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d., p. 3). Interestingly, lower-conflict incidents where mental illness is indicated in the presence of a weapon generates higher referral than without (Watson, Ottati, Morabito, Draine, Kerr & Angell, 2010, p.305), although the status of these events as less-serious implies the weapon was not used in resistance or the crime would be serious and result in arrest.

Other situational factors outside particular incidents also affect the rate of arrest for all officers. Officer workload itself pushes down on the rate of arrest, where busier districts report higher rates of 'no action' on minor crimes, and referral where mental health is a factor, which allows more officer time on the street pursuing serious crime and regular duties (Morabito, 2007, p. 1584). Finally, officer characteristics generate different responses in similar scenarios, where officer comfort with or stigma against mental illness affects rates of arrest or diversion to mental health intervention (Watson, Ottati, Morabito, Draine, Kerr & Angell, 2010, p. 303). The result is that a few distinct categories of contact, specifically non-resistant, less critical events (perhaps where a weapon is present but not employed) generate diversion to mental health treatment by CIT officers more than non-trained officers but the increase comes instead of 'contact only' rather than formal intervention for serious offenses.

The "criminalization hypothesis" also oversimplifies complex results

Absent centralized crisis facilities and officer confidence, comfort with and implementation of CIT training, the minor mental-health related incidents that would be diverted to intervention end up in the justice system, with a higher cost for treatment in corrections than in the community (Slate, 2009, p. 26). Whereas the vast majority of offenders do not have clinical mental illness (Swartz & Lurizio, 2007, p. 598), and subjects with mental illness without substance abuse "do not have an increased risk of arrest" for some offenses (Swartz & Lurizio, 2007, p. 595). The "criminalization hypothesis" reveals more difference than similarity because nor do all mentally ill citizens commit serious crimes (Morabito, 2007, p. 1586). The proportion of mentally ill offenders who return to the justice system is higher than the general jail population by perhaps 1.5 times (Fisher, Banks, Roy-Bujnowski, Grudzinskas, Simon & Wolff, 2010, p. 478), and the arrested population has higher incidence of mental illness than the non-arrested general population (Swartz & Lurizio, 2007, p. 590), but if the majority of individuals with serious mental illness in society fail to offend, this demonstrates mental illness is not the predictor but rather individual willful commission of serious crime by all users regardless of mental health status. The justice system punishes the behavior rather than the state of mental illness, even if mental illness combined with drug abuse results in higher arrest rates compared to the general population. Mental illness is being criminalized where it could be treated, particularly where functional impairment is higher (Swartz & Lurizio, 2007, p. 596, but only in specific kinds of minor violations that could be diverted but for lack of resources including CIT programs. The "criminalization hypothesis" applies to a limited scope of officer contacts with the mentally ill, just as CIT improves results in these specific categories but serious crime still incurs justice system intervention regardless of mental illness or not.


The CIT model can achieve cost savings particularly where informal outcomes can be shifted toward diversion into mental health instead of corrections for less serious violations. More serious crimes are not appropriate for diversion to the mental health system, and substance abuse disorder occurring beside mental illness indicates pronounced increases in arrest and recidivism. CIT programs require linkages with community providers, officers who understand and empathize with mental illness, and persistent treatment participation on part of subjects after contact and referral. Improving measurability for CIT outcomes will improve justification for programs which can save money and improve outcomes for officers, criminal justice consumers with mental illness, and the general public, if implemented with adequate and sustained support.


Colins, O., Vermeiren, R., Vahl, P., Markus, M., Broekaert, E. & Doreleijers, T. (2011).

Psychiatric disorder in detained male adolescents as risk factor for serious recidivism. Canadian Journal of Psychiatry, 56 (1):44 -- 50. Retrieved from

Fisher, W.H., Banks, S.M., Roy-Bujnowski, K., Grudzinskas, Jr., A.J., Simon, L.J., & Wolff, N. (2010, October). Categorizing temporal patterns of arrest in a cohort of adults with serious mental illness. Journal of Behavioral Health Services & Research, 37(4), 477-490.

Hanafi, S., Bahora, M., Demir, B.N. & Compton, M.T. (2008). Incorporating crisis intervention team (CIT) knowledge and skills into the daily work of police officers: a focus group study. Community Mental Health Journal 44: 427 -- 432. doi 10.1007/s10597-008-9145-8

Morabito, M. (2007, Dec.). Horizons of context: understanding the police decision to arrest people with mental illness. Psychiatric Services 58(12). Retrieved from

National Alliance on Mental Illness (NAMI) (n.d.). CIT Toolkit CIT facts. Arlington,

Virginia: NAMI-National Alliance on Mental Illness. Retrieved from

Slate, R. (2009). Seeking alternatives to the criminalization of mental illness. American Jails, March-April,…[continue]

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