Every day in 2024, Chicago police officers were assigned to more than 100 emergency calls potentially related to mental health.
But despite specialized training meant to defuse mental health crises, public records obtained by Medill and MindSite News show that many officers—including those trained in crisis intervention and de-escalation techniques—still resorted to force.
The Chicago Police Department logs such calls from 911 operators as “CIT calls”—meaning they are eligible to receive a response from an officer who has received Crisis Intervention Team (CIT) training. But that doesn’t necessarily mean that a CIT-trained officer will be the one responding.
The department launched CIT training in 2004. The forty-hour program—now used by more than 2,700 police departments nationwide—is mandatory for CPD command staff and senior executives and voluntary for all other officers.
CIT-trained officers are more likely to connect people in crisis with some form of care, said Amy Watson, a leading CIT expert and a professor at the Wayne State University School of Social Work in Detroit. But many Chicago officers have not received CIT training. As of the end of February, 5,870 CPD officers, current and retired, had taken part in this training. There are currently 10,320 police officers on the force.
Even with CIT training, police aren’t the right responders for mental health crises, said Frank Chapman, executive director of the National Alliance Against Racist and Political Repression.
“People who need to be treated need to be treated,” Chapman said. “They don’t need to be murdered and they don’t need to be traumatized. Too often the police show up and do the wrong thing. They’re just not trained to handle mental health crises and the experiences have been tragic.”
Some CIT officers still using force during mental crises
While CIT training is meant to help reduce the use of force in mental health crises, 169 CIT-trained officers in Chicago used force at least once during a mental health-related incident in 2024, according to records obtained by Medill and MindSite News.
A 2019 scientific review of studies on CIT training concluded that it tends to improve officer satisfaction and may help divert people from jails to psychiatric facilities. But the study, published in the Journal of the American Academy of Psychiatry and the Law, also found that there is little peer-reviewed evidence showing CIT reduces arrests, injuries, or use of force.
CIT training educates officers on how to recognize the signs of a mental health crisis by assessing behavior and using de-escalation techniques, such as avoiding sudden movements and validating people’s experiences. Officers also receive detailed overviews of various conditions like schizophrenia, mania, anxiety, and personality disorders, along with guidance on suicide risk and response.
While Watson hasn’t reviewed CIT training materials in Chicago and Illinois, she said some curricula she’s reviewed are overly clinical and encourage officers to act more like mental-health professionals than first responders even though they lack actual medical training. While well-meaning, this approach can be ineffective, she said.
“You may have officers trying to diagnose somebody,” Watson said. “If you’re focusing on somebody’s diagnosis, you might be missing what is actually going on with the person.”
Debunked “excited delirium syndrome” still in police training manuals
Materials used to train new recruits at Chicago’s police academy have referenced “excited delirium syndrome,” a debunked term that has been used by law enforcement to describe a state of extreme agitation and sudden collapse.
It has been used as a defense by police officers accused of using excessive force but has been rejected as a diagnosis by medical societies including the American Medical Association. Studies have found that it has disproportionately been used to justify force against Black and Brown people.
The term ‘excited delirium’ “has been misapplied and diagnosed disproportionately in law enforcement-related deaths of Black and Brown individuals, who are also more likely to experience excessive sedative intervention instead of behavioral de-escalation,” the AMA’s policy reads.
A 2020 presentation for pre-service sergeants on bail-bond procedures notes that “a person who is in a severe emotional crisis or state of ‘excited delirium’ may not be able to comprehend or even hear attempts at de-escalation, which is based on a capacity for communication.”
Chicago Police Department officials did not respond to multiple questions from Medill regarding whether excited delirium is currently part of the department’s CIT training curriculum or respond in a timely manner to a public records request for its most recent CIT curriculum.
The Chicago Police Department and Illinois State Police follow the same training guidelines and the Illinois State Police instruct about excited delirium in its CIT curriculum, which was obtained by Medill and MindSite News through a public records request. It outlines physical and psychological signs officers should look for in order to identify excited delirium, including “intense paranoia,” “extreme agitation,” “rapid emotional changes,” and “superhuman strength.”
A February 2023 Illinois State Police CIT presentation included thirty-five slides on excited delirium.
Watson said the inclusion of excited delirium syndrome in curriculum is “alarming,” noting the lack of evidence for the condition and the opposition of the American Medical Association.
Bias baked in?
Watson said CIT programs can unintentionally reinforce racial biases within the force, noting that officers are more likely to interpret erratic behavior from white individuals as signs of mental illness, while perceiving the same behavior from Black individuals as criminal.
Chapman added that CIT training isn’t sufficient because it doesn’t address the “military” culture of policing.
“If a guy is pulling out his cell phone and it looks like a pistol, you’re gonna kill him, because you’re not expecting him to pull out a cell phone,” Chapman said. “You’re expecting him to pull out a pistol. That’s the way you’re thinking.”
Chapman said the presence of police tends to exacerbate mental health crises in communities that are disproportionately impacted by police presence.
“When the police over a period of time come to represent the symbol of racist oppression in your community and you are a Black person in crisis and the police show up, you’re not seeing that as a friend showing up, as somebody showing up to help you, a compassionate person,” Chapman said. “You’re seeing that as somebody who is hostile to you, so that’s not going to diminish your problems. That’s going to enhance them.”
Emma Sullivan is a magazine journalist and freelance investigative reporter based in Washington, D.C. She graduated valedictorian of the Medill School of Journalism’s undergraduate class of 2025.