Policing people with mental illness: experimental evaluation of online training to de-escalate mental health crises

Abstract

Objectives: This study was conducted to complete a proof of concept for a brief online training designed to improve the policing of people with mental illness. The training, positioned within a stress inoculation framework, is scalable worldwide at minimal cost. Our primary intent was to effect improvements in law enforcement officers’ ability to effectively respond to and de-escalate mental health crises. Method: Participants were randomly assigned to either DEFUSE, the online de-escalation training, or a delayed treatment control condition. DEFUSE was evaluated with the full array of measures also used to assess CIT, the most comprehensive mental health training available to law enforcement in the USA. Additionally, DEFUSE was evaluated using a randomized controlled trial design, including additional measures assessing performance competence, knowledge, and satisfaction with the training. Results: Participants initially receiving DEFUSE showed significant improvement in performance competence, assessed from their responses to simulated mental health crises. Multivariate and univariate analyses indicated that DEFUSE produced significant beneficial effects on all CIT measures (empathy, stigma, self-efficacy, and behavioral self-report) with strong effect sizes; control participants obtained comparable benefits after DEFUSE training. Conclusions: DEFUSE appears to be a promising tool for teaching law enforcement officers how to intervene in mental health crises. It provides consistent training at the convenience of the learner and is engaging, time and cost effective, and easily scalable worldwide. Furthermore, participants found it interesting and the skills easy to understand and remember. Future studies will evaluate DEFUSE with a larger law enforcement sample and consider the possibility of collecting longitudinal data on level of force and resolution, referral, and arrest.