Thursday, March 24, 2011

The Role of CIT in Preventing Violent Tragedies ~ NAMI

By Laura Usher
NAMI CIT Coordinator

The recent tragic shootings in Arizona have raised painful questions about what went wrong. And while we all think about how to prevent these tragedies in the future, it’s important to keep in mind the bigger picture. For many, this debate has been about guns and civil commitment laws, but the real culprit is a failing mental health system.

While media reports focus on the role of mental illness in this tragedy, incidents of violence by people living with mental illness are extremely rare, and the total contribution of people living with mental illness to violence in society is very small. This is the view of the U.S. Surgeon General and is supported by research.

Although research suggests that there are factors that may increase risks of violence – such as co-occurring substance use, or not being engaged in treatment – people living with mental illness are 10 times more likely to be victims of violence than perpetrators. Homelessness, incarceration and poverty increase these risks.

When violence does occur and mental illness is involved, we know that it’s a sign that something has gone terribly wrong with the mental health system--a person who desperately needed treatment could not access it.

Too often, when a person living with mental illness is in crisis, law enforcement are the first responders--not necessarily because the person is dangerous, but because there are often no alternatives. Sadly, people in crisis often can get more help from police than they can from the mental health system.

Because of this Catch-22, NAMI enjoys strong partnerships with law enforcement agencies and others in the criminal justice system around the country. These are some of our most valued partnerships, because law enforcement officers share our concerns about this broken system, and through involvement with crisis intervention team (CIT) programs, put their hearts into helping people in crisis navigate a flawed system.

Although it is impossible to know, it is unlikely that a CIT program could have prevented the Arizona tragedy. But that does not leave NAMI and its many partners in criminal justice without a role moving forward. Preventing these tragedies will take all of us working together.

First and foremost, states need to stop cutting mental health services and instead support evidence-based, integrated (with substance abuse) services for people living with mental illness. Early identification and intervention strategies, as well as joint planning between law enforcement, mental health providers and schools, can link people with the services they need.

CIT is a model for communities because it is not just a one-time training to put a band-aid on the problem, rather it builds partnerships that work to improve the systems that serve, or should serve, people living with mental illness. Successful CIT programs often serve as springboards for broader efforts, including advocacy by judges, chiefs and sheriffs in support of community mental health services; the creation of mental health courts and other programs that use the power of the criminal justice system to get people treatment, not jail time; and efforts to reach out to schools and young families in the form of CIT for Youth. In all of these cases, partnerships prove to be a powerful force for systems change.

A violent tragedy, no matter how heart-breaking, does not change the course of our work, but it does give us an opportunity to evaluate how we can do more. Our criminal justice partners around the country can help us to prevent these tragedies in the future by continuing to stand with NAMI in support of stopping the cuts to mental health services.

To learn more about cuts to mental health services, read our report,State Mental Health Cuts: A National Crisis at

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