The development of specialized training programs can come with considerable costs for agencies or academies, and may inhibit an agency from moving forward with developing the new program. The idea of developing a 40-hour training program can be daunting. Some of the common impediments include costs associated with:

• coordinating a training initiative, including expenses related to contracting with trainers
• developing the internal capacity of trainers to teach all the relevant topics
• identifying and paying for external resources, particularly instructors, speakers, and role players

Many agencies have been able to develop mental health and de-escalation training programs with minimal, or even no costs, by relying upon existing networks of law enforcement agencies and mental health advocates for assistance. Developing the necessary in-house expertise can also be achieved by allowing officers to take a "Train the Trainer" course as part of their agency-sanctioned professional development—that is, attend the course while on-duty rather than on their own time. Many states have CIT associations that routinely provide such courses at minimal, or no cost. Similarly, state POSTs may offer these courses at minimal or no cost. Some states even offer grants to offset costs associated with obtaining the necessary training. Other neighboring agencies may have experienced trainers who can provide the necessary instruction. Several agencies can also work together to offset the costs of a train the trainer course.

These are just some of the strategies to address many of the perceived obstacles to developing a training program and are discussed in more detail in Improving Responses to People with Mental Illnesses Strategies for Effective Law Enforcement Training.

Lastly, even if an agency has trouble developing a comprehensive 40-hour program, it can still enhance its officers' knowledge and skills gradually and over time by relying upon shorter training programs, such as "Mental Health First Aid," or shorter courses provided by CIT International.

For additional information see:

• CIT International
• Mental Health First Aid

Across the country interest in law enforcement response to people with mental illness is growing, in part because of increased calls for service, high-profile tragic events, and the effectiveness of PMHC programs. Interest in PMHC programs and training for law enforcement officers is becoming a national priority.

In 2015, the President's Task Force on 21^st Century Policing was convened to examine was created to strengthen community policing and trust among law enforcement officers and the communities they serve. The Task Force's final report issued several recommendations and action items pertaining to responding to people with mental illness, including the following:

Pillar 5: Training and Education

5.6 Recommendation: POSTs should make Crisis Intervention Training (CIT) a part of both basic recruit and in-service officer training.

While the decision about the number of hours and curricula to use was left to each state, never before has a Presidential report called for the institution of a specific training program to enhance officers' preparedness for responding to people with mental illness.

Nationally, law enforcement leaders are examining training on responding to people with mental illness, verbal communication skills, and de-escalation tactics. In 2015, Harvard University's Executive Session on Policing and Public Safety issued a policy paper entitled, "From Warriors to Guardians: Recommitting American Police Culture to Democratic Ideals," which, in part, describes the Washington State recruit curriculum and the need to significantly increase training devoted to crisis communication and de-escalation.

In 2016, the Police Executive Research Forum issued the report, "Guiding Principles on Use of Force," which includes 30 guiding principles on use of force that recommend the implementation of de-escalation training, CIT training, training for call-takers and dispatchers, and the use of scenario training to prepare officers for situations they are likely to encounter.

For additional information, see:

• Final Report of the President's Task Force on 21st Century Policing
• From Warriors to Guardians: Recommitting American Police Culture to Democratic Ideals
• Guiding Principles on Use of Force

Determining when officers should be trained is best answered according to the needs to the jurisdiction, the type of PMHC program an agency is implementing, as well as its overall approach to training.

Some agencies adhere to the "Memphis Model" approach in which only patrol officers with at least two years' experience, who volunteer to be CIT officers, receive the 40-hour training in a specialized course. Agencies attempt to train enough officers to ensure that each shift is staffed with these specialists, but will not train all officers.

Other agencies train all sworn personnel, or at least all patrol personnel. Some agencies use a tiered approach in which all sworn staff receive a shortened version of the mental health and de-escalation training (i.e., 16 or 24 hours) either at the recruit or in-service level, while those officers who assume additional responsibilities associated with mental health calls receive comprehensive training (i.e., 40 hours).

Other agencies have determined that because all officers respond to mental health calls, they need to have the appropriate knowledge and skills to respond appropriately. These agencies typically incorporate a comprehensive mental health and de-escalation training curriculum into their recruit academy training. Many agencies use the original 40-hour CIT curriculum or modify the topics to fit their needs. Still, other agencies have developed their own mental health and de-escalation training curriculum to ensure that it is consistent with the agency's training approach and community resources and needs.

Any officer who assumes additional responsibilities relating to people with mental illness—including CIT officers, mental health officers, co-responders, or case managers—should receive comprehensive mental health and de-escalation training appropriate to their duties. To successfully perform in these roles, officers need knowledge of mental illnesses and their signs and symptoms, awareness of the local mental health system, and the skills to identify people with mental illness, interact with them, and deescalate crisis situations.

Many agencies provide mental health and de-escalation training to other individuals whose role it is to assist responders and facilitate PMHC program operations, such as supervisory personnel, call-takers and dispatchers, and field training officers.  In an effort to enhance operational collaboration, many agencies invite mental health personnel and other stakeholders to participate in the specialized training to help improve cross-system understanding of agencies' roles and responsibilities, as well as to convey any requirements for accessing community-based services.

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