NAMI CA Public Policy Position on Crisis Services and Response
In California, people experiencing a behavioral health crisis are increasingly unable to get the care they need. In virtually no corner of the state can they or their families be assured they will get the right care, in the right place, at the right time. We need a comprehensive crisis care system that ensures Californians receive the care they deserve in the most expedient way possible.
The state has never had a comprehensive, integrated network of services on which people in a mental health or substance use disorder crisis can rely. Instead, we have a complex patchwork of state and local agencies involved at different touch points, with services that vary by county and based on whether a person is covered by Medi-Cal or private insurance. As a result, people in a behavioral health crisis too often face arrest, involuntary detention, multiple hospitalizations, homelessness, and even early death.
NAMI California considers the law enforcement Crisis Intervention Team (CIT) Program to be an invaluable tool in diverting persons with serious mental illness toward treatment rather than jail, and expects all law enforcement agencies to develop similar programs.
When children and adolescents appear to be experiencing a crisis associated with a serious mental illness, qualified mental health professionals should always be among the first responders contacted. Families should not be directed to law enforcement when a child is experiencing a psychiatric crisis at home or in the community. Every community must have access to an effective and appropriate crisis response system for children and adolescents with serious mental illnesses.
All school staff should be trained on the school’s emergency and crisis prevention procedures, deescalation to help avoid crises, and debriefing procedures. School staff should receive training and demonstrate competence in the following areas: the early warning signs of mental illness and effective crisis intervention for students with mental illnesses; positive behavioral supports and interventions; communicative intent of behaviors; relationship building; alternatives to restrictive procedures; identifying events and environmental factors that may escalate behavior; de-escalation methods; obtaining emergency medical assistance; the physiological and psychological impact of restraints and seclusion; and the skills that students need to better regulate and manage their behaviors.
Crisis Intervention Teams (CIT)
The lack of mental health crisis services across the U.S. has resulted in law enforcement officers serving as first responders to most crises. A Crisis Intervention Team (CIT) program is an innovative, community-based approach to improve the outcomes of these encounters.
In more than 2,700 communities nationwide, CIT programs create connections between law enforcement, mental health providers, hospital emergency services and individuals with mental illness and their families. Through collaborative community partnerships and intensive training, CIT improves communication, identifies mental health resources for those in crisis and ensures officer and community safety.
The Benefits of CIT
CIT programs bring community leaders together and help keep people with mental illness out of jail and in treatment, on the road to recovery. That’s because diversion programs like CIT reduce arrests of people with mental illness while simultaneously increasing the likelihood that individuals will receive mental health services. CIT programs also:
- Give police officers more tools to do their job safely and effectively. Research shows that CIT is associated with improved officer attitude and knowledge about mental illness. In Memphis, for example, CIT resulted in an 80% reduction of officer injuries during mental health crisis calls.
- Keep law enforcement’s focus on crime. Some communities have found that CIT has reduced the time officers spend responding to a mental health call. This puts officers back into the community more quickly.
- Produce cost savings. It’s difficult to estimate exactly how much diversion programs can save communities. But incarceration is costly compared to community-based treatment. For example in Detroit an inmate with mental illness in jail costs $31,000 a year, while community-based mental health treatment costs only $10,000 a year.
NAMI promotes the expansion of CIT programs nationwide by providing NAMI Affiliates and State Organizations, local law enforcement, mental health providers and other community leaders with information and support about CIT implementation. NAMI also works with local and national leaders to establish standards and promote innovation in CIT.
NAMI California Conference 2020 Session on CIT
2021 Legislation on Crisis Services and Response
Assembly Bill 1065 (Maienschein) will help improve the outcomes of crisis calls involving law enforcement and people who are mentally ill. Assembly Member Brian Maienschein introduced AB 1065 to create a Mental Health Help Program that aids in training law enforcement officers to assist, and engage safely with, people living with a mental illness and allows taxpayers to make voluntary contributions to the fund on their California tax returns. Find out more about the legislation and read NAMI CA’s letter of support and sign our petition in support of SB 1065
Assembly Bill 1331 (Irwin) will ensure that individuals experiencing a behavioral health crisis get the right care, in the right place, at the right time. Assembly Member Jacqui Irwin introduced AB 1331 to establish a new position at the Department of Health Care Services (DHCS) to focus on establishing and monitoring a comprehensive crisis care system that ensures Californians receive the care they deserve in the most expedient way possible. NAMI California is a co-sponsor of this bill with The California Hospital Association. Find out more about the legislation and read NAMI CA’s letter of support and sign our petition in support of SB 1331.
Assembly Bill 988 (Bauer-Kahan) will establish the “9-8-8” emergency response system for Californians experiencing a mental health crisis. Assembly Member Rebecca Bauer-Kahan introduced AB 988 to establish the “9-8-8” emergency response system for Californians experiencing a mental health crisis. Find out more and read NAMI CA’s letter in support of AB 988.
Community Voices and Discussions
30-Second Survey: Have you had to access emergency response/crisis services to get help for yourself or a loved one?
Fighting Injustice in Our Communities by Gigi Crowder, Executive Director of NAMI Contra Costa
NAMI’s “Help Not Handcuffs” Webinar Series video clips: