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Law enforcement officers (LEOs) may play the most important role in directing people in mental health crises into treatment versus incarceration. While most military veterans will never experience a crisis interaction with LEOs, they represent an important at-risk target group for whom to enhance LEO response. The evidence supporting LEO crisis training models includes important limitations that stem from jurisdiction-limited studies, and emphasize LEOs who volunteer for mental health training. The current study reports the primary outcomes of a national (U.S.) large-scale mandated train-the-trainer program to enhance VA LEO response to military veterans with mental health issues. Multidisciplinary teams comprised of VA LEOs, Veterans Justice Outreach Specialists, and mental health professionals (n = 245) were trained in two nested waves. Both trainers and endpoint LEOs (n = 1,284) improved from pretest to posttest on knowledge and skills in identifying psychological services and related treatment referral resources and cross-discipline collaboration, the latter of which showed some retention at 3-month follow-up. The findings support the potential for LEOs mandated to training to improve in important prerequisites to diverting people with mental health issues into care, and away from the criminal justice system. Such results may require professional trainers of LEOs who have themselves received relevant specific training. Potential cautions of such an approach, including inter-team differences and potential for publication bias in extant literature, are also elucidated by the current methodology. The links to all of the collaboratively-developed curriculum materials from the current study are provided for use by qualified professionals. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

This study evaluated the prevalence and types of criminal arrest among 99,512 male veterans in substance use disorder (SUD) treatment across 150 VA facilities from 1998 to 2001. Participants were assessed with the Addiction Severity Index (ASI), which includes detailed information about lifetime criminal activity. A majority of the patients (58.2%) had three or more previous arrests, with 46.0% reporting one or more criminal convictions. Criminal arrests were frequent and varied. A majority of patients (69.3%) had at least one arrest that was not due to drug possession, drug sale, or intoxication. Nearly 24% reported at least one arrest for a violent crime. Patterns of arrest for specific crimes varied across SUD diagnostic categories. Screening for specific types of offending is informative and viable. Existing VA SUD treatment is a potentially underrecognized point of intervention for justice involvement among veterans.

When crisis situations involving veterans occur, responding police officers find themselves playing an important role in the spectrum of health and mental health services for those veterans. Crisis response training can help officers respond in a manner that increases safety and optimizes outcomes for all people involved. Yet, current crisis response police training models are only accessible to select officers. Nor do they emphasize the unique challenges and strengths that impact veterans who experience acute symptoms of mental illness. In the current study, we report the results from the first generation of training, collaboratively designed to enhance officers' (a) knowledge of relevant topics, including posttraumatic stress disorder and traumatic brain injury, (b) attitudes about veterans, and (c) and skills helpful in identifying and deescalating veterans and referring them to treatment. Officers completed in-class evaluations (N = 314), and a subsample (n = 53) completed 3-month follow-up evaluations. Pre- versus posttest comparisons indicated significant improvements in total score, and individually in knowledge, attitudes, and skills. Consistent with previous literature, the specific in-class gains were not retained on follow-up. However, responding officers widely endorsed use of de-escalation techniques during, and a positive impact of the training on, their interactions with veterans in the 3 months following the training. Implications for future training and policy are discussed.