On-scene mental health counseling provided through police departments.
The expectation that police officers can address every need in every situation is daunting and unrealistic. Recognizing this, some police departments have instituted special training or used other resources to better serve the needs of citizens. One example is an on-scene crisis counseling unit comprised of volunteer mental health professionals who respond to calls with police officers. These counselors provide mental health services that police officers cannot. This article explains the usefulness of this type of program, and crisis counseling in general, for both officers and victims as they deal with crises like domestic violence, homicide, suicide, and sexual assault. The study examines survey results from victims and police officers about the impact of this intervention. The data support the helpfulness of the program. Implications and recommendations for further research are included.
A typical call for the on-scene crisis counseling unit (the Crisis Team) with the local police department in a Texas city, population over 200,000, is the following: At 1:00 a.m. police officers are dispatched because a young woman called 911 screaming that her mother had just shot herself in her living room. When officers knock on the front door, no one answers, so they ask the dispatcher to call the residence and ask the young woman to open the door. When called, the young woman states she is too frightened to leave her room. At this point, one of the officers asks the dispatcher to page the Crisis Team.
After officers ease the young woman out of her house through her bedroom window, the Crisis Team volunteer helps her calm down by asking simple questions about what transpired. The young woman reports her estranged mother had asked to visit her for the holidays. During the visit, her mother shot herself in the head as she watched.
Over the course of the next hour, the volunteer counsels with her and answers her questions about what the officers are doing in her house and what will happen to her mother's body. The volunteer helps the young woman make a plan for where she will stay, who to call for support, and what she will say to her boss about work. She decides to stay with some friends but needs some items retrieved from her home. The Crisis Team member coordinates with the investigating officers and goes into the living room, steps over the body of the mother, finds her suitcase, meets her in her bedroom, and helps her pack. Before she leaves the home, plans are made for a follow-up call from the Crisis Team volunteer for support.
The importance of the field of crisis intervention is increasing. Recent experiences like the September 11th terrorist attacks and Hurricane Katrina and the increased visibility of home, school, and community violence are the most obvious types of crisis that require psychotherapeutic attention on both personal and community levels (Brown & Rainer, 2006). It is clear that events like terrorist attacks, natural disasters, wars, suicides, large-scale riots, and homicides--and the posttrauma stress symptoms associated with them--present mental health counselors with unique challenges (Dingman, 1995; Dingman & Ginter, 1995).
One approach to helping people in situations like these is crisis intervention (Swanson & Carbon, 1989); it provides emotional aid to victims with specific attention to the circumstances of the presenting problem. Crisis intervention also seeks to mitigate the impact of the stress on the victim (Dykeman, 2005).
The literature about crisis intervention is primarily concerned with reducing anxiety and posttraumatic stress symptoms through critical incident stress debriefing (CISD). CISD is a group crisis intervention technique designed by Mitchell (1983) to ease the acute symptoms of distress associated with psychological crisis and trauma (Everly, Flannery, & Eyler, 2002). CISD was originally a way to allow emergency services personnel who had been exposed to traumatic events to emotionally process the event. Later, CISD was expanded to treat civilian victims of trauma (Pennebaker, 2001). A number of studies produced evidence to support the use of CISD in preventing posttraumatic stress disorder (PTSD) (Campfield & Hills, 2001; Everly & Boyle, 1999; Stapleton, Lating, Kirkhart, & Everly, 2006); other studies concluded that CISD was not effective and may even have adverse effects (Emmerik, van Kamphuis, Hulsbosch, & Emmelkamp, 2002; Gist & Devilly, 2002; Harris, Baloglu, & Stacks, 2002; Raphael, 2000; Small, Lumley, Donohue, Potter, & Waldenstrom, 2000; Wessely, Rose, & Bisson, 1999).
Research on CISD is useful but limited because it mainly deals with group debriefing provided several days to weeks after the traumatic event (Rauch, Hembree, & Foa, 2001). Therefore, it becomes necessary to consider other modes of crisis intervention. Many studies strongly support immediate, acute intervention after traumatic events (Bisson, McFarlane, & Rose, 2000; Everly, Flannery, Eyler, & Mitchell, 2001). For example, Everly et al. (2001) proposed that psychological support is more effective if it occurs quickly at or near the location of the crisis. Similarly, Stein and Eisen (1996) found that early short-term crisis intervention for members of the general population helps prevent the development of PTSD and restore balance. Campfield and Hills (2001) also suggested that early crisis debriefing designed so as to help victims through a normal recovery process helps prevent PTSD. Studies of victims of sexual assault (Marotta, 2000; Resnik, Aciemo, Holmes, Kilpatrick, & Jager, 1999) and armed holdups (Manton & Talbot, 1990; Talbot, 1990) also demonstrated a decrease in PTSD symptoms when psychological intervention occurred quickly.
In some research the findings related to psychological intervention after trauma are inconclusive. Rose and Bisson (1998) reviewed six randomized control trials, all focused on individual debriefing after a variety of traumatic events. Two of the studies yielded evidence that supported the use of debriefing, two demonstrated no effect, and two offered evidence of negative effects. A few studies (Gard & Ruzek, 2006; Litz, Gray, Bryant, & Adler, 2002; McNally, Bryant, & Elhers, 2003) that looked at interventions immediately after crisis have provided evidence that debriefing does not prevent the development of PTSD. Despite the inconclusive and negative findings, an accepted protocol is that psychological intervention should be provided immediately after a trauma and in combination with medical assistance (Burges, 1987; Raphael, 1986; Talbot, 1990).
Psychological first aid (PFA) has been proposed as the main alternative to immediate individual crisis intervention in the hours and even days after a traumatic event. According to Gard and Ruzek (2006) and Ruzek, Brymer, Jacobs, Layne, Vemberg, and Watson (2007), PFA is designed to meet the immediate practical needs of survivors. Elements of PFA are making contact and engaging in conversation with the victim in a helpful manner, providing immediate and continuing safety, stabilizing and calming, gathering information, addressing immediate needs and concerns, connecting with social support systems, providing information on coping, and giving the victim appropriate referral information (Ruzek et al., 2007). Rauch et al. (2001) suggested that psychoeducation (e.g., information about medical intervention, the legal system, and normal reactions to the specific trauma) helps prevent misinterpretation of PTSD symptoms.
A review of the literature pertaining specifically to on-scene counseling units that employ crisis intervention strategies, the focus of the current study, produced limited results. Many of the programs studied focused solely on law enforcement response to mental illness or domestic violence. Though descriptions of specific programs were available, empirical data were scarce (Landeen, Pawlick, Rolfe, Cottee, & Holmes, 2004); moreover, several studies in this area were conducted over 20 years ago. However, regardless of their age the studies on crisis counseling units associated with police departments were reviewed.
An example of such research is that of Deane, Steadman, Borum, Veysey, and Morrissey (1999), who surveyed 195 police departments in U.S. cities with a population over 100,000 and found that 55% (96 departments) had no specialized response to the mentally ill. Of those that did, the specialized programs fell into one of three categories: police-based specialized police response, police-based mental health response, and mental health-based mental health response. A police-based specialized police response used specially trained officers to respond to calls involving the mentally ill and served as a liaison with the mental health community. This type of program was the rarest. A police-based mental health response relied on mental health consultants that officers contacted by telephone. The most common type of program, mental health-based mental health response, utilized mobile mental health units (crisis teams) on-scene; 82% of departments with mobile crisis teams rated themselves as moderate to very effective in their response to the mentally ill, compared to only 50% of the programs with a police-based mental health response.
Patterson (2004) examined the work of a police-social work crisis team in a midsize law enforcement agency in the northeastern United States. In this program, crisis team duties were described as providing assessment, crisis intervention, short-term counseling, and referrals. Additional services included mediation, transportation, consultation with social services agencies, providing case status information, acting as a liaison between the police department and the mental health community, and follow-up contact with victims and agencies. Typical calls to which this crisis team responded included domestic violence, homelessness, runaways, mental health and medical needs, landlord-tenant and neighbor conflicts, alcohol and substance abuse, and helping officers to interview sexual assault victims. This team also provided crisis counseling in such situations as homicide, suicide, fatal traffic accidents, construction accidents, and robberies. Consistent with these typical crisis team duties, Thomas (1994) identified the five situations where crisis teams were most likely to be used, in order of frequency, as mental illness, domestic violence (see also Scott, 2000), child abuse, juvenile offenders, and community policing programs.
More recently, Corcoran and Allen (2005) created and implemented a crisis team specifically for domestic violence cases. Each team consisted of one crisis intervention volunteer and a uniformed detective from the police Family Violence Unit. The volunteers represented fields such as counseling, social work, and psychology. They were required to complete specific training on domestic violence and ride along once with a police officer for additional experience. Crisis intervention services included encouraging victims to ventilate feelings, educating victims about the criminal justice system, providing information on family violence, and giving referrals for social and legal services. The study examined not only crisis team involvement in domestic violence situations but also likelihood of arrest and cooperation of victims with law enforcement. Arrests were found to be more likely when the crisis team was involved, although victims were less likely to cooperate with law enforcement. The authors stated that lack of cooperation is common because many victims do not like to see loved ones arrested. They concluded that combining law enforcement and social service agencies is promising, but more research is needed on how best to serve victims of domestic violence.
A program similar to the one presented here is the Erie Family Intervention Program (EFIP) started in 1976. EFIP was set up as a social work-mental health component independent of the mental health community to better adapt to the needs of the police department. The program operated 24 hours a day, 7 days a week, and was prepared to respond to a crisis whenever police felt it would be helpful. The crisis team consisted of volunteers from a wide variety of backgrounds, including college students in the behavioral sciences departments of surrounding universities. The main purpose was to reduce the amount of time police spent in dealing with domestic calls and the program was limited to domestic violence intervention (Henderson, 1976).
Finally, a crisis team assembled in 1975 in Tucson, Arizona, worked with law enforcement in crisis situations. The crisis team patrolled each night from 6:00 p.m. to 3:00 a.m. in a marked patrol car equipped with a police radio. The team assumed control on-scene to allow officers to return to service once they concluded law enforcement duties. The purpose of the program was to give battered women immediate crisis counseling, referral information, and access to community resources (Horton & Williamson, 1988).
None of the articles discussed provided data on the helpfulness of these programs. An exception is a study by Carr (1982), who surveyed families that received services from the Pawtucket, Rhode Island, Police Department's crisis team (comprised of a police officer and a victim assistance team member) and found that 79% of the participants described the services as helpful. Unfortunately, this research, conducted 25 years ago, has not been replicated.
In this study we seek to add to the body of literature and to understand the helpfulness of a mental health-based response to those in crisis that is not limited to addressing mental illness or domestic violence. We examined both police officer and victim perceptions of the helpfulness of a mental health-based response program by reviewing the utilization rates of the program and surveying victims and police officers.
PURPOSE OF THE STUDY
This study had three goals:
1. Understand police officer and victim perceptions of the Crisis Team's helpfulness.
2. Determine how often the Crisis Team was utilized and in what situations.
3. Identify the demographics of those who serve as volunteers on the Crisis Team and those served by the team.
BACKGROUND ON THE CRISIS TEAM PROGRAM
The Crisis Team program at this police department began in July 2000; its primary goal was to resolve domestic disputes, especially in situations where officers have been called repeatedly. Other goals were to reduce the incidence of domestic violence, free officers to perform duties for which they were better trained, provide support to victims, stabilize volatile situations, and provide referral information. Over time, due to the needs of victims, the team responded to a wider variety of crises that included sexual assault, suicide intervention, traffic fatalities, grief support, and homicide.
Mental health professionals were recruited from the community to volunteer for the Crisis Team. The current policies and procedures manual for the program states that crisis team volunteers are responsible for providing "crisis intervention, judicial advocacy, and information and referral services" (Lubbock Police Department, 2000, p. 4). Volunteers are responsible for determining if those with whom they come in contact are a danger to themselves or others and taking appropriate action, which may entail coordinating with officers or initiating a medical response via police radio. Volunteers are also required to assess all at-risk individuals (e.g., children, the elderly, the disabled) to assure safety and support and to contact agencies (e.g., child or adult protective services) as required by law. Other roles outlined in the manual are to explain victim rights and victim compensation, provide information on typical psychological reactions, explain and help petition for an Emergency Protective Order, assist in contacting sources of social support, protect victims from the media, and coordinate with law enforcement (e.g., giving statements to detectives, supplying officers with information about a crime, acting as liaison between victims and officers, or giving information about jail release dates and times).
The departmental policies and procedures manual also outlines on-scene duties and protocols, such as notifying the officer of the volunteer's presence, responding to the officer's requests for assistance, consulting with an officer before initiating any contact with a victim, protecting the crime scene, explaining to the victim who the volunteer is and what his or her duties are (e.g., provide support, give victims a chance to psychologically process their experiences, develop a plan for dealing with the crisis, provide referral information, explain the investigative, judicial, or medical system), and providing transportation for the victim (e.g., to Women's Protective Services).
The Crisis Team studied operates in a city whose population in 2000 was 199,564, of which 61% were Caucasian, 28% Hispanic, and 9% Black; and 51% were female and 49% male. (U.S. Census, 2000). Currently, the police force has more than 400 officers and averages about 130,000 calls for service each year.
Crisis Team volunteers (N = 61 for the period studied) were predominantly Caucasian (85%) and female (80%); 13% were Hispanic and 2% Black. According to the application information available, 57% had a bachelor's degree in a mental-health-related field, 38% had a master's degree (usually in counseling), and 5% had a doctorate; 54% had a background in psychology, and 18% had a background in social work. Other backgrounds included family studies and pastoral care.
CRISIS TEAM CALLS AND DUTIES
The Crisis Team patrolled the city every Friday and Saturday night from 7:00 p.m. until 2:00 a.m. Each volunteer was asked to work at least once a month. Working in pairs they patrolled the city in unmarked police cars, responding to officer requests for assistance within 15 minutes, anywhere within the city limits. An in-car computer allowed volunteers to access information about every call to which officers were responding and self-initiate a response if they could determine that the scene was safe and the situation might benefit from the presence of a mental health professional. Officers could also request Crisis Team involvement at other times by paging the coordinator, who assembled volunteers to respond.
The Crisis Team averaged 118 calls a year from July 4, 2000, to December 31, 2007 (N = 768). The majority of calls (82.7%) occurred on Friday and Saturday, the other 17.3% occurred through paging. The Crisis Team responded to
* domestic disturbances and domestic violence calls (29.3%)
* completed suicides, attempted suicides, and suicidal ideation (13%)
* murders, death investigations, and child deaths (11%)
* traffic accidents/traffic fatalities (6%)
* sexual assault calls (4.3%) (there is also a specialized agency officers call to respond to sexual assaults)
* child/elderly abuse, mental illness, burglaries/robberies/shoplifting, and missing persons/kidnappings/runaways (3% each)
* nondomestic assault, chemically dependent subjects, and assisting officers involved in lethal force incidents (1%).
Other calls included assisting the homeless, house fires, child care after service of a drug warrant, a boating accident fatality, and a construction accident fatality. In about 5% of cases, drug or alcohol use or suicide ideation was a factor. Victims consented to a follow-up phone call or visit 32.4% of the time.
From July 2000 through December 2007, the police department utilized volunteers in a variety of situations and with increasing frequency, particularly in four areas. The Crisis Team did not respond to any murders from 2000 to 2003 but by 2007 had responded to 7. The team did not respond to any death investigations from 2000 to 2002 but was used in 17 cases in 2007. It responded to 2 incidences of sexual assault for 2000-2003 and 23 for 2004-2007. After responding to only 2 traffic fatalities before 2006, the team responded to 11 that year. Statistics about suicides were not available for any year before 2006, but in 2006 the Crisis Team responded to all 9 completed suicides to meet with surviving family or witnesses and in 2007 to 11 of the 16 completed suicides.
The largest increase in Crisis Team call volume occurred between 2002 (N = 53) and 2005 (N = 121) for a 128% increase; Police Department calls for the same period increased only 5% (from 123,598 in 2002 to 130,347 in 2005). But from 2005 through 2007, police department calls decreased 2% (from 130,347 to 128,441) and Crisis Team calls decreased 11% (from 121 to 108).
An analysis of all information on Crisis Team calls (N = 768) clarified how volunteers typically performed on-scene. The most common action performed was crisis counseling, which occurred in 68% of all calls. Giving referral, parenting, and Emergency Protective Order information, a Victim's Rights booklet, or other handouts occurred in 45.7% of calls. Volunteers also provided support to victims (12.5%), assisted and consulted with police officers (10%), helped family members (10%), supervised victims and provided child care (10%), and transported victims and family members (8%). Among other actions taken were retrieving items from a residence during a death investigation, helping officers search for a victim, and assessing victims. Usually more than one action was performed during the course of a call.
Finally, data were collected on when police officers left a scene and when Crisis Team volunteers left it. Police officers returned to service before the Crisis Team on 25% of the calls; it appears the team freed officers to respond to other calls for service.
POLICE OFFICER SURVEY
Police officers were surveyed to gather demographic information about officers, determine how often and in what capacity they used the Crisis Team, and learn their perception of how helpful volunteers were to both officer and victim. Four questions asked officers to fill in the blank or check a box regarding demographic data (age, rank, years as a police officer, and to which shift/unit the officer was assigned). Officers were also asked to check "yes" or "no" whether the officer had ever requested the Crisis Team at a call. Next came a fill-in-the-blank question about how many times officers requested the Crisis Team.
To gather information on officer perceptions of the Crisis Team volunteers, an item stated: "When the Crisis Team responded, I would characterize them as (check all that apply): helpful to me, helpful to the victim(s), courteous and professional, in the way/not helpful, not courteous or not professional, other." The "other" option allowed the officer to add a short response. Officers were also asked: "Do you think we should keep the Crisis Team?" This question was followed by a ranking question: "The purpose of the Crisis Team is to 1) assist officers, 2) get officers back in service when there is no criminal activity, 3) assist victims and their families. How well are they fulfilling their purpose?" To rank the Crisis Team's performance on each purpose, the officers chose: "above and beyond, very well, adequate, fair, [or] poorly." The final question was open-ended: "Is there anything else you can say about the Crisis Team, its mission, its personnel, etc.?"
All Crisis Team calls (N = 768) were reviewed to find which officers were most likely to have used the Crisis Team. These were identified as officers from Patrol, Person Crimes, Juvenile, and Special Operations. A cover letter that explained the purpose of the survey and that participation was voluntary was approved by a supervisor from the police department administration, attached to the survey (both were approved by our University's Institutional Review Board), and then handed out at each Patrol briefing and to each detective in the Person Crimes, Juvenile, and Special Operations divisions on December 1, 2005. Completed questionnaires were gathered from the drop box at the police station on January 9, 2006, and kept in a locked file cabinet off-site.
There were approximately 285 officers, supervisors, and commanders in the Patrol, Person Crimes, Juvenile, and Special Operations divisions at the beginning of 2006. Of these, 91 completed the survey (a response rate of 32%), and 73 reported using the Crisis Team on at least one call. Only those who reported using the Crisis Team were included in the sample (N = 73); 79% reported using the Crisis Team more than once. The Patrol Division, which used the Crisis Team most often, represented 88% of the sample. Detectives from the Person Crimes section comprised 10% of the sample, and the remaining 2% came from officers who did not report their division.
The age range of officers who reported their age (N = 72) was from 21 to 57 years, with a mean of 32.89 years (SD = 8.27). Sixty seven percent were patrolmen, 16% corporals, 12% sergeants, 1% lieutenants, 1% captains, and 1% did not report their rank. Years of law enforcement experience ranged from less than one up to 34 (M = 8.7, SD = 7.33).
Ninety three percent of officers stated the department should keep the Crisis Team program; the other 7% left this question blank. In the space provided on the survey, responding officers stated that volunteers were able to deal directly with traumatized family members, free officers to conduct investigations, have extensive patience, have resources available for victims, are an asset that is overlooked at times, and victims are more receptive to someone not in uniform. Officers also stated volunteers should be given some type of compensation, work later hours, and work more days of the week.
The purpose of the victim survey was to gather demographic information about those served by the Crisis Team, learn about their perception of the program and the volunteers, and gain a general understanding of its helpfulness. Three questions asked respondents to check boxes regarding demographic data (age, gender, and race). One asked them to check the box that best described the crisis they experienced. This was followed by the question: "How helpful was the Victim Services Unit to you?" with a ranking option from zero to ten. Zero corresponded to "not helpful," five to "average," and ten to "extremely helpful." The respondents were then asked to circle "yes," "no," or "do not remember" when asked: "Did you receive a follow-up call?" The ranking option on helpfulness was again provided.
We also asked respondents: "How would you describe the people who responded to your crisis?" and then provided a list of descriptors for them to check. This was followed by the question: "How else could they have been helpful to you or what could be improved?" Finally, we asked: "Do you have a need that requires the Victim Services Unit to contact you again? If so, what is the best way for them to contact you?"
We reviewed all Crisis Team reports to produce a list of names and addresses of victims served. To each address we mailed a cover letter, questionnaire, and self-addressed stamped return envelope, all of which were approved by our University's Institutional Review Board. The cover letter explained the purpose of the survey (to gather opinions about the Crisis Team program) and how confidentiality would be ensured (no identifying information was included with the information returned). The primary researcher's name and phone number were included in case of any questions or concerns. Questionnaires were returned to the primary researcher by mail.
In 2007, 190 questionnaires were mailed to victims served by the Crisis Team (2003-06) for whom addresses were accessible; of these 97 were returned because the victim no longer lived at the address reported, and 25 completed questionnaires were analyzed, representing a response rate of 27% for surveys sent to correct addresses.
The age of the respondents ranged from 15 to 71 (M = 42.5, SD = 17.94); 18 were female (72%), 5 male (20%), and 2 did not report their gender (8%); 15 were Caucasian (60%), 6 Hispanic (24%), and 4 did not report race (16%).
A death investigation was the crisis most frequently experienced by respondents (32%); three of the eight deaths were children. Seven cases were suicide (28%), three were domestic disputes (12%), two were sexual assaults (8%), and two were traffic accidents (8%). One respondent experienced an assault (4%) and one a robbery (4%). The last respondent checked the option "other," but did not indicate what the crisis was. Nineteen respondents (76%) reported receiving a follow-up call or visit, two stated they did not receive a call or visit (8%), and four stated they could not remember (16%).
HELPFULNESS OF THE CRISIS TEAM
Common factors across both the officer (n=73) and victim surveys (n=25) were perceptions of the Crisis Team program and its volunteers, and how helpful the program was to officers and victims. Victims were asked to rank their perception of the overall helpfulness of the Crisis Team intervention at the time of the crisis and at the time of the follow-up call. On a scale from zero to ten, only one person stated the intervention was not helpful. The rest (96%) indicated a level of helpfulness from average (5) to extremely helpful (10). A mean of 8.2 (SD = 2.41) indicated a level of helpfulness well above average.
One victim indicated the follow-up call was not helpful; the rest (96%) again indicated a level of helpfulness from average (5) to extremely helpful (10). Participant ratings of the helpfulness of the follow-up calls was again well above average, with a mean of 8.1 (SD = 2.49).
The victim survey also asked respondents to choose from a checklist of adjectives to describe the Crisis Team volunteer. This checklist of positive and negative descriptors was also used to assess victim perceptions of Crisis Team helpfulness. Twenty-two respondents (88%) checked both "concerned" and "caring," 84% chose "supported my feelings," 80% indicated "supportive," 72% chose "focused," 68% marked "helped me talk about what happened," and 64% indicated both "knew what was going on" and "made the situation easier to handle." Seven other positive descriptors were each chosen once. On the negative descriptors checklist, 12% indicated the Crisis Team volunteer "made me feel stupid," and 8% marked both "didn't address my needs" and "awkward." Eight other negative descriptors were checked by one respondent each.
Victims wrote a number of narrative responses. Examples were: "I think everything was handled in a professional manner," "they were excellent, but of course couldn't fix what was wrong," "they took very good care of my needs," "through all the sadness and grief I remember the group being so supportive, even with my son's friends," "I feel they were very helpful to me in my situation and helped me understand what was going on and were very caring to me as well as my family," and "I had someone to sit on the curb with outside of my house, otherwise I would have been alone while they were putting my dad's body in the van."
The officer survey also provided a checklist for ranking the helpfulness of the Crisis Team, with rankings ranging from 1 to 5. Seventy four percent of officers (N=73) indicated that the Crisis Team was "helpful to me"; 95% indicated that the Crisis Team was "helpful to the victim(s)"; and 93% stated the Crisis Team volunteer on their call was "courteous and professional." No negative feedback was given, though the checklist provided an opportunity to do so.
Officers (N=73) were asked to rank how well the Crisis Team fulfilled its purpose of assisting victims and officers. No officer ranked the team "poor" (1); 1% ranked it "fair" (2), 4% "adequate" (3), 41% "very well" (4), 48% "above and beyond" (5), and 6% did not answer the question. The mean was 4.2 (SD = 1.2). No officers ranked the team "poor" (1) or "fair" (2) when reporting the team's ability to assist officers; 14% ranked it "adequate" (3), 60% "very well" (4), 23% "above and beyond" (5), and 3% did not answer this question. The mean was 4.0 (SD = 0.91).
IMPLICATIONS AND CONCLUSIONS
Although information about crisis team programs is available, empirical research about mental-health-based response teams is rare. By examining program goals, utilization statistics, and surveys of police officers and victims, we can draw some conclusions about the helpfulness of this Crisis Team. The data suggest that the program goal of providing necessary assistance to victims, stabilizing volatile situations, and providing referral information was addressed. This is supported by the information on the actions Crisis Team volunteers commonly performed on-scene (e.g., counseling, providing support, providing information, etc.) and in the data gathered by the victim survey (e.g., volunteers were perceived as concerned, caring, and helpful). However, the goal of reducing the incidence of repeated response to the same domestic disputes by police officers could not be measured given the data available. That the team met the intended goal of freeing officers to perform the duties for which they were trained is supported by the data on the number of times officers returned to duty before the Crisis Team left the scene (25%).
There was a trend towards utilization of the Crisis Team beyond its original intention (addressing domestic disputes) and beyond the typical use of crisis teams for addressing the needs of the mentally ill. For example, only 29.3% of calls were for domestic disputes and domestic violence, and apparently only 3% involved mentally ill subjects. Moreover, according to data from the Victim Survey, only 12% were calls for domestic disputes and there were no calls labeled as involving mental illness.
The perceptions of helpfulness gathered through the officer and victim surveys support the conclusion that this program has value and its volunteers perform their duties well. The narrative information from victim and police officer surveys suggest the program is helpful. The results obtained through the officer survey are of particular interest. For instance, although the police culture is typically suspect of others from outside law enforcement and many officers do not value the mental health community (Patterson, 2004), the officers answering this survey seem to have positive perceptions of the mental health community.
The interdisciplinary nature of this corps of volunteers may affect perceptions of helpfulness. A program that draws from all levels of education and professional backgrounds may be the best way to provide services in a wide variety of crisis situations. This is consistent with the interdisciplinary application that Dykeman (2005) described, but in this study the program had a broader job description than in Dykeman's. The background, training, and contribution offered by someone with a social work background may be quite different from that offered by someone with a psychology background. The fact that volunteers in this program work in pairs increases the likelihood that a victim can draw on multiple disciplines.
The demographic information collected on the city, the Crisis Team volunteers, and the Victim Survey is also worth consideration. Although the population of the city is almost evenly split between male and female, the majority of volunteers (80%) and victims (72%) served by the Crisis Team were female. The high number of female victims may be influenced by the higher rates of domestic violence and sexual assault for females. The number of Black Crisis Team volunteers (2%) and the Black population of the city (9%) are similar, but the Black population was not represented in the victim survey. The Hispanic population, compared to the demographics of the city (28%), was well represented on the victim survey (24%) but not among the Crisis Team volunteers (13%). Future research should examine how specific racial groups could be better served by a crisis team program and the benefits of a racially diverse corps of volunteers.
The intervention provided by the Crisis Team was consistent with the PFA model (Gard & Ruzek, 2006; Ruzek et al., 2007) and may help explain the helpfulness of this program. The team's duties respond to the recommendations by various authors that a psychological response occur as quickly as possible (Bisson, McFarlane, & Rose, 2000; Horton & Williamson, 1988; Manton & Talbot, 1990); be in close proximity to the event (Everly et al, 2001; Horton & Williamson, 1988); and offer a positive environment with comfort and consolation (Manton & Talbot, 1990). According to a few authors (Campfield & Hills, 2001; Talbot, 1990; Stein & Eisen, 1996), the PFA method of crisis intervention helps prevent PTSD by assisting the victim in properly and rationally interpreting the traumatic experience. Furthermore, crisis intervention that properly interprets PTSD symptoms (e.g., common physiological reactions to uncommon events) will also decrease the hypervigilance and avoidance components of PTSD. This is accomplished primarily through on-scene psychoeducation (see also Rauch et al., 2001), which is a component of this Crisis Team's work with victims.
Recommendations that the crisis counseling intervention be psychoeducational and normalize reactions to traumatic events (Rauch et al., 2001), give goal orientation and reality support, offer an opportunity for victims to ventilate feelings and tell of the events that occurred, connect the victim with social support, and provide long-term support (in this case through follow-up calls) (Raphael, 1986) are also common practices for this Crisis Team. Educating victims about the criminal justice system, providing information on family violence, and giving referrals for social and legal services (Corcoran & Allen, 2005; Gard & Ruzek, 2006; Horton & Williamson, 1988) occurred on a number of Crisis Team calls. Even the recommendation of providing transportation (Horton & Williamson, 1988) occurred in cases of domestic dispute and sexual assault calls. Future research should focus on the efficacy of these practices.
Future research would be strengthened by a more rigorous examination of the specific interventions employed on-scene and differences between the interventions of professionals from different disciplines. Research that finds a way to measure psychological outcomes would also be of value. For instance, a comparison of PTSD symptoms among victims served by the Crisis Team with victims served only by the police department (controlling for the type of crisis) could also advance understanding of the helpfulness of these types of programs.
Negative findings about this program were gathered through the police officer and victim survey. The victim survey checklist indicated that some victims felt stupid or felt their needs were not addressed, and one victim checked eight negative descriptors of the Crisis Team. The helpfulness rating of the Crisis Team also indicated the need for improvement, with one respondent indicating that the response was not helpful. Additionally, one officer indicated the Crisis Team did only a "fair" job of assisting victims.
There are limitations to this research, chief among them the small number of survey participants. Although the Crisis Team responded to 768 calls for service, it received feedback from only 25 victims, just 3% of the potential sample. Clearly, these results cannot be generalized to larger groups. Unfortunately, a dynamic associated with some crisis situations is the need to relocate, making it difficult to contact victims. More participation from the officers who have used this program would also strengthen future research.
The lack of psychometric data on the surveys themselves is another limitation. Currently there are no surveys available for use in gathering data related to this type of crisis response. Future research on the reliability and validity of the measures employed in gathering data from officers and victims is recommended.
Another limitation is the lack of information on the volunteers themselves. Differences in how volunteers conduct themselves on-scene may be an important variable; volunteer ability, personality, or experience could greatly affect any research outcome and should be a component of future research.
Despite this study's limitations, it provides some support for the helpfulness of on-scene crisis counseling programs integrated with police departments. Both officers and victims seemed to benefit from the immediate assistance and support provided by these mental health professionals. Mental health assistance in the darkest of circumstances may aid victims in their coping and recovery.
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Andrew T. Young, Jill Fuller, and Briana Riley are affiliated with the Department of Behavioral Sciences at Lubbock Christian University. Correspondence concerning this article should be addressed to Andrew T. Young, Department of Behavioral Sciences, Lubbock Christian University, 5601 19th St., Lubbock, TX 79407. E-mail: email@example.com.