasize collective ownership of the issue along with solutions. 

Law enforcement leaders should identify which mental health agencies in their communities provide services to individuals with mental health issues or intellectual/developmental disabilities. This will help identify services and resources needed to effectively develop collaborative strategies for effective short- and long-term responses. Collaboration within the community, to include partnerships with municipal and county nonprofits and other service providers, as well as state associations will help make the work successful. Consumers of mental health services, their families, and advocates should all be engaged in planning, delivering, and monitoring a collaborative law enforcement-mental health partnership.​ 

For additional information, see: 

• Stepping Up: A National Initiative to Reduce the Number of People with Mental Illnesses in Jails

As first responders, law enforcement professionals encounter people with mental illnesses or intellectual/developmental disabilities every day. Some of these individuals are in an emotional crisis, or unable to care for themselves, and need assistance. Other individuals exhibit behavior that is perceived as threatening, or they may be linked to or engaged in criminal acts. And, research has shown that persons who have mental illnesses, like many persons who have disabilities, are at a greater risk for victimization.

Law enforcement agencies have responded to people with mental illnesses throughout their history. Since the mid-1980s the frequency with which officers encounter persons with mental illnesses has steadily increased to the point that all law enforcement agencies—large and small, urban and rural—now have regular interactions with people in their communities who have mental illnesses. Consensus exists among that law enforcement agencies are bearing a disproportionate responsibility for these encounters because of an inadequate mental health system. Nonetheless, the reality is that these encounters are occurring and it is therefore important to ensure an appropriate response.

Responding to mental health calls for service can be difficult for officers, but by recognizing the extent to which officers interact with people with mental illnesses, agencies can take the necessary steps to train and prepare officers, develop policies, and build collaborative partnerships with mental health providers that will lead to safe encounters and appropriate dispositions.

Recognizing the impact these encounters have on policing, both as a public safety and as a public health concern, addressing these encounters should be a priority for law enforcement leaders.

For additional information, see:

• Building Safer Communities: Improving Police Response to Persons with Mental Illness
• Crisis Intervention Team Programs

​PMHCs can create positive changes for law enforcement agencies, law enforcement officers and consumers alike.  Based on research and the experiences of agencies, the most common benefits are:

Improved safety for all

• Improved safety for all
• Fewer injuries to consumers
• Fewer uses of force

Increased access to mental health treatment, supports and services for consumers

• More diversions from the emergency room
• More referrals of consumers to the appropriate behavioral health provider
• More crisis prevention services

Decreasing the frequency of these individuals' encounters with the criminal justice system

• Fewer arrests
• More jail diversions

Reduced costs incurred by law enforcement agencies

• Fewer repeat CFS
• Fewer SWAT call-outs

For additional information, see:

• A Comprehensive Review of Extant Research on Crisis Intervention Team (CIT) Programs
• Crisis Intervention Teams: Responding to Mental Illness Crisis Calls
• Variations in Specialized Policing Response Models as a Function of Community Characteristics - A Survey of Crisis Intervention Team Coordinators

Communities working to improve outcomes for people with mental disorders in contact with the criminal justice system can benefit greatly from a better understanding of the experiences of colleagues from across the country. The Council of State Governments (CSG) Justice Center regularly features profiles and news articles about JMHCP grantees and other criminal justice and behavioral health programs—you may subscribe to receive updates. Additionally, the National Criminal Justice Initiatives Map provides information about recipients of federal funding related to reentry and recidivism reduction across the country.

One common denominator among all strategies that provide a response to this problem is a commitment to collaboration between at least one criminal justice and one mental health agency. Chapter Five of the Consensus Project Report provides recommendations for improving collaboration. The CSG Justice Center's Advocacy Handbook provides useful strategies for reaching out to different stakeholder agencies and groups.

The GAINS Center has developed fact sheets and detailed discussion papers on six evidence-based practices and how they can be applied in criminal justice settings. Three of the evidence-based practices are particularly relevant for individuals transitioning from jail or prison into the community: Assertive Community Treatment, evidence-based housing programs, and supported employment.

The National Institute of Justice (NIJ) has funded two groups to develop screening instruments for jails. Both instruments have psychometric properties, with low rates of false positives and false negatives that allow for the detection of individuals who warrant additional assessment for mental disorders. The Brief Jail Mental Health Screen, developed by Policy Research Associates, can be used as a screening instrument for both men and women. The Correctional Mental Health Screen, developed by researchers at the University of Connecticut, provides separate instruments for men and women. See NIJ's Mental Health Screens for Corrections to learn more about the instruments.

As part of its technical assistance work in this area, the CSG Justice Center has developed detailed case studies of corrections/mental health collaboration in several jurisdictions. One case study describes what leaders of the Departments of Corrections and the Department of Social and Rehabilitation Services in Kansas have done together to improve the likelihood of safe and successful transitions from prison to the community for individuals with mental illness. The Orange County, Florida case study describes the experiences of county jail staff and community providers collaborating to design post-booking diversion options.

The National Institute of Corrections (NIC), a component of the U.S. Department of Justice, together with the CSG Justice Center, has developed a Collaboration Assessment Tool to help justice and mental health organizations assess their existing level of collaboration.

Outcome data can be of enormous value to mental health courts in their efforts to demonstrate the initial promise of their approach and garner long-term support as well as make data-driven program modifications. A Guide to Collecting Mental Health Court Outcome Data provides practical strategies for obtaining and analyzing data. It also identifies challenges that mental health courts often face during the data collection process and ways in which to overcome them.

Developing a Mental Health Court: An Interdisciplinary Curriculum is a free online multimedia curriculum for individuals and teams seeking to start, maintain, or just learn about mental health courts. Developed by the Council of State Governments (CSG) Justice Center with the support of BJA, it is the first single resource with the information teams need to translate current research on mental health courts into program design and operation. Other resources dedicated to the planning and implementation of mental health court programs include, The Guide to Mental Health Court Design and Implementation which describes different steps planners will encounter when launching a mental health court and addresses issues such as determining whether a mental health court is the most appropriate court-based program for a jurisdiction, selecting a screening mechanism for potential court participants, and sustaining a court's operation. The Essential Elements of a Mental Health Court builds upon the Guide by describing ten features—identified by leading experts and informed by hundreds of practitioners—as critical to establishing and sustaining a mental health court. See the Mental Health section of the CSG Justice Center site for resources that are responsive to needs expressed by practitioners.

At each juncture of the criminal justice process-from before arrest to after release from a correctional facility-there are steps that you can take to improve the response to people with mental illnesses in your community. The Criminal Justice/Mental Health Consensus Project Report (Consensus Project Report) provides more than 100 recommendations, endorsed by law enforcement, judges, advocates, consumers, and corrections officials, for addressing the problem at different stages of the criminal justice process. See “A Person with Mental Illness in the Criminal Justice System: A Flowchart of Select Events,” located on page 25 of the Consensus Project Report for specific information.