Listening to the Field: Observations and Recommendations to Reduce Jail Populations During a Pandemic

updated behavioral health banners

Task Force Activities

Today the Task Force, in collaboration with the CCJ-COSCA Rapid Response Team, released three new behavioral health related pandemic resources for courts and judges:

Listening to the Field: Observations and Recommendations to Reduce Jail Populations During a Pandemic This brief describes lessons learned by four communities as they respond to the pandemic and its effects on people with significant behavioral health needs in the criminal justice system, particularly in jail. What emerges from the sessions conducted with these sites are unanticipated problems, useful data, and innovative practices that inform strategies that all criminal justice systems should embrace during and after the pandemic.

Improving Outcomes for People with Behavioral Health Needs: Diversion and Case Processing Considerations During a Pandemic The CSG Justice Center and NCSC produced “Improving Case Processing and Outcomes for People with Behavioral Health Needs” which includes strategies for improving case processing that emerged during the peer learning collaborative. This brief, developed by NCSC as part of its Pandemic Resources series, highlights strategies for diversion and case processing during and after the pandemic.

Addressing the Mental Health and Well-Being of Judges and Court Employees The purpose of this brief is to help court leaders promote a mentally healthy workplace by reducing pandemic-related stress within the workforce. Individual state responses addressing the mental health and well-being of judicial system employees are provided, along with links to resources, best practices, and tips.

Research and Resources

Virtual Summit Seeks to Disentangle Mental Health, Criminal Justice in Colorado In the absence of adequate access to health services, people with unmanaged mental health needs often intersect with law enforcement and spend time in jails, then cycling in and out of detention, homelessness, and joblessness. Mental Health Colorado, the state’s leading mental health advocacy organization, will host the Virtual Summit on Mental Health and Criminal Justice on Feb. 4 to identify opportunities for state policy change and to promote changing practices statewide. The keynote speaker for the virtual summit is Florida Judge Steve Leifman from Miami-Dade County, who helped launch Miami-Dade County’s jail diversion initiative.

JPLI Newsletter, including How One Psychiatrist is Helping People in the Justice System with a Free, Online Resource START NOW is a skills-based, manual-guided group psychotherapy program that was developed to help people in the justice system manage their behavioral health needs. Co-developed by Dr. Robert L. Trestman, an American Psychiatric Association council member, the program is available online for free and has been adapted for forensic psychiatric hospitals and some community settings.

NCSC Implementation Lab Initiative The overall goal of the Implementation Lab Initiative is to foster the implementation of sustainable innovations across a large, diverse group of courts throughout the United States, to continue to learn about the impact of these innovations, and to nationally spread lessons learned throughout the process.

Strengthening Families: What Role Can Courts Play in Upstream Family Preservation? This joint presentation by NCSC and COSSAP discusses the ways in which serving the needs of children and families affected by substance use and misuse can be proactive.  Preventative, upstream approaches can decrease the negative impacts on children, decrease the load on formalized systems, and help families stay together while they heal.  In working with families at risk for child welfare system involvement, there is a valuable judicial leadership role for the courts within the community.

Telehealth and Telecommunication Opportunities in the Criminal Justice System Technology is fundamentally changing the way that behavioral health care and services are delivered across the country. For leaders in the criminal justice system, telehealth is expanding access to assessments, case management, connections to treatment providers, and more—critical services that can improve outcomes for people with behavioral health needs.

Supporting Peers Providing Services at Intercept 0 This SAMHSA webinar will present practical information from the field and highlight new innovations to support peers who respond to mental and substance use crises at Intercept 0 of the Sequential Intercept Model. Presenters will discuss safety considerations, opportunities for leveraging technology, and promising practices that have emerged in response to the COVID-19 pandemic.

COSSAP Webinar: Telehealth Implementation Support Tool Demonstration During this webinar, attendees will learn how jail facilities can use the tool to understand the various protocols, policies, technologies, and staff positions that will need to be in place to facilitate the implementation of telehealth. Attendees will also learn how they can volunteer their agencies to test the tool.

Making Changes: Cognitive Behavioral Interventions in Jails and Community Corrections Jails and community corrections settings provide different challenges to the implementation of CBT programs. For those exploring the implementation of these types of programs, learning from similar agencies who have successfully implemented is valuable. This webinar will feature presentations from jail and community corrections leaders describing the implementation of CBT programs in their organizations.

NASMHPD Update Includes the Acting Assistant Secretary for the Substance Abuse and Mental Health Services Administration (SAMHSA) announcement, NIMH’s launch of the Early Psychosis Intervention Network (EPINET): A National Learning Health Care System, and more.

Training and Technical Assistance Related to COVID-19 The latest update to the list of SAMHSA pandemic resources.

New Support Centers Offer Behavioral Health Resources and Assistance The Council of State Governments (CSG) Justice Center has launched two national support centers for communities and organizations looking to improve outcomes for people with behavioral health needs in contact with the criminal justice system. The Law Enforcement-Mental Health Collaboration Support Center and the Center for Justice and Mental Health Partnerships will serve as unique clearinghouses for free training, resources, and tailored assistance.

SAMHSA's GAINS Center Newsletter Includes announcements of SAMHSA awards, and a listing of newly available webinar archives.

FRN Newsletter: Deflection & Pre-Arrest Diversion Frontline Responders Network is continuing its collaboration with PTACC to put on a series of conversations from the field, featuring the informative output from its 7 core strategy areas. PTACC's main focus is the importance of Deflection and Pre-Arrest Diversion. A list of upcoming FRN webinars is also included.

Winnable Criminal Justice Reforms A Prison Policy Initiative Briefing on Promising State Reform Issues for 2021 Contains a list of strategies and accompanying resources across the continuum of justice reforms, including expanding alternatives to criminal justice system responses to social problems.

Neuroimaging Biomarkers for Schizophrenia In this review, the authors discuss a range of mechanistically plausible neuroimaging biomarker candidates. Currently, no objective biological measures—that is, biomarkers—are available to inform diagnostic or treatment decisions. Neuroimaging is well positioned for biomarker development in schizophrenia.

TAC Research Weekly: January Research Roundup Includes summaries of research about mortality after the first diagnosis of schizophrenia, substance use patterns in individuals with schizophrenia, and suicides in vulnerable populations during the COVID-19 pandemic.

Supporting Family Drug Court Participants through Comprehensive Case Plans: We’re in This Together Presenters on this SAMHSA webinar will share ideas on how community-based organizations can collaborate effectively with child welfare and other public agencies—enabling them to meet the requirements of regulations and funding—while creating a meaningful and manageable case plan for families.

PRA's January eNews 2020 year in review, a new resource: Graphic Recording Notes From the Discussion on Diversity, Equity, and Inclusion Throughout the Intersection of Criminal Justice and Behavioral Health, and a new article in the Journal of Psychosocial Nursing and Mental Health Services explores using nudges to support well-being for individuals with behavioral health needs.

Reimagining Response to Vulnerable Populations in Crisis Abt provides a framework for considering the different types of programs for preventing crises or improving emergency responses for individuals experiencing SMI, SUD, and/or homelessness and are in crisis. The types of programs included in the framework support efforts to minimize involvement of first responders by engaging behavioral health or other specialists in the response and, when first responders are involved, ensuring they have the training and support to de-escalate, screen, and connect individuals to needed services and care.

VIP’s to Discuss Housing, Homelessness & Ending Street Suffering Paul Webster, MPP, former policy advisor with the Department of Housing and Urban Development (HUD), Elinore McCance-Katz, MD, PHD, 1st Assistant  Secretary under HHS for Mental Health and Substance Use, and Drew Pinsky, MD, and Popular Media Personality will discuss new advocacy efforts that are beginning to take shape to push for housing to stop street suffering for people living with chronic untreated and under treated serious mental illnesses and substance use disorders.

Mental Health First Aid Monthly Newsletter Tips to help you practice resilience, remain hopeful, and support your loved ones as we face the challenges this year may bring. Keeping everything in perspective and creating a self-care plan are great places to start – making your mental health a priority this year will make all the difference.

SSI for Children - Engaging Families for Successful SOAR Applications SSI for children can provide critical support to families who are experiencing or at-risk of homelessness. Establishing a child’s eligibility for SSI benefits requires engagement with various child serving systems such as education, behavioral health, child welfare, and juvenile justice. Building relationships with these systems and engaging the entire family in the process is critical to submitting a successful SOAR-assisted child SSI application.

Justice Briefing - CSG Justice Center newsletter New center to help states strengthen victim restitution programs; 10 ways to improve the competency to stand trial process; how to leverage technology to expand access to critical services, and President Biden’s COVID-19 plan.

Application Deadline Approaching: Individual Trauma-Informed Responses Train-the-Trainer Events SAMHSA's GAINS Center is now soliciting applications from experienced trainers (individuals) who are interested in developing their capacity to provide trauma-informed training in their local agencies/communities via the How Being Trauma Informed Improves Criminal Justice System Responses curriculum.

AI Predicts Schizophrenia Symptoms in At-Risk Population In recently published research, the tool was used to analyze functional magnetic resonance images of 57 healthy first-degree relatives (siblings or children) of schizophrenia patients. It accurately identified the 14 individuals who scored highest on a self-reported schizotypal personality trait scale.

In the News

Why Defunding the Police Won’t Fix Mental Health Care One of the consequences of the death of George Floyd and subsequent civil unrest has been the idea of defunding the police to reallocate money back to social service programs that provide care to those with mental illness. On paper and as a media sound bite, this sounds good, but it is unlikely to succeed. Rather, it is a reactionary measure to poor decision-making and systemic lack of funding for the mentally ill that dates back to the 1960s.

Kansas ‘Stepping Up’ to reduce number of inmates with mental illness According to Gov. Kelly, the Kansas Stepping Up TA Center is only the second of its kind in the nation and will offer virtual and in-person technical assistance that was designed specifically for Kansas counties to support policies and programs that improve outcomes for inmates with mental illnesses and co-occurring substance use disorders in jails.

Utahns’ mental health hasn’t been significantly affected by the pandemic, a new state report says The COVID-19 pandemic hasn’t caused “significant increases” in suicide, mental distress or drug overdoses in Utah, according to the state Department of Health, which attributes that to the state’s existing mental health and substance use resources. “There has certainly been this narrative out there that we have seen significant increases in suicides or overdose deaths. The good news is that is not true,” Gov. Spencer Cox said.

Who Will Replace Dr. McCance-Katz At SAMHSA? Could Be A Surprise But Here’s (sic) Six Names Being Whispered Six names are being whispered, but insiders are warning that California Attorney General Xavier Becerra, the Biden Administration’s nomination for Secretary of Health and Human Services, will make the final call after he is confirmed by the U.S. Senate. He isn’t coming from the mental health and substance use community so his choice to head the Substance Abuse and Mental Health Services Administration could be a surprise. Among the names I’m hearing are: Dr. Jeffrey Lieberman. Andrew Keller. Dr. Anita Everett, Arthur C. Evans, Judge Steve Leifman and Paolo del Vecchio.

Hays County mental health court has taken no cases more than a year after created Hays County confirms its mental health court that commissioners voted to create more than a year ago has not taken a single case. Commissioners created the court in December 2019. It sets out to take on criminal misdemeanor and felony cases, where mental health might have played a role.

Covid linked to risk of mental illness and brain disorder, study suggests One in eight people who have had Covid-19 are diagnosed with their first psychiatric or neurological illness within six months of testing positive for the virus, a new analysis suggests. The analysis – which is still to be peer-reviewed – also found that those figures rose to one in three when patients with a previous history of psychiatric or neurological illnesses were included.

Crisis Intervention Team Training vs Alternatives Without Police: Which Is Better? Instead of CIT, what about Co-Response and Alternative Response models, where mental health professionals assist the police during a mental health crisis either in person such as a social worker ride along or remotely from a control room or crisis center. This is sometimes framed as an either/or discussion when it comes to CIT.  It shouldn’t be.

The Latest from The Kennedy Forum The Kennedy Forum hosted a webinar titled “Shocking Injustices: Mental Healthcare & Black Americans” as part of the 2021 National Day of Service to honor the life and legacy of Reverend Dr. Martin Luther King, Jr., and Patrick Kennedy also joined Well Being Trust and Inseparable for a webinar titled “Becoming an Advocate for Mental Health Reform.” Links and other news items are included.

National Council for Behavioral Health Capitol Connections newsletter This edition includes information on the reintroduction of the Mental Health Access Improvement Act, and information about NatCon21.

Data Scientists Ask, “What if We Could See the Entire Crisis System?” They’re developing a care traffic control center, featuring large screens that track the three main hospital access points in Queensland for a person in crisis: a crisis call, ambulance to emergency department, or a community clinic referral. The screens also give the controllers an overview of all patients in the ED and inpatient hospitalization. “We can visualize the system as a whole and key characteristics of individual patients, giving crisis teams better awareness of the decisions they’re making and the implications.”

PEW's The Rundown PEW recommends that the new administration embrace policy solutions that are evidence-based, bipartisan—and have already been tested at the state and local levels. The first recommendation: make sure police aren’t the first response to people in crisis.

Don’t Undo the Trump Administration’s Mental-Health Reforms In naming the next SAMHSA head, Biden and Becerra must resist calls to reverse some of McCance-Katz’s initiatives and return to the old regime, under which people with severe mental illnesses were regarded as second-class constituents. The new administration should instead look for a leader who will build on McCance-Katz’s groundbreaking work in caring for those with the most devastating diseases of the mind and brain.

COVID cuts beds for mentally ill Some people with serious mental illnesses who require hospitalization aren’t getting the treatment they need, local law enforcement leaders said. Due to the pandemic, the Northwest Ohio Psychiatric Hospital, a Toledo-based facility run by the Ohio Department of Mental Health and Addiction Services, has temporarily halted all new patient arrivals. “I have five inmates pink-slipped, and they can’t go anywhere,” Sheriff Corbin said. “They really need professional help. We have to hold them indefinitely until there’s room available or until we can find a placement for them.”

Albuquerque’s vision for non-police first responders comes down to earth Printed in white block letters, the question stretched across billboards around Albuquerque last summer. “What if emergency responders came armed with compassion instead of guns?” But the planned overhaul of Albuquerque’s crisis response system has run into funding and implementation hurdles from which others should learn.

Newsweek: The Future of Mental Health Crises and Police A June 2020 survey by Data for Progress found that 68 percent of American voters support the creation of a new, non-police first responder agency to answer mental health calls. This support cuts across racial and partisan lines, with huge majorities of Republicans, Democrats, white and Black voters all supporting this essential change. Our coalition is calling for reforms along these lines and modeled after similar efforts emerging from other cities throughout the country.

Navajo County reforms help mentally ill The Queen of Scotland wandered through traffic on the highway outside of Holbrook, naked from the waist down. She gestured and shouted unintelligibly at the traffic, over which she reigned. Arriving Navajo County Sheriff’s deputies found themselves confronted with a dangerous and perplexing dilemma — how to handle the Queen of Scotland on a busy night. The incident illustrates the huge step forward Navajo County has made in the last six months by setting up two mental health crisis teams, Dawn Wilson told an appreciative Navajo County Board of Supervisors on Tuesday.

New north shore court to help mentally ill people get treatment - and stick with it Called Assistive Outpatient Treatment Court, it differs in a key way from the other six specialty courts already operating in the district, such as Veterans Court and Drug Court. Participants won't be criminal defendants who have run afoul of the law; instead, they'll be people struggling with severe mental illness, with histories of psychiatric hospitalizations and noncompliance with treatment. The only downside for someone who doesn't follow the court's plan is that they likely will be hospitalized.

Midland County’s Mental Health Court aims to rehabilitate minor offenders with mental illness “As a judge, we have tremendous authority, but jail is not always the answer,” says 42nd Circuit Court Chief Judge Stephen Carras. “... We can do what we’ve always done and we’re going to get what we’ve always got.”

Plans to divert people suffering mental health crisis from jails, ER evolve in Kent County The plan to divert people suffering mental health crises from jails and emergency rooms to a crisis center in Kent County has evolved to potentially include mobile crisis response units, a central behavioral health call center and two crisis campuses. The intent is to fill a “critical gap” in behavioral health crisis services in the county that saw many in crisis ending up in hospital emergency departments and jails.

Tuscaloosa Police Department sees “rapid rise” in mental health calls, launches new behavioral health unit After receiving double the amount of mental health calls in one year, The Tuscaloosa Police department is now launching a behavioral health unit. Every officer in the department has had a day of training in mental illness response, but now the department will also have officers specifically for mental health calls. The new unit has five certified mental health officers and nine crisis intervention team officers. The officers experienced hands-on training and get a certification after 40 hours.

Bucks County District Attorney pens open letter to President Judge on importance of mental health court With the development of a mental health court expected later this year in Bucks County, District Attorney Matt Weintraub penned an open letter to President Judge Wallace H. Bateman to detail the importance of how it will address the unique situations of defendants living with serious mental illness. He also attached a copy of a 41-page report from the University of Pennsylvania's Quattrone Center for the Fair Administration of Justice. This report concludes that a mental health court will help reduce the time offenders with mental illness spend in jail, improve public safety by reducing recidivism and lead to quality-of-life improvements.

Sarpy County to launch Nebraska's first mental health problem-solving court The Sarpy County Wellness Court will be a voluntary option for those with major mental health diagnoses who are facing nonviolent felony charges. The county on Tuesday unveiled the program that’s expected to begin in early February. At full capacity, the program will be able to serve 25 people at a time.

Mental health is one of the biggest pandemic issues we'll face in 2021 As the physical risks are better managed with vaccines, what will likely still remain is the indelible impact of the pandemic weighing on the collective psyche.

Want to get the Behavioral Health Alerts newsletter automatically? Subscribe here.

Have comments or feedback about Behavioral Health Alerts? Contact Rick Schwermer at