Accessible text version

2023 Summit Behavioral Health Crisis Response Model CIT QRT

This page is the plain-text version of a 16-page PDF, provided for screen readers and easier reading. Open the original PDF.

Behavioral Health Crisis Response Models Discussion on Theory and Practice Based on a 2022 literature review by Adam Sorensen, LPCC-S January 17, 2023 Learning Objectives

Understand a Structural Functional approach to balancing community crisis behavioral health resources.
Understand the potential for competing system priorities among crisis behavioral health stakeholders.
Understand factors of success and barriers to implementation of behavioral health crisis response models.

First, define the target population.

Structural Functional Theory

Criminalization of mental illness theory
Currently, in the United States, there are more people in jail with serious BH concerns than in psychiatric hospitals (Thordarson & Rector, 2020; Watson et al., 2021)
Trans-institutionalization theory
Teplin (1984) observed that psychiatric hospitalization rates declined by sixty- six percent by 1980. Further restrictions of inpatient psychiatric care occurred with the Mental Health Systems Care Act of 1980 (Mukherjee & Saxon, 2019).

Psychiatric hospitalization bed access declined by ninety-four percent by the year 2000 and by ninety-six percent by 2010 (Prins, 2011; Grecco & Chambers, 2019).

Structural Functional Theory

The structure of society in SFT is understood as the ways in which the systems interact (Cornwell & Laumann, 2019).
Okolo et al. (2019) add that dysfunctional structures force social problems on unprepared and less effective systems.
SFT supports the theory that the lack of appropriate community BH resources results in the increased frequency of police encounters with the target population (Tyuse et al., 2017).
Differences in population characteristics and available resources lead to diversity in how local systems function (Huey et al., 2021).
Cornwell and Laumann (2019) add that SFT provides a comprehensive framework to conduct dynamic systems analysis which can facilitate a systems perspective among policymakers, align views on the performance of the system, and develop pathways to appropriate care for the target population
As the system is studied, the values and ideologies that form the foundation of the status quo may emerge and provide an opportunity to align the system with health equity outcomes (Hiroki, 2021; Goulka et al., 2021). Potentially Competing Priorities
Collectively identify stakeholders in crisis behavioral health response.
Do different systems have different goals with the shared population?
What does “adequate resources mean?”
What is our best outcome for the target population?
Remember Egon Bittner from 1967. Bittner (1967) concluded that police decisions in situations involving a mentally ill person were related to the craft of policing not patient outcomes, and “to settle for less than an adequate solution is apt to result in repeated calls and more work” (pg.288). What doesn’t work for BH Crisis Response According to LR review for MCRT, BH ED, Co-Responder, CIT, QRT.
Stakeholders may have difficulties complying with HIPAA and 42CFR across provider networks and may use incompatible data systems (Beil et al., 2019). Health care provider shortages may lead to access and quality of care challenges (Beil et al., 2019; Shulz et al., 2021).
The lack of funding is also a barrier to the implementation of home and community based BH services (Smith et al., 2020; Krider & Huerter, 2020;

Bratina et al., 2021; Shulz et al., 2021; Efstathopoulou et al., 2022).

The insufficient intensity of BH follow-up, the lack of a peer support component, and the reliance on the ED for BH crises are associated with a lack of access to quality BH care (Morabito et al., 2018; Gabet et al., 2020; Charlier & Reichert, 2020; Smith et al., 2020).
Tension between patients’ needs and expectations and the services offered is associated with poor health outcomes (Walsh et al., 2022).
A criminogenic risk approach to assess the target population, which fails to recognize the effectiveness of biomedical, trauma-informed, and person- centered approaches (Grecco & Chambers, 2019; Thordarson & Rector, 2020).
The tough on crime and war on drugs policies have imposed a sense of hopelessness, lack of control, and exposure to institutional violence on the target population (Prins, 2011; Yang et al., 2018; Grecco & Chambers, 2019).
Traditional criminal justice models operate in direct opposition of treatment science, which has resulted in increased barriers to care, increased overdoses, increased rates of bloodborne pathogens, and decreased access to stable housing (Grecco & Chambers, 2019; Thordarson & Rector, 2020).
Criminal justice, public health, and BH sectors that do not collaborate around the shared population may experience fragmentation between service providers, long waiting times for BH care, and limited financial resources (Smith et al., 2020; Schulz et al., 2021; Bratina et al., 2021; Shulz et al., 2021;

Efstathopoulou et al., 2022).

Competing views among health care providers about the patient’s primary condition and misaligned goals among stakeholders who interact with the shared population may prevent the development of functional stakeholder relationships (Morabito et al., 2018; Gabet et al., 2020; Rochefort, 2020;

White et al., 2021).

What does work

A multi-disciplinary collaborative or integrated team of providers and stakeholders that uses a patient-centered and trauma informed approach is essential for successful program implementation (Kubiak et al., 2017; Yang et al., 2018; Schmidt et al., 2018; Shahzad et al., 2019; Osteen et al., 2020; Schulz et al., 2021; Seo et al., 2021; White et al., 2021).
Stakeholder relationships should be based on a shared philosophy that centralizes patient health outcomes of the shared population and have respect for each other’s differences in approaches toward this goal (Kubiak et al., 2017). A key feature of stakeholder collaboration is coordinated and patient-centered decision making that involves a comprehensive care plan and the ability to share information across provider and stakeholder systems (Beil et al., 2019; Wood, 2020; Bratina et al., 2020; White et al., 2021).
BH crisis care models must be flexible for adaptation to the local system of care (Beil et al., 2019; Wood, 2020; Bratina et al., 2020; White et al., 2021). The makeup and role definitions of the collaborative group of stakeholders are unique to each community as are the specifics of care coordination mechanisms (Thordarson & Rector, 2020; Schulz et al., 2021). County-specific programs and efforts are necessary to strengthen interorganizational collaboration and address existing service gaps within the county (Marsden et al., 2019; Efstathopoulou et al., 2022).
Patient-centered care in the BH crisis literature includes outreach to the patient, a focus on holistic health, engagement of family in the treatment process, and access to peer recovery coaches. The engagement process during the outreach phase has a higher likelihood of success if the person has no fear of arrest (Kopak & Gleicher, 2020). More frequent initial opportunities to participate in treatment are associated with long term treatment engagement (Smith et al., 2020; Champagne et al., 2020; Comartin et al., 2021).
Flexible health care delivery and payment models are needed to achieve higher quality, integrated, and coordinated behavioral health care in the United States (Carlo et al, 2020). Value-based payment models are designed to provide more reliable access to necessary community- based services and avoid insurance loopholes (Beil, 2019; Rochefort, 2020). The value of services improves with this payment structure due to the integration of a patient-centered network of social, psychological, and bio-medical services (Grecco & Chambers, 2019; Rochefort, 2020). However, a common value-based payment structure for community-based crisis BH care does not exist in the US, and it takes a collective and local effort to implement this payment structure for services to the target population (Gong, 2019; Wang et al, 2021;

Comartin et al, 2021).

References Aby, M. (2020). A Case Study of Implementing Grant-Funded Integrated Care in a Community Mental Health Center. The Journal of Behavioral Health Services & Research, 47(2), 293–

https://doi-org.links.franklin.edu/10.1007/s11414-019-09671-7 Abram, K. M. (1990). The Problem of Co-Occurring Disorders among Jail Detainees: Antisocial Disorder, Alcoholism, Drug Abuse, and Depression. Law and Human Behavior, 14(4), 333–345.

Abram, K. M., & Teplin, L. A. (1991). Co-occurring disorders among mentally ill jail detainees: implications for public policy. American psychologist, 46(10), 1036.

Baia Medeiros, D. T., Hahn-Goldberg, S., Aleman, D. M., & O’Connor, E. (2019). Planning capacity for mental health and addiction services in the emergency department: a discrete- event simulation approach. Journal of healthcare engineering, 2019.

Bailey, K., Lee, G., Victor, G., Sightes, E., Comartin, E., Grommon, E., & Ray, B. (2021). Crisis event dispositions following a crisis response team intervention. Psychiatric Rehabilitation Journal, 44(4), 310–317. https://doi-org.links.franklin.edu/10.1037/prj0000501 Bailey, M., & Peirce, J. (2021). Reversing the Rural Jail Population Boom. Idaho Law Review, 57(3), 525–557.

Balfour, M. E., Hahn Stephenson, A., Delany-Brumsey, A., Winsky, J., & Goldman, M. L. (2022). Cops, clinicians, or both? collaborative approaches to responding to behavioral health emergencies. Psychiatric Services, 73(6), 658-669.

Becker, L. T., & Varano, S. P. (2022). Let’s Work Together: Police Views on Collaborating with Recovery Coaches. Journal of Restoration, Rehabilitation, and Reentry, 2022(1), 2.

Beil, H., Feinberg, R. K., Patel, S. V., & Romaire, M. A. (2019). Behavioral Health Integration With Primary Care: Implementation Experience and Impacts From the State Innovation Model Round 1 States. Milbank Quarterly, 97(2), 543–582. https://doi-org.links.franklin.edu/10.1111/1468-0009.12379 Belson, C., Sheitman, B., & Steiner, B. (2020). The effects of an enhanced primary care model for patients with serious mental illness on emergency department utilization.

Community mental health journal, 56(7), 1311-1317.

Bittner, E. (1967). Police Discretion in Emergency Apprehension of Mentally Ill Persons. Social Problems, 14(3), 278–292. https://doi-org.links.franklin.edu/10.2307/799150 Blais, E., Brisson, J., Gagnon, F., & Lemay, S.-A. (2022). Diverting people who use drugs from the criminal justice system: A systematic review of police-based diversion measures. The International Journal on Drug Policy, 105, 103697. https://doi-org.links.franklin.edu/10.1016/j.drugpo.2022.103697 Booty, M. D., Williams, R. G., & Crifasi, C. K. (2020). Evaluation of a crisis intervention team pilot program: Results from Baltimore, MD. Community Mental Health Journal, 56(2), 251–

https://doi-org.links.franklin.edu/10.1007/s10597-019-00474-w Bratina, M. P., Carrero, K. M., Kim, B., & Merlo, A. V. (2020). Crisis intervention team training: when police encounter persons with mental illness. Police Practice & Research, 21(3), 279–296. https://doi-org.links.franklin.edu/10.1080/15614263.2018.1484290
Bratina, M. P., Carsello, J. A., Carrero, K. M., & Antonio, M. E. (2021). An Examination of Crisis Intervention Teams in Rural Jurisdictions. Community Mental Health Journal, 57(7), 1388–1398. https://doi- org.links.franklin.edu/10.1007/s10597-021-00797-7
Busch, S. H., Tomaino, M., Newton, H., & Meara, E. (2022). Access to mental health support services in Accountable Care Organizations: A national survey. Healthcare (Amsterdam, Netherlands), 10(1), 100613. https://doi-org.links.franklin.edu/10.1016/j.hjdsi.2022.100613
Campbell, W., Swan, H., Jalbert, S.J. (2020). An Exploratory Analysis of the Relationship Between Various Community Supervision Field Contact Activities and Recidivism. Journal for Advancing Justice, 3, 59-84.
Carlo, A. D., Benson, N. M., Chu, F., & Busch, A. B. (2020). Association of alternative payment and delivery models with outcomes for mental health and substance use disorders: a systematic review. JAMA network open, 3(7), e207401-e207401.
Center For Health and Justice. (2022). Quick Response Teams - TASC's Center for Health and Justice.
https://www.centerforhealthandjustice.org/chjweb/tertiary_page.aspx?id=109&title=Quick-Response-Teams:-Interdisciplinary-Overdose-Response-and-Prevention
Champagne, L. T., Bakos, B. C., Yatsco, A., & Langabeer, J. R. (2020). Emergency medical services targeting opioid user disorder: An exploration of current out‐of‐hospital post‐overdose interventions. Journal of the American College of Emergency Physicians Open, 1(6), 1230–1239. https://doi-org.links.franklin.edu/10.1002/emp2.12208
Charlier, J. A., & Reichert, J. (2020). Introduction: Deflection—Police-led responses to behavioral health challenges. Journal for Advancing Justice, 3, 1-13.
Clark, M.D. (2020). Finding the Balance: The Case for Motivational Interviewing to Improve Probation and Parole. Journal for Advancing Justice, 3, 85-99.
Cleary, P. D., & Angel, R. (1984). The analysis of relationships involving dichotomous dependent variables. Journal of Health and Social Behavior, 334-348.
Cockerham, W. C., & Scambler, G. (2021). Medical sociology and sociological theory. The Wiley Blackwell Companion to Medical Sociology, 22-44.
Collins, S. E., Goldstein, S. C., Suprasert, B., Doerr, S. A., Gliane, J., Song, C., ... & Hoffmann, G. (2021). Jail and Emergency Department Utilization in the Context of Harm Reduction Treatment for People Experiencing Homelessness and Alcohol Use Disorder. Journal of Urban Health, 98(1), 83-90.
Comartin, E. B., Burgess-Proctor, A., Hicks, M. R., Putans, L., & Kubiak, S. P. (2021). A statewide evaluation of jail-based mental health interventions. Psychology, Public Policy, and Law. https://doi- org.links.franklin.edu/10.1037/law0000331
Comartin, E., Nelson, V., Hambrick, N., Kubiak, S., Sightes, E., & Ray, B. (2021). Comparing For-Profit and Nonprofit Mental Health Services in County Jails. Journal of Behavioral Health Services & Research, 48(2), 320–
https://doi-org.links.franklin.edu/10.1007/s11414-020-09733-1
Comartin, E. B., Nelson, V., Smith, S., & Kubiak, S. (2021). The criminal/legal experiences of individuals with mental illness along the sequential intercept model: An eight-site study. Criminal Justice and Behavior, 48(1), 76-95.
Comartin, E. B., Swanson, L., & Kubiak, S. (2019). Mental health crisis location and police transportation decisions: The impact of crisis intervention team training on crisis center utilization. Journal of Contemporary Criminal Justice, 35(2), 241-260.
Compton, M. T., Bakeman, R., Broussard, B., Hankerson-Dyson, D., Husbands, L., Krishan, S., & Watson, A. C. (2014). The police-based crisis intervention team (CIT) model: I. Effects on officers’ knowledge, attitudes, and skills. Psychiatric services, 65(4), 517-522.
Cornwell, B., & Laumann, E. O. (2019). If Parsons had Pajek: The relevance of midcentury structural-functionalism to dynamic network analysis. Journal of Social Structure, 17(1).
Di Carlo, F., Sociali, A., Picutti, E., Pettorruso, M., Vellante, F., Verrastro, V., & di Giannantonio, M. (2021). Telepsychiatry and other cutting‐edge technologies in COVID‐19 pandemic: Bridging the distance in mental health assistance. International Journal of Clinical Practice, 75(1).
del Pozo, B., Sightes, E., Goulka, J., Ray, B., Wood, C. A., Siddiqui, S., & Beletsky, L. A. (2021). Police discretion in encounters with people who use drugs: operationalizing the theory of planned behavior. Harm Reduction Journal, 18(1), 1–12. https://doi-org.links.franklin.edu/10.1186/s12954-021-00583-4
Enang, I., Murray, J., Dougall, N., Aston, E., Wooff, A., Heyman, I., & Grandison, G. (2022). Vulnerability assessment across the frontline of law enforcement and public health: a systematic review. Policing and Society, 32(4), 540-559.
Engel, R. S., & Silver, E. (2001). Policing Mentally Disordered Suspects: A Reexamination of the Criminalization Hypothesis. Criminology, 39(2), 225–252.
Efstathopoulou, L., Jagger, G., Mackenzie, J., Faulkner, K., Barker-Barrett, T., Cameron, R., Wagner, A. P., & Perez, J. (2022). The Peterborough Exemplar: a protocol to evaluate the impact and implementation of a new patient-centered, system-wide community mental healthcare model in England. Health Research Policy & Systems, 20(1), 1–9. https://doi-org.links.franklin.edu/10.1186/s12961-022-00819-0
Eswaran, V., Raven, M. C., Wang, R. C., Cawley, C., Izenberg, J. M., & Kanzaria, H. K. (2022). Understanding the association between frequent emergency department use and jail incarceration: A cross‐sectional analysis. Academic Emergency Medicine, 29(5), 606–614. https://doi-org.links.franklin.edu/10.1111/acem.14437
Fahimi, J., Aurrecoechea, A., Anderson, E., Herring, A., & Alter, H. (2015). Substance abuse and mental health visits among adolescents presenting to US emergency departments. Pediatric emergency care, 31(5), 331- 338.
Fields, D., Dingman, M. E., Roman, P. M., & Blum, T. C. (2005). Exploring predictors of alternative job changes. Journal of Occupational and Organizational Psychology, 78(1), 63-82.
Formica, S. (2022). Implementation of a post-overdose quick response team in the rural Midwest: A team case study. Journal of Community Safety and Well-Being, 7(2), 59-66.
Futo, Jeff & Bowling, Chris. (2020). Crisis Intervention Law Enforcement Policy Guide (CIT Focused). Version 2020: Last Edit: 11.11.20. Criminal Justice Coordinating Center of Excellence, A NEOMED CCoE.
Gabet, M., Grenier, G., Cao, Z., & Fleury, M. J. (2020). Implementation of three innovative interventions in a psychiatric emergency department aimed at improving service use: a mixed-method study. BMC health services research, 20(1), 1-14.
Glasgow, A., Khan, A., & Scalmati, A. (2022). Addressing Access to Care in Geriatric Psychiatry through Outpatient Consultation. American Journal of Geriatric Psychiatry, 30(4), S98–S99. https://doi- org.links.franklin.edu/10.1016/j.jagp.2022.01.232
Gong, G. (2019). The Next Step: Building, Funding, and Measuring Pretrial Services (Post-Bail Reforms). NCL Rev., 98, 389.
Goulka, J., Del Pozo, B., & Beletsky, L. (2021). From public safety to public health: Re-envisioning the goals and methods of policing. Journal of community safety & well-being, 6(1), 22–27. https://doi.org/10.35502/jcswb.184
Graaf, G., Snowden, L., & Keyes, L. (2021). Medicaid Waivers for Youth with Severe Emotional Disturbance: Associations with Public Health Coverage, Unmet Mental Health Needs & Adequacy of Health Coverage. Community Mental Health Journal, 57(8), 1449–1463. https://doi-org.links.franklin.edu/10.1007/s10597-020-00759-5
Graaf, G., & Snowden, L. (2019). State approaches to funding home and community-based mental health care for non-Medicaid youth: Alternatives to Medicaid waivers. Administration and Policy in Mental Health and Mental Health Services Research, 46(4), 530–541. https://doi-org.links.franklin.edu/10.1007/s10488-019-00933-2
Grecco, G. G., & Andrew Chambers, R. (2019). The Penrose Effect and its acceleration by the war on drugs: a crisis of untranslated neuroscience and untreated addiction and mental illness. Translational psychiatry, 9(1), 1-11.Haley, T. L., & Jones, C. T. (2020). Sites and shapes of transinstitutionalization. Canadian Journal of Disability Studies, 9(3), 1-15.
Green, C. (2020). Better together: Maximizing the Benefits of a Behavioral Health Co-Responder Program. MGMA Connexion / Medical Group Management Association, 62–66.
Griffin, P. A., & Abreu, D. (2015). The Sequential Intercept Model and Criminal Justice: Promoting Community Alternatives for Individuals with Serious Mental Illness. Oxford University Press.
Gumport, N. B., Dolsen, M. R., & Harvey, A. G. (2019). Usefulness and utilization of treatment elements from the Transdiagnostic Sleep and Circadian Intervention for adolescents with an evening circadian preference. Behaviour research and therapy, 123, 103504.
Henry, B. F. (2019). Adverse experiences, mental health, and substance use disorders as social determinants of incarceration. Journal of Community Psychology, 48(3), 744-762. https://doi.org/10.1002/jcop.22289
Hewner, S., Sullivan, S. S., & Yu, G. (2018). Reducing emergency room visits and in‐hospitalizations by implementing best practice for transitional care using innovative technology and big data. Worldviews on Evidence‐Based Nursing, 15(3), 170-177.
Hiroki, T. (2021). A critical analysis of transinstitutionalization: The social needs of justice-involved people with mental illness and the role of government. Journal of Human Life Design, (16), 197-211.
Hogan, M. F., & Goldman, M. L. (2021). New opportunities to improve mental health crisis systems. Psychiatric Services, 72(2), 169-173.
Huey, L., Ferguson, L., & Vaughan, A. D. (2021). The limits of our knowledge: Tracking the size and scope of police involvement with persons with mental illness. FACETS, 6(1), 424-448.
Hyder, A., Lee, J., Dundon, A., Southerland, L. T., All, D., Hammond, G., & Miller, H. J. (2021). Opioid Treatment Deserts: Concept development and application in a US Midwestern urban county. PLoS ONE, 16(5), 1–20. https://doi-org.links.franklin.edu/10.1371/journal.pone.0250324
Jalbert, S.K. (2020). Introduction: Emerging Best Practices in Community Supervision to Address Behavioral Health Challenges. Journal for Advancing Justice, 3, 57.
Jennings, J. L., Rice, K., & Baglio, C. (2021). Jail‐based competency treatment comes of age: Multi‐site outcomes and challenges to the implementation of an evidence‐based forensic continuum. Behavioral Sciences & the law, 39(1), 83-105.
Kaltsidis, G., Bamvita, J. M., Grenier, G., & Fleury, M. J. (2021). Predictors of frequent emergency department utilization for mental health reasons. The Journal of Behavioral Health Services & Research, 48(2), 259-273.
Kirby, J. B., & Yabroff, K. R. (2020). Rural–urban differences in access to primary care: beyond the usual source of care provider. American journal of preventive medicine, 58(1), 89-96.
Klopfenstein, L. (2018). Opioid Epidemic: The Justice, Health, and Social Systems. IU South Bend Undergraduate Research Journal, 18, 125-140.
Krider, A., & Huerter, R. (2020). Responding to Individuals In Behavioral Health Crisis Via Co-Responder Models. Policy Research Incorporated. 1-13.
Kopak, A. M., & Gleicher, L. (2020). Law enforcement deflection and prearrest diversion programs: A tale of two initiatives. Journal for Advancing Justice, 3, 37-55.
Koziarski, J., O’Connor, C., & Frederick, T. (2021). Policing Mental Health: The Composition and Perceived Challenges of Co-Response Teams and Crisis Intervention Teams in the Canadian Context. Police Practice and Research, 22(1), 977–995.
Kubiak, S., Comartin, E., Milanovic, E., Bybee, D., Tillander, E., Rabaut, C., & Schneider, S. (2017). Countywide implementation of crisis intervention teams: Multiple methods, measures and sustained outcomes. Behavioral Sciences & the Law, 35(5-6), 456-469.
Lamoureux-Lamarche, C., Berbiche, D., & Vasiliadis, H. M. (2022). Health care system and patient costs associated with receipt of minimally adequate treatment for depression and anxiety disorders in older adults. BMC psychiatry, 22(1), 1-14.
Laniyonu, A., & Goff, P. A. (2021). Measuring disparities in police use of force and injury among persons with serious mental illness. BMC Psychiatry, 21(1), 1–8. https://doi-org.links.franklin.edu/10.1186/s12888-021- 03510-w
Liu, S., Yang, L., Zhang, C., Xu, Y., Cai, L., Ma, S., ... & Zhang, B. (2021). Gender differences in mental health problems of healthcare workers during the coronavirus disease 2019 outbreak. Journal of psychiatric research, 137, 393-400.
Logsdon, A. R., Antle, B. F., & Kamer, C. (2021). Family Treatment Drug Court Cost Analysis: An In-depth Look at the Cost and Savings of a Southeastern Family Treatment Drug Court. Child Welfare, 99(5), 51–74.
Lucey, B. P. (2020). It's complicated: The relationship between sleep and Alzheimer's disease in humans. Neurobiology of disease, 144, 105031.
MacKinnon, N. J., & Privitera, E. (2020). Addressing the Opioid Crisis through an Interdisciplinary Task Force in Cincinnati, Ohio, USA. Pharmacy, 8(3), 116.
Magee, L. A., Fortenberry, J. D., Rosenman, M., Aalsma, M. C., Gharbi, S., & Wiehe, S. E. (2021). Two-year prevalence rates of mental health and substance use disorder diagnoses among repeat arrestees. Health & Justice, 9(1), 1-10.
Maglić, D. R., Holt, W., Daley, T. C., & Rosenblatt, A. (2021). Family Organizations in Children’s Mental Health Systems of Care: the Challenge of Maintaining Financial Sustainability. The Journal of Behavioral Health Services & Research, 48(1), 15–35. https://doi-org.links.franklin.edu/10.1007/s11414-020-09711-7
Marcus, N., & Stergiopoulos, V. (2022). Re‐examining mental health crisis intervention: A rapid review comparing outcomes across police, co‐responder and non‐police models. Health & Social Care in the Community.
Marsden, M., Nigam, J., Lemetyinen, H., & Edge, D. (2020). Investigating police officers’ perceptions of their role in pathways to mental healthcare. Health & Social Care in the Community, 28(3), 913–921. https://doi- org.links.franklin.edu/10.1111/hsc.12922
Marzola, E., Duranti, E., De-Bacco, C., Lupia, E., Villari, V., & Abbate-Daga, G. (2021). Psychiatric patients at the emergency department: factors associated with length of stay and likelihood of hospitalization. Internal and Emergency Medicine, 1-11.
Matsueda, R. L. (2017). Social Structure, Culture, and Crime: Assessing Kornhauser's Challenge to Criminology 1. Challenging Criminological Theory, 117-144.Medicaid: HHS’s Preliminary Analyses Offer Incomplete Picture of Behavioral Health Demonstration’s Effectiveness. (2021). GAO Reports, 1–19.
Michaud, L., der Meulen, E. V., & Guta, A. (2022). Between Care and Control: Examining Surveillance Practices in Harm Reduction. Contemporary Drug Problems, 00914509221128598.
Miranda-Mendizabal, A., Castellví, P., Parés-Badell, O., Alayo, I., Almenara, J., Alonso, I., & Alonso, J. (2019). Gender differences in suicidal behavior in adolescents and young adults: systematic review and meta-analysis of longitudinal studies. International journal of public health, 64(2), 265-283.
Mongelli, F., Georgakopoulos, P., & Pato, M. T. (2020). Challenges and opportunities to meet the mental health needs of underserved and disenfranchised populations in the United States. Focus, 18(1), 16-24.
Morabito, M. S., Wallace, K., Savage, J., & Sneider, L. (2018). Police Response to People with Mental Illnesses in a Major U.S. City: The Boston Experience with the Co-Responder Model. Victims & Offenders, 13(8), 1093–1105. https://doi-org.links.franklin.edu/10.1080/15564886.2018.1514340
Morse, S. J., Wright, K. A., & Klapow, M. (2022). Correctional rehabilitation and positive psychology: Opportunities and challenges. Sociology Compass, 16(3), 1–15. https://doi-org.links.franklin.edu/10.1111/soc4.12960
Mukherjee, D., & Saxon, V. (2019). “Psychological boarding” and community-based behavioral health crisis stabilization. Community mental health journal, 55(3), 375-384. Murray, C. H., Contreras, J. L., Kelly, C. H., Padgett, D. K., & Pollack, H. A. (2022). Behavioral Crisis and First Response: Qualitative Interviews with Chicago Stakeholders. Community mental health journal, 1-8. Nakic, M., Stefanovics, E. A., Rhee, T. G., & Rosenheck, R. A. (2022). Lifetime risk and correlates of incarceration in a nationally representative sample of U.S. adults with non-substance-related mental illness. Social Psychiatry and Psychiatric Epidemiology, 57(9), 1839–1847. https://doi- org.links.franklin.edu/10.1007/s00127-021-02158-x Narita, Z., Koyanagi, A., Oh, H., & DeVylder, J. (2022). Association between incarceration and psychotic experiences in a general population sample. Schizophrenia Research, 243, 112-117.

Ngo, S., Shahsahebi, M., Schreiber, S., Johnson, F., & Silberberg, M. (2018). Evaluating the Effectiveness of Community and Hospital Medical Record Integration on Management of Behavioral Health in the Emergency Department. The Journal of Behavioral Health Services & Research, 45(4), 651–658. https://doi-org.links.franklin.edu/10.1007/s11414-017-9574-7 Ohio Department of Medicaid. (2021). Medicaid Behavioral Health State Plan Services: Provider Requirements and Reimbursement Manual. Version 1.18. https://bh.medicaid.ohio.gov/Portals/0/Providers/Manual/3-18-2021 Okolo, O. D., Philip, A. A., & Ali, M. A. (2019). Financing Health Care in Nasarawa State, Nigeria: Assessment of the Universal Health Coverage (UHC). International Journal of Public Administration and Management Research, 5(1), 120-133. Osteen, P. J., Oehme, K., Woods, M., Forsman, R. L., Morris, R. C., & Frey, J. (2020). Law enforcement officers’ knowledge, attitudes, self-efficacy, and use of suicide intervention behaviors. Journal of the Society for Social Work and Research, 11(4), 509-527. Ostermeyer, B., Baweja, N. U. A., Schanzer, B., Han, J., & Shah, A. A. (2018). Frequent utilizers of emergency departments: characteristics and intervention opportunities. Psychiatric Annals, 48(1), 42-50. Ott, R. L., & Longnecker, M. T. (2021). An Introduction to Statistical Methods and Data Analysis (7th Edition). Cengage Learning US. https://reader2.yuzu.com/books/9781305465527 Pajo, B. (2017). Introduction to Research Methods: A Hands-On Approach. FUSE (Franklin University Scholarly Exchange).

Pech, A., Curran, M., Speirs, K., Li, X., Barnett, M., & Paschall, K. (2020). Understanding child behavior problems in young children with previously incarcerated fathers: Parents’ depressive symptoms, relationship quality, and coparenting. Marriage & Family Review, 56(6), 553-574. Penzenstadler, L., Gentil, L., Grenier, G., Khazaal, Y., & Fleury, M. J. (2020). Risk factors of hospitalization for any medical condition among patients with prior emergency department visits for mental health conditions. BMC psychiatry, 20(1), 1-14. Peterson, J., & Densley, J. (2018). Is Crisis Intervention Team (CIT) training evidence-based practice? A systematic review. Journal of Crime and Justice, 41(5), 521-534.

Ramezani, N., Breno, A. J., Mackey, B. J., Viglione, J., Cuellar, A. E., Johnson, J. E., & Taxman, F. S. (2022). The relationship between community public health, behavioral health service accessibility, and mass incarceration. BMC Health Services Research, 22(1), 1-11. Rochefort, D. A. (2020). Making Single-Payer Reform Work for Behavioral Health Care: Lessons From Canada and the United States. International Journal of Health Services, 50(3), 334–349. https://doi-org.links.franklin.edu/10.1177/0020731420906746 Rohrer, A. J. (2021). Law Enforcement and Persons with Mental Illness: Responding Responsibly. Journal of Police & Criminal Psychology, 36(2), 342–349. https://doi-org.links.franklin.edu/10.1007/s11896-021-09441-2 Rosen, D. L., & Travers, D. (2021). Emergency department visits among patients transported by law enforcement officers. PLoS ONE, 16(1), 1–13. https://doi-org.links.franklin.edu/10.1371/journal.pone.0244679 Sausdal, D., & Vigh, H. (2019). Introduction: Anthropological criminology 2.0. Focaal, 2019(85), 1-14.

Schmidt, E. M., Behar, S., Barrera, A., Cordova, M., & Beckum, L. (2018). Potentially preventable medical hospitalizations and emergency department visits by the behavioral health population. The journal of behavioral health services & research, 45(3), 370-388. Schulz, J. A., Ramaswamy, M., Collie-Akers, V., Jordan, S., Koon, L. M., & Tryanski, R. (2021). Understanding the impact of an integrated crisis team: a qualitative study of emergency department staff. Community mental health journal, 57(7), 1278-1287. Semple, T., Tomlin, M., Bennell, C., & Jenkins, B. (2020). An evaluation of a community-based mobile crisis intervention team in a small Canadian police service. Community Mental Health Journal. https://doi-org.links.franklin.edu/10.1007/s10597-020-00683-8 Seo, C., Kim, B., & Kruis, N. E. (2021). Variation across police response models for handling encounters with people with mental illnesses: A systematic review and meta-analysis. Journal of criminal justice, 72, 101752. Shahzad, M., Upshur, R., Donnelly, P., Bharmal, A., Wei, X., Feng, P., & Brown, A. D. (2019). A population-based approach to integrated healthcare delivery: a scoping review of clinical care and public health collaboration. BMC Public Health, 19(1), 1-15.

Shin, H. D., Price, S., & Aston, M. (2021). A poststructural analysis: Current practices for suicide prevention by nurses in the emergency department and areas of improvement. Journal of Clinical Nursing, 30(1-2), 287-297.
Smith, J. L., Khatri, U. G., Olubiyi, O., Hadley, T., Lim, S., Mandell, D., & Kang, Y. C. (2022). Behavioral health service use post‐jail release and reduced risk of return to jail. Journal of Community Psychology, 50(7), 3044–3053. https://doi-org.links.franklin.edu/10.1002/jcop.22813
Smith, R.G., Mindrup, R.M., Foley, L.T., Porter, R.L., Herron, F.B., Patterson, D.A., Wooten, R.M. (2020). Engagement in Mental Health Services After CIT: The Effects of Mobile Crisis Team Involvement. Journal for Advancing Justice, 3, 15-35.
Stapelberg, N. J. C., Sveticic, J., Hughes, I., & Turner, K. (2020). Suicidal Presentations to Emergency Departments in a Large Australian Public Health Service over 10 Years. International Journal of Environmental Research and Public Health, 17(16). https://doi- org.links.franklin.edu/10.3390/ijerph17165920
Strassle, C. G. (2019). CIT in small municipalities: Officer-level outcomes. Behavioral Sciences & the Law, 37(4), 342–352. https://doi-org.links.franklin.edu/10.1002/bsl.2395
Substance Abuse and Mental Health Services Administration (2018). Crisis Intervention Team (CIT) Methods for Using Data to Inform Practice: A Step-by-Step Guide. HHS Pub. No. SMA-18-5065.
Swan, H., Karon, S., Yarmosky, E., & Chapman, M. (2020). A Comprehensive Framework of Emergency Response Approaches to Vulnerable Populations in Crisis. Translational Criminology, 19, 13–16.
Tabachnick, B. G., & Fidell, L. S. (2018). Using Multivariate Statistics (7th Edition). Pearson Education (US). https://reader2.yuzu.com/books/9780134792910
Teplin LA. Criminalizing mental disorder: the comparative arrest rate of the mentally ill. American Psychologist. 1984;39:794-803. doi:10.1037/0003-066X.39.7.794
Thordarson, H., & Rector, T. (2020). From trauma-blind to trauma-informed: re-thinking criminalization and the role of trauma in persons with serious mental illness. CNS spectrums, 25(5), 577-583.
Thurgood, M. (2020). Transforming pedagogy in criminology. In Scholarship of teaching and learning in criminology (pp. 17-36). Palgrave Macmillan, Cham.
Timmer, A., & Nowotny, K. M. (2021). Mental illness and mental health care treatment among people with criminal justice involvement in the United States. Journal of health care for the poor and underserved, 32(1), 397-422.
Todd, T. L., & Chauhan, P. (2020). Seattle police department and mental health crises: Arrest, emergency detention, and referral to services. Journal of Criminal Justice. https://doi-org.links.franklin.edu/10.1016/j.jcrimjus.2020.101718
Tubbs, A. S., Perlis, M. L., Basner, M., Chakravorty, S., Khader, W., Fernandez, F., & Grandner, M. A. (2020). Relationship of nocturnal wakefulness to suicide risk across months and methods of suicide. The Journal of clinical psychiatry, 81(2), 12825.
Tyuse, S. W., Cooper-Sadlo, S., & Underwood, S. E. (2017). Descriptive study of older adults encountered by crisis intervention team (CIT) law enforcement officers. Journal of Women & Aging, 29(4), 281–293.
United States Census Bureau (2021). Population of Champaign County Ohio. https://www.census.gov/quickfacts/champaigncountyohio
United States Census Bureau (2021). Population of Logan County Ohio. https://www.census.gov/quickfacts/logancountyohio
Usher, L., Watson A.C., Bruno, R., Andriukaitis, S., Kamin, D., Speed, C. & Taylor, S. (2019). Crisis Intervention Team (CIT) Programs: A Best Practice Guide for Transforming Community Responses to Mental Health Crises. Memphis: CIT International
Victor, G. A., Comartin, E., Willis, T., & Kubiak, S. (2022). Factors of Recidivism among Individuals with Co-Occurring Conditions in Rural Mental Health Jail Interventions. International Journal of Offender Therapy and Comparative Criminology, 66(6–7), 758–773.
Walsh, A., Bodaghkhani, E., Etchegary, H., Alcock, L., Patey, C., Senior, D., & Asghari, S. (2022). Patient-centered care in the emergency department: a systematic review and meta-ethnographic synthesis. International journal of emergency medicine, 15(1), 1-12.
Wang, S., Glied, S., Dragan, K., Billings, J., Baquero, M., Zweig, K., Meropol, S., Vasan, A., Delany, B. A., Veras, M., Chaitoo, N., Vidal, G., Demyan, A., & Davis, C. (2021). Health Care Needs and Utilization Among New Yorkers with Criminal Justice System Involvement. Health Services Research, 56, 48. https://doi-org.links.franklin.edu/10.1111/1475-6773.13815
Watson, A. C., & Compton, M. T. (2019). What research on crisis intervention teams tells us and what we need to ask. J Am Acad Psychiatry Law, 47(4), 422-426.
Watson, A. C., Compton, M. T., & Draine, J. N. (2017). The crisis intervention team (CIT) model: An evidence‐based policing practice?. Behavioral Sciences & the Law, 35(5-6), 431-441.
Watson, A. C., Owens, L. K., Wood, J., & Compton, M. T. (2021). The impact of crisis intervention team response, dispatch coding, and location on the outcomes of police encounters with individuals with mental illnesses in Chicago. Policing: a journal of policy and practice, 15(3), 1948-1962.
Wood, J. D. (2020). Private policing and public health: A neglected relationship. Journal of contemporary criminal justice, 36(1), 19- 38.
Wood, J. D., Watson, A. C., & Barber, C. (2021). What can we expect of police in the face of deficient mental health systems?

Qualitative insights from Chicago police officers. Journal of Psychiatric and Mental Health Nursing, 28(1), 28-42.

White, C. J. (2021). An inevitable response? A lived experienced perspective on emergency responses to mental health crises.

Journal of Psychiatric and Mental Health Nursing, 28(1), 90-93.

White, M. D., Perrone, D., Watts, S., & Malm, A. (2021). Moving beyond Narcan: a police, social service, and researcher collaborative response to the opioid crisis. American journal of criminal justice, 46(4), 626-643.
Yang, S. M., Gill, C., Kanewske, L. C., & Thompson, P. S. (2018). Exploring police response to mental health calls in a nonurban area:

A case study of Roanoke County, Virginia. Victims & Offenders, 13(8), 1132-1152.

Download the original PDF · Ohio Deflection Association home