Supporting Vulnerable Populations: Civil Interventions and Diversion for Those with Mental Illness

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Task Force Activities

Supporting Vulnerable Populations: Civil Interventions and Diversion for Those with Mental Illness A criminal justice system already ill-equipped to appropriately handle people with mental illness is made even less appropriate by the COVID-19 pandemic. This brief describes non-criminal justice interventions that have been shown to be effective in increasing public safety while providing effective interventions to those in need, and  discusses ways in which courts can play a role in diverting people in crisis from entering or penetrating the criminal justice system. A pandemic resource from NCSC developed in collaboration with the National Judicial Task Force to Examine State Courts’ Response to Mental Illness.

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Research and Resources

Reducing the Effects of Adverse Childhood ExperiencesThough legislatures have shifted focus to respond to COVID-19, more than 35 states introduced legislation on ACEs this year. Since January 2019, at least 26 states enacted or adopted legislation to address childhood trauma, child adversity, toxic stress, or ACEs specifically. Many bills create a new task force or commission, implement workforce training on ACEs or trauma-informed practices, or strengthen behavioral health supports for children. This NCSL brief reviews these efforts.

SAMHSA SOAR August Newsletter Includes a Supplemental Security Income for Children Fact Sheet, a suite of six fact sheets that provides an at-a-glance look at how different entities can apply the SOAR model to assist children (under age 18) who are experiencing or at risk of homelessness and have a serious mental illness, medical impairment, and/or a co-occurring substance use disorder to apply for SSI.

8 Ways Managers Can Support Employees’ Mental HealthUncertainty breeds anxiety, and we are living in uncertain times. Between rising numbers of Covid-19 cases, questions about whether or not to reopen economies and businesses, the ongoing protests in the wake of George Floyd’s murder, and the economic fallout of the pandemic, we do not know what will come next. And that’s taking a toll on our mental health, including at work. This Harvard Business Review article has suggestions.

The Impact of COVID-19 on Law Enforcement AgenciesThis joint report between the International Association of Chiefs of Police and the Center for Evidence-Based Crime Policy, George Mason University provides fascinating insight into how jail and other pandemic policies affected arrests in the early days of the pandemic. For example, 73% of responding agencies had adopted policies to reduce or limit community oriented policing activities.

New Certified Community Behavioral Health Center (CCBHC) Resource The Certified Community Behavioral Health Center (CCBHC) movement is transforming health care with new approaches to service delivery while expanding community members’ access to care. To help organizations and states make the most of these opportunities, the National Council is excited to announce the launch of our CCBHC Success Center – a hub for information, implementation support and advocacy on the CCBHC model.

National Council for Behavioral Health Webinars A listing of upcoming webinars.

Upcoming SAMHSA Webinars SAMHSA's GAINS Center is covering essential topics through its upcoming national webinars and its two ongoing Virtual Learning Community webinar and discussion group series: Crisis Response Models and Leveraging Teleservices in Drug Courts to Improve Treatment Access.

Register Today: Reframing Crisis Services and Law Enforcement Partnerships Discussion Group The Crisis Response Models Virtual Learning Community series has explored various crisis response approaches, models, and partnerships to effectively respond to individuals with mental illness. In a roundtable format, hosted by SAMHSA's GAINS Center, experts from the fields of crisis response, law enforcement, and peer services and support will discuss how crisis services are evolving and current events are reshaping crisis response, providing new opportunities to design a more responsive, recovery-oriented system of care.

SAMHSA Headlines Details technical assistance and funding opportunities, including a Centers of Excellence (CoE) for Behavioral Health Disparities (CoE-BH Disparities) solicitation. SAMHSA plans to issue 3 grants of Up to $700,000 per year for up to 5 years.

Webinar: How to Develop a Competitive Grant ApplicationSAMHSA’s Office of Financial Resources will be conducting a webinar on how to develop a competitive grant application.

Designing a Law Enforcement-Friendly Crisis ServiceThis is the summary document resulting from the recent SAMHSA webinar.

Housing that Heals Theresa Pasquini and Lauren Rettagliata will share highlights from their report, Housing that Heals and address critical questions such as what distinguishes good housing options from bad, how to avoid cherry picking, and what happens when communities invest in a full continuum of psychiatric care. A Treatment Advocacy Center webinar.

Trauma-informed, Resilience-oriented Crisis Navigation Webinar How do we intentionally design and maintain healing environments that empower and resist retraumatizing those who have already experienced so much trauma? Join the National Council for Behavioral Health on August 18 from 2-3 p.m. for Trauma-informed, Resilience-oriented (TIRO) Crisis Navigation, a webinar exploring ways to visualize and assess the readiness of your staff to provide effective trauma-informed, resilience-oriented services and care.

Visit A Mentor Court - Virtually! NADCP’s National Drug Court Institute has named eight new mentor treatment courts. These outstanding programs are available for virtual site visits, giving you the opportunity to learn from the best. Teams or individuals interested in starting a treatment court can see the model in action, and established courts can learn new and innovative practices.

Bail or Jail? Judicial versus Algorithmic Decision-Making in the Pretrial System Policymakers are torn between the promise of technology to contribute to a more just system and a growing movement that calls for the abolishment of the use of actuarial risk assessment tools in general and the use of machine learning-based tools in particular. This paper examines the role that technology plays in this debate and examines whether deploying artificial intelligence (“AI”) in existing risk assessment tools realizes the fears emphasized by opponents of automation or improves our criminal justice system. It focuses on the pretrial stage and examines in depth the seven most commonly used tools.

A Comparison of Criminogenic Risk Factors and Psychiatric Symptomatology Between Psychiatric Inpatients With and Without Criminal Justice Involvement People have often assumed persons with mental illness become criminal justice involved because of symptoms associated with their illness or lack of mental health treatment; however, criminal risk factors (the Big Four and Central Eight), not severity of psychiatric symptomatology, most accurately classified psychiatric inpatients with and without a history of criminal justice involvement. Thus, psychotherapeutic interventions should target criminal risk factors, such as antisocial personality, attitudes toward criminal associates, and job-seeking behavior. In other words, to be most successful, when treating criminal justice--involved persons with mental illness, practitioners should assess and treat not only symptoms associated with their mental illness but their criminal risk as well.

The Impact of Misdemeanor Arrests on Forensic Mental Health Services: A State-wide Review of Virginia Sanity Evaluations Approximately 22.3% of sanity evaluations (not competency to stand trial) involved defendants charged only with misdemeanor offenses. Defendants facing only misdemeanor charges were 1.82 times more likely to be opined insane than were defendants facing only felony charges, primarily due to their increased likelihood of experiencing psychotic symptoms at the time of the offense (1.83 times more likely than defendants facing felony charges).

Mental Health, Substance Use, and Suicidal Ideation During the COVID-19 Pandemic — United States, June 24–30, 2020 This CDC report finds that during this time period, U.S. adults reported considerably elevated adverse mental health conditions associated with COVID-19. Younger adults, racial/ethnic minorities, essential workers, and unpaid adult caregivers reported having experienced disproportionately worse mental health outcomes, increased substance use, and elevated suicidal ideation.

Have Problem-Solving Courts Changed the Practice of Law?Drug courts started thirty years ago in the United States. The introduction of these courts brought high hopes that they would refocus our criminal legal system to therapeutic and rehabilitative methods while moving away from an otherwise largely punitive and punishment-oriented approach. Has this happened?

Public Health Peer Support Models Peer recovery support services (PRSS) are increasingly offered across diverse criminal justice settings to address opioid and other substance misuse and to achieve positive outcomes.  The power and potential of PRSS come from the unique roles that peers play, promoting both hope and pragmatic steps for change. This webinar presented by the Bureau of Justice Assistance (BJA) leadership, in collaboration with the Comprehensive Opioid, Stimulant, and Substance Abuse Program (COSSAP) team.

Sesame Workshop Launches New Webinar Series on Substance Abuse and Parental Addiction to Help Providers Support Children and FamiliesAlmost 6 million children under the age of 11 in the United States live in households with a parent who has a substance use disorder, putting the children at risk for direct and indirect trauma. To provide support and help families cope, Sesame Street in Communities (SSIC) is expanding its parental addiction initiative with a new webinar series for child and family therapists, first responders, community leaders, and other service providers.

New Publication: The Opioid Crisis and the Hispanic/Latino Population: An Urgent Issue The opioid crisis has not abated and has had a significant impact on Hispanic/Latino communities in the U.S. This SAMHSA issue brief presents recent data on prevalence of opioid misuse and death rates in the Hispanic/Latino population; contextual factors and challenges to prevention and treatment; innovative outreach and engagement strategies to connect people to evidence-based treatment; and the importance of community voice.

TAC Research Weekly: Schizophrenia Research More Relevant Now Than Ever Coronaviruses can invade nerve cells and have been found in brain tissue postmortem. In addition, various research studies have linked viral infections to psychiatric illness. Because of the known risk of viral infections in the development of psychotic disorders, even if that risk is low, the large population exposure to COVID-19 may have drastic implications for the prevalence of psychiatric diseases in the future.

In the News

California State Auditor: California Has Not Ensured That Individuals With Serious Mental Illnesses Receive Adequate Ongoing CareThe audit of implementation of the Lanterman‐Petris‐Short Act (LPS Act) finds that “The LPS Act permits involuntary mental health treatment when, because of mental illness, individuals pose a risk of harm to themselves or others or cannot provide for their basic needs. We conclude that the LPS Act’s criteria for involuntary treatment allows counties sufficient authority to provide short‐term involuntary treatment to people. Expanding the LPS Act’s criteria to include additional situations in which individuals may be involuntarily treated could potentially infringe upon people’s liberties—and we found no evidence to justify such a change. Nonetheless, California has not ensured adequate care for individuals with serious mental illnesses in its broader mental health care system.

Nearly 30 States Introduced More Than 350 Policing Bills Twenty-nine U.S. states introduced bills intended to change their approaches to policing as of July 17. Notably, several of these bills focused on how law enforcement responds to people with mental illnesses, including mandating Crisis Intervention Training for all officers, and establishing Crisis Stabilization Units as places that can serve as alternatives to arrest.

Black Psychiatrists are Few. They’ve Never Been More Needed. Anxiety and depression among African Americans is skyrocketing, and so are suicides. Black boys, ages 5 to 12, are twice as likely to die by suicide compared to their White peers, according to the Congressional Black Caucus Emergency Task Force on Black Youth Suicide and Mental Health.

CDC Details COVID-19's Massive Mental Health Impact Among 5,470 people surveyed in the last week of June, 30.9% reported symptoms of an anxiety or a depressive disorder, 25.3% reported a traumatic or stressor-related disorder (TSRD), and 13.3% said they were using substances to cope with the pandemic's stressors, said Rashon Lane, MA, of the CDC's COVID-19 Response Team. And 10.7% reported seriously considering suicide in the prior month, more than double the rate reported in a 2018 CDC survey, the researchers wrote in the agency's Morbidity and Mortality Weekly Report.

7 Steps To Reduce Jailing Of Americans With Mental Illnesses That Your Community Should Adopt Partner for Mental Health, an affiliate of Mental Health America, has developed a 7 step program to reduce interactions between Americans with mental illnesses and the police and to reduce inappropriate incarceration. The group is urging city officials in Charlottesville, Virginia, to accept what it calls “a holistic reform” of the local criminal justice system.

Pairing Therapists with Cops in the Field Works, Police Say. Why don't we do it more? “Trump, $1.50, I’m in Fort Collins, and it’s the 23rd,” the woman said as Fort Collins Police Services' mental health co-response team approached her in the Poudre River. It was at least the fourth time officers had paid her a visit that week. The woman, wise to their routine, was answering their coherency-testing questions before they could even ask them.

PTACC Ticker Wednesday, August 12th The latest Police, Treatment and Community Collaborative newsletter.

Forensic Psychology: More Than Meets the Eye Forensic psychology professionals can be found in many settings. These range from jails to courts, to sex offender registry boards and forensic hospitals. Today, we’ll examine what “forensic psychology” means and introduce a primer for what the field has to offer. Over the next couple of weeks, we’ll examine the below in more detail.

National Council for Behavioral Health Capitol Connector Links to news about how the COVID-19 pandemic has drastically shifted the delivery of behavioral health services, with many providers moving to delivering most or all of their services via telehealth, and more.

He’s Not a Criminal, He’s in Crisis Mental illness is not a criminal offence. And even when officers understand the need for care instead of arrest, they need better support to make it possible. It is reported in my county that officers take people to jail instead of the treatment center because it is faster and requires less paperwork. The situation tends to be worse for Black and Brown people who have less access to health care — and that includes mental health care — than their white counterparts.

Urbana Council to Discuss Pilot Program for Mental-Health Emergencies Mayor Diane Marlin is hoping a new program called One Door will help shift mental-health-related emergency calls from the police department to behavioral-health organizations. Under this program, instead of being taken to the emergency room or jail or left with a family member, “we would provide an alternative, One Door, at the men’s shelter,” Marlin said.

Mental Health Court Report Shows its EffectivenessThe Yolo County Mental Health Court team has published its Outcome Report for fiscal year 2019-20, which shows reductions in arrests, jail bed days, and hospital bed days of Mental Health Court participants.

Bucks Eyes Mental Health Court, Police Co-Responder Program Bucks County could see a new mental health court and other police changes in the wake of ongoing protests nationwide against police brutality. County Commissioner Chairwoman Diane Ellis-Marseglia and District Attorney Matt Weintraub said recently the programs were aimed at changing how police and courts deal with mental illness and not aimed at defunding police departments.