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Commentary: Is CIT Today's Lobotomy?

Dr. Geller is Professor of Psychiatry, Department of Psychiatry, University of Massachusetts Medical School, Worcester, MA. Address correspondence to: Jeffrey L. Geller, MD, MPH, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, MA 01655. E-mail: jeffrey.geller{at}umassmed.edu

Birthed in Memphis, Tennessee, in 1988, Crisis Intervention Teams (CITs) have had remarkable growth spurts with few, if any, developmental milestones to document their progress. Compton and colleagues investigated the evidence basis for CIT and found very little. They perhaps found even more than there actually is. There are contributions to CIT outcomes that are rooted in local variations in mental health services and regional culture. These are considered in this commentary, using Memphis as the example. None of us should be surprised that reform is evidence-absent. The mental illness delivery system and the criminal justice system have been instituting reform, and these reforms have had reverberating changes between the two systems, with little or no data to support the changes, for centuries. That there would be unexpected consequences should be obvious. But apparently not so evident that we don't continue to take one blind step after another. Is CIT on firm footing, or just another fool's journey?

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