MODELING OFFICER-LEVEL EFFECTS OF CRISIS INTERVENTION TEAM (CIT) TRAINING
Michael T Compton
Emory University, 1599 Clifton Road, 4th Floor, Atlanta, Ga 30322
Grant 5R01MH082813-02 from National Institute Of Mental Health
Abstract: In Crisis Intervention Team (CIT) training, police officers participate in 40 hours of specialized training provided by local mental health professionals, family members/advocates, and mental health consumer groups. Upon completion of the training, these officers serve as specialized first-line responders for calls involving people with serious mental illnesses (SMI). The CIT model also supports partnerships between psychiatric emergency services and police departments, increasing the likelihood that people in psychiatric crisis will be taken to medical facilities rather than jails. The proposed study was developed in response to a prominent dearth of research on CIT, even though it is being implemented widely in numerous municipalities across the U.S. This research, which will build on the PI´s ongoing CIT research, will examine the ways in which CIT training may ultimately lead to improved patient- and system-level outcomes by addressing the crucial issue of officer-level outcomes of CIT. This research will be a first step toward understanding how this collaborative model works and will set the stage for research that could have major implications for people with SMI who often interact with law enforcement/criminal justice systems. This project will compare CIT and non-CIT officers and test two complementary models of effects of CIT-the Theory of Planned Behavior (TPB) and the novel Model of Officer-Level Effects of CIT (MOLEC). The specific aims of the research are Aim 1 To design, adapt, and study the psychometric properties (i.e., reliability, validity) of a number of measures developed specifically for use with police officers; Aim 2 To evaluate the utility of the TPB, the exploratory MOLEC model, and a combined model, in explaining intentions to facilitate mental health referrals and de-escalation skills of 250 CIT vs. 250 non-CIT officers; and Aim 3 To examine the effectiveness of the CIT program in facilitating actual mental health referrals by comparing reports of encounters with individuals with suspected SMI and appropriateness of referrals in CIT vs. non-CIT officers over 6 weeks. Months 1-6 will be dedicated to careful instrument development/adaptation, engagement of police departments, preparation for recruitment and data collection, and testing of instrument reliability/validity. Months 7-30 will include in-depth cross-sectional and 6- week longitudinal data collection, database development, and data entry. Months 31-36 will involve data analysis and dissemination of findings to various relevant audiences. Ultimately, this research may elucidate how the mental health and law enforcement communities can collaborate to improve the health of individuals living with SMI by reducing criminalization and enhancing access to mental health services. The public health importance of the proposed research is substantial given the nationwide problem of criminalization of mental illnesses resulting in incarceration of people with serious mental illnesses for minor infractions, which delays or precludes the provision of recovery-oriented mental health services. By studying officer-level effects of Crisis Intervention Team (CIT) training, collaborations between law enforcement and mental health can be enhanced and people with serious mental illnesses may be able to lead safer, healthier lives supported by mental health treatment services rather than being entangled in the criminal justice system
Keywords: Access to Care; Access to Health Care; Access to Healthcare; Accessibility of health care; Accounting; Address; Advocate; Analysis, Data; Attitude; Availability of Health Services; Behavior; Behavior Control; Behavioral; Behavioral Manipulation; Cities; Collaborations; Communities; County; Criminal Justice; Crisis Intervention; Data; Data Analyses; Data Banks; Data Bases; Data Collection; Databank, Electronic; Databanks; Database, Electronic; Databases; Development; Device or Instrument Development; Distal; Effectiveness; Environment; Exploratory Behavior; Family member; Future; Health; Health Care Professional; Health Professional; Health Services Accessibility; Health profession; Healthcare professional; Healthcare worker; Hour; Human Resources; Imprisonment; Individual; Intention; Investigators; Jail; Knowledge; Law Enforcement; Law Enforcement Officers; Lead; Life; Literature; Manpower; Measures; Medical; Mental Health; Mental Health Services; Mental Hygiene; Mental Hygiene Services; Mental disorders; Mental health disorders; Method LOINC Axis 6; Methodology; Minor; Modeling; Monitor; Municipalities; Outcome; Patients; Pb element; Planning Theory; Police; Police officer; Preparation; Programs (PT); Programs [Publication Type]; Property; Property, LOINC Axis 2; Psychiatric Disease; Psychiatric Disorder; Psychiatric Emergency Services; Psychological Health; Psychometric; Psychometrics; Public Health; Qualifying; Recovery; Reporting; Research; Research Personnel; Research Resources; Researchers; Resources; Self Efficacy; Services; Sound; Sound - physical agent; Staging; Stigmata; Survey Instrument; Surveys; System; System, LOINC Axis 4; Testing; Training; Unspecified Mental Disorder; Utility Theories; Validity and Reliability; Work; access to services; access to treatment; availability of services; behavioral control; clinical data repository; clinical data warehouse; cost; data repository; design; designing; device development; health care availability; health care service access; health care service availability; health services availability; healthcare access availability; healthcare service access; healthcare service availability; heavy metal Pb; heavy metal lead; improved; incarceration; innovate; innovation; innovative; instrument; instrument development; mental illness; novel; personnel; programs; psychological disorder; psychosocial; public health medicine (field); public health relevance; relational database; response; serious mental illness; severe mental illness; skills; social stigma; sound; stigma
Relevance: RELEVANCE The public health importance of the proposed research is substantial given the nationwide problem of criminalization of mental illnesses resulting in incarceration of people with serious mental illnesses for minor infractions, which delays or precludes the provision of recovery-oriented mental health services. By studying officer-level effects of Crisis Intervention Team (CIT) training, collaborations between law enforcement and mental health can be enhanced and people with serious mental illnesses may be able to lead safer, healthier lives supported by mental health treatment services rather than being entangled in the criminal justice system
Project start date: 2009-09-30
Project end date: 2011-08-31
Budget start date: 1-SEP-2010
Budget end date: 31-AUG-2011
PFA/PA: PA-07-070
5R01MH082813-02 (2010): $771736
Sponsored Links Excellgen http://Excellgen.com
Grants awarded to Michael T Compton
Correlates Of Duration Of Initial Untreated Psychosis
Michael T Compton
Emory University 1599 Clifton Road, 4th Floor Atlanta, Ga 30322
Grant 5K23MH067589-03 from National Institute Of Mental Health IRG: SRV
Abstract: This Mentored Patient-Oriented Research Career Development Award will provide support for Dr. Compton s development as an independent clinical research scientist. His training goals are as follows (1) to acquire practical experience in the planning, design, implementation, and evaluation of empirical clinical research with individuals with schizophrenia and their families; (2) to continue training in data analysis, interpretation of results, and dissemination of research findings; (3) to learn the necessary skills for ethically sound, culturally competent research with participants with schizophrenia-spectrum disorders and their families; (4) to gain expertise in prevention-oriented scientific inquiry, especially in the area of secondary prevention-oriented schizophrenia research; and (5) to combine empirical research with a public health perspective, including the translation of findings into clinical practice and appropriate community-level policy changes. Dr. Compton is a psychiatrist and a preventive medicine physician, and his overarching scientific objective is to pursue prevention-oriented schizophrenia research. This K23 application is guided by a secondary prevention paradigm and an ecological conceptual model by studying predictors and outcomes associated with delays in seeking early evaluation and intervention during the initial phases of schizophrenia. Dr. Compton s proposed research will investigate three domains of potential influence on the duration of untreated psychosis (DUP) parent/family factors, patient/illness factors, and services/systems factors. To do so, he will recruit 100 patients with a first-episode of a schizophrenia-spectrum disorder, who will be assessed during their first hospitalization. Dr. Compton will also evaluate cross-sectionally 200 relatives and other informants for his study of factors that may be associated with the length of the DUP. Additionally, he will use a longitudinal research design to sequentially assess the patients for two years from the time of their first hospitalization, to study a variety of outcomes that may be related to the duration and dose of initial psychosis (DDIP), a proposed construct that measures cumulative exposure to initial psychosis (duration until resolution of acute symptoms, and frequency and intensity of symptoms). The overall aim of the research project is to provide an in-depth exploration of the potential causes and consequences of initially untreated psychosis among first-episode patients.
Keywords: disease /therapy duration, family structure /dynamics, health behavior, health care service utilization, longitudinal human study, mental disorder chemotherapy, mental health education, psychotherapy, schizophrenia, coping, family genetics, health care service availability, health insurance, interpersonal relations, outcomes research, psychosocial separation, quality of life, social psychology, social support network, socioeconomics, adult human (21+), behavioral /social science research tag, clinical research, data collection methodology /evaluation, neuropsychological test, patient oriented research
Project start date: 2004-08-06
Project end date: 2009-07-31
5K23MH067589-03 (2006): $165501
5K23MH067589-02 (2005): $162328
1K23MH067589-01A2 (2004): $154158
5K23MH067589-05 (2008): $168504
5K23MH067589-04 (2007): $166690
MODELING OFFICER-LEVEL EFFECTS OF CRISIS INTERVENTION TEAM (CIT) TRAINING
Michael T Compton, Assistant Professor
Emory University, 1599 Clifton Road, 4th Floor, Atlanta, Ga 30322
Grant 1R01MH082813-01A1 from National Institute Of Mental Health
Abstract: In Crisis Intervention Team (CIT) training, police officers participate in 40 hours of specialized training provided by local mental health professionals, family members/advocates, and mental health consumer groups. Upon completion of the training, these officers serve as specialized first-line responders for calls involving people with serious mental illnesses (SMI). The CIT model also supports partnerships between psychiatric emergency services and police departments, increasing the likelihood that people in psychiatric crisis will be taken to medical facilities rather than jails. The proposed study was developed in response to a prominent dearth of research on CIT, even though it is being implemented widely in numerous municipalities across the U.S. This research, which will build on the PI´s ongoing CIT research, will examine the ways in which CIT training may ultimately lead to improved patient- and system-level outcomes by addressing the crucial issue of officer-level outcomes of CIT. This research will be a first step toward understanding how this collaborative model works and will set the stage for research that could have major implications for people with SMI who often interact with law enforcement/criminal justice systems. This project will compare CIT and non-CIT officers and test two complementary models of effects of CIT-the Theory of Planned Behavior (TPB) and the novel Model of Officer-Level Effects of CIT (MOLEC). The specific aims of the research are Aim 1 To design, adapt, and study the psychometric properties (i.e., reliability, validity) of a number of measures developed specifically for use with police officers; Aim 2 To evaluate the utility of the TPB, the exploratory MOLEC model, and a combined model, in explaining intentions to facilitate mental health referrals and de-escalation skills of 250 CIT vs. 250 non-CIT officers; and Aim 3 To examine the effectiveness of the CIT program in facilitating actual mental health referrals by comparing reports of encounters with individuals with suspected SMI and appropriateness of referrals in CIT vs. non-CIT officers over 6 weeks. Months 1-6 will be dedicated to careful instrument development/adaptation, engagement of police departments, preparation for recruitment and data collection, and testing of instrument reliability/validity. Months 7-30 will include in-depth cross-sectional and 6- week longitudinal data collection, database development, and data entry. Months 31-36 will involve data analysis and dissemination of findings to various relevant audiences. Ultimately, this research may elucidate how the mental health and law enforcement communities can collaborate to improve the health of individuals living with SMI by reducing criminalization and enhancing access to mental health services. The public health importance of the proposed research is substantial given the nationwide problem of criminalization of mental illnesses resulting in incarceration of people with serious mental illnesses for minor infractions, which delays or precludes the provision of recovery-oriented mental health services. By studying officer-level effects of Crisis Intervention Team (CIT) training, collaborations between law enforcement and mental health can be enhanced and people with serious mental illnesses may be able to lead safer, healthier lives supported by mental health treatment services rather than being entangled in the criminal justice system
Keywords: Access to Care; Access to Health Care; Access to Healthcare; Accessibility of health care; Accounting; Address; Advocate; Analysis, Data; Attitude; Availability of Health Services; Behavior; Behavior Control; Behavioral; Behavioral Manipulation; Cities; Collaborations; Communities; County; Criminal Justice; Crisis Intervention; Data; Data Analyses; Data Banks; Data Bases; Data Collection; Databank, Electronic; Databanks; Database, Electronic; Databases; Development; Device or Instrument Development; Distal; Effectiveness; Emergency Services, Psychiatric; Environment; Exploratory Behavior; Family member; Future; Health; Health Care Professional; Health Professional; Health Services Accessibility; Health profession; Healthcare professional; Healthcare worker; Hour; Human Resources; Imprisonment; Individual; Intention; Investigators; Jail; Justice, Criminal; Knowledge; Law Enforcement; Law Enforcement Officers; Lead; Life; Literature; Manpower; Measures; Medical; Mental Health; Mental Health Services; Mental Hygiene; Mental Hygiene Services; Mental disorders; Mental health disorders; Method LOINC Axis 6; Methodology; Minor; Modeling; Monitor; Municipalities; Officers, Law Enforcement; Outcome; Patients; Pb element; Planning Theory; Police; Police officer; Preparation; Programs (PT); Programs [Publication Type]; Property; Property, LOINC Axis 2; Psychiatric Disease; Psychiatric Disorder; Psychiatric Emergency Services; Psychological Health; Psychometric; Psychometrics; Public Health; Qualifying; Recovery; Reporting; Research; Research Personnel; Research Resources; Researchers; Resources; Self Efficacy; Services; Sound; Sound - physical agent; Staging; Stigmata; Survey Instrument; Surveys; System; System, LOINC Axis 4; Testing; Theory, Planning; Training; Unspecified Mental Disorder; Utility Theories; Validity and Reliability; Work; access to services; access to treatment; availability of services; behavioral control; clinical data repository; clinical data warehouse; cost; data repository; design; designing; device development; health care availability; health care service access; health care service availability; health services availability; healthcare access availability; healthcare service access; healthcare service availability; heavy metal Pb; heavy metal lead; improved; incarceration; innovate; innovation; innovative; instrument; instrument development; mental illness; novel; personnel; programs; psychological disorder; psychosocial; public health medicine (field); public health relevance; relational database; response; serious mental illness; severe mental illness; skills; social stigma; sound; stigma
Relevance: RELEVANCE The public health importance of the proposed research is substantial given the nationwide problem of criminalization of mental illnesses resulting in incarceration of people with serious mental illnesses for minor infractions, which delays or precludes the provision of recovery-oriented mental health services. By studying officer-level effects of Crisis Intervention Team (CIT) training, collaborations between law enforcement and mental health can be enhanced and people with serious mental illnesses may be able to lead safer, healthier lives supported by mental health treatment services rather than being entangled in the criminal justice system
Project start date: 2009-09-30
Project end date: 2011-08-31
Budget start date: 30-SEP-2009
Budget end date: 31-AUG-2010
PFA/PA: PA-07-070
1R01MH082813-01A1 (2009): $772136
FIRST-EPISODE PSYCHOSIS AND PRE-ONSET CANNABIS USE
Michael T Compton, Assistant Professor
Emory University, 1599 Clifton Road, 4th Floor, Atlanta, Ga 30322
Grant 5R01MH081011-03 from National Institute Of Mental Health
Abstract: Cannabis use in adolescence and young adulthood is very common in the United States. Accumulating evidence suggests that, unlike other illicit drugs, cannabis used in adolescence may be a causal risk factor for schizophrenia, and cannabis use affects the symptoms, course, and outcomes of the illness. The proposed research seeks to clarify the impact of cannabis use on the age at onset of prodromal symptoms (e.g., decline in functioning, difficulties concentrating, irritability, and sleep disturbances that precede psychosis), the age at onset of psychotic symptoms (i.e., hallucinations and delusions), and the nature of negative, cognitive, neurological, and positive symptoms of schizophrenia. The study also will determine whether or not a previously characterized gene-environment interaction} involving the catechol-O-methyltransferase (COMT) gene and pre-onset cannabis use} influences onset ages and symptomatology. The study involves hospitalized patients with a first episode of a schizophrenia-spectrum disorder, most of whom are African American. This population is of particular relevance given well-recognized ongoing healthcare disparities across ethnic groups, under-representation of African Americans in clinical research, underuse of mental health services by African Americans, and very high rates of cannabis use in this population. The specific aims of the research are (1) to clarify the effects of cannabis use on disease onset by studying (a) age at onset of prodromal symptoms and (b) age at onset of psychotic symptoms in first-episode patients who used cannabis in the years prior to onset as well as those who did not; (2) to study the impact of cannabis use on disease phenomenology (i.e., symptoms, cognitive deficits, neurological signs) by comparing the clinical characteristics of first-episode patients who used cannabis prior to hospitalization with those who did not; and (3) to elucidate the impact of a specific gene-environment interaction on disease onset and disease phenomenology by investigating the effects of the COMT Val158Met functional polymorphism genotype, cannabis use, and their interaction on onset ages and symptom profiles of first-episode patients. The research will be conducted using extensive cross-sectional assessments of hospitalized first-episode patients whose data will be supplemented by information from family members/informants. Thorough and psychometrically sound instruments will be used to retrospectively assess past substance use. Because schizophrenia can be such a devastating illness, efforts to better understand modifiable determinants of course and outcomes are crucial. Innovative aspects of this research that make it especially relevant and innovative include (1) testing of focused hypotheses will be tested related to a specific recently discovered gene-environment interaction, (2) reliance on a predominantly African American sample, a group that is under- represented in psychiatric research despite a high prevalence of key risk factors, (3) the preventive implications related to future potential enhancements of outcomes by reducing cannabis use among adolescents who are at especially high risk, (4) measurement of all past use of all substances thoroughly and carefully, allowing for examination of potential interactions among the key variables being studied, and (5) the use of Ancestry-Informative Markers in the genetic analysis to control for potential effects of admixture and population stratification
Keywords: 12 year old; 12-20 years old; 14 year old; AOD use; Address; Admixture; Adolescence; Adolescent; Adolescent Youth; Affect; African American; Afro American; Afroamerican; Age; Age of Onset; Alcohol or Other Drugs use; Alcohols; Attention; Auditory; Black Populations; Black or African American; COMT; Cannabis; Care, Health; Catechol Methyltransferase; Catechol O-Methyltransferase; Characteristics; Chemical Class, Alcohol; Clinical; Clinical Research; Clinical Study; Cognitive; Cognitive deficits; Data; Delusions; Disease; Disorder; Drugs; Drugs, Illicit; EC 2.1.1.6; Environment; Epidemiology, Family Medical History; Ethnic group; Family Medical History; Family history of; Family member; Future; Genes; Genetic; Genetic Markers; Genetic Polymorphism; Genetic analyses; Genotype; HOSP; Hallucinations; Healthcare; Hemp Plant; Heterogeneity; High Prevalence; History; Hospitalization; Illicit Drugs; Knowledge; L-valyl-L-valine; Measurement; Mediating; Medication; Memory; Memory, Immediate; Memory, Short-Term; Memory, Shortterm; Mental Health Services; Mental Hygiene Services; Methyltransferase Gene; Nature; Neurobiology; Neurologic; Neurological; Onset of illness; Outcome; Patients; Pattern; Pharmaceutic Preparations; Pharmaceutical Preparations; Polymorphism (Genetics); Polymorphism, Genetic; Population; Preventive; Psychoses; Psychotic Disorders; Recommendation; Recording of previous events; Reliance; Research; Risk; Risk Factors; Role; S-Adenosyl-L-methionine[{..}]catechol O-methyltransferase; Sampling; Schizoaffective Disorders; Schizophrenia; Schizophrenic Disorders; Schizophreniform Disorder; Short-Term Memory; Sleep disturbances; Sound; Sound - physical agent; Specific qualifier value; Specified; Stratification; Symptoms; Syndrome; Testing; United States; Val-Val; adolescence (12-20); black American; decline in function; dementia praecox; disease onset; disease/disorder; disorder onset; drug/agent; environment effect on gene; executive control; executive function; first episode psychosis; fourteen year old; functional decline; gene discovery; gene environment interaction; genetic analysis; high risk; informant; innovate; innovation; innovative; instrument; juvenile; juvenile human; neurobiological; polymorphism; public health relevance; schizophrenic; sex; social role; sound; substance use; teenage; twelve year old; valylvaline; working memory
Project start date: 2008-09-05
Project end date: 2013-05-31
Budget start date: 1-JUN-2010
Budget end date: 31-MAY-2011
PFA/PA: PA-07-070
5R01MH081011-03 (2010): $360365
5R01MH081011-02 (2009): $355530