Sometimes Upstream Interventions Are Needed

In some of the webinars we have been doing for the Network of Jewish Human Service Agencies and in our individual discussions with groups across the country, we have been discussing not just how to build new programs and services, but also other interventions that may better enable those programs and services.  Sometimes it is hard to pull ourselves out of the day-to-day work and take a macro look at the social landscape in which we are building.

In Memphis, we had a challenging time keeping up with the number of persons suffering from mental illness then ending up in jail.  In jail it is extremely difficult to serve this population, especially since they spend 3-5 times longer in jail, than those who don’t have a mental illness.

In 1987, police were called together to an area of public housing where a young man who had a history of mental illness was threatening others with a knife.  He was shot several times after he refused to obey orders to put the knife down.  He was black and the police officers were white.  Sound familiar?  This was an eye-opening moment for the Memphis community where we saw groups come together to begin strategizing better solutions.  Led by the Mayor of Memphis who reached out to the National Alliance on Mental Illness and others, a task force was created.  What emerged from this initial task force was the Memphis Police Department Crisis Intervention Team (CIT) that would become known nationwide in later years as the Memphis Model. The originators of CIT combined several insights that revolutionized how individuals with mental illness in crisis would be approached by police officers and effectively routed to appropriate mental health care facilities rather than jail.

To handle these specialized duties, CIT officers would receive training in selected topics including mental health diagnoses, psychiatric medications, and issues of drug abuse and dependence. The officers would be trained in mental health law and cross-cultural sensitivity. Officers would spend time with individuals who experienced mental illness to learn first-hand of challenges of the illness. Most importantly, the officers would receive intensive training in verbal de-escalation skills with consistent attention to officer safety throughout all components of the CIT training.  In addition to the training, a volunteer faculty model was created to manage and administer the work, and as a result this became an effective means of jail diversion allowing those nonprofits in the trenches a better chance to provide the support that is needed.

It sounds so simple, but we still today we struggle with this as a country. The Memphis CIT Program has now been modeled by 2700+ other communities across the country.  For those of you who work with the mentally ill, this will obviously resonate with you, and those who do not you can still see how working upstream to your agency’s core work can make a huge difference on your value delivery system.

Think about:

  • Where can you intervene upstream that improves your chances of success?
  • Who would you need to partner with?
  • What are the mechanics of creating a system like this?
  • Where could resources come from?
  • Do you have to wait for a tragic event to take place before action happens?

In our work to address so many challenges within Jewish Poverty, we must assess the social landscape by assessing the actors in the community and how they deliver value.  In the case of Memphis CIT, they found a critical tipping point that they knew, if addressed, would benefit all actors.  This can be done through an intense discovery process that not just evaluates the nonprofits, but also is centered on the client journey and experience.

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