Modeling the effects of Crisis Intervention Team (CIT) training for police officers: How knowledge, attitudes, and self-efficacy drive de-escalation skills and referral decisions.

OBJECTIVE: Prior research on Crisis Intervention Team (CIT) training for police officers has demonstrated improvements in knowledge, attitudes, self-efficacy, and stigma, but how these factors work together to influence behavioral outcomes like de-escalation skills and referral decisions remains unstudied. METHOD: 251 CIT-trained and 335 non-CIT officers completed in-depth surveys measuring these six constructs. We used structural equation modeling to test fit of the data to our hypothesized model and made indicated changes to improve fit. RESULTS: An alternate 8-path model (with three paths originally hypothesized being removed) fit reasonably well, and allowing path coefficients to differ for CIT and non-CIT groups resulted in models with similar fit statistics. CONCLUSION: CIT training enhances knowledge and attitudes, both of which have beneficial effects on stigma. Though an important outcome itself, lower stigma does not have an effect on de-escalation skills and referral decisions, though self-efficacy clearly does.

Using the Theory of Planned Behavior to Understand How Crisis Intervention Team (CIT) Training Facilitates Police Officers' Mental Health Referrals.

The Theory of Planned Behavior posits that behaviors are predicted by one's intention to perform them; intention is driven by attitude toward the behavior, subjective norm, and perceived behavioral control. We used this theory to predict Crisis Intervention Team (CIT)-trained and non-CIT officers' intention to facilitate referral of persons with suspected mental illnesses to mental health services. CIT-trained (n = 251) and non-CIT (n = 335) officers from six law enforcement agencies participated. CIT-trained officers had significantly greater scores on all constructs. Theory constructs fit the data well, and fit did not differ meaningfully between the two groups. Direct and indirect predictors together accounted for 28% and 21%, respectively, of variance in behavioral intention. Attitude was the strongest predictor. Intentions to facilitate mental health referrals may be driven by the same factors among CIT-trained and non-CIT officers, but CIT officers, even at a median of 22 months after training, have significantly higher scores on those factors.

Evaluating the Use of Mindfulness and Yoga Training on Forensic Inpatients: A Pilot Study.

Forensic inpatients (i. e., individuals found not responsible for a criminal offense on account of mental illness) represent an often marginalized and difficult-to-treat population. This has led to the need for research exploring the effectiveness of novel interventions. A Canadian forensic hospital has developed an 8-weeks mindfulness and yoga training program (MTP). This pilot study examined the potential effects of this program on patients' mindfulness, stress, and use of cognitive and emotion regulation strategies. A sample of 13 forensic inpatients (male = 92%) participating in the MTP program completed self-report measures assessing dispositional mindfulness, perceived stress, and use of cognitive emotion regulation strategies at baseline, post-intervention, and a 3-months follow-up. Repeated measure ANOVAs found a significant increase in the describe facet of mindfulness (p = 0.03) with a large effect size (ηp 2 = 0.26) and a significant decrease in stress (p = 0.003) with a large effect size (ηp 2 = 0.39). Pairwise comparisons revealed medium to large significant changes between baseline and post-intervention for both the describe facet (p = 0.03, Hedge's g = 0.55) and stress (p = 0.003, Hedge's g = 0.70). However, comparisons were insignificant between baseline and follow-up. No significant main effects were found on the use of cognitive emotion regulation strategies. This pilot study offers preliminary support for the use of the MTP as an adjunctive therapy in forensic inpatient treatment. Further investigation is needed into the long-term impacts of this training.

Systematic review of posttraumatic stress disorder in police officers following routine work-related critical incident exposure.

BACKGROUND: The prevalence of PTSD in police officers has been the subject of a large and highly variable empirical literature. The present systematic review evaluates the extant literature on PTSD in police officers using an international dataset. METHODS: We employed best-evidence narrative synthesis to evaluate whether PTSD prevalence in police is elevated in comparison to the general population of Canada (8%), which itself has a higher lifetime PTSD prevalence than many other regions and thus serves as a conservative standard of comparison. RESULTS: PTSD prevalence in police varied considerably across studies from 0% - 44% (M = 14.87%, Median = 9.2%). Despite this variability, strong evidence exists to suggest PTSD prevalence is elevated in police officers. Examination of possible sources of variability in prevalence outcomes highlighted substantial variability in outcomes due to the selection of measurement tool for assessing PTSD (e.g., DSM vs. IES). Examination of commonly-assessed predictive factors for PTSD risk across the literature showed that individual-difference factors (e.g., age, years of service) bear weak-to-nonexistent relationships with PTSD risk, while incident-specific factors (e.g., severity of exposure) are more strongly and consistently associated with PTSD prevalence. Organizational factors (e.g., low support from supervisor) are at present understudied but important possible contributors to PTSD risk. CONCLUSIONS: PTSD prevalence is elevated in police officers and appears most strongly related to workplace exposure. Measurement variability remains a critical source of inconsistencies across the literature with drastic implications for accurate detection of officers in need of mental health intervention.