“I try to visit as much as I

can, but Charlie Shift is

really busy. There’s a little

boy, Bobby, 12 years old.

Sometimes he gets real

angry at things and gets

in fights with his little

brother. I try to stop in

every now and again and

make sure things are

good, if he’s keeping with

his medication and trying

to work things out. It also

shows somebody cares

and wants to help him.

The parents are real

cooperative. They like to

see you coming. If there

was ever a problem, I’m

sure Bobby’s mother would

call and ask for me.” 

—CIT Officer Carl Craig

Memphis, Tennessee, 

Police Department’s Crisis

Intervention Team

By Betsy Vickers

January 2000, Memphis,

TN—Delta Watch: 1700

to 0100: 911 Calls

2100 Call

Three police officers, four firefighters, and

two paramedics fill the modest living room

that has been decorated with evident

pride. Green overstuffed furniture and

drapes in lavish folds and swags are

accented by clusters of unlit red candles

shaped like rose blossoms. Everyone’s

attention is focused on Eugene, an agitated

17-year-old who sits on the couch. His

grandmother, whose perfectly kept house

this is, moves about, volubly retelling her

story.

2315 Call

In an upper middle-class neighborhood,

the front door of the house on a small rise

from street level stands wide open, a glowing rectangle of yellow light. On entering,

an expanse of polished hardwood and 

austerely furnished rooms creates an

ambiguous impression of a household in

the process of becoming or undoing. The

ominous stillness is broken by the bounding of a young black Labrador retriever,

chased from the back of the house by a

man in his midtwenties. Behind them, in

the kitchen, a blond, 28-year-old woman,

Helena, leans languidly against the 

Officer Carl Craig and consumer.

U.S. Department of Justice

Office of Justice Programs

Bureau of Justice Assistance

July 2000

Onsite Visits, Case Histories, and State 

and Local Innovations From the erspectives Bureau of Justice Assistance

ractitioner

Nancy E. Gist, Director

Bulletin From the Field
2

Bulletin From the Field: Practitioner Perspectives

This series is dedicated to the exploration of vital issues in criminal justice program development and management. Case studies highlight the work of progressive, innovative people and programs in state and local criminal

justice systems. Although a case study may include a detailed description of the operational aspects of a program,

it is not a scientific program evaluation. Rather, it is a document designed to explore the interaction of factors

such as collaboration, politics, resources, culture, and others that play a part in successful public management.

counter, flanked by two paramedics

and faced by a police officer.

The CIT Program

On a day’s or night’s routine patrol

duties, Memphis police officers may

respond to a number of dispatch calls

before receiving one specifically for

a member of the Crisis Intervention

Team (CIT). CIT officers are regular

patrol officers who have gone through

an intensive 40-hour training program to learn how to respond to the

mentally ill in crisis. The effective

CIT officer is able to respond to and

understand the needs of a consumer,

as mentally ill people are called, and

demonstrates sensitivity and caring.

The city of Memphis has seven

precincts and nine wards. All 911

calls come into the police department’s command center, from which

officers are dispatched by precinct

and ward. Paramedics and firefighters

respond to 911 calls when there is a

medical emergency. CIT officers

respond to situations having a mental

health component.

Because patrol officers are assigned

to a specific ward, they know their

sector intimately. They are familiar

with both its law-abiding citizens and

its lawbreakers. They can identify the

substance abusers and the chronically mentally ill. Calming consumers in

emotionally explosive situations that

could erupt into violence is their job.

Sometimes a calming influence is all

that is needed; other times a consumer must be hospitalized. The CIT

program works because of the police

partnership with the University of

Tennessee Medical Center, referred to

as The Med. At the discretion of CIT

officers, consumers may be brought to

The Med 24 hours a day, 7 days a

week. With access to an organized

reception facility, emergency medical

and psychiatric units, and criminal

medical/psychiatric treatment areas,

CIT officers can leave consumers in

capable hands and be back on patrol

within 15 minutes.

The Memphis CIT program is gaining

recognition throughout the United

States. Several cities—Albuquerque,

New Mexico; Portland, Oregon; San

Jose, California; Seattle, Washington;

and Waterloo, Iowa—have already

put in place response programs based

on the Memphis model, and requests

arrive daily from all over the United

States for CIT training information.

The goals of the CIT are to provide

immediate response to and management of situations where the mentally

ill are in a state of crisis; prevent,

reduce, or eliminate injury to both

the consumer and the responding

police officer; find appropriate care

for the consumer; and establish a

treatment program that reduces

recidivism.

2100 Call

Eugene’s grandmother explains that

he has just spent 13 days in the

Memphis Mental Health Institute

(MMHI). CIT officers are trained to

change a confrontation into a less

hostile meeting. As a starting point,

Officer Mike Schafer asks Eugene

what medication he is taking. He is

told Haldol (to treat schizophrenia

and other types of psychoses) and

Cogentin (to counter the effects of

other drugs and help him sleep) for a

30-day trial period. Eugene is to take

his medications right before bedtime.

This evening he took them early and

then wanted to go out with his

friends. His grandmother said he

couldn’t because he had taken his

pills, and an argument ensued.

“He was shouting and perspiring so

much he soaked right through his

clothes,” she said. She had made the

911 call because, in the middle of the

altercation, Eugene had suffered

chest pains. The paramedics have

found nothing physically wrong with

him.

CIT Officer Schafer asks Eugene for

his version of the events. At times,

Eugene seems to lose connection, his

eyes rolling. His grandmother repeatedly comments on his version until

a police officer guides her away. As

the crux of the dispute is reached,

Eugene jumps up gesticulating and

is told firmly to sit back down. He
Memphis, Tennessee, Police Department’s Crisis Intervention Team

3

complies and complains about the

way the doctor at MMHI looked at

him and was reticent about sharing

information about his medications.

Eugene is desperate for information

about his illness.

“I want help,” he cries, “but I don’t

like the medication. I don’t feel good.

I have chest pains. I need to play

basketball so I can get a scholarship

to Shelby State. What I want to know

is, am I going to be able to run full

court if I take the medication?”

Officer Schafer explains that he must

take the medication before bedtime,

because it will help him sleep. After

30 days his prescription would be

reevaluated. As he speaks, he checks

with Eugene to make sure he is listening and understands. He also advises

Eugene to listen to his grandmother.

He lives in her house, and she has his

best interests at heart. Back in the

patrol car, he shakes his head at the

poignancy of Eugene’s concerns.

Arriving home, she took a large 

quantity of her husband’s antibiotics,

Cephalexin, washed down with vodka.

The nearly empty bottle stands on the

counter. Initially, her husband had no

idea his wife was in distress, and he

is still off balance. It is he who called

911. One of the other officers takes

him to another room to ask about his

version of events and allow Helena

the privacy to speak her mind.

Officer Schafer asks Helena why she

took the pills. She replies, “I’m tired

of life. Life is so heavy.”

“Did something happen between you

and your husband?”

Helena shakes her head as Officer

Schafer explains that she will have 

to be taken to The Med. She does 

not want to go and says she feels

fine. He says evenly that it is no

longer her choice, “Once the paramedics are called, you must go and

be examined.”

When The Med is the destination, a

CIT officer will either take the consumer in the patrol car or meet the

ambulance there. Put on the stretcher

for the ride, Helena is rolled into the

emergency room (ER). She is now

shaking. Officer Schafer signs her in

as a medical team takes over. Within

20 minutes he is sitting in the patrol

car completing the paperwork.

Why the CIT Was

Born

The deinstitutionalization of the mentally ill in the 1960s, requiring the

release of nonviolent patients was

laudable in theory. Release back into

the community, the resultant downsizing of mental health institutions, and

the development of drug therapies

were heralded by rights advocates.

The money saved by hospital closings

was to be put into outpatient community programs. 

Unfortunately, the money did not end

up in the community. Instead, states

rebudgeted the savings, and many

mentally ill people found themselves

without appropriate social services

and support systems. Without monitoring, many stopped taking their

medication, while others continued

with medications that had severe side

effects and quickly became outmoded. This resulted in many unstable

individuals living in the community

with their families who were unprepared for the role of caretaker, or in

the too few halfway houses and group

homes, or on the street. 

When people with mental illness

became psychotic, quality-of-life 

initiatives in the community led to

some rough handling. The police

were most commonly called and, as

Mary Zdanowicz of the Treatment

Advocacy Center (TAC) observed,

“Officers were serving as frontline

mental health workers.”

As is often the case, it took a crisis, a

shocking incident, and the ensuing

public outcry to crystallize existing

efforts into solutions in Memphis. The

city, with a population of 630,000,

demonstrates enormous civic pride.

Evidence is everywhere of a small

town still trying to recover from the

devastating effects of the flight of

middle-class whites by trading on its

tradition of Delta blues, the music

and watering holes of Beale Street,

the reputation of its regional cuisine,

and the ongoing attraction of its

favorite son, Elvis Presley. 

CIT Officer Mike Schafer in patrol car 

accessing computer.

2315 Call

Sleepy, depressed, Helena responds

slowly and with tonal flatness to

Officer Schafer’s questions as he

establishes the chain of the evening’s

events. She had been out drinking at

a neighborhood bar with her husband.
4

Bulletin From the Field: Practitioner Perspectives

As part of its contemporary face,

Memphis is involved in business

attraction efforts. A number of downtown office and bank buildings,

including a new police headquarters

and courthouse, have been built and

others are being renovated. Parts of

downtown have a barren quality, suffering from the wrecking ball of urban

renewal before new construction

comes in to fill the gaps. 

Another Memphis fans out from the

downtown restoration. Half of the

city’s population is African American,

the majority living at the poverty level.

There is little neighborhood integration, and black and white residential

areas are insular and separated.

In September 1987, against this

polarized backdrop, some white

Memphis police officers answered a

911 call. A young African-American

man with a history of mental illness

was cutting himself with a knife and

threatening suicide. Police officers

are trained to respond with deadly

force when they perceive their lives

are in danger. At the outset of the

incident, it appeared that the only life

in danger was the young man’s from

self-inflicted wounds. As they were

trained to do at the time, officers at

the scene confronted the man and

demanded he drop his weapon. At

this, he became more upset and ran

at the officers who, in fear for their

own safety, opened fire and killed

him.

Although the welfare of both officers

and the mentally ill in situations of

confrontation had been a concern for

some time, this death, with its racial

overtones, was the catalyst that

resulted in the creation of CIT a

year later.

CIT’s Formation

The public outcry in the aftermath

of the shooting caused the mayor to

establish a task force. He enlisted the

input of the police, the heads of the

psychology department and the medical center at the University of

Tennessee, the head of the psychology department of the board of education, representatives from the

University of Memphis and the

National Alliance for the Mentally Ill

(NAMI), the managers of mental

health facilities in Memphis, and

local citizens. This group was

charged with finding ways to prevent

such tragedies in the future.

“The mayor was really smart by making it a community thing and keeping

it simple,” said CIT Coordinator Lt.

Sam Cochran. “He said he wanted

the task force to come back with a

program that would provide safety for

the officers, for the mental health

consumers, and for their family members. That was generic, mutual

ground. Who could be against that?

When you are talking about system

changes—government and private

institution changes—you are going to

need some political clout. The mayor

gave that to the task force. As this

thing grew, partnerships grew. At

some point money was going to come

into it, but it was clearly put down

that this was not to be about money,

but about the community.”

At the time of the shooting, Police

Director Walter Crews was in charge

of hostage negotiation and was asked

to join the task force. He recalled,

“Back then if a mentally ill person

was violent when the police arrived,

it usually ended up with the consumer and the police being injured.

What we tried to do was look at a

plan that would allow us to insert a

tool that would help us, as a police

agency, bring the consumer under

control, which was a diversion from

our normal tactic. I knew immediately that education and technology

would be the keystone.”

A Partnership

Program

Without a committed partnership

among the constituents affected by

the needs of the mentally ill, no program will get off the ground, much

less succeed. In Memphis, those constituents are the families of the mentally ill, law enforcement agencies,

emergency medical/psychiatric services, regional short- and long-term

receiving hospitals, and the consumers themselves.

Families of People With 

Mental Illness

The concept of CIT was formed in

1983 when NAMI Memphis, a local

Police Director Walter Crews with CIT

Coordinator Lt. Sam Cochran.
latest information on dealing with

consumers, points them to published

recognition of CIT activities, and

notifies them of upcoming inservice

training. Other rewards are a CIT

identifying pin, an annual NAMI

awards dinners, written commendations for outstanding service, and a

chance for a promising officer to

assist Lt. Cochran for a few months

and learn the administrative side of

the program. This sort of attention

sets CIT personnel apart from their

fellow officers, promotes camaraderie,

and allows them to see themselves as

a specialized unit.

Emergency

Medical/Psychiatric

Services Staff: The Med

The University of Tennessee

Medical Center Psychiatric

Unit

Dr. Kendall Vitulli, Medical

Director

Dr. Marie Tobin, Staff Psychiatrist

Psychotropic Medicines

Dr. Randy Dupont, Head of

Psychiatric Services

◆ 400–500 psychiatric ER 

admissions for evaluation per

month.

◆ 350 brought in by CIT officers.

◆ 40–50 percent new patients.

Without The Med’s open-door policy,

the CIT program would not work.

The synergistic system is designed to

admit within 15 minutes whoever is

brought in by the police. The quick

transfer from officers to the mental

health facility is considered the key

Memphis, Tennessee, Police Department’s Crisis Intervention Team

5

division of the National Alliance for

the Mentally Ill, held its first meeting. The initially small group consisted of parents of mentally ill children

who found they could not get the help

they needed for their children and

themselves from the police, state

agencies, or mental health facilities.

They became activists and had a

hand in revising the Tennessee state

code covering mental health. Today,

some family members regularly assist

instructors teaching the 40-hour CIT

officer training program.

Law Enforcement

Agencies: Memphis Police

Department CIT

The Memphis Police Department

employs some 900 uniform patrol

officers. Of that total, 213 are CIT

patrol officers. Efforts have been

made to have a diverse staff: 112 officers are white men, 11 are white

women, 62 are black men, 27 are

black women, and 1 officer is an

Hispanic male.

As well as overseeing the Hostage

Negotiation Team and Critical

Incident Services, Lt. Cochran coordinates the Crisis Investigation

Bureau. He has held this position for

the past 10 years, and his leadership

has shaped the program. For Lt.

Cochran, the CIT program is so close

to a calling that his evangelical zeal

galvanizes the officers who work in

the program.

Because the financial incentive to be

a CIT officer is small ($45 a month

extra), Lt. Cochran does everything

he can to encourage and reward his

people. He is in regular contact with

the officers, both in person and

through a newsletter that offers the

to the program’s success. It is also

noteworthy that without the agreement of all entities in the health services on The Med’s clearinghouse

role, turf wars could break out among

hospitals looking for their share of

regional patients requiring care.

Guided by state statute, CIT officers

make the judgment in the field

whether a consumer is dangerous to

himself or others and if transport to

The Med is appropriate. At The Med,

the consumer is placed in protective

custody with no charges, after which

the doctors decide if the consumer

should be transferred to the state

hospital or guided to another solution. These solutions involve referral

to various community resources,

such as medical detoxification 

programs, mental health centers,

rehabilitation programs, and social

service agencies.

The medical component serves the

following critical functions:

◆ It ensures cooperation among the

advocates; the medical, psychological, and psychiatric communities;

the police department; and the

state hospitals.

◆ It protects against dumping—

misrepresenting the situation to

off-load the consumer in trouble.

◆ It gives doctors the time to assess

patients—extremely important

with co-occurring substance abuse

and mental health disorders.

◆ It provides appropriate patient

care: 

— Treating medical problems.

— Restarting medication and 

releasing to current living 

situation or finding a new one.
6

Bulletin From the Field: Practitioner Perspectives

— Placing in a short- or long-term

care mental hospital. 

— Offering rehabilitative care.

— Arranging for continuous 

care services.

— Assigning a case manager.

“All parts of the system encourage

the flow to come through here and not

the jail, and that’s the bottom line,”

said Dr. Randy Dupont, head of The

Med’s psychiatric services. “If this

doesn’t turn out to be mental illness,

but turns out to be alcohol or drugs,

or dementia in the elderly, that’s our

problem. This is still a health-care

issue, but we are not going to try to

figure that out at the door.” 

Dr. Dupont observed, “Most crisis

facilities’ failings happen because

they are underfunded, so they tend to

start to restrict the doorway. Pretty

soon there are facilities that will not

take the handicapped, will not take

the blind, the mentally ill, or those

under the influence of alcohol and

drugs. If I were a police officer, I

would be asking, ‘Well what do you

take?’ We are going to take all comers,

and will sort it out. If it turns out to be

a complicated medical problem which

needs surgery, we can take that too. I

think our ability to take care of the

range of needs is what is impressive.”

The Consumers

Officer Stacey LaMondue, 1998 CIT

Officer of the Year, exemplifies the

dedication and caring for consumers

required of CIT work. She perceives

herself as a first responder whose job

is meeting people, learning their

needs, and acting as a referral source.

When her regular duties allow, she

visits the consumers in her ward.

Because she works the 0700 to 1500

Bravo Watch, she is better situated to

do this than officers on nighttime

shifts. One of the reasons she visits

is that regularly interacting with

“her” consumers allows them to feel

comfortable calling her if they have

a question, need help obtaining a service, or sense they are about to have

an episode.

“A lot of people think they can only

call us when it is totally out of control,” said Officer LaMondue. “I

would rather come when things aren’t

full blown. Many consumers do have

presence of mind. I hadn’t seen Alvin

in a couple of years and last week, he

calls and says the voices are coming

back up on the TV, telling him to

walk here and there. They can call a

police officer in their area and this is

someone with whom they’ve established rapport and might be readily

available. If they call the hospital

they’ve got to leave a message, be put

on hold, or hear an unfriendly or

strange voice on the phone.”

A fellow CIT officer reported to

her that he had seen one of her 

consumers wearing a bottle cap pretending it was a CIT pin. When she

heard this, she stopped by police

headquarters to pick up a CIT pin,

drove out to the group home where

he lives, and ceremoniously pinned

on the badge. That same visit, she

helped another consumer negotiate

with the head of the home over how

much spending money he should

have from his disability check and

waited while he telephoned his caseworker for information.

When asked if she ever felt fear

around consumers, Officer LaMondue

replied, “If an officer tells you they

are never afraid, they’re lying. You

need some fear to survive. With some

consumers, the delusion has taken

over and you can’t break through.

This person doesn’t see you as you

but as whoever the aggressor is in

their delusion, and may attack you.

So I can be in control of the situation

where I have total compliance one

second and lose it the next just

because of a delusion. You have to be

aware and prepared. I can’t have bad

days because I have to be responsible

for myself, my coworkers on the

scene, and the consumer. And we all

have to get in and out safely. If it goes

wrong, it’s my fault.”

Success Depends on

Training

CIT Training at the

Memphis Police Training

Academy

Lt. Cochran insists there is no magic

to the training program he helped

devise for his CIT officers. He is

proud that officers readily complete

the 40-hour training program in CIT Officer Stacey LaMondue visits a group

home.
Memphis, Tennessee, Police Department’s Crisis Intervention Team

7

addition to the annual week of inservice training required for all police

officers. After that, CIT officers

receive another 8 hours of specialized

training.

Perhaps the most important aspect of

the program is that the instructors’

involvement is on an in-kind basis.

Each partner agency donates instructional staff. Because of the instructors’ volunteer status, the sense of

ownership of and investment in the

success of the program is enhanced.

The training consists of fundamentals

in recognizing mental illness; instructions on psychotropic medications;

small-group visits to Veterans’

Administration and state mental hospitals facilitated by NAMI members;

visits to patients’ homes; a tour of

Lowenstein House, where consumers

learn job skills; crisis deescalation

skills; and defense weapons training.

There are more than 9 hours of role

playing, with distinctive goals and

objectives, in which seasoned CIT

officers participate. 

Health Professionals

It was not smooth sailing in the early

days. The task force had developed a

training program, but Lt. Cochran

said that when the health professionals came in to teach, “it was like cats

and dogs. We thought what they said

about how to handle the mentally ill

and people who were acting out high

on drugs was the stupidest stuff we

ever heard. We were saying, how are

you going to handle these big men?

And they just [heard police ignorance

of the consumers’ reality]. The truth

of the matter is we didn’t know each

other. We were polite, but when it

came down to it, both sides had their

prejudices and preconceived ideas

about how the others did or didn’t do

their duties. We said, ‘We gotta get

these health people into the cars so

they can see, so the officers can have

some credibility.’ ” Mutual education

took place, and understanding and a

sense of partnership grew.

Dr. Dupont starts the training week

by introducing some rudimentary

diagnostic concepts and showing

videotapes of consumers with diagnostic mental illnesses—such as

depression, bipolar disease, schizophrenia, and obsessive compulsive

disorder—to teach the officers how to

recognize the illnesses. He discusses

acting out on delusions and how alcohol/drugs exacerbate behavior.

Dr. Maria Tobin, a staff psychiatrist,

lectures on psychotropic medicines.

She said, “Most students’ eyes kind

of glaze over after you mention the

first medicine, but I give it a shot.

We use Dr. Dupont’s videos of particular diagnoses that they have seen

before. Afterwards they know what

medicines you might find lying

around when they go into a consumer’s house. I think the officers

quite like having this knowledge; it

empowers them.”

Speaking a common language with

the doctors gives officers the ability

to report on the medications prescribed and to assess and describe a

consumer’s condition. When they

arrive at The Med, this information is

invaluable to the doctors.

“If, for instance, the officer reports

the consumer has said, ‘I have the

devil riding on my back,’ this indicates psychosis to us,” said Dr.

Tobin.

Weapons

Sometimes reasoning alone cannot

diffuse a crisis. A consumer in the

grip of a psychotic episode can be

surprisingly powerful. Officers are

trained to keep their distance. If a

deadly weapon is in the hands of

the person in crisis, the danger is

magnified.

Over time, police have tried various

methods to subdue consumers from a

safe distance. The taser gun shoots

two darts that provide high-voltage

but low-amperage shock on contact

and cause the person to fall to the

ground. At times, someone in the

grip of psychosis will have an unusual resistance to shock and a high 

tolerance for pain. In addition, an

individual living on the street may

be wearing many layers of clothing,

which the darts cannot penetrate. 

Pepper spray also has proved to have

limited effectiveness in the same circumstances and must be sprayed at

a close range. Pepper foam is more

concentrated, but again must be discharged at a possibly unsafe distance,

particularly if the consumer has a

weapon. Given the goals of using the

minimum amount of force necessary

for officers to accomplish their duties

and ensuring that neither the officer

nor consumer be injured while the

situation is brought under control, a

better method had to be found.

The solution was the Impact Delivery

System (IDS), specifically the Sage

Less-Lethal Launcher (SL-6). The

IDS is designed for a contained situation, one in which negotiation has

failed and the consumer, in danger of

harming oneself or others, must be

immobilized in a nonlethal way.
8

Bulletin From the Field: Practitioner Perspectives

if they are paranoid schizophrenic,

manic, it doesn’t matter—that is in

the training.”

Officer Schafer continued, “He was

concerned that I was going to have to

handcuff him like a criminal. I said,

‘Anyone, I don’t care if it’s the

President of the United States, my

policies and procedures say if you

are in my back seat, I’ve got to handcuff you.’ But because he was embarrassed, I agreed to cuff him in front.

Finally he put down the gun, I put

him in the car, and was gone. I let

other officers handle the gun. I took

him to The Med because he had

been talking suicide. With people

like that, it feels good because you

made a difference.”

Effects of the Program

Jail

Before the CIT program, officers

responding to disturbing-the-peace or

misdemeanor calls would take the

citizen directly to jail. This cast the

homeless, mentally ill, alcoholics,

and drug abusers together; created an

unsafe mix; and clogged the court

IDS training officer Lt. Joe Ruff on firing

range.

Police have rarely had to fire it. The

visual intimidation factor when the

IDS is produced is often enough to

convince someone to be reasonable.

IDS is an imposing 10.6-pound rifle

with a large ammunition canister, giving it the appearance of a modern-day

tommy gun. The IDS’ cartridge is a

37mm rubber baton that travels at

140 miles per hour when launched

and has both near- and far-firing

impact capabilities. Each launcher

costs $1,500. The need for IDS is

what involved the Bureau of Justice

Assistance (BJA) in the CIT program.

The Memphis Police Department

applied to BJA under the Local Law

Enforcement Block Grants Program.

The department received money for

12 IDS launchers and cases, a number of rubber projectiles, and baton

reloaders. The police department has

since purchased more launchers, providing two IDS per precinct. 

Police officers who show up at a

volatile scene follow a use-of-force

continuum. CIT officers must not only

know the stages of the continuum, but

also learn and use communication

techniques designed to keep a situation from escalating up the continuum. These stages of the use of force

are spelled out in training and are

learned in practice. Officers develop

their own methods and find an area of

specialization in which they feel most

skilled.

“The reason all officers can’t be CIT

trained and certified is that not all

have it in them to be compassionate,

especially with the mentally ill,” said

Officer Schafer. “If somebody’s just

completely out of this world, you’ve

got to learn how to talk them down,

talk them into the handcuffs and into

the back seat of the squad car. A

police officer in uniform wearing a

gun and a badge can look intimidating. I begin by telling them I am

Officer Schafer and to call me Mike.”

A recent incident in which IDS might

have been used illustrates the value

of CIT training. Officer Schafer tells

of a man, upset over a relationship,

who had gotten a gun and was threatening to kill himself. “It’s really dark.

I am behind a 7- or 8-foot fence looking through a little crack, and he’s

on the back porch. I was scared to

death. He could have shot through

the fence. First he didn’t want to talk.

He was asking for a police officer he

knew, and I continually said, ‘I will

try to get in touch with him, but will

you do me a favor and lay down the

gun?’ But he didn’t want to get separated from it. I told him we could not

locate that officer, but we were trying.

You never want to lie, because not

only could that particular situation go

bad if you lie, but you may have to

answer a call there again. I don’t care

Use-of-Force

Continuum

1. Physical presence.

2. Verbal warning.

3. Verbal command.

4. Chemical weapon.

5. Hands-on control (soft hands/

hard hands).

6. Impact weapons.

7. Deadly force.
once aware of the consumer’s psychiatric history, the decision to press

charges is often left to the victim.

New Detox Center

Memphis is close to funding a detoxification unit at The Med. This facility

is intended to provide the missing

link in the CIT network. It is being

put in place for both police and jail

personnel who have difficulty making

an accurate preliminary diagnosis

when alcohol or drugs are involved.

The 300 intoxication arrests made

each month will be rerouted from the

Memphis, Tennessee, Police Department’s Crisis Intervention Team

9

system. Now, people with mental illness who have committed a misdemeanor or caused a disturbance go to

jail only if they are considered by the

officer to be responsible for their own

behavior. Otherwise they are transported to The Med.

The jail accommodates between 400

and 700 prisoners. In Dr. Dupont’s

view, screening by the medical service at the jail is not the best place

to establish if someone is mentally

ill. They lack the resources to track

those with a past history of mental

illness. When someone is brought to

jail drunk or on drugs, that condition

may mask serious mental illness.

When the person regains sobriety, he

or she may be in full psychosis and

dangerous to other prisoners.

With CIT training, officers are able to

recognize mental illness and provide

transport to The Med for triage. As a

result, conditions have improved at

the jail by reducing the number of

mentally ill individuals arrested. Dr.

Dupont acknowledges the importance

of diverting additional individuals

under the influence to The Med

instead of bringing them directly to

jail because of the increase in alcohol

and drug use.

“I am not going to tell you that everything is wonderful in Memphis,” said

Lt. Cochran. “We have all the problems of other cities. We are making

great efforts in getting people into

The Med. And even if it is only 72

hours, that 72 hours of care is better

than 72 hours in jail.”

There is a separate locked facility for

injured or ill prisoners at The Med.

In the case of less serious crimes,

jail, helping to move the jail out of

the role of health-care provider. 

Critics

The Memphis CIT program has few

critics, owing largely to its genesis

from community action. When all the

constituents involved participate in

creating the program, they become

invested in its success. Funding is

always an issue, but it does not have

to be an impediment. People who

support the CIT program may be protective of funding for their own programs; those whose programs are not

funded can be resentful. The CIT

program works because it is not about

money, but is about belief, ownership,

and commitment among the partners.

Although some regular officers may

feel that the CIT is a favored group

within the department, for the most

part they seem to welcome CIT officers’ intervention in volatile, emotional situations involving someone

not entirely “in reality.” When police

have been called to a confrontational

scene, they clearly see the difference

between cases appropriate to CIT

handling and commonplace lawbreaking confrontations.

The CIT Program and

New Initiatives

When asked what kept the momentum going as the CIT program was

evolving, Police Director Crews

explained, “We had excellent leadership. Success motivates success.

Right now we make about 7,000 calls

a year on the mentally ill. And we

have seen a dramatic decrease in

injury (consumer and police) since

1988. It’s not hard to multiply 7,000

Confronting

Mental Illness

◆ Deinstitutionalization of the

mentally ill resulted in many 

being abandoned.

◆ Quality-of-life initiatives often

led to mentally ill individuals

being arrested to get them off

the streets.

◆ Jails have become mental 

hospitals. Nationally there 

are 250,000 mentally ill 

prison inmates.

◆ 3.5 million Americans are

afflicted with severe mental 

illness.

◆ 20 percent of Americans with

severe mental illness are also 

mentally retarded.

◆ Mental illness is a disease, 

not a crime.

Updated statistical information

may be found on the NAMI 

Web site (www.nami.org/).
10

Bulletin From the Field: Practitioner Perspectives

by 11 years. CIT has just about put

our hostage negotiation team out of

business. We’ve had only two or three

hostage situations in the past several

years. That’s not many if you consider

that we make over 73,000 police

service calls a month overall.”

The Memphis CIT program has had

highly beneficial results including:

◆ Reduced stigma and perception of

danger attached to mental illness.

◆ Increased involvement of officers

on calls related to mental illness.

◆ Reduced use of deadly force.

◆ Reduced use of restraints.

◆ Fewer injuries to officers and 

citizens.

◆ Greater flexibility in the use of

misdemeanor charges.

◆ Lower arrest rates.

◆ 21⁄2- to 3-percent decline in number of consumers sent to jail.

◆ Relief to an overburdened criminal justice system.

The benefits for The Med ER

include:

◆ Officers’ initial report of medical

history better prepares doctors and

nurses.

◆ Officers spend less time in ER.

◆ Patient violence has been

reduced.

◆ The need for acute hospitalization

has decreased from 40 to 25 

percent.

◆ Health-care referrals have

increased dramatically.

◆ Recidivism has decreased to less

than 15 percent after 1 year.

agencies from all over the country

have been to Memphis, and requests

for site visits from scores more come

in every day.

Epilogue

A month after the visit to Memphis

for this Bulletin, an incident occurred

that received national news media

attention. Responding to a 911 fire

call, two firefighters and a sheriff’s

deputy were shot and killed by a man

who had murdered his wife. In a telephone conversation about the incident, Lt. Cochran was asked if CIT

officers had been involved.

“No, they weren’t,” Lt. Cochran said.

“It was an ambush situation; the

whole thing happened in a matter of

seconds.” 

“I’ll tell you what though,” Lt.

Cochran continued, “last night CIT

was called to a Kroger’s grocery store.

A man who had refused to leave was

by the bakery section shouting. His

attention was all over the place.

When the police arrived, he pulled

out two pairs of long-bladed scissors.

Holding a pair in each hand, he started yelling, ‘Kill me, Kill me!’ at the

officers. They tried talking to him,

and that didn’t work. They tried pepper spray, and that didn’t work.

Finally when he started coming at

them waving the scissors saying, ‘If

you won’t kill me, I’ll kill you,’ from

about 8 feet an officer shot him in the

leg with one of the IDS lesser energy

rounds. He fell down, and they were

able to subdue him and get him to

The Med. Now that’s the way the

Impact Delivery System is supposed

to work. It saved a life.”

Consumers’ names have been changed.

Drs. Marie Tobin and Kendall Vitulli of The

Med.

All the members of the Memphis

partnership believe the program is

replicable but must be tailored to the

needs of the local community. Dr.

Dupont noted, “In larger cities there

is so much ingrained heterogeneity in

the systems that it’s hard to give the

police a single source of entry as with

The Med. You have to adapt for that.

In the smaller city you’d have to create a constellation of municipalities

to network into something where you

have enough available for a facility,

perhaps a countywide draw.”

To project success, a community

wishing to create a Crisis Intervention

Team needs organizational intervention; sufficient political will to change

the existing public/governmental

mindset and police culture; a mental

health emergency system capable of

responding to the needs of police; a

safe place for consumers that is not

jail; and a full understanding of the

crisis team concept.

Currently, Lt. Cochran and Dr.

Dupont are helping at least 50 other

sites nationwide assess their needs.

Representatives of law enforcement
Memphis, Tennessee, Police Department’s Crisis Intervention Team

11

Acknowledgments

The Bureau of Justice Assistance is

a component of the Office of Justice

Programs, which also includes the

Bureau of Justice Statistics, the 

National Institute of Justice, the

Office of Juvenile Justice and 

Delinquency Prevention, and the 

Office for Victims of Crime. 

For More Information

For more information about the CIT

program, contact:

Lt. Sam Cochran, Coordinator 

Crisis Investigation Bureau

Memphis Police Department

201 Poplar Avenue

Memphis, TN 38103–1947

901–545–5735

World Wide Web: www.

memphispolice.org

Dr. Randy Dupont, Associate Professor

University of Tennessee–Memphis

College of Medicine

Department of Psychiatry

135 North Pauline, Suite 633

Memphis, TN 38105

901–448–4575

Fax: 901–448–4276

Helen Adano, Advocate

Alliance for the Mentally Ill

499 Patterson

Memphis, TN 38111

901–323–5928

Fax: 901–680–9327

Treatment Advocacy Center

3300 North Fairfax Drive, Suite 220

Arlington, VA 22201

703–294–6001

Fax: 703–294–6010

World Wide Web: www.psychlaws.org

National Alliance for the Mentally Ill

Colonial Place Three

2107 Wilson Boulevard, Suite 300

Arlington, VA 22201–3042

1–800–950–6264

Fax: 703–524–9094

World Wide Web: www.nami.org

For more information about the

Bureau of Justice Assistance and its

programs, contact:

Bureau of Justice Assistance

810 Seventh Street NW.

Washington, DC 20531

202–514–5943

World Wide Web:

www.ojp.usdoj.gov/BJA

NCJ 182501

Bureau of Justice Assistance 

Clearinghouse

P.O. Box 6000

Rockville, MD 20849–6000

1–800–688–4252

E-mail: askncjrs@ncjrs.org

World Wide Web: www.ncjrs.org

Clearinghouse staff are available

Monday through Friday, 8:30 a.m. to

7 p.m. eastern time. Ask to be placed

on the BJA mailing list.

U.S. Department of Justice Response 

Center

1–800–421–6770 or 202–307–1480

Response Center staff are available

Monday through Friday, 9 a.m. to 5

p.m. eastern time.
U.S. Department of Justice

Office of Justice Programs

Bureau of Justice Assistance

Washington, DC 20531

Official Business

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