Opioid Crisis: The State Court Perspective

updated behavioral health banners

Task Force Activities

Opioid Crisis: The State Court Perspective National Judicial Task Force to Examine State Courts’ Response to Mental Illness Member Chief Justice Loretta Rush (Indiana Supreme Court) shares her experience as a chair of the National Judicial Opioid Task Force, presenting the findings of that task force as well as new resources and a call for enhanced cooperation between federal and state courts in addressing the opioid crisis.

Panel Discussion Tackles Mental Health And The Courts A documentary screening and panel discussion put a spotlight on the challenges of mental illness and the criminal justice system. Hosted by the Illinois Supreme Court Mental Health Task Force, the panel featured three mothers whose children had severe mental illness. All the mothers spoke of difficulty accessing treatment for their children, getting them involuntarily committed if needed, and the lack of psychiatric beds.

Research and Resources

Introducing the Mental Health and Justice Partnerships Project On any given day in the U.S., far more people with serious mental health needs are in jail than in mental health facilities. That fact fuels Pew's new project, mental health and justice partnerships, aimed at uncovering how the justice system is falling short—and what can be done to improve access to treatment.

SAMHSA Publishes Guidelines, Toolkit to Strengthen Crisis Care in America's Communities The Substance Abuse and Mental Health Services Administration (SAMHSA) has published “Crisis Services: Meeting Needs, Saving Lives,” a compendium detailing crisis intervention services, best practices, and related components of crisis services, for use by a wide array of community leaders and health care providers to work toward better outcomes for Americans in crisis. The book is composed of SAMHSA’s “National Guidelines for Behavioral Health Crisis Care: Best Practice Toolkit” and related papers on crisis services.

Behavioral Health Crisis Alternatives - Shifting from Police to Community Responses This Vera Institute report provides an overview of crisis response programs, including a typology of approaches organized by the involvement of law enforcement, before examining the efforts of three communities—Eugene, Oregon; Olympia, Washington; and Phoenix, Arizona—to reduce the number of crisis calls directed to police.

The Community Responder Model - Center for American Progress Today, a significant portion of 911 calls are related to quality-of-life and other low-priority incidents that may require a time-sensitive response but are better suited to civilian responders, rather than armed police officers. Some 911 calls may not require a time-sensitive response at all. Recent original analysis conducted by the Center for American Progress (CAP) and the Law Enforcement Action Partnership (LEAP) examined 911 police calls for service from eight cities and found that 23 to 39 percent of calls were low priority or nonurgent, while only 18 to 34 percent of calls were life-threatening emergencies. While many 911 calls do merit an emergency police response, unnecessarily dispatching armed officers to calls where their presence is unnecessary is more than just an ineffective use of safety resources; it can also create substantially adverse outcomes for communities of color, individuals with behavioral health disorders and disabilities, and other groups who have been disproportionately affected by the American criminal justice system.

Crisis Response for Mental Illness Is Not Enough. We Need to Fix the Root By the time law enforcement comes on the scene, our system has already failed the person in crisis multiple times. Police shouldn’t be expected to deal with the result of our failed mental health system. To fix the problem, we need to look upstream. In truth, our system denies medical help for people with mental illness until they reach a crisis point.

Frontline Responders Network Newsletter FRN is collaborating with PTACC to put on a series of Seminars featuring the informative output from its 7 core strategy areas. The next program will feature the latest output from the PTACC Public Safety Strategy Area.  The 90-minute discussion will examine the current public safety strategies within multiple areas of substance use, treatment, and community resources. The panel of nationally recognized experts from law enforcement, behavioral treatment and recovery services will discuss challenges in community recovery support systems that COVID-19 has impacted as well as potential solutions.

Three Reasons to Become a Law Enforcement-Mental Health Learning Site  The Council of State Governments (CSG) Justice Center is now accepting applications to expand the Law Enforcement-Mental Health Learning Sites Program. Conducted in partnership with the U.S. Department of Justice’s Bureau of Justice Assistance, the program highlights successful police-mental health collaborations that are improving encounters between law enforcement and people with mental health needs.

MHTTC Pathways - December 2020 This Mental Health Technology Transfer Center newsletter includes a general COVID-19 page, as well as resources that cover grief, loss, and bereavement, intimate partner violence (IPV) and child abuse, mental health disparities, telehealth, and provider well-being.

National Association of State Mental Health Program Directors Weekly Update Bipartisan COVID Relief Act Would Send $3.15 Billion to SAMHSA for Block Grants, Tribal Programs, Emergency Relief, and Peer Recovery, and $150 Million for CCBHCs; and links to other new behavioral health resources.

SAMHSA Training and Technical Assistance Related to COVID-19 SAMHSA is committed to providing regular training and technical assistance (TTA) on matters related to the mental and substance use disorder field as they deal with COVID-19. View the updated available TTA resources to assist with the current situation.

SAMHSA Grant Announcements SAMHSA is accepting applications for the Grants for Expansion and Sustainability of the Comprehensive Community Mental Health Services for Children with Serious Emotional Disturbances (System of Care [SOC] Expansion and Sustainability Grants); Mental Health Awareness Training grants (MHAT); Tribal Behavioral Health Grant Program (Native Connections); and Enhancement and Expansion of Treatment and Recovery Services for Adolescents, Transitional Aged Youth, and their Families grant program (Youth and Family TREE).

Connecting Mental Health Court Participants with Services: Process, Challenges, and Recommendations This article discusses the challenges of connecting mental health court participants with appropriate services and proposes recommendations to mitigate these challenges. Recommendations include the establishment of specialized treatment programs, ensuring treatment programs are informed by the risk-need-responsivity model of criminal recidivism, trauma and cultural considerations, use of integrated case management services, and implementation of flexible treatment mandates.

Eight Steps Your Community Can Take To Launch A Jail Diversion Program Cynthia Kemp, a deputy director at the Substance Abuse and Mental Health Services Administration, told attendees at a mental health summit two years ago how Arlington County, Va., created a jail diversion program that now is considered one of the best in the nation. Her advice is worth reading.

Collaboration Among Criminal Courts and Justice System Partners During a Time of Crisis Criminal courts have witnessed unprecedented societal challenges over the past ten months, including both the COVID-19 pandemic and the emergence of civil unrest challenging the fairness of the criminal justice system. This NCSC webinar will address the need for collaboration among justice system partners during a time of national crisis, while at the same time ensuring the integrity of the courts, justice system partners, and criminal justice system.

Justice Briefing: New Tool to Measure the Quality of Your Police-Mental Health Partnership Police-Mental Health Collaborations support law enforcement agencies in planning and implementing effective public safety responses to people who have mental illnesses. Our new self-assessment tool enables agencies and their partners to measure their progress toward creating high-quality, joint interventions. The tool provides resources to help improve responses to calls for service involving people with mental illnesses or substance use conditions.

TAC Research Weekly: Medicaid Program Ineffective in Improving Hospital Readmissions People with severe mental illness die up to 25 years earlier than people in the general population, in part due to high levels of comorbid physical health conditions such as cancer, diabetes and heart disease. As part of a waiver process as a result of the Affordable Care Act of 2008, the Centers for Medicare and Medicare Services approved 19 states to create behavioral health home programs for Medicaid beneficiaries with serious mental illness. Their findings were surprising. Although the results indicate that the behavioral health home had modest impacts on improving follow-up care among individuals with serious mental illness who were hospitalized, this did not translate to reducing the risk of readmission among this population

Self-Care for Criminal Justice Professionals Across the Sequential Intercept Model: Considerations for Intercepts 0-2 Self-care is a critical component of wellness for professionals across all intercepts of the criminal justice and behavioral health systems. Within Intercepts 0-2 of the Sequential Intercept Model (SIM), first responders and jail staff responding to behavioral health emergencies may have an increased exposure to stressors as they navigate additional challenges brought by the COVID-19 pandemic. This webinar will present information about potential stressors faced by staff across Intercepts 0-2 and ways that agencies can support self-care as a protective factor against harmful responses to stress.

2020 Texas Tech Mental Health Law Symposium This year’s program addressed practical legal and policy issues that can contribute to improvements in our public mental health system and help address the significant challenges faced by our criminal justice system and law enforcement with regard to alleged offenders with mental illness. The program was specifically designed to be of use to practicing lawyers and judges. Links to the full program.

Welcome to the SJI Funding Toolkit The toolkit is designed to support local courts, state courts, and their justice system partners as they pursue federal and philanthropic funding opportunities. This toolkit includes resources that encompass the entire grant seeking, writing and management process, such as planning checklists, sample documents, frequently asked questions and fact sheets.  Technical assistance is also available to courts to provide support and feedback during the grant writing and development process. Recently updated.

SAMHSA SOAR eNews Includes the 2020 National SAMHSA SOAR Outcomes Issue Brief, racial equity resources, and COVID-19 Resources for SOAR Providers.

Second Annual National Co-Responder Conference: Save the Date & Call for Presenters The Johnson County (Kansas) Mental Health Center invites law enforcement agencies, mental health providers, community stakeholders, elected officials, schools and partner organizations to save the date for the second annual National Co-Responder Conference.

Webinar: High-Risk Impaired Drivers - Substance Use Disorders, Psychiatric Diagnosis, and Challenges with Treatment The DWI court population has unique characteristics and responsivity needs, including the high rate of underlying mental health disorders among repeat impaired drivers. When working with this high-risk, high-need population, treatment for both substance use and mental health disorders is critical.

In the News

Judge Steven Leifman: My Choice For Most Important Advocate During 2020 For a decade, Judge Leifman has worked tirelessly to reform how our criminal justice system interacts with individuals with mental illnesses. He has traveled across the nation educating judges, prosecutors and defense attorneys about the so-called Miami Model that has become the gold standard in our nation for reducing violence, unnecessary arrests, and inappropriate incarceration. The model encourages recovery, reduces stigma, and gives individuals hope. Judge Leifman’s approach has a proven and impressive track record.

'Our police shootings have dropped precipitously' On any given day in the United States, far more people with serious mental health needs are in jail than in mental health facilities, according to the Treatment Advocacy Center. In Miami-Dade County, Florida, a large percentage of adults suffer from a mental illness such as bipolar disorder or schizophrenia. Steve Leifman, a criminal court judge and creator of the Criminal Mental Health Project, aims to place those with mental illnesses into treatment instead of jail. He spoke with The Pew Charitable Trusts about the nationally recognized program.

Los Angeles' new district attorney announces sweeping reforms on first day On his first day leading the country's largest district attorney's office, the top prosecutor in Los Angeles County announced a series of sweeping criminal justice reforms aimed at "permanently" changing the course of California's criminal justice system. Under his announced reforms, children will no longer be sent to adult court; low-level crimes associated with poverty, addiction, mental illness and homelessness will be diverted to health services; and his office will review cases in which lengthy prison terms were "inconsistent" with sentencing and charging policies.

Trained civilians, not sworn police officers, could better respond to hundreds of 911 calls When a person sees police lights and uniforms, they often become visibly agitated — which we saw up close in the tragic police shooting of Walter Wallace Jr. last month in Philadelphia. Police presence has a particularly strong impact on people with an untreated mental illness, who are 16 times more likely to be killed during a police encounter than the general population.

Legal victory for vets with mental illness Veterans advocates recently celebrated the Veterans Legal Services Clinic at Yale Law School’s legal victory in a class action lawsuit against the Army. The lawsuit sought to rectify the Army board’s mishandling of discharge upgrade requests that involved mental health conditions. Under the proposed settlement agreement, the Army will reconsider thousands of discharge decisions involving mental health conditions to more fully evaluate whether a veteran’s mental health condition mitigates misconduct — and if it does, the Army will grant an upgrade to “honorable.”

Stop the Stigma Podcast - New Episode with Toni Cornell and Director Jim Carroll of the White House Office of National Drug Control Policy In the episode, Director Carroll discusses the agency’s role in addressing the stigma surrounding substance use disorders, ONDCP work impacting criminal justice reform, private sector partnerships, and eliminating stigma in health care, along with current efforts to support individuals and families experiencing the added emotional stresses associated with the COVID pandemic.

In Indy, an alternative to jail for mental illness and addiction The city of Indianapolis’ new Assessment and Intervention Center, which will provide a safe place to stay — and an alternative to arrest — for our neighbors with mental health and addiction treatment needs, recently opened to the public. Its goal is to divert low-level offenders before they are arrested and enter the criminal justice system, and provide connection to a variety of community resources that can address the long-term needs that people have, such as housing or mental health and addiction treatment.

State of Justice - The Council of State Governments (CSG) Justice Center newsletter The Orange County Sheriff’s Office plans to begin testing a new program in the coming weeks that will send mental health clinicians out with deputies on certain calls; and COVID-19 has triggered jail population drops—with one exception.

SAMHSA GAINS Center Newsletter An interview with Georgia mental health court judge Rhathelia Stroud; From Survival to Recovery: How Housing First Promotes Success; and GAINS Products in Review: Best of 2020.

Should Ohio decriminalize addiction? Advocates tout drug bill coming to a vote this week The goal: Get people treatment for their drug addictions and keep them out of prison, which can impact a person's ability to find a job for the rest of their life. The bill has broad support from opposite ends of the political spectrum, from the Koch brothers to employment agencies. But law enforcement and judges remain opposed. They say reducing felony possession charges to misdemeanors, punishable by jail time but not prison, will remove an effective tool for nudging people into treatment.

When Going to the Hospital Is Just as Bad as Jail Simply diverting people from jail to a hospital isn’t enough of a solution, lawyers and activists say. Many who have endured a short-term hospital stay say the experience of being held against their will in a psychiatric ward was as traumatizing as being arrested, and didn’t connect them with any follow-up treatment. Along with creating separate 911 response teams, activists have called for reinvesting police funds in community organizations to support people with mental illness long before they’re in crisis, being shot at, or pinned to the pavement by police.

How the Justice System Fails People With Mental Illness Highway Patrol Trooper Chaney Wade was sitting in his car monitoring eastbound traffic on Interstate 20 in Smith County, Texas when he clocked Davis going 89 in a 75-mile-per-hour zone. Wade took Davis’s license and registration back to his car to run it through the computer. He watched Davis as he rocked his head back and forth. Then the brake light came on; Davis looked over his shoulder and just took off. Wade gave chase. Ultimately, Davis accepted a plea deal and was sentenced to four years in prison. Since he’s been inside, things have gotten worse.

Urgent Action Needed to Address Growing Mental Health Needs in Wake of COVID-19 In the same way we have taken actions to reduce the physical risk of COVID-19 transmission, we can also take actions to mitigate behavioral health risks that have resulted from the pandemic by implementing evidence-based practices and policies and by advancing a national conversation about mental health and suicide prevention.

BHive - National Council for Behavioral Health newsletter Mark your calendar for NatCon21, the largest conference in behavioral health care, occurring from May 3-5, 2021, and a list of upcoming webinars and other learning opportunities.

CDC: Proportion of pediatric emergency room visits for mental health increased sharply amid pandemic The CDC analyzed hospital data from 47 states that comprised about 75 percent of nationwide emergency room visits. One in 85 pediatric visits were mental health-related from March to October in 2019, compared to one in 60 in 2020.

ER visits, long waits climb for kids in mental health crisis By early fall, many Massachusetts ERs were seeing about four times more children and teens in psychiatric crisis weekly than usual. When children and teens are overwhelmed with anxiety, depression or thoughts of self-harm, they often wait days in emergency rooms because there aren’t enough psychiatric beds. The problem has only grown worse during the pandemic, reports from parents and professionals suggest.

A Tragic Recent Death Sheds Light on the Mental Health Crisis in Nashville A final autopsy report listed the manner of death as natural, with the cause of death being dehydration and malnutrition, with schizophrenia being a contributory cause. Hyperthermia, or overheating, could also not be ruled out as a contributing factor. The exact details of one man’s life and the circumstances that led to his death are unique. But the discovery of his body near a soccer field on a summer evening is a tragic reminder of the way many among us can suffer in isolation.

Assisted Outpatient Treatment: A First-Hand Perspective For many, assisted outpatient treatment (AOT) may variously be: a matter for academic study, a hobbyhorse for those in anti-psychiatry circles, a political football for (perhaps short-sighted) civil libertarians, or just a matter of applied public policy. It was that last one for me when, as an employee of the Texas Senate in 2013, I played a very minor role in the passage of an AOT statute in America’s second most populous state.

Solutions to restore inmates’ mental health and get them to trial For years, Texas’ state hospital system has operated at capacity, causing hundreds of mentally ill county jail inmates to wait months for a bed and treatment. The situation has forced mental health experts and county and state officials to explore alternatives, such as outpatient competency restoration, jail-based competency restoration, tele-psychiatry and specialized county mental health courts that can divert individuals from jail.

City, police officials unveil Detroit mental health initiative Some city police officers responding to runs that may involve the mentally ill soon will be accompanied by behavioral health specialists, as part of an initiative rolled out Monday which aims to address what Detroit's top cop describes as one of the biggest challenges facing law enforcement.

A look at our broken mental health system In January 2019 the Los Angeles Board of Supervisors approved a motion to the California Legislature to expand the definition of grave disability to include persons who are unable to seek medical care because of their mental illness. The legislature should act on that motion. In addition, the level of evidence for Grave Disability should be reduced from the current “beyond a reasonable doubt” to “clear and convincing.” If these changes were implemented California would have more psychiatric beds, fewer mentally ill persons in prison and more seriously ill persons receiving treatment.

Researchers flag racial inequity in Saskatoon mental health court Indigenous people have been underrepresented by a program that takes a compassionate approach to criminal justice, according to a new University of Saskatchewan study. Researchers found few Indigenous people move through Saskatoon’s Mental Health Strategy Court (MHSC), which coordinates treatment for people with mental health or cognitive issues.

Santa Barbara County Opens 34 New Beds for Severely Mentally Ill People Finally, Lompoc’s Champion Center opened its doors for a new mental health treatment center offering 80 new beds for those suffering serious mental health issues. Of those 80 beds, 34 will be filled by clients of the County’s Department of Behavioral Wellness at a cost of $362 a night per bed. On the first day, two of those slots were filled. By the end of the week, 10 had been.

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