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Crisis Intervention Teams (CIT)

CIT in Action

July 2008: Vol. 3, Issue 7

Feature Story: NAMI Indiana Correctional Training: Improving Safety for Inmates with Mental Illnesses

Contributor: Kellie Meyer

As part of our effort to address the needs of people with mental illnesses involved in the criminal justice system, NAMI Indiana has developed a 10-hour program to educate correctional officers about mental illness and provide them with practical skills for working with people with mental illnesses. By teaching correctional staff about mental illness, we prepare them to better understand and more effectively communicate with inmates with mental illness, and thus enhance their personal safety.   We have trained more than 1700 correctional staff in Indiana and 247 from Kentucky.

The training has improved working and living conditions tremendously for both correctional staff and for inmates living with mental illnesses.   Use of force by correctional officers who were trained has decreased by as much as 70%.


We chose a team of outstanding experts in the field of criminal justice, and collaborated with Indiana University to review the available data and to establish a best practice.  We worked with Wabash Valley Correctional Facility to ensure the practicality of the program. 


Our training curriculum includes modules on: "The Categories of Mental Illness"; "The Biological Basis of Mental Illness"; "The Treatment of Mental Illness"; "Interacting With Persons With Mental Illness"; and "Criminal Justice & Mental Illness:  Principles and Applications, A New Beginning." While the first four modules provide officers with vital information and education, the last module is an interactive session that allows participants to apply their new knowledge to scenarios from the workplace. We work with the officers to develop and practice the tools they need to more effectively communicate with someone living from mental illness.


One of the most important aspects of the correctional training is the effort we put into customizing the program for each setting. While overall education and awareness about mental illness has been extremely helpful in all settings, understanding the protocols of each respective agency helps us to ensure that what we are teaching is relevant to the officers.  We work with veteran officers at each facility to find out what procedures they currently follow, and what needs they see. Rather than simply educating, we strive to help them develop tools they can use in every day practice.  We also work to ensure that the officers feel they can continue to put their safety first; if the officer does not feel safe, no one else will either.

Why Not CIT?

The training course outlined was designed for maximum security prisons. While the training shares many of the same verbal de-escalation skills that are emphasized in CIT, in a corrections setting it is important to teach officers how to assess symptoms over time and build effective rapport with people with mental illnesses in custody. This training better equips the officers to make those assessments by recognizing certain symptoms and by developing a basic knowledge of the patterns of behaviors associated with the various mental illnesses. On the street, in a crisis situation, the officer is walking into the unknown, and often will never see the person again. In a corrections environment, officers have to build rapport in order to work effectively and safely with individuals with mental illness.   

Kellie Meyer, M.A. is Criminal Justice Director and Development Director at NAMI Indiana. To learn more about Indiana’s corrections training, contact her or NAMI Indiana Executive Director Pam McConey at (317)-925-9399 or

Advocacy Spotlight: Supreme Court Decision may Enhance Fairness in Criminal Cases Involving Defendants with Serious Mental Illnesses

On June 19, 2008, the Supreme Court of the U.S. issued a decision in which it held that a higher standard must be used to determine the competence of defendants to represent themselves in criminal cases than to determine the competence of defendants to stand trial.  The decision in Indiana v. Edwards can be found  here.  Although the implications of the decision are somewhat limited, NAMI believes that it represents a positive step towards the goal of ensuring greater fairness in criminal cases in which the mental illness of the defendant is at issue.   

Facts of the case:

In July, 1999, Ahmad Edwards was discovered trying to steal a pair of shoes from an Indiana department store.  After being discovered, he fired a gun at a store security officer and wounded a bystander.  He was charged with attempted murder, battery with a deadly weapon, criminal recklessness and theft.  He was diagnosed with schizophrenia and subsequently found incompetent to stand trial and was committed to a state psychiatric hospital for further evaluation and treatment.  His competency and mental status fluctuated over the course of five years and he was not found competent to proceed to trial until July, 2004. 

In June, 2005, Edwards stood trial.  He asked to represent himself but the trial court rejected this request and the jury found him guilty of criminal recklessness and theft but failed to reach a verdict on the charges of attempted murder and battery.  The State decided to retry him on the attempted murder and battery charges and he was retried in December, 2005.  The trial court again found that he was competent to stand trial but not competent to represent himself.  Despite being represented by counsel at his retrial, the jury convicted him on both counts. 

Edwards appealed, arguing that he had been wrongfully deprived of his constitutional right to represent himself.  The case eventually reached the Supreme Court, which addressed the legal question of whether the standard for allowing defendants to represent themselves at trial should be higher than the standard for finding defendants competent to stand trial. 

The Court’s decision:

In the Edwards decision, the Supreme Court held that defendants determined competent to stand trial are not necessarily competent to represent themselves at trial.  Historically, courts have applied an extremely low standard for finding defendants competent to stand trial, requiring simply that they understand the nature of the charges against them and are capable of consulting with their attorneys with "a reasonable degree of rational understanding." 

According to the Edwards decision, a higher degree of competence is required to engage in self-representation at trial, including "organization of defense, making motions, arguing points of law, … questioning witnesses and addressing the court and jury." 

The Court specifically cited two factors in reaching its decision.  First, the Court emphasized the fluctuating nature and severity of mental illnesses, which can significantly interfere with the ability of a defendant to mount an effective legal defense over a period of time.   

Second, the Court expressed concern that allowing defendants with questionable capacity to represent themselves at trial does not ultimately protect the civil rights of those individuals but rather "threatens an improper conviction or sentence" and "undercuts the most basic of the Constitutions criminal law objectives, providing a fair trial."

The Supreme Court stopped short of defining the criteria that trial courts should use in determining the competency of defendants to represent themselves at trial, stating that trial court judges are better able to make those determinations, taking into consideration "the individualized circumstances of a particular defendant."

The significance of the decision:

The Court’s decision will help ensure more fairness in cases in which defendants with severe mental illnesses seek to waive a defense or represent themselves at trial.  It is not uncommon for defendants experiencing delusions, hallucinations or other symptoms of a severe mental illness to fire their attorneys and argue that they should be allowed to represent themselves.  When this occurs, the ability to present relevant information to the judge or jury and thus ensure a fair trial may be seriously compromised.  

NAMI has been particularly concerned in recent years about criminal defendants being allowed to represent themselves at trial despite evidence of delusions and other symptoms of psychosis.  The right to waive counsel and represent oneself at trial is a fundamental constitutional right if the decision is made knowingly and rationally.  However, in cases when an individual is experiencing symptoms of psychosis, this decision may not be knowing and rational.      

A recent and highly publicized case illustrates the wisdom of the Supreme Court’s decision.  Scott Panetti was allowed to fire his attorneys and represent himself at trial despite a long history and active symptoms of schizophrenia.  He fired his attorneys because they wanted to assert an insanity defense which would have required entering evidence of his mental illness into the record.  At trial, Panetti sought subpoenas on John F. Kennedy and Jesus Christ.  He wore a cowboy outfit, sang cowboy songs, spoke in incoherent sentences, and asked irrational questions of witnesses.  He was convicted and sentenced to death.  Under the new standard articulated by the Supreme Court in Indiana v. Edwards, it is unlikely that a defendant such as Panetti would have been permitted to represent himself.    

Many have argued that the standard used for determining competency to stand trial is too low and does not reflect current understanding of serious mental illnesses and their potential impact on rationality and cognition.  However, the decision in this case will not impact on these determinations.  Re-consideration of the standards used for evaluating competency to stand trial will have to wait for another day.   

News and Announcements

Report Shows Low Risk of Death and Serious Injury from Less Lethal Weapons

A report  released in June by the Department of Justice finds that “there is no conclusive medical evidence…that indicates a high risk of serious injury or death from the direct effects of CED [conducted energy device] exposure.” The study is the interim report of an Office of Justice Programs panel on the “Study of Deaths Following Electro Muscular Disruption.” The panel reports that individuals who experience so-called “excited delirium,” a condition characterized by psychosis, agitation and high body temperature, may die from that condition and not necessarily as a result of the use of a CED, such as a Taser. The authors report that the safety of CEDs has not been studied in sensitive populations such as children, the elderly, pregnant women and those with heart disease. They also note that there have been some reports of deaths following continuous or repeated CED application, and that there is little data on the safety of repeated or continuous use of CEDs.

NAMI’s recently released policy on Application of Less Lethal Weapons is available  online (see Section 8.9).  

NAMI Accepting Applications for Consumer and Family Scholarships for CIT National Conference

NAMI’s CIT Center is happy to announce that it is accepting applications for a limited number of family and consumer scholarships for this fall’s CIT National Conference. Scholarships will cover the cost of registration and hotel (3 nights maximum)—scholarship recipients will be responsible for their own travel and other expenses. In order to be eligible, applicants must be a consumer or family member, must be a NAMI member, must be financially unable to fund their trip, and must submit a letter of support from their local NAMI affiliate or state organization. Click here   to download an application. If you have any questions, contact Laura Usher at or by calling 703-600-1109. The deadline for applications is September 2, 2008.

PowerPoint Presentations Available from NAMI Convention

The NAMI national convention in June featured a variety of speakers and workshops focused on criminal justice issues. Many of these presentations are now available on the NAMI website  for download, free of charge. Presentations that  may be of particular interest to CIT in Actionreaders include:

  • "CIT Special Networking Session," including presentations by  Major Sam Cochran of the Memphis CIT program;Wendy Stewart of NAMI Cambria County and Lt. Dan Marguccio on the Laurel Highlands (PA) CIT program, and Lt. Jeffry Murphy of the Chicago PD and Suzanne Andrukaitis of NAMI Greater Chicago on the  Chicago CIT program.
  • "Treatment Not Jail," which focused on the advocacy coalition and strategy that successfully pushed for  Florida’s Justice Reinvestment Act. Michele Saunders, of Florida Partners in Crisis, and Judge Mark Speiser, of the Broward County Felony Mental Health Court, presented.
  • "Building Diverse Coalitions that Get Results," featuring presentations by Alicia Woodsby, Criminal Justice Coordinator for NAMI Connecticut, and Major Sam Cochran of the Memphis CIT program.

In addition, audio CDs of NAMI convention sessions are available for purchase.  Click here to download the order form. 

Comments or Suggestions?

Please let us know what you think we should include in future editions of CIT in Action by emailing Laura Usher at