Planning 101 Kicking-Off a Collaborative Criminal Justice /Mental Health Program JMHCP National Training and TA Event: Collaborating to Achieve and Communicate Positive Public Health and Public Safety Outcomes
Learning Objectives Identify key stakeholders to include in collaborative criminal justice/mental health planning projects Understand the role that data can play in informing strategic priorities Have familiarity with different questions/frameworks for collaborative planning process
Presentation Overview Honorable Katherine McCarthy, Judge, Behavioral Health Court, Macon County (IL); JMHCP FY 2009 & FY 2010 Risë Haneberg, Criminal Justice Coordinator, Johnson County (KS); JMHCP FY 2010 C. Terence McCormick, CEO and Founder, Coordination Aftercare Recovery Educational Services, LLC (CARES)
ILLINOIS MACON COUNTY BEHAVIORAL HEALTH COURT Kitty McCarthy Circuit Judge and Supervising Judge of Mental Health Court; Chair of Mental Health Court Steering Committee
STEERING COMMITTEE Judiciary Macon County State s Attorney s Office Public Defender Macon County Sheriff s Office Emergency responder and operator of the jail Decatur Police Department - Emergency responder Macon County Court Services (Probation) Heritage Behavioral Health Center - Treatment provider St. Mary s Hospital - Inpatient behavioral healthcare MHA of Macon County Family advocate agency Consumer of Mental Health Services Macon Co. Mental Health Board - Funder and coordinator of mental health and substance abuse services
PRINCIPLE DUTIES OF STEERING COMMITTEE 1. Setting policies and procedures for operation of Behavioral Health Court program 2. Coordination of funding efforts 3. Sharing information regarding community resources and public education regarding the BHC program (cultivates community awareness and support for the program)
TREATMENT TEAM The treatment team for the Behavioral Health Court consists of the following: 1. Judiciary - Presides over Mental Health Court and attends staffings each week. 2. Probation Officer - Supervises BHC participants while in the community to ensure they are following program requirements. 3. Heritage Behavioral Health Center (Treatment Counselors) - Assigned to each participant. Counselors are responsible for administering the mental health screening instruments as well as development of treatment plans. 4. Behavioral Health Court Coordinator - The coordinator screens referrals for initial admission eligibility and notifies the team to initiate the assessment process.
MISSION STATEMENT 1. To increase public safety - by reducing criminal activity 2. To increase treatment engagement - providing an avenue for treatment 3. To improve the quality of life - by ensuring that participants are connected to needed community based treatments, housing, and other services that encourage recovery (work/study programs) 4. To use resources effectively - by reducing repeated contact between persons with mental illness and the criminal justice system through the use of treatment
CURRENT STATUS Pilot program was initiated in March 2010 and will graduate its first participants in March 2011. At that time a formal Behavioral Mental Health Court will start.
Johnson County, Kansas Population: ~550,000 County jail population: 800-850 New jail to hold 1,038 10
Johnson County, Kansas Developed process around the Gains Sequential Intercept Model Project was originally funded through local grant that provided for outside facilitation and Council of State Governments Justice Center Consultation Created Leadership Team, Work Team, Data Committee and Steering Committee, based on consensus decision-making System mapping, followed by data analysis, creation of MH Flag, and development of Evidence-based programming to match target population
Criminal Justice Flowchart Decision Point 1: Law Enforcement Decision Point 2: Initial Detention / Initial Court Hearings Decision Point 3: Jails / Courts Decision Point 4: Re-entry Decision Point 5: Community Corrections / Community Supports Local Law Enforcement Arrest Decision Point 1: Law Enforcement Scope 17,642 # of Adult arrests, 2008 3,600 # of bookings in need of MH treatment, 08 (est.) 14 # of Law Enforcement Agencies utilizing CIT Impact People with mental illness require specialized approaches during contact with police, a substantial amount of time is spent on these contacts. Worst Case Scenario Individuals remain in the criminal justice system, are injured or die, or commit suicide. Opportunities Strengthening police training. Improving police / mental health collaboration. Improving diversion alternatives. Initial Detention Scope and Impact on Individuals First Court Appearance Bond Supervision Decision Point 2: Initial Detention / Initial Court Hearings Scope 447 # of Suicide assessments ADC, 2008 600 # assigned bond supervision each month, 2008 (average) 120 # assigned bond supervision with mental illness (est.) Impact Many individuals with MI have little or no resources & may be detained because they are unable to post bail and are not offered release on personal recognizance. An absence of supervised treatment/support alternatives for these offenders may lead to incarceration instead of more appropriate treatment. Worst Case Scenario Individuals remain in the criminal justice system, are injured or die, or commit suicide. Opportunities Test diversion alternatives. Jail (pre-trial) Mental Health Diversion Dispositional Court Decision Point 3: Jails / Courts Scope 44 Avg. # of days served in ADC for those staying past 72 hours. 96 Avg. # of days served in ADC for those staying past 72 hours if MI. 15 Number granted mental health diversion, 2008 Impact People with MI stay twice as long in jail than persons without MI. People with MI are charged, convicted, and sentenced more severely than other people accused of similar crimes. Jails are not adequately staffed or equipped to provide mental health care. Jail costs increase because of these challenges. Worst Case Scenario Individuals remain in the criminal justice system, are injured or die, or commit suicide. Opportunities Evaluate alternatives to incarceration. Prison Jail (sentenced) Decision Point 4: Reentry Scope 715 Average daily ADC population, 2008 120 Average daily ADC pop. prescribed medication for MH treatment, 2008 19 Average # of inmates with SPMI in ADC Impact Seriously MI individuals leave prison to places at a great distance so it is difficult to connect to community based services. Housing in conjunction with mental health programs is the greatest challenge. Delay in acquiring SSI/Medicaid benefits presents an obstacle to accessing community based mental health services. Worst Case Scenario Individuals remain in the criminal justice system, are injured or die, or commit suicide. Opportunities Address specific mental health needs of re-entering MI inmates. Parole Probation Work Release Decision Point 5: Community Corrections / Community Supports Scope 584 # of individuals on parole in Johnson Co. 115 # of parolees utilizing MH services (est.) 2727 # of individuals on probation in Jo. Co. 670 # probationers utilizing MH services (est.) Impact The stigma of criminal justice involvement for parolees and probationers increases their difficulties in accessing community based services. A large majority (72%) of people w/ serious MI have a co-occurring substance abuse disorder. Worst Case Scenario Individuals remain in the criminal justice system, are injured or die, or commit suicide. Opportunities Develop treatment and housing for parolees & probationers, mainly those with co-occurring disorders. Community
CJ/MH Diversion System Flow: Johnson County, KS (2010) Individuals/month Arrest Booked: 1,411 Johnson County Residents: 817 Medical and MH Screen Residents with MH Flag: 141 LE Process Jail Process Court Process Prosecutorial Review of Charges District level charges: 101 Bond 29 First Appearance Additional Appearance/ Adjudication MH Diversion 4 Monthly estimates based on 3 month intake (Jan-Mar 2010) Sentencing 13
Mental Health Flag Data Cohort tracked at 3 months and 6 months Out of 1,411 bookings, 101 flagged cases were charged, 29 released on pretrial supervision and 4 approved for diversion Key opportunities existed at the early intercepts of law enforcement and initial detention/court decision points Developed recommendations around co-responder program and expanding diversion
Mental Health Flag Data 17% of ADC inmate population on psychotropic medication. 21% of Johnson County residents jailed for misdemeanor or felony were referred to mental health services. The average length of stay for misdemeanant with referral was twice that of misdemeanants without referral. Nearly one-third of Johnson County females booked for misdemeanor have a mental health flag. First time bookings made up 25% of population Frequent Fliers: 10 or more times booked made up 25% of misdemeanors and 23% of felony bookings; 20 or more made up 45% misdemeanors and 46% felony bookings
Johnson County, KS Prior to Project Happening Now Under Consideration Lack of collaboration Lack of data from law enforcement pertaining to MH related calls. Stakeholders at the table Named Federal Demonstration Site Intercept 1: Law Enforcement Law Enforcement participation in survey. On-going through CJAC Annual submission of data from law enforcement. CIT implementation at various levels across law enforcement agencies. Various levels of law enforcement training related to Criminal Justice Mental Health issues. Crisis Stabilization Center identified need for our community. Lack of tracking of offenders in justice system with mental health issues. Continued growth in CIT trained officers; new emphasis on dispatch. Increased training has occurred; NACo training Bexar Co TX CIT training Bexar Co., TX CJ / MH systems visit to Sedgwick Co, KS Increased use of data for decision-making; Justice and Mental Health Collaboration Grant submitted; funding for co-responder pilot and expansion of MH Diversion. KU Med Center contacted; negative response to reinstating Crisis Stabilization Center. Creation of the Mental Health Flag. Information available within the jail and by probation; under consideration for use by law enforcement (dispatch). Use of I-LEADS initiated. Strive for all Jo Co law enforcement agencies to reach 20% level of officers CIT trained, including dispatch. Investigate Police Academy providing Mental Health First Aid training for justice professionals. Need for increased training for all justice and MH professionals. Waiting results of grant request; if not funded pursue other funding sources. Pilot coresponder program to identify if crisis need can be met through that level of programming. Consider expanding communication between law enforcement and mental health to be more reflective of the child protection process will require legislative action. Lack of collaboration amongst all screeners at the jail. (CCS, bond, MH, Work Release and classification) Intercept 2: Initial Detention/Court Hearing Committee in process to streamline efforts, reduce duplicity and better share information through use of JIMS. Improved screening and sharing of information for jail classification, programming needs, and court decisions. Minimal use of MH Diversion. Grant request for expansion of MH diversion JCMH case manager that would not be funded based on SPMI diagnosis. If grant not funded; pursue other funding options.
Prior to Project Happening Now Under Consideration Intercept 3: Jail Medication issues dominated needs list. Transition to CCS managing medications, improved communication between CCS and MH Staff on medication strategy; clinical team now meets weekly. Increase programming including the use of Peer to Peer, Double Trouble and/or other evidence based treatment. Connect inmates to support available in the community. JIMS and LUCI did not cross reference common clients. Mental Health Referrals in the Jail are tracked by JIMS. JIMS will send daily bookings to LUCI for cross reference and early notification. Intercept 3, 4 and 5; Courts, Reentry, Probation/Community Corrections Court Services had specialized caseloads and consultation with MH case manager. Added on-site consultation for Court Services and Corrections staff with the MH Case Manager. Increased specialized training for probation and use of joint case management wit mental health. Residential Center has Therapeutic Community in place for substance abuse clients. Reentry Task Force in place. Lack of resources for non-spmi clients to obtain medication post release from jail. Is a Mental Health Court needed in Johnson County? Therapeutic Community has completed a program evaluation; Modified TC design under consideration, consultation with MTC expert has occurred includes programming for cooccurrence of mental illness and substance abuse. Second Chance Act grant has been submitted requesting funding for a FACT Team which would address reentry for the mentally ill, as well as non-mentally ill inmates. Pilot Reentry program started in July 2010 with no additional funding. MH Case Manager serves on the admissions panel and provides limited case planning for those inmates identified for the program with mental health needs. Clients leaving the jail are encouraged to utilize JCMHC s crisis clinics; M-F, 8:30-9:30 AM. Initial data is suggesting if cases better managed at earliest intercepts, demand for a specialized court will decrease. Need for better programming for co-occurrence clients. Further consider implementation of MTC at Adult Residential Center and other ways to implement co-occurrence programming. If grant not funded, will need to seek other funding source. Consider ways to ensure when inmate is released funding for continued medication is in place. Funding for temp. supply of medications postrelease & quicker access to psychiatric services. Continue to analyze municipal court needs, Mental Health Achieving Court and and Communicating Civil Court Outcomes related issues.
A Consultant s View C. Terence McCormick, MSW, MPA CARES,LLC
QUESTIONS What is driving the planning effort? Is there empowerment to make systems changes? How will consumers and families be involved in the planning, implementation and evaluation of the [project? How will sustainability be built into the planning process?
QUESTIONS What are the parameters of the planning effort (e.g. where do we stop)? Who else is planning in this focus area (state, regional, local etc) Is the stakeholder group static or dynamic? Are evidence based practices being employed by both mental health (e.g. IDDT) and criminal justice (e.g. criminogenic factor analysis)?
QUESTION Why Are You Doing This Planning?
QUESTION How do you find the right Stakeholders and form leadership committee and functional workgroups?
QUESTION How do you Make the Leadership Group (and workgroups?) effective.
Thank you www.consensusproject.org This material was developed by presenters for February 2011: Collaborating to Achieve and Communicate Positive Public Health and Public Safety Outcomes. Presentations are not externally reviewed for form or content and as such, the statements within reflect the views of the authors and should not be considered the official position of the Bureau of Justice Assistance, Justice Center, the members of the Council of State Governments, or funding agencies supporting the work.