Mental Health Crisis Training for Police, Firefighters, and Public Health Staff

Evaluating Mental Health Crisis Training Outcomes Among Police, Firefighters, and Public Health Staff

This study evaluated whether a mental health crisis response training course improved the knowledge, confidence, and attitudes of police officers, firefighters, emergency medical personnel, and public health staff who may encounter people experiencing mental health or substance use crises.

Participants attended a four-hour training course covering mental health laws, recognition and assessment of behavioral emergencies, crisis identification, the escalation of violent behavior, communication, and de-escalation techniques. Participants voluntarily completed an online questionnaire immediately before and after the course.

The study compared participants' responses before and after training to determine whether the course improved their understanding of mental health crises, confidence in responding to these situations, and attitudes toward people with mental health conditions or substance use problems.

Study Overview

• Status: Completed
• Conditions: Mental Health Crisis
• Intervention / Treatment: Behavioral: Mental Health Crisis Response Training

Detailed Description

This was an observational, single-group pre-post study conducted among personnel attending a mental health crisis response training program organized in New Taipei City, Taiwan. Eligible attendees included police officers, firefighters, emergency medical personnel, public health personnel, and other frontline staff involved in responding to mental health or behavioral emergencies. Participation in the research questionnaires was voluntary and was separate from participation in the training course. The study did not assign participants to receive the training or to a comparison group.

Before the course, participants who agreed to participate scanned a QR code and completed an online 32-item questionnaire. The questionnaire assessed knowledge and understanding of mental health crises, perceived confidence and self-efficacy in responding to behavioral emergencies, attitudes toward people with mental health conditions, and attitudes toward people with substance use problems.

The four-hour course included mental health legislation, initial and secondary assessment of behavioral emergencies, identification of mental health crises, recognition of the escalation of potentially violent behavior, personal and scene safety, communication strategies, and verbal de-escalation techniques. Immediately after completing the course, participants completed the corresponding online post-training questionnaire.

No personally identifying information was collected. Pre-training and post-training responses were compared to evaluate changes associated with participation in the course. Analyses included descriptive statistics and appropriate comparisons of pre-training and post-training measures according to the distribution and measurement level of each variable. Additional analyses examined whether participant characteristics were associated with training outcomes.

• Study Type: Observational
• Enrollment (Actual): 714

Contacts and Locations

Study Locations

• Taiwan
  • New Taipei City, Taiwan, 220
    • Far Eastern Memorinal Hospital

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Child; Adult; Older Adult
• Accepts Healthy Volunteers: Yes

• Sampling Method: Non-Probability Sample

Study Population

The study population consisted of police officers, firefighters, emergency medical personnel, mental health personnel, public health personnel, and other frontline staff who attended a four-hour mental health crisis response training program in New Taipei City, Taiwan. Course attendees were invited to voluntarily complete online questionnaires immediately before and after the training. Participation in the research questionnaires was voluntary and was not required for attendance at the training course.

Description

Inclusion Criteria:

• Police officers, firefighters, emergency medical personnel, mental health personnel, public health personnel, or other frontline staff attending the mental health crisis response training program organized in New Taipei City.
• Willing to participate voluntarily after reading the questionnaire information and participant rights statement.
• Willing to complete the online study questionnaire before and/or immediately after the training course.

Exclusion Criteria:

- No protocol-specified exclusion criteria.

Study Plan

How is the study designed?

Number of groups / cohorts

1

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
Mental Health Crisis Training Participants; Police officers, firefighters, emergency medical personnel, public health personnel, and other frontline staff who attended a four-hour mental health crisis response training course and voluntarily completed online questionnaires immediately before and after the course.	Behavioral: Mental Health Crisis Response Training; A four-hour instructor-led training course covering mental health legislation, initial and secondary assessment of behavioral emergencies, recognition of mental health crises, escalation of potentially violent behavior, personal and scene safety, communication strategies, and verbal de-escalation techniques.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change in Self-Efficacy for Managing Mental Health Crises and Behavioral Emergencies	Self-efficacy was assessed using the mean score of eight items from the study-specific questionnaire (items 6-13). Each item was rated on a 5-point confidence scale. The overall mean score ranged from 1 to 5, with higher scores indicating greater confidence in recognizing, assessing, communicating with, and responding to individuals experiencing mental health crises or behavioral emergencies. Change was calculated as the post-training mean score minus the pre-training mean score.	Immediately before the training session and immediately after completion of the 4-hour training session

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change in Cognition Toward Behavioral Emergencies	Cognition toward behavioral emergencies was assessed using the mean score of six items from the study-specific questionnaire (items 15-20). Each item was rated on a 5-point agreement scale. Item 20 was reverse-coded because agreement with routine use of force represented less favorable cognition. The mean score ranged from 1 to 5, with higher scores indicating more favorable understanding and attitudes regarding behavioral emergency response. Change was calculated as the post-training score minus the pre-training score.	Immediately before the training session and immediately after completion of the 4-hour training session
Change in Stigma Toward People Experiencing Behavioral Emergencies	Stigma toward people experiencing behavioral emergencies was assessed using the mean score of six dichotomous items from the study-specific questionnaire (items 21-26). Positive recovery-oriented or interaction-related items were reverse-coded so that higher scores consistently represented greater stigma. The mean score ranged from 0 to 1, with higher scores indicating greater stigma. Change was calculated as the post-training score minus the pre-training score; a negative change indicated reduced stigma.	Immediately before the training session and immediately after completion of the 4-hour training session
Change in Stigma Toward People With Substance Use Problems	Stigma toward people with substance use problems was assessed using the mean score of six dichotomous items from the study-specific questionnaire (items 27-32). Positive recovery-oriented or interaction-related items were reverse-coded so that higher scores consistently represented greater stigma. The mean score ranged from 0 to 1, with higher scores indicating greater stigma. Change was calculated as the post-training score minus the pre-training score; a negative change indicated reduced stigma.	Immediately before the training session and immediately after completion of the 4-hour training session
Post-Training Satisfaction With the Mental Health Crisis Response Training	Training satisfaction was assessed using five items from the post-training questionnaire (items 33-37). Items evaluated the perceived usefulness of the course for participants' work, satisfaction with the instructor and course content, usefulness of practical exercises, course flow, and overall course satisfaction. Each item was rated on a 5-point Likert scale ranging from 1 to 5. The mean satisfaction score ranged from 1 to 5, with higher scores indicating greater satisfaction with the training course.	Immediately after completion of the 4-hour training session

Collaborators and Investigators

• Sponsor: Far Eastern Memorial Hospital

Publications and helpful links

General Publications

• McCloskey RJ, Ulintz AJ, Hammond GC, Brown JL, Parrish M, Toliver I. Post-Opioid Overdose Response Team Intervention Barriers and Facilitators to Substance Use Treatment: Perspectives of Patients and Team Members. Prehosp Emerg Care. 2025;29(4):491-500. doi: 10.1080/10903127.2025.2479569. Epub 2025 Apr 7.
• Rogers MS, McNiel DE, Binder RL. Effectiveness of Police Crisis Intervention Training Programs. J Am Acad Psychiatry Law. 2019 Dec;47(4):414-421. doi: 10.29158/JAAPL.003863-19. Epub 2019 Sep 24.
• Crisanti AS, Fairfax-Columbo J, Duran D, Rosenbaum NA, Melendrez B, Trujillo I, Earheart JA, Tinney M. Evaluation of Ongoing Crisis Intervention Team (CIT) Training for Law Enforcement Using the ECHO Model. J Police Crim Psychol. 2022;37(4):863-875. doi: 10.1007/s11896-022-09529-3. Epub 2022 Jun 17.
• Nick GA, Williams S, Lekas HM, Pahl K, Blau C, Kamin D, Fuller-Lewis C. Crisis Intervention Team (CIT) training and impact on mental illness and substance use-related stigma among law enforcement. Drug Alcohol Depend Rep. 2022 Sep 29;5:100099. doi: 10.1016/j.dadr.2022.100099. eCollection 2022 Dec.
• Compton MT, Krishan S, Broussard B, Bakeman R, Fleischmann MH, Hankerson-Dyson D, Husbands L, Stewart T, D'Orio B, Watson AC. Modeling the effects of Crisis Intervention Team (CIT) training for police officers: How knowledge, attitudes, and self-efficacy drive de-escalation skills and referral decisions. Int J Law Psychiatry. 2022 Jul-Aug;83:101814. doi: 10.1016/j.ijlp.2022.101814. Epub 2022 Jun 24.

Study record dates

Study Major Dates

• Study Start (Actual): April 7, 2026
• Primary Completion (Actual): June 20, 2026
• Study Completion (Actual): June 20, 2026

Study Registration Dates

• First Submitted: July 5, 2026
• First Submitted That Met QC Criteria: July 5, 2026
• First Posted (Actual): July 13, 2026

Study Record Updates

• Last Update Posted (Actual): July 13, 2026
• Last Update Submitted That Met QC Criteria: July 5, 2026
• Last Verified: July 1, 2026

More Information

Terms related to this study

• Keywords: Emergency Medical Services; Interprofessional Education; Self-Efficacy; Firefighters; Mental Health Crisis; Substance Use Stigma; Crisis Intervention Training; Behavioral Emergency; Public Health Personnel; De-escalation Training; Mental Health Stigma; Pre-Post Study
• Other Study ID Numbers: 114067-E; FEMH-2026-C-073 (Other Grant/Funding Number: Far Eastern Memorial Hospital)

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO
• IPD Plan Description: Individual participant data will not be publicly shared because the study used anonymous questionnaire responses, and the participant information process did not include consent for unrestricted secondary use or public data sharing. Aggregate study results may be published. Deidentified summary data or study materials may be considered upon reasonable request, subject to approval by the principal investigator, the institution, and the relevant research ethics committee.

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No