1 Brief historical perspective prior to CIT program Inception of the CIT program and how it evolved into the Mental Health Unit Unit organization chart How the creation of a CIT database benefits our police department Implementing your own CIT Tracking Program Information management 2 City of Houston Population: 2,100,000 HPD Calls for Service: 1,145,734 CIT Calls for Service: 25,500 CIT Offense Reports: 11,528 Total CIT Reports Catalogued: 8,270 Total HPD Officers: 5,300 Total CIT Officers: 1,848 Total CIT Cases Investigated by MHU: 1,155 Total Mental Health Unit (MHU) Investigative Staff: 5 3 1991- Impetus for Working on Mental Health Issues • • • The process of obtaining an emergency detention order was very complicated and time consuming Officers spent on average 5 to 6 hours filing 7 pages of affidavits, locating a judge, a notary, and a hospital bed. Only one hospital facility available with 12 beds – limited area resources for law enforcement to utilize 1992 – The Roots of inter-agency collaboration & CIT • • One officer took initiative and met with MHMRA director to streamline the EDO process and reduce time Developed plans for a future facility that would handle consumers brought in by police in a timely manner 4 1993 – First Class on Mental Illness • • • • • Prior to the 1990’s there was no formal training available for police officers regarding different mental disorders No tactics or techniques for crisis de-escalation available for officers dealing with individuals with serious mental health crises Officers had mostly negative attitudes about mental illness and the lengthy, time consuming process of obtaining an emergency detention order Most officers did not feel responding to individuals with mental illness was role of law enforcement Officer Frank Webb and Dr. Schnee developed 8 hour in-service class ‘Dealing with the Mentally Ill’ 5 1996 – Mandatory 16 hour class for Patrol Sergeants • Chief Nuchia approved and mandated 16 hours of training regarding mental health issues for all patrol sergeants. 1998 – Harris County Criminal Justice Workgroup • • • A multi-agency workgroup was formed to address barriers to responding to the mentally ill in Harris County. Committee decided primary issue to address was the law enforcement’s response to individuals in serious crisis situations. This paved the way for the development of the CIT program in the Houston Police Department. 6 1999 – CIT 6 month pilot program • • • • • 40 hour class taught by Officer Frank Webb. Program was voluntary and offered to patrol 63 patrol officers became CIT trained Opening of the Neuro-Psychiatric Center (NPC) Average time on EDO – 15 minutes 2000 – Department-wide Implementation • 213 patrol officers trained. 2001 – CIT Coordinator Position Approved • • Over 700 officers have received training This position reported directly to Executive Assistant Chief over Patrol Operations 7 2005 – State Mandated CIT training; Senate Bill 1473 • Senate Bill 1473 mandates 16 hours of CIT and deescalation training for all Texas peace officers. 2006 – CIT Administrative Unit formed • The size and complexity of Houston’s CIT program, along with increased training responsibilities related to Senate Bill 1473, resulted in a program too large for one person (Senior Officer Frank Webb) to coordinate. Chief of Police Harold L. Hurtt approved the formation of a CIT administrative unit in August 2006. 8 2007 – Formation of the Mental Health Unit • The CIT program is the foundation of the unit • This unit oversees the department’s multi-faceted, comprehensive program for responding to individuals in serious mental health crisis • Programs under this unit include the following: 1) 2) 3) 4) 5) 6) Administration & CIT Training Unit Investigations Crisis Intervention Response Team (CIRT) Chronic Consumer Stabilization Initiative (CCSI) Homeless Outreach Team (HOT) Sobering Center (January 2013) 9 a) A peace officer, without a warrant, may take a person into custody if the officer: 1) has reason to believe and does believe that: A. the person is mentally ill; and B. because of that mental illness there is a substantial risk of serious harm to the person or to others unless the person is immediately restrained; and 2) believes that there is not sufficient time to obtain a warrant before taking the person into custody. b) A substantial risk of serious harm to the person or others under Subsection (a)(1)(B) may be demonstrated by: 1) the person's behavior; or 2) evidence of severe emotional distress and deterioration in the person's mental condition to the extent that the person cannot remain at liberty. (c) The peace officer may form the belief that the person meets the criteria for apprehension: 1) from a representation of a credible person; or 2) on the basis of the conduct of the apprehended person or the circumstances under which the apprehended person is found. 10 4 INCIDENT REPORTS Officers will complete an incident report on all incidents involving persons suspected of mental illness. The title of the report will be the same as the offense. If no criminal offense was committed, the offense report will be titled Investigation-Mental Illness. The report will include the name of the psychiatrist who examined the person suspected of mental illness 11 12 Lieutenant M. A. Lee Mental Health Unit Sergeant M. Loera Sergeant P. Plourde Sergeant J. Ramirez Sergeant S. Wick INVESTIGATIONS CIRT CIRT HOMELESS OUTREACH SPO M. Rubin PO R. Arias PO M. Stevens SPO J. Giraldo Investigator CIRT Officer CIRT Officer H.O.T. Officer SPO D. Anders SPO J. Osborne PO J. Llorente PO J. Terry CIRT Officer CIRT Officer H.O.T. Officer PO P. Rayon PO N. Baines PO J. Garcia Investigator CIRT Officer CIRT Officer PO M. Pate PO R. Dunn PO R. Conchola Investigator CIRT Officer CIRT Officer SPO F. Webb PO C. McKinney PO S. Augustine Training CIRT Officer CIRT Officer PO R. Skillern PO C. Vaughan Training Training Investigator 13 Define it’s purpose Information source – offense reports, calls for service Type of data collected How will the information collected be used Investigations and follow-ups Research and analysis – Response strategies Statistics 14 Proper Dispatch Call Codes and Titles a) Non-Family Disturbance/CIT b) Suspicious Person/CIT Proper Offense Report Titles a) Investigation Mental Illness (CIT) b) Harassment (CIT) c) Trespassing (CIT) 15 16 17 The initial steps to help identify who your mental health clients are within your jurisdiction starts with a thorough screening procedure a) Source of information: Offense Reports A report screener reviews every printed offense report that has been coded ‘CIT’ and makes notations of all relevant mental health components and major indicators that were documented by the patrol officer at the scene 18 Filtering out the major indicators and mental health components from a police report will be crucial when collecting this information and imputing this into a comprehensive database (Statistics) Examples of Mental Health Components and Major Indicators: Delusional Paranoia Hearing Voices Suicidal Homicidal Off Medication Violence/Threat Weapons used Use of Force Request Suicide by cop Suicide Attempt/Method Jail Diversion 19 20 OFFENSE REPORT Lieutenant M. A. Lee Mental Health Unit SPO M. Rubin Sergeant M. Loera Investigator Investigative Supervisor INVESTIGATIVE ASSIGNMENTS PO P. Rayon PO M. Pate SPO D. Anders Investigator Investigator Investigator DATABASE ENTRY 21 Mental health consumers who were reported to be in a mental health crisis and met the criteria for an Emergency Detention Order (EDO) Mental health consumers who were reported to have committed a criminal offense or were likely to have committed a criminal offense due to their untreated or uncontrolled psychotic behavior Known mental health consumers who pose a danger or serious threat to themselves or the public 22 23 24 25 Critical information gleaned from the CIT database can be shared with segments of the law enforcement community and the local police department under specific circumstances: 1) 2) 3) Safety awareness to first responders Safety alert bulletins disseminated to the appropriate Patrol Division or Precinct where the mental health consumer resides Premise histories on certain locations issued to the Emergency Communications Division (Dispatcher) 26 27 28 29 30 The database is not a department wide program and it cannot be accessed by anyone outside the agency Maintained on secure server 31 900 to 1000 offense reports (CIT) are reviewed each month 75 to 125 cases are assigned to all 4 investigators each month Such cases include: a) b) c) d) e) Criminal charges on serious offenses Firearms investigations Premise histories on locations or persons with serious mental illness who engaged in violent behavior Chronic consumers involving numerous contacts with the police Referrals 32 Properly reviewed offense reports are developed into case files and are assigned for follow-up investigations or referred to outside agencies for appropriate handling. Some examples are the following: a) b) c) d) e) Child Protective Services (CPS) Adult Protective Services (APS) Department of Public Safety (DPS) Mobile Crisis Outreach Team (MCOT) Crisis Intervention Response Team (CIRT) 33 34 35 36 All files and records are retained solely within the police department’s Mental Health Unit. Access is only authorized to investigators and supervisors assigned within the Mental Health Unit. 37 38 39 40 41 42 43 C.I.T. INCIDENTS TOTAL CIT CALLS FOR SERVICE TOTAL CIT REPORTS REVIEWED 2007 2008 2009 2010 2011 15,122 21,109 23,913 25,105 24,771 N/A N/A 6503 10628 11528 - 2007/2008 2008/2009 2009/2010 2010/2011 % CHANGE % CHANGE % CHANGE % CHANGE 39.6% 13.3% 5.0% - - 63.4% -1.3% 8.5% 2102 3642 4811 7024 8270 73.3% 32.1% 46.0% 17.7% N/A N/A N/A 1514 1155 - - - -23.7% 1254 2112 2699 3822 4580 68.4% 27.8% 41.6% 19.8% 846 1528 2106 3115 3696 80.6% 37.8% 47.9% 18.7% WHITES (TOTAL) 635 1120 1735 3014 3233 76.4% 54.9% 73.7% 7.3% WHITE MALES 398 606 966 1634 1795 52.3% 59.4% 69.2% 9.9% WHITE FEMALES 237 514 769 1380 1438 116.9% 49.6% 79.5% 4.2% BLACKS (TOTAL) 1113 1843 2225 3223 3711 65.6% 20.7% 44.9% 15.1% BLACK MALES 636 1094 1250 1782 2020 72.0% 14.3% 42.6% 13.4% BLACK FEMALES 477 749 975 1451 1691 57.0% 30.2% 48.8% 16.5% HISPANICS (TOTAL) 305 604 680 521 1125 98.0% 12.6% -23.4% 115.9% HISPANIC MALES 188 370 386 324 682 96.8% 4.3% -16.1% 110.5% HISPANIC FEMALES 117 234 294 197 443 100.0% 25.6% -33.0% 124.9% ASIANS (TOTAL) 45 66 109 158 181 46.7% 65.2% 45.0% 14.6% ASIAN MALES 30 35 60 75 76 16.7% 71.4% 25.0% 1.3% ASIAN FEMALES 15 31 49 83 105 106.7% 58.1% 69.4% 26.5% OTHERS (TOTAL) 3 3 62 5 5 0.0% 1966.7% -91.9% 0.0% TOTAL REPORTS CATALOGUED TOTAL CASES INVESTIGATED TOTALS BY GENDER MALES FEMALES TOTALS BY SEX/RACE AGE GROUPS 2007/2008 2008/2009 2009/2010 2010/2011 % CHANGE % CHANGE % CHANGE % CHANGE 2007 2008 2009 2010 2011 16 - 19 73 135 178 241 301 84.9% 31.9% 35.4% 24.9% 20 - 29 467 786 999 1493 1742 68.3% 27.1% 49.4% 16.7% 30 - 39 336 572 805 1115 1191 70.2% 40.7% 38.5% 6.8% 40 - 49 387 655 748 918 1157 69.3% 14.2% 22.7% 26.0% 50 - 59 205 387 549 883 941 88.8% 41.9% 60.8% 6.6% 60 - 69 58 96 153 226 330 65.5% 59.4% 47.7% 46.0% 70 - 79 17 37 44 114 110 117.6% 18.9% 159.1% -3.5% 80 - 89 0 0 0 0 50 - - - - 90 - 99 0 0 0 0 10 - - - - - JUVENILES 8.2% JUVENILE MALES 51 108 122 217 262 111.8% 13.0% 77.9% 20.7% JUVENILE FEMALES 35 98 114 197 211 180.0% 16.3% 72.8% 7.1% 0 0 0 0 2 - - - - TASER INCIDENTS 19 33 26 30 30 73.7% -21.2% 15.4% 0.0% REQUEST SUICIDE BY COP 40 44 47 82 77 10.0% 6.8% 74.5% -6.1% SWAT INVOLVED INCIDENT 5 10 10 9 9 100.0% 0.0% -10.0% 0.0% THREAT OF VIOLENCE 780 153 741 1237 782 -80.4% 384.3% 66.9% -36.8% WEAPONS INVOLVED 228 25 262 317 221 -89.0% 948.0% 21.0% -30.3% FIREARMS INVESTIGATIONS N/A N/A N/A N/A 83 - - - - ILLEGAL DRUG USE / ALCOHOL 231 371 484 337 493 60.6% 30.5% -30.4% 46.3% COMPLETED SUICIDES MAJOR CATEGORIES REPORTED DIAGNOSES 2007/2008 2008/2009 2009/2010 2010/2011 % CHANGE % CHANGE % CHANGE % CHANGE 2007 2008 2009 2010 2011 SCHIZOPHRENIA 235 457 634 742 1063 94.5% 38.7% 17.0% 43.3% BI-POLAR DISORDER 327 620 808 1110 1375 89.6% 30.3% 37.4% 23.9% MAJOR DEPRESSION 303 593 848 1148 1743 95.7% 43.0% 35.4% 51.8% PTSD N/A N/A N/A 44 78 - - - 77.3% DEMENTIA N/A N/A N/A N/A 89 - - - - HEARING VOICES 317 400 641 940 1099 26.2% 60.3% 46.6% 16.9% DELUSIONAL 443 932 920 1186 1216 110.4% -1.3% 28.9% 2.5% PARANOIA 120 18 167 647 975 -85.0% 827.8% 287.4% 50.7% SELF MUTILATING N/A N/A N/A 139 181 - - - 30.2% HOMICIDAL N/A N/A N/A 462 584 - - - 26.4% SUICIDAL IDEATIONS 1454 184 1881 257 2208 350 2313 540 57.4% 29.4% 17.4% 4.8% SUICIDAL THREATS 924 220 -16.4% 39.7% 36.2% 54.3% SUICIDE ATTEMPTS 182 272 514 1158 1423 49.5% 89.0% 125.3% 22.9% COMPLETED SUICIDES N/A N/A N/A 62 122 - - - 96.8% OFF MEDICATIONS 667 1160 1393 1677 2172 73.9% 20.1% 20.4% 29.5% 4 46 63 127 168 1050.0% 37.0% 101.6% 32.3% HOMELESS 189 311 359 528 517 64.6% 15.4% 47.1% -2.1% PERSONAL CARE HOMES 107 120 275 233 341 12.1% 129.2% -15.3% 46.4% SYMPTOMS/BEHAVIORS OTHER GROUPS MILITARY VETERANS REPEAT CONSUMERS 2007/2008 2008/2009 2009/2010 2010/2011 % CHANGE % CHANGE % CHANGE % CHANGE 2007 2008 2009 2010 2011 CHRONIC CONSUMERS 2X 133 225 228 322 267 69.2% 1.3% 41.2% -17.1% CHRONIC CONSUMERS 3X 37 50 52 92 79 35.1% 4.0% 76.9% -14.1% CHRONIC CONSUMERS 4X 6 16 19 29 33 166.7% 18.8% 52.6% 13.8% CHRONIC CONSUMERS 5X 7 11 6 13 16 57.1% -45.5% 116.7% 23.1% CHRONIC CONSUMERS 6X 3 3 2 5 7 0.0% -33.3% 150.0% 40.0% 7X 0 3 2 0 1 - -33.3% -100.0% - 8X 0 1 1 2 1 - 0.0% 100.0% -50.0% 9X 0 1 0 0 1 - -100.0% - 100.0% 10X 0 0 0 1 0 - - - - 11X 0 0 0 0 3 - - - - 12X 0 1 0 2 0 - -100.0% - -100.0% 13X 0 0 0 0 0 - - - - 14X 0 0 0 0 1 - - - - 1959 2688 2604 3617 4198 37.2% -3.1% 38.9% 16.1% 71 302 805 413 1406 325.4% 166.6% -48.7% 240.4% ADMITTED TO V.A. HOSPITAL 4 46 64 144 165 1050.0% 39.1% 125.0% 14.6% ADMITTED TO ST. JOSEPH’S N/A 46 73 N/A 16 - 58.7% - - 12 126 223 341 138 950.0% 77.0% 52.9% -59.5% ADMITTED TO N.P.C. ADMITTED TO BEN TAUB OTHER AREA HOSPITALS JAIL DIVERSIONS / CRIMINAL OFFENSES 2007/2008 2008/2009 2009/2010 2010/2011 % CHANGE % CHANGE % CHANGE % CHANGE 2007 2008 2009 2010 2011 JAIL DIVERSION TOTALS (DEP’T) 814 1244 1508 2099 1847 52.8% 21.2% 39.2% -12.0% JAIL DIVERSION TOTALS (CIRT) N/A N/A N/A 242 614 - - - 153.7% AGGRAVATED ASSAULT N/A N/A N/A N/A 66 - - - - AGGRAVATED ASSAULT D/W N/A N/A N/A N/A 14 - - - - ASSAULT BY THREAT N/A N/A N/A N/A 135 - - - - ASSAULT CLASS C N/A N/A N/A N/A 421 - - - - ASSAULT CLASS A N/A N/A N/A N/A 75 - - - - CRIMINAL MISCHIEF N/A N/A N/A N/A 163 - - - - CRIMINAL TRESPASS N/A N/A N/A N/A 59 - - - - DISORDERLY CONDUCT N/A N/A N/A N/A 201 - - - - CITY WARRANTS N/A N/A N/A N/A 19 - - - - IMPEDING TRAFFIC N/A N/A N/A N/A 163 - - - - INDECENT EXPOSURE N/A N/A N/A N/A 79 - - - - PUBLIC INTOXICATION N/A N/A N/A N/A 60 - - - - RESISTING ARREST/DETENTION N/A N/A N/A N/A 13 - - - - TERRORISTIC THREAT N/A N/A N/A N/A 268 - - - - THEFT N/A N/A N/A N/A 22 - - - - 49 49 Mental Health Unit Lieutenant Mike Lee, M.A. Mike.Lee@cityofhouston.net Mental Health Unit Sergeant Patrick Plourde Patrick.Plourde@cityofhouston.net WWW.HOUSTONCIT.ORG