November 2019

National Initiative Updates

Hawaii Summit First in Nation On November 6th the first state summit held as a follow-up to the CCJ/COSCA regional summits was held in Hawaii. Supported by National Initiative technical assistance funded by SJI, the Hawaii summit was attended by almost 120 participants. Attendees included local law enforcement, behavioral health providers, judges, prosecutors, defense counsel and others from around Hawaii.

Plenary session presenters included Judge Steve Leifman, Dr. Margie Balfour, Los Angeles County District Attorney Jackie Lacey, and Travis Parker. The event was hosted by Hawaii Chief Justice Mark Recktenwald and State Court Administrator Rod Maile. Local television news coverage, including comments from the Chief Justice, Judge Leifman, and Hawaii Governor Ige can be viewed here, and other comprehensive coverage of the event is here.

CCJ/COSCA Midwest Summit held October 23-25, 2019 “Improving the Court and Community Response to Mental Illness”Chief Justice David E. Gilbertson and State Court Administrator Greg Sattizahn hosted the eleven attending Midwest state multi- disciplinary teams in Deadwood, South Dakota last month. The workshop combined outstanding educational sessions and time for the state teams to identify their plans and priorities. Teams attended from Illinois, Indiana, Iowa, Kansas, Michigan, Minnesota, Missouri, Nebraska, North Dakota, Ohio and South Dakota. We look forward to hearing about their work ahead!

First National Convening on Competency to Stand Trial October 28, 2019Representatives from the SJI funded National Initiative Advisory Committee joined with the Judges and Psychiatrists Leadership Initiative (JPLI), the Council of State Government (CSG) Justice Center, the National Association of State Mental Health Directors (NASMHD), and others to address delays and deficiencies in competency to stand trial procedures. In addition to developing a set of policy recommendations, the attendees discussed recommending a National Call to Action. Further updates will be forthcoming.

In the News

Column: Shamed by Hollywood homeless catastrophe, she went to Italy for answers “I couldn’t reconcile the sight of cranes, signifying progress, while stepping over mentally ill people on the street,” said Morrison, who was director of the Hollywood Property Owners Alliance for many years, and a decade ago began taking a closer look at the growing homeless population. But it was a trip to Trieste, on the uppermost rim of the Adriatic in Northern Italy, that turned her despair into hope. It was there, in the summer of 2017, that Morrison found a mental health model in which every patient was looked after and no one was left to pitch a tent and fend for themselves. And it was there that she began mapping a plan to bring the Trieste model home to Hollywood.

Three Month Delay for Mental Health Evaluations in New Zealand. While statute requires a person must not be detained for more than 14 days for the purpose of an assessment, which could be extended in limited circumstances to a maximum of 30 days, assessments are now being set in mid-January.

"Stop the madness!’: City’s Misguided Spending on Seriously Mentally Ill Leads to Recurring Tragedies Outrage over the Big Apple’s mental health crisis has reached critical mass — with lawmakers, first responders, patient advocates and everyday New Yorkers imploring the city to take meaningful action after a recent rash of violence.

San Diego County approves ambitious mental health plan designed to prevent hospitalization, jail The funding will help establish and operate a new psychiatric crisis-stabilization center at the county’s Live Well Center in Oceanside, start planning for two new mental health service hub complexes in San Diego and Escondido, and provide $3 million to purchase psychiatric care for seniors at the newly-completed geriatric psychiatric unit at Alvarado Hospital Medical Center in La Mesa.

ACLU: Hawaii Needs Fewer People In Prison, More Treatment Programs The Blueprint for Smart Justice Hawaii report, which is part of a national campaign by the American Civil Liberties Union to reduce prison populations by 50% and reduce racial disparities in correctional systems around the country, lays out the problems and solutions specific to Hawaii.

Tackling mental health head-on in Collier County (Florida) After a year of research and planning, leading experts from local treatment centers, law enforcement, the courts, and other organizations, presented the details of a wide-reaching mental health plan to Collier County commissioners.

America’s Crime Problems Being Fed by a Broken Mental Health System Incarceration has become the norm for those with severe mental illness. But the question remains: Why do we make law enforcement responsible for a public health crisis? With medication and other support services, those with severe mental illness are no more dangerous than anyone else, capable of leading happy, productive lives. Without treatment, their prospects worsen.

J-PAL North America announces five new partnerships with state and local governments New partners will work with J-PAL to develop rigorous evaluations of policies related to criminal justice, health, housing stability, and economic security. One of the partnerships will evaluate the California new Pre-trial Felony Mental Health Diversion program, through which approximately 20 counties will receive funding to divert individuals who are incompetent to stand trial out of the criminal justice system and into wrap-around community treatment services. This evaluation will contribute significant insight into how diverting those found to be incompetent to stand trial due to mental health reasons to community mental health services may impact their individual well-being, as well as broader outcomes in the criminal justice and behavioral health systems.

Elderly, Confused, and Under Arrest Murphy knows a thing or two about mental health and the courts. She’s a Justice of the Peace in a Brampton courthouse. When it came to her father, it didn’t help. “The fundamental problem is there is a long waiting list for a behavioral support unit but there is no waiting list for jail.”

Opinion: Prison crisis also a mental health crisis Kansas faces a prison crisis of crowded facilities and escalating costs to taxpayers. Fixing that requires addressing mental health and the grim reality that our approach to the mentally ill is often to imprison them.

Public Crisis, Private Toll: Key findings of The Seattle Times’ investigation of private psychiatric hospitals in Washington Washington state has approved or expanded 10 private psychiatric hospitals since 2012, promising to transform the way mental-health care is delivered in a state with a chronic shortage of treatment options. Yet on the inside, these new institutions have failed patients in ways both known and unknown to regulators and all but invisible to the public, according to an investigation by The Seattle Times.

Dangerous but disarmed: How Florida has confiscated thousands of gunsWelcome to Florida’s Risk Protection Court, created last year to take guns from people judged too dangerous to have them.

Mental Health Courts, Treatment Improve Lives Switching from non-therapeutic punishment to treatment with therapy as managed by problem-solving courts is more humane and reduces recidivism.

California voters may be asked to steer homeless to services Former Assemblyman Mike Gatto, a Democrat, proposed a ballot measure on Thursday aimed at providing services to people who commit crimes like defecating in public or using drugs. "When someone breaks the law, it should be enforced. However, certain criminal acts should be treated not as something meriting harsh punishment, but as a 'cry for help,'" the introductory text to his proposed ballot measure reads.

Taking police officers out of mental health-related 911 rescues One in 4 deaths from police shootings represent people with mental illness. Denver is one of at least eight cities considering an Oregon program called Crisis Assistance Helping Out On The Streets to decriminalize and improve the treatment of people with severe mental illness — while saving the city money. The 30-year-old CAHOOTS program diverts nonviolent, often mental health-related 911 calls to a medic and a mental health professional instead of law enforcement.

'It's Just a Sin:' With Nowhere to Go, America's Mentally Ill Often End Up on the Streets Tens of thousands of people live on the streets of our most beloved cities. It's unsanitary and unsafe. One psychiatrist who closely examined Skid Row, the notorious section of Los Angeles that has widely become known the worst and most profound depiction of America's homeless crisis, says many people who wound up there as well as in nearby hospitals and jails are mentally ill and simply had nowhere else to go.

PT Police add navigator to de-escalate crisis situations It’s not every police officer that’s introduced to his new beat from the dais of a film festival panel discussion, but Judson Haynes’ is not every cop. He’s a navigator, tasked with handling the mentally ill residents police serve and protect in Port Townsend, Washington.

HBO to Tackle Mental Illness Stigma in New Campaign The network will put alerts at the beginnings of some episodes and release a series of explainer videos narrated by a psychologist, in an effort to normalize conversations around mental health.

Taking police officers out of mental health-related 911 rescues Denver is one of at least eight cities considering an Oregon program called Crisis Assistance Helping Out On The Streets to decriminalize and improve the treatment of people with severe mental illness — while saving the city money. The 30-year-old CAHOOTS program diverts nonviolent, often mental health-related 911 calls to a medic and a mental health professional instead of law enforcement.

We need to stop treating mentally ill people like criminals This opinion piece by Los Angeles County District Attorney Jackie Lacey argues that “the criminal justice system needs to better treat people living with mental illness for a wide variety of reasons, as the current system is bad for taxpayers, public safety officers and most importantly, the people struggling with mental health issues.”

Research and Resources

The Pretrial Justice Institute is hosting a webinar for those interested in implementing a Law Enforcement Assisted Diversion (LEAD) program on November 12. In this interactive webinar, participants will learn all about LEAD - its principles, purposes, and operations; how and why it differs from other diversion approaches; and how to implement LEAD with fidelity - and will hear from New Orleans about their experiences implementing LEAD. You can register here.

New Mobile App for Mental Health Professionals Launched 
SMI Adviser is a free resource for all mental health professionals who care for individuals with serious mental illness (SMI). Download the all-new SMI Adviser mobile app to access free education, submit questions and receive feedback from national experts, and find resources that help you implement evidence-based care.

Recently the Substance Abuse and Mental Health Services Administration (SAMHSA) announced the launch of FindTreatment.gov, a new and improved website for helping to connect Americans throughout the United States who are looking for substance abuse treatment. FindTreatment.gov is designed to provide the most relevant information for each individual’s recovery needs by creating a modern, user-friendly experience that is visually clear, simple, and welcoming to those in crisis.

Implementing Assisted Outpatient Treatment: Essential Elements, Building Blocks and Tips for Maximizing Results In 2018, the American Psychiatric Association was awarded a grant from SAMHSA to establish a training program to facilitate the national expansion of assisted outpatient treatment (AOT). This paper was developed as a baseline for the content of that training program. It aims to explain what AOT is and how it can benefit communities, provide a view into the variability of AOT programs, and identify practices considered promising for successful systematic implementation.

Diversion to What? This Bazelon Center fact sheet describes essential and effective community services that should be part of every community’s mental health system. It also describes the evidence that these services decrease the incarceration and institutionalization of individuals with mental health disabilities. When communities provide these services in sufficient amounts and ensure that there is ongoing coordination between the criminal and mental health systems, they will dramatically reduce the damaging and costly cycling of people with mental health disabilities in and out of jails, emergency rooms, hospitals, and shelters.

The APA and SAMHSA have developed an online resource intended for individuals and families with questions about SMI. This Knowledge Base covers a wide range of topics and has a number of resource links as well.

Navigating a Mental Health Crisis "Navigating a Mental Health Crisis: A NAMI Resource Guide for Those Experiencing a Mental Health Emergency" provides information for people experiencing mental health crises and their loved ones. This guide outlines what can contribute to a crisis, warning signs that a crisis is emerging, strategies to help de-escalate a crisis, available resources and more.

A recent TAC research piece, Serious Mental Illness and Likelihood of Incarceration after Arrest found, among other disturbing results, that the presence of serious mental illness increased the likelihood of incarceration following a misdemeanor by more than 50%, even when controlling for variables such as race, violence of the offense, and prior arrest history.

Reducing the Use of Jails: Exploring Roles for City Leaders is a recent publication of the National League of Cities that follows pilot programs in five cities. It promotes diversion, deflection, triage, and behavioral health treatment as policy choices for Mayors and other elected municipal officials.

Five Ways to Engage County Elected Officials in Your Justice Initiatives Justice initiatives need support at every level in county government in order to be successful. While most justice-related work is undertaken by leaders and staff in the sheriff’s office, department of corrections and the courts, elected county leadership has a paramount role in pushing justice initiatives forward. These champions can inform justice policy and implementation, assist with securing funding and resources for justice initiatives and act as the public face of local efforts. NACo, supported by the John D. and Catherine T. MacArthur Foundation’s Safety and Justice Challenge, created this brief to highlight strategies local leaders can use to better engage elected officials in criminal justice initiatives.

People With Mental Illnesses Aren’t More Violent. Why Do People Believe They Are? A new study found that over the past two decades support grew for forced treatment of people with mental health issues, even if they don’t need it.

Introduction to the Evidence- Based Judicial Decision Making CurriculumThis NCSC developed curriculum first reviews the underlying Risk Needs Responsivity principles of effective corrections interventions, and supporting research, and then applies those principles and that research to address the special needs of persons with mental and/or substance use disorders, and those charged with DUI and DV offenses who are frequently subject to local jail sentences.

A PROJECT ON BEHALF OF THE NATIONAL INITIATIVE TO IMPROVE THE JUSTICE SYSTEM RESPONSE TO MENTAL ILLNESS

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