Criminal Justice / Mental Health Consensus Project

These profiles of advocacy in action illustrate strategies and principles outlined in the handbook. They provide powerful illustration of what advocates can accomplish when they know the facts, find the right partners, and remain persistent. As such, they are included to offer templates for advocates beginning efforts in their own communities.

These profiles are by no means the only such examples of the integral role advocates have played. We encourage you to contribute information about your own advocacy efforts to improve the response to people with mental illness in the criminal justice system. To complete a short survey about your advocacy efforts, please click here (staff may follow-up for more information).

ORGANIZATION: Mental Health Association of Tulsa (MHAT)
STATE: Oklahoma
PROJECT(S): Police Training, Jail Diversion

Overview

The Mental Health Association of Tulsa (MHAT) has helped to create a continuum of diversion opportunities for individuals within the criminal justice system.

History

MHAT's work on diversion builds on past efforts to improve services, including advocacy for a mobile crisis team that visits participants in their homes and the relocation of commitment hearings from the courthouse to mental health facilities.

After a police shooting involving a person with mental illness, the county sheriff asked MHAT to help train officers. In responses, MHAT helped to convene a group of participants, mental health providers, criminal justice officials, and advocates to plan improvements on how the criminal justice system responds to people with mental illness. Through their efforts, Tulsa police officers with mental health training are now assigned to a crisis response unit and given access to the county mobile crisis team as an alternative to arrest. Mental health workers stationed at the county jail conduct mental health assessments and divert nonviolent offenders with mental health needs. And for more serious offenders, a mental health liaison encourages court officials to consider diversion and to factor mental health needs into court decisions.

The support of local law enforcement officials has been integral to the creation of diversion opportunities in Tulsa. The Tulsa police chief was an active member of the group that advocated for the mobile crisis team and participated in the group that designed the jail diversion program.

Funding

MHAT has brought together a variety of funding sources, including a federal SAMHSA grant, and state and local funding to support jail diversion.

Obstacles

Bringing treatment providers on board proved to be MHAT's main obstacle. The mobile crisis team and mobile treatment teams posed a change for local clinicians who were accustomed to providing services in clinic settings. Getting providers to revise their mode of service delivery took time, patience, and understanding from MHAT staff.

ORGANIZATION: NAMI Baltimore
STATE: Maryland
PROJECT(S): Police Training

Overview

NAMI Baltimore has partnered with police departments in Baltimore and nearby Montgomery County to improve police response to people with mental illness.

History

NAMI Baltimore, which serves both the city of Baltimore and nearby Montgomery County, has taken a different approach in the two communities.

Montgomery County

In Montgomery County, an officer who was also a NAMI member became the head of training and lobbied the department to increase officer mental health training. With the help of NAMI, the officer developed a daylong training course open to all officers and a weeklong training course for designated officers. During a portion of the weeklong course participants discuss gaps in the system and possible solutions. As a result of one such discussion, Montgomery County established an emergency mental health hotline.

Baltimore

After a 1996 police shooting of a woman with mental illness, NAMI and Baltimore's mental health community became concerned with the police response to people with mental illness. After several failed attempts to spark dialogue, NAMI partnered with the Baltimore Police Department by offering officers a free course for family members of affected individuals through the Department's employee assistance program. The course was well attended but failed to produce momentum for sustained efforts.

Eventually NAMI funded delegations of officers and mental health officials to visit CIT programs in Memphis and Seattle. These trips were the turning point, after which the Baltimore Police Department decided to enhance mental health training. The department recently established a specialized unit of officers to respond to mental health crisis called the BEST (Behavioral Emergency Services Team), and the mental health system established a single point of referral for people with mental illness in police custody.

Funding

NAMI Baltimore received funding from the Eli Lilly Corporation to send officers and county officials to Memphis and Seattle to observe those cities' CIT programs. NAMI also received grants from the Maryland Governor's Office and from several foundations to fund the creation of an emergency room hub for police intakes.

Obstacles

A major obstacle to NAMI's advocacy efforts in Baltimore has been officer turnover. After several years of discussions with the police department, an officer was assigned to attend NAMI meetings. After building a relationship with this officer, she left the department. NAMI was then forced to develop a relationship with the new officer assigned to their meetings, who, after her trip to Memphis, became a leading advocate for improved training in the department.

ORGANIZATION: Howie T. Harp Advocacy Center
STATE: New York
PROJECT(S): Consumer Run Employment and Transitional Services, Educating State Actors

Overview

The Howie T. Harp Advocacy Center provides job and life skills training to people with mental illness and co-occurring substance abuse problems, including those who have been homeless or incarcerated. The organization also educates state policymakers and staff on the hurdles facing individuals reintegrating into the community after incarceration.

History

Founded in 1995, the Howie T. Harp Advocacy Center is a participant-run organization that has helped to pioneer the concept of peer services. Its efforts include the STARR program (Steps To A Renewed Reality), which offers employment training and placement assistance to individuals with mental illness who also have criminal histories. The program is divided into two sections: some participants receive traditional job training (i.e., interview preparation, computer classes, job placement), while others obtain intensive instruction to become peer support specialists.

In 2000, the New York Office of Mental Health asked the Howie T. Harp Advocacy Center to help educate state agency officials on the hurdles faced by former inmates with mental illness returning to their communities. In response, the Howie T. Harp staff organized panels of formerly incarcerated participants, service providers, parole officers, and others who discussed their experiences with decision-makers at relevant state and local agencies.

STARR staff and participants have also met with correctional officers at New York's Sing Sing Prison about their program. This outreach has helped to both educate inmates from across the state about Howie T. Harp programs, and to better sensitize correctional officers about the needs of participants. Corrections and parole officers now regularly inform inmates about the STARR program during pre-release discharge planning.

Funding

The STARR program and the Transition Project receive the bulk of their funding from New York State. In addition, the Center relies on grants and donations.

ORGANIZATION: NAMI Texas
STATE: Texas
PROJECT(S): Legislative Reform

Overview

NAMI Texas has helped spur legislative efforts to overhaul the Texas criminal justice system's response to people with mental illness.

History

NAMI's focus on criminal justice issues came after NAMI's then-president, Tom Hamilton, met with NAMI boards across the state to learn about issues of concern. During those meetings, stories of criminal justice involvement came up repeatedly. NAMI Texas decided to address the issue using economic arguments.

NAMI Texas staff first constructed an analysis of state spending on mental health care for criminal justice-involved individuals. This proved difficult, because the state Department of Criminal Justice relied on average inmate costs that did not account for treatment or extra supervision costs. NAMI Texas used connections in state government to get more specific data, and then constructed a macroeconomic model to demonstrate the inefficiency of warehousing people with mental illness in the corrections system. This effort helped to defeat a 2002 proposal to build an additional prison. Instead, the Republican-led legislature agreed to reallocate funds to provide for increased mental health treatment. Primed by this 2002 initiative, NAMI Texas then successfully advocated for legislation to promote jail diversion in 2003.

Funding

A major selling point of NAMI Texas' approach is that criminal justice and mental health reform can be economically beneficial. The requested reforms did not require additional money, but instead are predicated on generating savings by making the criminal justice and mental health systems more efficient.

ORGANIZATION: NAMI Alabama
STATE: Alabama
PROJECT(S): Criminal Justice/Mental Health Summits, Mental Health Courts

Overview

NAMI Alabama has helped establish several mental health courts in the state, and convened two statewide conferences on mental illness in the criminal justice system.

History

In 2000, administrators of the Jackson County Drug Court began considering a mental health court to address the needs of the many dually diagnosed defendants entering drug court. NAMI Alabama staff helped by bringing in officials from the San Bernardino County, California, Mental Health Court to share their experience. By 2002, one mental health court had been established in Birmingham, and another in Jackson County.

With the aid of the newly appointed mental health court judge, NAMI staff then convened a statewide summit on criminal justice and mental health issues. NAMI Alabama staff contacted NAMI affiliates across the state to identify leaders in each county who should attend the conference. Some speakers and funding for the conference were obtained from the TAPA Center for Jail Diversion and the Council of State Governments.

The conference consisted of nationally known speakers and county-based break out groups, in which attendees planned advocacy efforts for their communities. As a result of the conference, eight mental health tasks forces were established across the state, each with a different, locally determined focus. NAMI Alabama subsequently sponsored a second annual conference, with 210 attendees, and is planning a third.

Funding

The planning and establishment phases of the mental health court initiative were funded through a federal Bureau of Justice Assistance grant. The courts are now staffed by the county, which reallocated resources within the judiciary to fund them.

Obstacles

Stigma is one of the biggest hurdles in advocacy. For example, in 2003, two months before the second conference, two deputy sheriffs in Athens, Alabama were killed by an individual with mental illness who had a criminal record; no one from Athens would agree to attend the conference.

ORGANIZATION: NAMI Wisconsin
STATE: Wisconsin
PROJECT(S): Improving Conditions of Confinement, Discharge Planning

Overview

NAMI Wisconsin has been the driving force behind a number of state reforms, including allowing inmates on psychiatric medications to be admitted into minimum-security facilities, improved protocols for assuring inmate medical treatment, social services discharge planning, and judicial training on mental health issues. The organization focuses on projects that can be accomplished in limited amount of time with significant potential for success.

History

For years, NAMI Wisconsin received calls from family members complaining that when incarcerated individuals were moved to a different facility, their medical records were not being transferred promptly. In 1998, a diabetic inmate died due to lack of medical care. This incident received media coverage and provided the opening for NAMI to act. NAMI Wisconsin staff approached the head of jail inspections for the Department of Corrections, with whom they had previously worked. With the help of NAMI, this official developed a medical record transfer procedure stating that the receiving facility must acknowledge receipt of records within twenty-four hours and all records must be logged in and out of facilities.

NAMI Wisconsin has also taken the lead on improving discharge planning. After learning about consumers being released from prison without Social Security or Medicaid benefits, NAMI Wisconsin Executive Director Helen Geyso approached the Secretary of Corrections. Emphasizing an economic argument, Geyso explained how assuring a continuum of benefits would reduce recidivism, and that, because individuals on probation and parole were still under the custody of the Department of Corrections, reinstating benefits would cut the cost of medical care for the DOC budget. The Secretary ultimately dedicated staff time and training to help inmates fill out benefits applications. The Secretary also agreed to establish an arrangement whereby, if social security benefits would not be ready by the discharge date, a social worker can submit emergency application for state insurance on the inmate's behalf.

Funding

NAMI Wisconsin has purposely tackled problems that can be ameliorated with regulatory or administrative changes and, therefore do not require additional funding.

ORGANIZATION: Mental Health Association of Albany
STATE: New York
PROJECT(S): Jail Diversion

Overview

In response to the death of an Albany County Jail inmate, the Mental Health Association of Albany (MHA) worked with the sheriff's office to develop a jail diversion program.

History

In 1999, Gregory Richardson, who suffered from schizophrenia, had a psychotic episode that led to his arrest for reckless driving. Once in jail, he continued to decompensate. County officials repeatedly tried to get him out of jail and into treatment, but inadequate policies and insufficient communication led to Mr. Richardson being strapped down face first and given a Haldol injection; two hours later, he was dead.

The MHA first put pressure on the governor to investigate the incident, but this request was declined. Subsequently, MHA staff contacted the sheriff, with whom they had a positive relationship. Instead of criticizing the Sheriff, MHA Executive Director Joe Glazer made clear that he knew of the Sheriff's efforts to prevent the Richardson tragedy; he proposed a dialogue to improve the system so that future incidents could be prevented. Promoting a positive, constructive dialogue was important, as the Sheriff had already received negative press and would have been sensitive to further criticism.

The sheriff's office and MHA first identified funding sources for a criminal justice/mental health initiative, and ultimately applied for and received a grant from the Substance Abuse and Mental Health Services Administration to create a jail diversion program. Next, the sheriff's office and the MHA researched programs that could serve as models. After numerous meetings with a variety of stakeholders in the county, and research about various programs, a jail diversion program in Albany County was launched in January 2003.

Funding

Initial funding came from a two-year SAMHSA grant, which provided $150,000 each year. When the grant expired, local foundations and a pharmaceutical company, Pfizer, provided continuation funding.

Obstacles

About a year into the project, friction developed between the stakeholders about who owned the jail diversion project. With the help of third-party facilitator, the MHA and other partners took steps to address the concerns, which included coming up with the project name in a group; putting the names of all project participants on the cover of the project brochure; and doing a better job of explaining how the grant money was being directed.

ORANIZATION: Marion County MHA
STATE: Indiana
PROJECT(S): Court-based jail diversion

Overview

The Marion County Mental Health Association (MHA) coordinated a process through which representatives of the courts, jails, and mental health service providers developed a court-based jail diversion program.

History

In 1994, after receiving calls from the courthouse and the jail asking for assistance with an increasing number of individuals with mental illness, staff of the Marion County MHA convened a group of local judges, prosecutors, jail staff, and service providers to talk about the scope of the problem and potential solutions. The diverse stakeholders all agreed: individuals with mental illness charged with minor infractions should be diverted into treatment.

As plans for a diversion program took shape, two sticking points became apparent. First, legislative changes were necessary to allow for a diversion program. A lawyer on the MHA's board volunteered to draft appropriate legislation, which promptly passed. Second, local judges and prosecutors wanted assurance that participants would comply with treatment and receive follow-up care. To address this concern, the parties agreed that MHA would monitor participants' compliance and would report back monthly to the court and district attorney. The parties also agreed to a weekly roundtable in which all relevant parties could discuss cases. Based on these and other agreements, Marion County launched the Psychiatric Assertive Identification and Referral Project (PAIR), which allows defendants with mental illness facing misdemeanor charges to receive treatment in lieu of prosecution, with the charges dismissed upon the successful completion of treatment for a set period of time.

Perhaps the greatest achievement of the MHA was establishing trust between different agencies. The cornerstone of the program is the weekly roundtable in which service providers, MHA staff, representatives from community corrections, the prosecutor, and public defenders review eligible cases. Open communication between all stakeholders is essential for the program to run smoothly.

Funding

PAIR was funded through a reallocation of resources. All participating parties the court, public defenders, prosecutors, treatment providers, and MHA volunteer staff time to make the program happen. As the program has expanded, it has grown from one judge to two. In addition, MHA has increased its staffing commitment and now provides a dedicated staff member. PAIR has received funding from the United Way in order to pay for the full-time program staff member.

Obstacles

At the start of the program, community mental health providers were not accustomed to providing updates to MHA and were slow to respond to information requests. In response to this problem, the court gave MHA subpoena power, which helped providers prioritize their reporting function. This has, in turn, increased judicial and prosecutorial confidence in the program.

ORGANIZATION: Tarrant County Mental Health Association (MHA)
STATE: Texas
PROJECT(S): Expanded Police Training, Pretrial Diversion

Overview

During the past six years, the Tarrant County Mental Health Association (MHA) has successfully advocated for expanded mental health training for police officers, for the establishment of a mental health service providers unit to work with the police, and for the creation of a mental health pretrial diversion program.

History

Tarrant County has a long-established Justice Coalition comprising local law enforcement, advocates, hospital and school officials, state policymakers, court officials, juvenile justice administrators, and others. In 1998, the Coalition began to consider an initiative related to mental illness and criminal justice. County officials were given a questionnaire regarding the problem, which led to an initial meeting of criminal justice personnel, service providers, and advocacy groups to discuss potential responses. Shortly thereafter, the Coalition held separate meetings for law enforcement officials and mental health service providers to ensure a candid discussion of the issues.

After these initial meetings, a community-wide forum was scheduled, at which representatives from Memphis and Galveston gave presentations on their CIT programs. Soon after those presentations, and with the input of many key stakeholders, the Coalition developed a plan to establish: (1) continuing officer education courses on mental illness; (2) increased access to the state peace officer certification course; and (3) a liaison unit of mental health providers to work with the police. All three goals were accomplished within a few years.

Building off of the success of their law enforcement efforts, the Coalition, with the urging of the MHA, turned its attention to the courts. The Justice Coalition sponsored a community forum on mental health courts in 2002, after which one judge committed to launching a pretrial diversion program in the county. With assistance from MHA staff, the judge applied for and received a Bureau of Justice Assistance grant to start the program, which launched one year later.

Funding

For its policing initiatives, the Coalition received initial funding from a Substance Abuse and Mental Health Services Administration grant. When the grant term ended, training was continued by the county municipalities, which allocated portions of their law enforcement block grant money to the training. This funding source has remained stable despite cuts to local budgets. When MHA staff appear before the county commissioner to request continued funding, they are always accompanied by local police chiefs and members of MHATC.

In addition, because employees of the County Department of Mental Health and Retardation staff the liaison unit, it receives Medicaid reimbursement for a number of its services.

Obstacles

Confidentiality posed an unexpected stumbling block for the liaison unit. By state statute, MHMRTC staff can speak freely with law enforcement if it is for the benefit of MHMRTC's client. This is not true, however, of private hospitals. Consequently, the liaison unit was unable to obtain the mental health history of individuals treated at private facilities and, therefore, had difficulty providing emergency services and executing referrals for these individuals. Since the identification of this obstacle, a number of private facilities have had clients sign consent forms that permit the facility to share information with the liaison unit.

ORGANIZATION: Rights for Imprisoned People with Psychiatric Disabilities (RIPPD)
STATE: New York
PROJECT(S): Consumer Organizing

Overview

Rights for Imprisoned People with Psychiatric Disabilities (RIPPD) is a grassroots consumer organization in New York City that engages policymakers, the media, and other citizens to win increased rights for prisoners and former prisoners with mental illness.

History

RIPPD evolved out of a class action lawsuit to force New York City to improve their procedures for releasing people with mental illness from Riker's Island, New York's largest jail. The lawsuit, know as Brad H. vs. the City of New York (after one of the class member's names) was brought by the nonprofit Urban Justice Center. The principal lawyer on the case was Heather Barr. Though the case was settled in 2003, Barr and others at the UJC were frustrated with pace of improvements, and recognized that there were many other issues related to the criminal justice involvement of people with mental illness. Taking inspiration from the civil rights movement, Barr hoped that a grassroots organizing effort would provide the needed impetus for far-reaching change.

In 2003, Barr secured funding to hire a community organizer, Lisa Ortega, who was formerly incarcerated and had social justice and grassroots organizing experience. Ortega began outreach efforts by going with group members to "places where people directly affected will be:" courthouses, street corners, laundromats, and jail visiting rooms.

After a few months of outreach, RIPPD held its first meeting, at which members identified five priority issues: 1.Outlawing the practice of placing individuals with psychiatric disabilities in solitary confinement; 2.Increasing the use of alternatives to incarceration; 3.Increasing mental health training and accountability for corrections officers; 4.Improving the quality of services in city jails; and 5.Improving discharge planning.

The group then identified targetsusually government officialswho are in positions to affect change in these areas. RIPPD sent letters to these officials explaining the nature of the organization and detailing the issues of concern to RIPPD. The letters invited the officials to meet with the group to discuss their concerns. Official response has been mixed. Some officials responded positively, while others have required follow-up.

When meeting with officials, RIPPD members set the agenda and make direct demands for action. While this tactic has met with varied reactions, group members feel that their feeling of empowerment is of equal importance to the responses from their targets. As part of these efforts, the group chooses its language carefully. They are organizers, not advocates. The group makes demands, not requests.

Funding

Funding to staff RIPPD came from the Ittleson Foundation, a national, New York-based foundation with a history of funding innovative, start-up proposals.

Obstacles

Getting members to RIPPD meetings can be a challenge. Much of RIPPD's membership juggles multiple commitments including jobs, care giving, and treatment programs. To facilitate attendance, food and child care are provided at every meeting. In addition, RIPPD recently began providing members subway passes, thanks to a $500 donation from a community church. Though meeting participation remains at a fraction of total membership, RIPPD is dedicated to keeping in contact with its membership through a newsletter and through continued community outreach.

ORGANIZATION: NAMI Kansas City
STATE: Missouri
PROJECT(S): Police Training, Mental Health Court

Overview

NAMI Kansas City has spurred the development of Crisis Intervention Teams (CITs) in several counties in Missouri, and has promoted the creation of a mental health court in Jackson County.

History

In the mid-1990s, staff at Kansas City NAMI, particularly the Executive Director Guyla Stidmon, began working to expand police training regarding mental illness in Kansas City. Their initial efforts were unsuccessful until, in 1999, Stidmon contacted a department in a neighboring jurisdiction where an officer had already approached the chief about instituting a Crisis Intervention Team (CIT). Stidmon and the officer partnered to form a local CIT council in 1999.

The council brought together individuals with mental illness, concerned police officers, and mental health providers to discuss potential improvements to the police response to people with mental illness. After numerous meetings over the course of one year, the council recommended the establishment of a CIT program in Lee's Summit.

The council then turned their attention to other jurisdictions, and promoted the development of more CIT programs. Four years later, more than twenty-one Missouri counties have instituted enhanced police mental health training courses, and four counties have fully implemented CIT programs. The council continues to meet monthly to troubleshoot problems and to help other jurisdictions establish similar programs.

Each jurisdiction employing CIT submits a monthly report to the council detailing its use of CIT and any problem areas. The council has separate committees including education, steering, and public relations, and members who leave the council are asked to provide a replacement from their stakeholder group.

Following the success of CIT, several council members became interested in establishing a mental health court. A separate group, that included several CIT council members, was formed to work on this project. The group identified jurisdictions with drug courts or CIT programs where a mental health court would add to the continuum of diversion opportunities. In 2002, the group's efforts resulted in the opening of the Jackson County Mental Health Court.

Funding

The Crisis Intervention Teams were established without additional funding, though the Jackson County Police Department does donate officer time and NAMI provides additional staffing and resource support to the CIT council.

The majority of funding for the mental health court comes from Jackson County and from a Substance Abuse and Mental Health Services Administration (SAMHSA) community action grant. Jackson County was particularly amenable to a mental health court because of a unique tax initiative there through which a portion of taxes collected in county are earmarked for mental health programs.

Obstacles

Overcoming the reluctance of police departments to institute new training without new funding has presented NAMI with its most significant obstacle. Until NAMI found an ally in one of the departments they approached, their advocacy was slow to take off. Even then, the department's leadership expressed discomfort about officer time being spent on planning CIT. This bump in the road was overcome when an influential community member contacted the police chief, at the request of NAMI, to explain the value of CIT.

ORGANIZATION: NAMI Ohio
STATE: Ohio
PROJECT(S): Police Officer Training

Overview

After helping to establish a thriving CIT program in Akron, NAMI Ohio has partnered with state agencies to promote these programs statewide.

History

CIT Ohio began in Akron in 1998, when the police department implemented a program based on the Memphis model, with some adjustments to fit Akron's needs. Once the Akron program became solidified, NAMI Ohio began working with the program director, Lieutenant Mike Woody, and the Ohio Criminal Justice Coordinating Center of Excellence (funded by the State Department of Mental Health) to promote CIT statewide.

NAMI Ohio leads the outreach to police departments across Ohio by identifying local community members, usually NAMI advocates, interested in CIT and willing to convene local stakeholders. In many cases, the interested community members contact NAMI Ohio staff to request assistance, Once a local partners is identified, NAMI then works with them to identify people in their community who should be brought on board. This usually includes law enforcement officials, judges, and local politicians.

NAMI Ohio then helps their local partner arrange a 30- to 40-person luncheon for local stakeholders. Media are invited as an incentive to get community members to attend. The lunch typically lasts an hour and a half, during which time the local partner describes why they think CIT is important and Lt. Woody discusses the concept and the benefits of CIT.

After the presentation, the local partner will invite all meeting participants to an initial steering committee meeting. At that meeting two individuals, one from law enforcement and one from mental health, are selected to attend 40 hours of CIT training in another jurisdiction. In addition, officials from other departments attend the initial meeting to provide input. As additional steering committee meetings are set up and the community moves forward, NAMI Ohio continues to assist by linking the community up with other localities around the state, providing resources, and offering advice.

Since 1998, NAMI Ohio has helped 22 counties launch CIT teams, with dozens more in the planning stages. In addition, NAMI Ohio recently launched a statewide network of CITs that helps mental health providers and law enforcement from communities with CIT remain in contact. NAMI Ohio is also planning a nationwide conference dedicated to CIT.

Funding

With the assistance of NAMI Ohio, a department can introduce a CIT program without additional funding. NAMI pays for the initial luncheon and food at subsequent steering committee meetings. Usually steering committee meetings and trainings can be held at local police departments, or other organizations donate space. Instructors volunteer or are loaned out from other departments and the mental health community, and training takes place in the department's standard training facility.

The campaign to spread CIT across the state, however, has required funding. When Lt. Woody retired from the force a few years ago, he made helping other departments implement CIT his full-time job. His work is funded through the CCOE, and is covered, in part, by a federal Byrne Grant.

Obstacles

The limited resources and small staffs of rural police departments present obstacles to spreading CIT across the state. To work around this problem, NAMI Ohio ensures that whenever one department offers CIT training, they set aside a few slots for officers from other, smaller departments. NAMI also encourages small departments to block off attendance at a CIT training like vacation time designating the time far in advance so that no other officer will take time off during the same period.