Crisis intervention training, commonly called CIT, is a 40-hour program that teaches law enforcement officers how to recognize and respond to people experiencing mental health crises. Developed in Memphis, Tennessee in 1988 after police fatally shot a man with a mental illness, the program has become the most widely adopted model in the United States for changing how officers handle these encounters. The core idea is straightforward: give officers enough clinical knowledge and communication skills to slow situations down, reduce conflict, and connect people to treatment instead of taking them to jail.
What the 40-Hour Curriculum Covers
The training spans a full work week and blends classroom learning, hands-on practice, and visits to mental health facilities. Classroom sessions cover the basics of major mental illnesses, how psychiatric medications work and what their side effects look like, substance use assessment, co-occurring disorders, developmental disabilities, personality disorders, PTSD, and suicide prevention. Officers also learn about civil commitment laws, their own legal liability, and the community resources available in their area.
A significant portion of the week is dedicated to scenario-based de-escalation practice. This moves through five progressive stages: basic strategies, basic verbal skills, understanding how a crisis escalates through predictable stages, advanced verbal skills, and finally complex scenarios that combine multiple challenges at once. Officers also hear directly from people living with mental illness and their family members, which is one of the program’s most distinctive features. On-site visits to local mental health facilities round out the experience, giving officers a firsthand look at where people go for treatment and what that process involves.
Some agencies use abbreviated models that compress training into as few as two to eight hours. These shorter programs cover similar territory but lack the depth, the scenario practice, and the facility visits that define the full 40-hour Memphis Model.
De-escalation Techniques Officers Learn
The communication skills taught in CIT follow a structured framework. Officers learn what the program calls the “ABCs of the CIT Scene”: develop awareness of both your own view of the situation and the other person’s, become the safe person they can trust and talk to, and create an open door for solutions.
A practical tool called the “Rule of Fives” applies when someone is aggressive. Officers are taught to use sentences of five words or fewer, with words under five syllables, and to repeat themselves. The goal is to cut through the noise of a crisis with simple, clear language that a highly distressed person can actually process.
Beyond that, the training emphasizes several specific verbal strategies. Officers practice shifting from commands (“You must”) to “I” statements (“I understand that…” or “How can I help with this?”). They learn to use open-ended questions that invite someone to talk rather than shut down (“What seems to be the problem?” or “Tell me more about…”). Reflective listening, where officers restate what they’ve heard to confirm understanding, is a central skill (“It sounds like…” or “I’m hearing you say…”). Officers also practice redirecting, which means briefly shifting the person’s attention to break the adrenaline cycle before returning to the issue, and reframing, which involves offering a hopeful alternative to how the person sees their situation playing out.
A consistent theme runs through all of these techniques: the person in crisis must feel taken seriously. The training draws a clear line between empathy and sympathy, pushing officers toward genuine understanding and acceptance rather than pity or pretense.
How CIT Changes Officer Attitudes
One of the program’s strongest and most consistent effects is on how officers think about mental illness. A study published in Archives of Psychiatric Nursing measured officers’ attitudes and perceptions before and after completing the 40-hour training. Officers’ attitudes toward people with mental illness improved by a full standard deviation, a meaningful shift. Their perceptions improved even more, shifting by 1.13 standard deviations. The training accounted for roughly 34 to 40 percent of the measured change in both attitudes and perceptions.
The researchers concluded that CIT training effectively aligns officers’ understanding of mental illness closer to that of mental health professionals, correcting myths and reducing stigma. This matters because an officer’s beliefs about mental illness shape split-second decisions about whether to use force, attempt to talk someone down, or call for specialized help.
What the Evidence Says About Outcomes
The attitude changes are real, but the picture gets more complicated when researchers look at harder outcomes like arrest rates, use of force, and injuries. A systematic review and meta-analysis published in Criminal Justice Policy Review found no statistically significant effect of CIT on arrests of people with mental illness or on officer safety. Across five studies examining use of force, the combined effect was also not significant. None of the individual studies showed a clear positive effect of CIT on force outcomes.
A separate review in the Journal of the American Academy of Psychiatry and the Law reached a similar conclusion: there is little evidence in the peer-reviewed literature that CIT produces measurable benefits on objective measures of arrests, officer injury, citizen injury, or use of force. The reviewers noted that standardized measurement across studies was so inconsistent that a meta-analysis of officer injury outcomes wasn’t even possible.
This doesn’t mean CIT is ineffective. It means the research has struggled to capture its effects with the measurement tools available. CIT may work through mechanisms that are harder to quantify, like building trust with mental health providers, increasing the likelihood that someone gets connected to treatment, or subtly changing how officers approach a scene in ways that prevent escalation before it starts. But advocates and skeptics alike should understand that the current evidence base for the program’s flagship claims is thinner than many people assume.
CIT Versus Co-Responder Models
CIT is not the only approach to mental health crisis response. Co-responder models pair a police officer with a mental health clinician who respond to calls together. When an incident involving a person in crisis occurs, both team members are dispatched to the scene to resolve it without force. These models are more common in Canada and the United Kingdom than in the United States.
The key structural difference is who holds the expertise. In CIT, a police officer receives enhanced training but remains the primary responder. In co-responder models, a clinical professional is physically present and can assess, de-escalate, and make treatment referrals on the spot. Each approach has trade-offs: CIT is cheaper to scale because it trains existing personnel, while co-responder teams require hiring or contracting mental health staff but bring clinical skills that 40 hours of training cannot fully replicate.
How CIT Programs Are Sustained
Standing up a CIT program is one challenge. Keeping it running is another. SAMHSA’s 2025 national guidelines for crisis care emphasize that successful programs need attention to both startup costs and ongoing operational support. Funding typically comes from a patchwork of sources: Medicaid waivers, local tax levies, insurance mandates, and braided funding approaches that combine multiple revenue streams.
Effective crisis systems also require a clearly defined entity responsible for coordination and oversight. At the community level, this might be a county government, a tribal government, a nonprofit, or a collaborative specifically created for crisis system administration. These entities are expected to involve a broad range of partners in planning, including behavioral health providers, peer and family-led organizations, public and private insurers, people who have used the system, and communities that have historically been underserved by crisis services. This community advisory structure helps ensure that CIT programs reflect local needs rather than operating as isolated police training initiatives.