Co-Response Teams (CRTs)
CRTs are a form of specialized police response to persons in crisis, with a goal of improving police interactions with such individuals and diverting them away from the criminal justice system or unneeded emergency hospital services. While the structure and composition of CRTs vary widely by jurisdictional needs and resources, CRTs are typically comprised of either: (1) a (uniformed or plain-clothes) officer and a mental health practitioner (e.g., registered psychiatric nurse, social worker) who work together on shift and jointly respond to calls for service at the request of 911 dispatch; or (2) an on-call team of mental health practitioners based out of a local hospital or community-based service that respond to crises at the request of 911 dispatch and typically join officers already on scene. A specific form of CRT is called a Mobile Crisis Rapid Response Team (MCRRT), which partners a CIT-trained officer with an experienced mental health practitioner. Many CRTs provide follow-up services with clients. This program marries aspects of safety and legal authority afforded by the police officer with specialized mental health knowledge and assessment acumen provided by the mental health practitioner. Potential benefits CRT’s inter-agency approach include information sharing, joint-decision-making and coordinated intervention (Parker et al., 2018).
The evidence on CRTs is promising, but more research is needed across several outcomes (i.e., officer-level outcomes and program-level outcomes).
Assessor: Jacek Koziarski, University of Western Ontario
Jacek Koziarski is a Ph.D. student in the Sociology department at the University of Western Ontario, and a Research Associate for Can-SEBP. Jacek has a broad interest in policing research and developing evidence-based approaches to policing, but his most recent work has specifically focused on specialized police responses to persons in crisis, missing persons, the spatial analysis of crime, and hot spots policing.
Reviewer: Dr. Jennifer Lavoie, Wilfrid Laurier University
Dr. Jennifer Lavoie is an Associate Professor and Chair of the Department of Criminology at Wilfrid Laurier University. With extensive research experience in mental health, her interests focus on policing of people with mental illness, as well as on identifying risk and protective factors for psychiatric decompensation, victimization and violence perpetration among homeless and other vulnerable populations in the community and correctional settings.
Is the program based on research?
It is unclear whether the origins of CRT are based on research. These teams emerged amidst calls for interagency collaboration between community social service and health care agencies with law enforcement (Usher & Trueman, 2015)
Has the program been independently evaluated?
Certain aspects of CRTs have been independently evaluated in numerous jurisdictions, such as Canada, Australia, New Zealand, the UK, and the US. Findings from Canadian jurisdictions show that: CRT officers divert more persons in crisis to the hospital than non-CRT officers, persons in crisis have positive interactions with CRT officers, persons in crisis have better engagement with outpatient services following an interaction with a CRT, and that CRTs are able to reduce unnecessary hospital transfers, among other findings.
Was the program rigorously tested?
The existence of the many diverse forms of CRTs presents challenges in measuring this program’s effectiveness. To-date, CRTs have not been rigorously tested at levels 4 or 5 of the Maryland Scientific Evidence Scale.
Has the program evaluation been replicated?
Certain aspects of CRTs have been evaluated in numerous jurisdictions, such as Canada, Australia, New Zealand, the United Kingdom, and the United States.
Was the program tested in Canada?
CRTs have been evaluated in some Canadian jurisdictions, such as Toronto (Lamanna et al., 2015; Kirst et al., 2014), Halifax (Kisley et al., 2010), and Hamilton (Fahim et al., 2016).
Cotton, D. & Coleman, T. (2013). Improving relationships between police and people with mental illness: Canadian developments. In Policing and the mentally ill: International Perspectives (pp. 19-38)
Fahim, C., Semovski, V., & Younger, J. (2016). The Hamilton Mobile Crisis Rapid Response Team: A First-Responder Mental Health Service. Psychiatric Services, 67(8), 929.
Kirst, M., Narrandes, R., Pridham, K. F., Yogalingam, J., Matheson, F., & Stergiopoulos, V. (2014). Toronto Mobile Crisis Intervention Team (MCIT) Program Implementation Evaluation Final Report. St. Michael's Hospital. Toronto: Centre for Research on Inner City Health.
Kisely, S., Campbell, L. A., Peddle, S., Hare, S., Pyche, M., Spicer, D., & Moore, B. (2010). A Controlled Before-and-After Evaluation of a Mobile Crisis Partnership Between Mental Health and Police Services in Nova Scotia. Canadian Journal of Psychiatry, 55(10), 662-668.
Lamanna, D., Kirst, M., Shapiro, G., Matheson, F., Nakhost, A., & Stergiopoulos, V. (2015). Toronto Mobile Crisis Intervention Team (MCIT): Outcome Evaluation Report. Centre for Research on Inner City Health and St. Michael's Hospital, Toronto.
Parker, A., Scantlebury, A., Booth, A., MacBryde, J. C., Scott, W. J., Wright, K., & McDaid, C. (2017). Interagency collaboration models for people with mental ill health in contact with the police: A systematic scoping review. BJM Open, 8 (2) Available: https://bmjopen.bmj.com/content/8/3/e019312.full
Usher, K & Trueman, S. (2015). Stop the shooting: it is time for partnerships between police and mental health nurses. International Journal of Mental Health Nursing, 24 (3), 191-192