Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, 49 Jesse Hill Jr. Drive, Atlanta, GA 30303, USA.
Schizophr Bull. 2011 Jul;37(4):737-45. doi: 10.1093/schbul/sbp146. Epub 2009 Nov 23.
Few studies have examined police officers' use of force toward individuals with schizophrenia, despite the widely disseminated Crisis Intervention Team (CIT) model of partnership between mental health and law enforcement that seeks to reduce use of force and enhance safety of officers and individuals with mental illnesses. This study tested the hypotheses that CIT-trained officers would select a lower level of force, identify nonphysical actions as more effective, and perceive physical force as less effective in an escalating psychiatric crisis, compared with non-CIT-trained officers.
Police officers (n = 135)-48 CIT trained and 87 non-CIT trained-completed a survey containing 3 scenario-based vignettes depicting an escalating situation involving a subject with psychosis. Data were analyzed using repeated-measures analyses of variance.
Officers escalated their preferred actions across the scenarios. A significant scenario by group interaction indicated that CIT-trained officers chose less escalation (ie, opting for less force at the third scenario) than non-CIT-trained officers. Officers reported decreasing perceived effectiveness of nonphysical action across the 3 scenarios. A significant scenario by group interaction indicated that CIT-trained officers reported a lesser decline in perceived effectiveness of nonphysical actions at the third scenario. CIT-trained officers consistently endorsed lower perceived effectiveness of physical force.
Efforts are needed to reduce use of force toward individuals with psychotic disorders. These findings suggest that CIT may be an effective approach. In addition to clinical and programmatic implications, such findings demonstrate a role for clinicians, advocates, and schizophrenia researchers in promoting social justice through partnerships with diverse social sectors.
尽管广泛传播的心理健康和执法合作危机干预小组 (CIT) 模式旨在减少使用武力并提高警察和患有精神疾病的个人的安全性，但很少有研究考察警察对精神分裂症患者使用武力的情况。本研究检验了以下假设：与未接受 CIT 培训的警察相比，接受 CIT 培训的警察在不断升级的精神科危机中，会选择较低水平的武力，将非身体行动视为更有效，并认为身体武力的效果较差。
共有 135 名警察（48 名接受 CIT 培训，87 名未接受 CIT 培训）完成了一项包含 3 个情景案例的调查，这些案例描述了一个涉及患有精神病的主体的不断升级的情况。使用重复测量方差分析对数据进行分析。
警察在整个情景中逐步升级他们的首选行动。情景与组的显著交互作用表明，接受 CIT 培训的警察比未接受 CIT 培训的警察选择的升级程度较低（即，在第三个情景中选择较少的武力）。警察报告说，在 3 个情景中，非身体行动的感知效果逐渐下降。情景与组的显著交互作用表明，在第三个情景中，接受 CIT 培训的警察报告非身体行动的感知效果下降幅度较小。接受 CIT 培训的警察一直认为身体武力的感知效果较低。
需要努力减少对患有精神病障碍的个人使用武力。这些发现表明 CIT 可能是一种有效的方法。除了临床和计划方面的影响外，这些发现还表明，临床医生、倡导者和精神分裂症研究人员在通过与不同社会部门的合作促进社会正义方面可以发挥作用。
