Nancy Cozine Discusses the Task Force’s Work and Goals

Task Force and Task Force Member Activities

Nancy Cozine Discusses the Task Force’s Work and Goals In the fourth of eight interviews of the National Judicial Task Force Executive Committee members, Oregon State Court Administrator Nancy Cozine, Co-chair of the Criminal Justice Work Group, discusses how the Task Force’s work will lead to real change, what she hopes the Work Group will accomplish, and what challenges Oregon is facing.

ICYMI: Task Force Report Delivered to CCJ and COSCA This comprehensive report provides details about future Task Force activities, resources that have already been developed and are available for use, and ways in which members of CCJ and COSCA can engage in the work of the Task Force. The report delivers new interim resources available for courts and communities to use now.

Registration for Pima Site Visits is Open The Task Force is organizing and supporting two site visits to Pima County Arizona to observe and meet with those that operate the model Crisis Response Center and the various behavioral health diversion programs. One is scheduled for October, and one for November.


Research and Resources

Adopting a Gender-Responsive Approach for Women in the Justice System: A Resource Guide This guide to gender-responsive approaches was developed by The Council of State Governments Justice Center in partnership with the National Resource Center on Justice Involved Women. The guide can help program providers in behavioral health and criminal justice settings across the country develop gender-responsive programs. The guide focuses on six topics that are fundamental to carrying out effective programs for women in the justice system.

Advancing the Work of Peer Support Specialists in Behavioral Health-Criminal Justice Programming Peer support specialists are often asked to draw on their lived experience with behavioral health conditions and criminal justice involvement to support participants of behavioral health-criminal justice programs. This experience allows them to offer inspiration and model positive behaviors, as well as connect people to needed supports and lead recovery groups, among other benefits. At the same time, implementation challenges can limit their effectiveness. The Council of State Governments Justice Center interviewed peers who work with three Justice and Mental Health Collaboration grantee programs to better understand how to overcome these challenges. This brief highlights four key strategies gleaned from these interviews, that can be used to advance the work of peer support specialists.

New Video from Addiction Policy Forum Breaks Down the Stigmatizing Language Addiction Policy Forum’s three-minute video explains why five commonly used addiction terms need to be erased from your vocabulary and offers suggestions for what to say instead.

Olmstead Enforcements for Moderate to Severe Brain Injury: The Pursuit of Civil Rights Through the Application of Law, Neuroscience, and Ethics Our Article considers what the legal system can do to identify and support the recovery and reintegration of persons with severe brain injury, suffering from disorders of consciousness. We explore the possibility of marshaling law to advocate for this cohort of patients, who are currently overlooked by the medical and legal systems. Despite their potential for recovery, many of these individuals remain segregated in nursing homes, where they do not receive adequate medical care, much less the rehabilitation that might permit the restoration of functional communication, which is so central to their reintegration to the nexus of their homes and families

New SAMHSA Publication: TIP 63: Medications for Opioid Use Disorder The Executive Summary of this Treatment Improvement Protocol provides an overview on the use of the three Food and Drug Administration-approved medications used to treat opioid use disorder—methadone, naltrexone, and buprenorphine—and the other strategies and services needed to support recovery.

Data Collection Is Crucial For Equity In Diversion Programs The Prosecutorial Performance Indicators project, an initiative led by researchers at the Florida International University and Loyola University of Chicago to help prosecutors collect data to improve their methods, recently released a report that looked at racial disparities in the number of people who had their cases diverted from criminal courts to diversion programs, like mental health or drug courts.

TAC Research Weekly: Hospitalization for Serious Mental Illness Among Most Frequent Inpatient Stays The Healthcare Cost and Utilization Project (HCUP) of the Agency for Healthcare Research and Quality, U.S Department of Health and Human Services released a statistical brief last month on the most frequent principal diagnoses for inpatient stays in U.S. hospitals in 2018. Mental illness or substance use disorders were in the top five reasons for inpatient hospitalization for individuals in the youngest age groups under 45 years old. The same data source from HCUP suggests that serious mental illness was the largest reason for hospital readmissions within 30 days of discharge in Medicaid patients, costing a combined $588 million in 2014, indicating individuals are not fully stabilized when discharged to the community.

Listen to the ACEdit! Podcast The ACEdit! Podcast, a product of the Justice Community Opioid Innovation Network (JCOIN), is a new way to learn about research without having to read full-length journal articles and research reports. This podcast is perfect for the busy student, researcher, or interested individual who just doesn't have enough hours each day for more reading. In each episode of the ACEdit! Podcast, hosts break down a research article, report, or scientific finding into everyday language so listeners can not only understand it... but so they can actually use it! All episodes are under 15 minutes in length.

Deflection: Leveraging Police and First Responders to Create New Pathways to Treatment and Recovery In this webinar, presenters will discuss the latest research and innovations in this emerging field. Topics covered include the scope and services covered by deflection partnerships, legislative and policy developments that are advancing the field, and new approaches to linkages to mental health services, police training, and police response.

Whole-Person Care for People Experiencing Homelessness and Opioid Use Disorder Join SAMHSA’s Homeless and Housing Resource Center as we introduce the Whole Person Care for People Experiencing Homelessness and Opioid Use Disorder Toolkit, a new resource to support and assist people experiencing homelessness and OUD with a whole-person care approach that supports and facilitates the recovery journey and a fulfilling life in their communities.

Virtual Roundtable: Creating and Enhancing Pathways to a Racially/Ethnically Diverse Behavioral Health Workforce Join SAMHSA’s National Network to Eliminate Disparities in Behavioral Health (NNED) Virtual Roundtable on Wednesday, August 18 at 1 p.m. ET to hear about strategies that motivate racially/ethnically diverse individuals to consider behavioral health as a career path. Discover how community-based organizations are working to diversify the behavioral health workforce including recruiting and retaining racially/ethnically diverse staff. Learn from panelists about professional pathways and programs/trainings that support racially/ethnically diverse people in behavioral health careers.

Reaching In: Planning for Successful Transition Back into the Community In-reach activities in incarceration settings are critical for preparing individuals for reentry and reducing the likelihood of reincarceration. For people with mental and substance use disorders, in-reach is vital to ensure continuity of medical and behavioral health care upon release as well as to reduce the likelihood of death by drug overdose in the community. In this SAMHSA webinar, three organizations providing in-reach programming inside jails and prisons will present the specific features of their programs and share their recommendations for effective program design and implementation

Promoting Workforce Mental Well-Being and Resilience: A Virtual Webinar Series One Mind at Work has recently partnered with BSR's Healthy Business Coalition to advance workforce mental health. Together, we are hosting a webinar series called Promoting Workforce Mental Well-Being and Resilience, with a special focus on the needs of low-income and frontline workers.

Upcoming SAMHSA GAINS Center Webinars SAMHSA's GAINS Center is covering essential topics through its upcoming national webinars.

New One-stop BJA Treatment Court Resource An overview of drug court and other problem-solving court program models and available guidance, updated regularly with information on program and research resources supported by BJA, the Office of Juvenile Justice and Delinquency Prevention, and the National Institute of Justice, with hyperlinks to current training and technical assistance providers and relevant documents.

Taking the Call: A National Conference Exploring Innovative Community Responder Models Join the CSG Justice Center, the U.S. Department of Justice’s Bureau of Justice Assistance, and the University of Cincinnati for Taking The Call, a two-day national conference exploring innovative community responder models. The conference will highlight the opportunities and challenges of these community responder models and discuss how the approach may improve community health, lessen the burden on law enforcement, and reduce unnecessary justice system contact. The virtual conference is free and open to the public; pre-registration is required.

NASMHPD Update A comprehensive compendium of resources from the National Association of State Mental Health Program Directors.

OJJDP Launches Opioid Affected Youth Initiative Website OJJDP recently launched the Opioid Affected Youth Initiative (OAYI) website. OAYI helps nationwide project sites to develop data-driven and coordinated responses to opioid abuse and other substance use disorders affecting youth, families, and communities. The website highlights OJJDP-funded OAYI grantees and serves as a central hub to share and document the impact of implemented strategies designed to combat the opioid epidemic.

COSSAP Digest The COSSAP Digest is a compilation of COSSAP-developed publications, webinars, podcasts, and other information recently posted to the COSSAP Resource Center, as well as upcoming events. This edition includes an NIH study, Emergency Department-Administered, High-Dose Buprenorphine May Enhance Opioid Use Disorder Treatment Outcomes, and information about the U.S. Drug Enforcement Administration (DEA) lifting the 14-year moratorium on mobile methadone-dispensing vans operated by narcotic treatment programs.

Safety and Justice Challenge - About Jails Local leaders involved in the Safety and Justice Challenge are proving it is possible for jurisdictions to rethink local justice systems from the ground up with forward-looking, smart solutions that safely reduce jail populations and eliminate ineffective, inefficient, and unfair practices. Beginning and sustaining these reform efforts requires data-driven strategies informed by the community.

Mental Wellbeing Weekly Addressing the CDC overdose death numbers, Youth Mental Wellbeing: Tips & Resources, and a list of upcoming webinars.

Providing a Routine Medical Necessity Letter to Improve Access to Care for Our Patients This Journal of Psychiatric Practice column explains the value of developing routine medical necessity letters to help patients maximize the likelihood of securing insurance approval for medically necessary services for the treatment of mental and substance use disorders, including psychotherapeutic treatment.

Science Over Stigma: Education and Advocacy for Mental Health In the July 2021 issue of the American Journal of Psychiatry, Stephen R. Marder, MD, describes the struggle to eliminate the stigma associated with schizophrenia. Marder notes that “the negative attitudes and beliefs about schizophrenia have detrimental effects, including discrimination in housing, employment and social opportunities.”1 Now comes Daniel B. Morehead, MD, with a book whose title hopefully proclaims, “Science over Stigma.” This is an outcome devoutly to be wished—but can it be achieved, given so many entrenched prejudices regarding both psychiatric illness and those of us who treat it?


In the News

The Chronic Misunderstanding of the Peer Role in Behavioral Health Peers are often thrown into roles more like behavioral health technicians because of a fundamental, nationwide misunderstanding of what peers do and the function they serve. “It’s why many crisis service providers find they’re struggling to retain their peer workforce.” That and because pay for certified peer specialists often lags far behind other mental health professions. A survey published in 2016 by the College for Behavioral Health Leadership revealed the average hourly wage among peer support specialists to be $15.42.

Serious gaps in mental health care in Washington prisons, report warns The report, months in the making, sounds the alarm about numerous shortcomings, including mental health workers with hefty caseloads and distressed prisoners who have to wait to see a mental health professional. Other issues identified by the Office of the Corrections Ombuds (OCO) include problems with how psychiatric medications are prescribed and a disciplinary process that often fails to take into account the incarcerated individual’s mental health.

New Illinois laws aim to advance safety, mental health resources for first responders Senate Bill 1575 requires the creation of an online resource page with a comprehensive collection of mental health resources specifically geared toward first responders. It will include crisis services, wellness, trauma information, nutrition, stress reduction, anxiety, depression, violence prevention, suicide prevention and substance use.

How a Liberal Michigan Town Is Putting Mental Illness at the Center of Police Reform When I ask Washtenaw Sheriff Jerry Clayton what he thinks about Anthony’s cycle of incarceration, he shakes his head slowly in frustration and says, almost inaudibly, “Shouldn’t be here.” When I ask him to elaborate, he returns to his full and commanding voice: “It’s not only a criminal justice failure, it’s a societal failure. The criminal legal system is the tool that society uses to carry out its policies. Society’s lack of understanding and sensitivity to mental illness have led to these terrible situations like Anthony’s and many others like him.”

Maryland Department of Health Sees Increased Wait Times in Providing Court-Ordered Treatment Though treatment wait times have increased, the COVID-19 pandemic has brought some benefits to the state’s psychiatric hospitals. Most notably: Zoom hearings. Since March 2020, the Maryland Judiciary has conducted 120,837 meetings over Zoom with approximately 175,000 participants, totaling almost 40 million minutes. Zoom has had a significant impact on defendants held in the state’s psychiatric facilities. “It’s wildly less disruptive” for people experiencing mental health problems to meet online rather than be transported to the courtroom.

Psychiatrist shortage in Michigan causes issues for mental health access According to statistics last year from the Association of Medical Colleges we are about 2800 psychiatrists short in the country. It's projected to go up to 6800, short by 2025. "Nationally, nobody is turning out enough. We have about 1000, maybe 1400 psychiatry residents in the country. So, we turn out somewhere around that number each year, that's not nearly enough to take care of the huge burden of mental illness in the country," Magen said

Opinion: To Improve Public Safety in NYC, Send Fewer People to Jail Research from across the country—including New York—has consistently found that while jailing people temporarily incapacitates them, it leads to more, not less, criminal activity following their release. Co-authored by former Chief Administrative Judge of the State of the New York Unified Court System Jonathan Lippman.

Give NJ youth mental health treatment, not prison time, advocates say According to the Institute's data, New Jersey spends an average of $445,504 to incarcerate one juvenile for one year. That money not only could be better used elsewhere, Jones said, but it could also help to halt a cycle of recidivism, substance abuse, and suicidal ideation, for dozens of kids at a time. "$350,000 for mental health services for 40 young people versus $445,000 to incarcerate a single one," Jones said. "Those are the type of numbers that we're looking at right now."

Washington State’s 988 Legislation Includes a 988 Tribal Crisis Line Washington State is creating a 988 tribal behavioral health and suicide prevention line, which includes $1 million in funding to develop and operate the line and a tribal 988 subcommittee. The new legislation states the subcommittee will “examine and make recommendations concerning the needs of tribes related to the 988 system.” That includes representation from the American Indian Health Commission of Washington State.

Freedom House Provides Model for States to Develop Behavioral Health First Responders Emergency medical services in the United States have been shaped by the pioneering 1960s-‘70s Freedom House, a professional Black-run ambulance service that replaced law enforcement and funeral homes in the role of emergency transport, many of whom refused to go into Black neighborhoods, and helped establish the national standards for emergency medical care used today. More than a half-century later, psychiatrist Eric Rafla-Yuan says states can learn from the Freedom House EMT model as they prepare for 988 by creating a new mobile crisis team role: dubbed by some as a behavioral health first responder or psych-EMT.

'Kayak Court' provides the homeless with access to legal services in Salt Lake City Once a month since May, the volunteers head to the homeless encampments. Social workers paddle or bike ahead of the legal teams to identify individuals who would be open to legal counsel and resolving their cases. The case workers assess trauma and other mental health issues and decide if the person is a good candidate and ready for the service, Russo said. Once the individual consents to legal help, the attorneys step in and discuss options and the cases against them. Usually, the defendants are facing violations such as public intoxication or public urination. The judges take up the case right on the river or bike path and usually resolve the problem that day. That means there's no need for the person to be summoned back to court.

Maryland Department of Health awards $48 million in mental health and substance use grant funds MDH will award $16 million through the Community Mental Health Service Block Grant (MHBG) and $32 million through the Substance Abuse Prevention and Treatment Block Grant (SABG). MHBG funding will be used to support early serious mental illness services, crisis care infrastructure, and expansion of Family Peer Support and Navigation. Nothing that appears to directly involve court processes, however.

How Mental Health First Responders in an Oregon City 'De-escalate' Conflict and Save Lives It works like this: When 911 calls come in, those that involve suicide threats, homelessness, substance abuse and other mental health-adjacent crises are diverted away from law enforcement and over to CAHOOTS' two-person teams consisting of an EMT and a mental health counselor. CAHOOTS staff who respond can provide everything from clothing, food, water, toiletries and first aid to on-the-scene counseling — or a ride to a crisis center or hospital. In 2019 CAHOOTS teams answered 24,000 calls and required police backup only 150 times.

Stepping in after 911: Jefferson County sheriff hires first in-house mental health pro Mental health professionals are becoming more common with metropolitan police forces as the topic has moved into the national conversation around police reform this year, but a full-time mental health coordinator is still rare for sheriff’s offices that tend to be smaller and patrol exurban and rural areas. In Jefferson County, Flamion will be focused on getting help to the people who prompt the most mental health calls. She will go on some 911 calls alongside deputies and will follow up to try and connect people with mental health and other support services.

Boston plans to redirect some 911 calls to mental health workers, away from police “Each call should have a response tailored to its purpose,” Janey said, adding that 911 dispatchers would be trained to differentiate among types of crisis calls. The hope in amplifying the roles of mental health workers and decreasing the roles of police officers, Janey said, is to divert people in crisis from jails, courts, and emergency rooms to the proper care they need, while also freeing up police to deal with violent crimes rather than issues of mental health.

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