Implementation sets the stage for a CIT model informed from a multidisciplinary lens that increases collaborations across community. Collaboration and cross discipline partnerships are essential to the CIT tenant of connect and redirect. Developing stakeholder meetings, utilizing and partnering with behavioral health crisis responders, creating in-house supports and establishing memorandums of agreements all play a vital role in CIT implementation.
Community Partnerships
Somerville Police inteacting with local youth during Annual Youth Police Basketball game.
“CIT is more than just a training . . . it’s a community program”. Successful CIT programs identify community partners who provide both urgent and non-urgent resources to support and address the complex needs of individuals experiencing an emotional crisis. Scheduling and inviting organizations to Stakeholder meetings is one way to accomplish this.
Stakeholder meetings are a great way to increase interdisciplinary sharing and inform community needs. They broaden the communities understanding of the role of law enforcement and serve as the foundation for a long lasting partnership. These regular meetings build trust, collaboration, and has resulted in more proactive conversations to address public safety. In addition, stakeholder meetings can be a forum to process challenging cases via case conference strategies such as the HUB or HUE models. These meeting focus on multi agency problem solving for specific individuals and families. Please see references below to develop these models.
Implementation Models
As your department moves toward implementation, consider selecting from one of the models below. Remember that an important aspect of any implementation model is a mission statement. An effective mission statement is engaging and articulates the purpose of your organization or unit. It should sum up what you do, how you do it, and why. It is an opportunity to create a picture of your organization and how you want the world to view your work. The Metro Boston CIT TTAC has created a sample mission statement for police departments interested in implementing a Community Impact Unit.
If you are interested in learning more about CIT Implementation models or how to write a Mission Statement for your specific program email sozit@police.somerville.ma.us.
In House Unit
In this model a Clinical unit is established as part of the operations of the Police Department. Law Enforcement and Civilians work side by side to effectively address the needs of the individuals impacted by behavioral health. The Clinical Unit is a resource for the entire department and provides Care Coordination for individuals and their families. Follow up is done in the community and can be with or without officers. Additionally, in-house units are able to provide longer term, ongoing supports. This model is a great example of the collaboration and partnerships that are core to a successful CIT program. The interdisciplinary team approach allows officers the opportunity to engage in consultation regarding cases, providing ongoing opportunities to further understand the health care systems as well as the capacity of individuals impacted by behavioral health.
Pros:
Accurate coding - all calls for service are reviewed for possible indicators of behavioral health
Onsite resources for officers and community members
Law enforcement training
Interdisciplinary Team Approach (social workers, officers, clinicians, recovery coaches)
Jail Diversion Program - reduces recidivism and provide connection to supports that promote recovery
For more information on In-House Units, click here.
Community Outreach, Help, & Recovery Unit (COHR)
The COHR unit has been a central part to the Somerville Police Department since its inception in 2013. Civilian led, the unit provides care coordination, jail diversion, law enforcement training, and community education networks. The unit utilizes the National Incident-Based Reporting System (NIBRS) in the RMS which allows officers the ability to indicate whether or not an incident is possibly related to Mental Health, Narcotics Misuse, or both for criminal and non-criminal encounters.
All COHR members are CJIS cleared and maintain open lines of communication with officers to reinforce the importance referral. For cases that are court involved or part of an open investigation, officers and Supervisors are always consulted. The unit maintains regular contact with the individual or family until they are either stabilized or connected to long term services. Through DMH, a jail diversion grant also allows for the flexibility of developing diversion plans which focus on treatment goals to reduce or hold charges.
Social Justice Unit
This In House Unit is police directed and another great example of interdisciplinary approach. Implemented by the Cambridge Police Department, the unit consists of 5 sectors, each with a unique focus and dedicated officers: Homelessness, Seniors, Juveniles, Overdose, and Mental Health. A Supervisor reviews all calls and assigns cases to the appropriate unit. Although officers are primarily responsible for follow up, the unit also employs a doctoral level Clinical Psychologist and two Social Workers.
Co-Response
The Co-Response Model is another way to address the needs of individuals impacted by behavioral health. This model utilizes a counselor employed by a partner agency, typically an Emergency Service Provider, who is assigned a shift and officer to ride along with. They also can conduct follow up outreach whether or not they were present on scene and serve as a resource for community members in need of additional mental health or related services. The counselor also has access to medical records which can help inform assessment of needs. Visit Advocates website to learn more.
For more information on the Co-Response model click here.
Community & Law Enforcement Assisted Recovery (C.L.E.A.R) - Winthrop Police Department
Similar to the Co-Response model, the CLEAR model is a partnership between the Health Department and the local police. A dedicated Police Sergeant and a team consisting of a Social Worker and Recovery Coaches work in collaboration to co-respond to calls for service. The team also works with a Public Health Nurse. The Police Coordinator, reviews all calls for service where community members would benefit from additional services and maintains a detailed outreach database. Police reports are shared with the team who then decide on appropriate next steps together with the resident. Outreach efforts are also extended to residents re-entering the community following their release from incarceration.
Regular weekly meetings are held in addition to Stakeholder Meetings with various community organizations. This helps to maintain open lines of communication and better serve community members needing higher access of care.
Pros:
Requires limited resources
Social Worker is not limited by insurance restrictions
Flexibility to address the complex needs of individuals
Ability to conduct home visits
Collaboration opportunities with other providers to inform care coordination
Fortify existing relationships with community organizations
For more information on the Co-Response model click here.
Community Crisis Intervention Team
The Community Crisis Intervention Team (CCIT) is a third model implemented by the Taunton Police Department. This model aims to promote communication and enhance the response of public and private agencies to intervene with individuals who are mentally ill, developmentally disabled or experiencing trauma in their lives. A key feature of this model is the Case Conference component. Any community partner agency or family member can bring a case to the case conference team to review and brainstorm strategies to assist an individual with accessing resources and mental health supports. The Case Conference team is a multidisciplinary team with members from schools, DMH, DCF and private and public Social Service Agencies. Taunton’s CIT program is open to community providers as well as police officers providing a unique cross training opportunity.
Pros
Case Conferencing - monthly meetings with law enforcement and community organizations
Simultaneous training of both law enforcement and behavioral health professionals - establishing a common foundation of knowledge
For more information on the CCIT model click here.
If you would like to learn more about Implementation Models listed here or are interested in a customized model for your department, click here or contact Sabrina Ozit at sozit@police.somerville.ma.us.
HUB Model References:
Mobile crisis services
It is essential to be aware of the “mobile crisis services” in your community. Every community is served by a Mobile Crisis Team (MCI) which is a program of your local Community Behavioral Health Center (CBHC). MCI provides a short-term service that includes onsite, face-to-face, therapeutic response to individuals experiencing a behavioral health crisis. Your local service provider can be found at: https://www.masspartnership.com/provider/CBHC.aspx
In addition to MCI, your community may have homeless resource supports or recovery supports that are available off business hours. Building partners with shelter and detox programs is ideal. These partnerships can later lead to expanded responsiveness to police drop off which can be very helpful. Establishing a partnership with your DMH community service provider is also highly recommended.
Building a lasting partnership with the mental health and advocacy community has proven time and time again to improve the safety of officers and individuals impacted by behavioral health, giving the community peace of mind.
HIPAA Exceptions
The Health Insurance Portability and Accountability Act (HIPAA) protects an individual’s health information from improper disclosure. Nevertheless, there are several exemptions to HIPAA that enable health care agencies to provide personal health information (PHI) to law enforcement without the patient’s permission. As an officer, when asking for PHI, it is incredibly important to be mindful of these exemptions. It is equally essential to identify which exemption applies.
Thanks to the hard work of those at the Law Enforcement Dimensions, a form was created which provides clear and concise guidelines on exactly what these HIPAA exemptions are. The link to the form is below.
It is also important to have conversations with health care providers about these exceptions and to develop an MOU reinforcing how these can be utilized to improved collaborations.
Be sure to keep in mind that the intent of these exceptions is public safety and therefore can only be utilized in situations involving imminent risk. If you have any questions, comments or concerns, please feel free to email sozit@police.somerville.ma.us
Memorandum of Understandings
One of the best ways law enforcement can solidify the relationship and commitment to community programs and agencies is to sign a Memorandum of Understanding with organizations willing and able to provide services to individuals impacted by behavioral health. See examples below. If you have any questions about building community partnerships or MOU’s please contact pcontente@police.somerville.ma.us.
MOU Templates
MOU: Massachusetts Trial Court, District Court, Probation Department