New Report: Mental Health Competency Hearings Need Reform

Task Force and Task Force Member Activities

New Report: Mental Health Competency Hearings Need Reform “The crisis in the competency system is the canary in the coal mine for the crisis at the intersection of our behavioral health and criminal justice systems,” said Oregon Circuit Court Judge Nan Waller, a task force member. “Too many mentally ill people end up in the criminal justice system for lack of other options and are then funneled through the clogged competency process.” “The solutions,” Judge Waller said, “require increasing community mental health supports and services, developing points of deflection and diversion from the criminal justice system and streamlining the competency process.” The report is intended to be an immediate resource for state court leaders.

Research and Resources

TAC Research Weekly: Co-Responding Police and Mental Health Team Reduces Likelihood of Arrest A new study published in Psychiatric Services examined the effects of a co-response team on mental health and criminal justice outcomes for individuals compared to those who only received a response from the police. The study found that the presence of a co-response team reduced the likelihood of arrest at the crisis incident but resulted in a higher likelihood of future involvement with emergency medical services in the following year. The researchers do not have a definitive reason for why emergency service use increased but posit that it may be because the individuals had a positive experience with the co-response team, leading them to use more crisis services as a result.

Addressing Misconceptions about Mental Health and Violence Despite public perception that there is a direct connection between mental health and violence, research shows that this relationship is complex and that the presence of a mental illness doesn’t automatically predispose a person to violent behavior. As criminal justice professionals work to protect public safety, it’s important that their policies and practices reflect accurate information, not common misperceptions. This brief addresses these misconceptions, presents important information about risk factors for violence, and offers ways that criminal justice professionals can help mitigate such risks.

Cultivating Law and Medicine Partnerships to Support Justice-Involved Individuals With Substance Use Disorders This resource guide is intended to support judges and other justice-system stakeholders as they seek to further integrate evidence-based substance use disorder (SUD) treatment practices into their work.  It is also designed to support the development of partnerships between the justice system and the medical community.

Responding to Familiar Faces in Crisis Part 2: Engagement Challenges and Strategies In this three-part series, Stepping Up Innovator counties will share how they effectively serve people who frequently cycle in and out of jails, emergency departments, and other community-based settings.

Arizona Attorney - September 2021: Special Focus on Mental Health Law This edition of the Arizona Bar magazine has five articles addressing mental health law, including Ethical Issues When Representing a Client with Mental Health Issues; The Crossroads of Family Court and Mental Health; and Misdemeanor Treatment Courts and Competency Proceedings.

Registration is Now Open for Kennedy Forum Free Virtual Annual Meeting Registration is now open to attend our free virtual sessions on October 6th & 13th, from 1-5pm ET/12-4pm CT. Our Words Matter: Harnessing the Power of Communications to Advance Mental Health Equity will bring together people from all walks of life to discuss the power of our words and the way that we portray mental health and substance use in the media.

New Homeless and Housing Resource Center (HHRC) Website HHRC is the central hub of easily accessible, no-cost training for health and housing professionals in evidence-based practices that contributes to housing stability, recovery, and an end to homelessness.

Minding Your Noggin: A Comparative Analysis of Mental Health Care Law in the U.S., U.K., and China The United States, United Kingdom, and People’s Republic of China each passed legislation bringing mental health care (“care”) into parity with physical health care.1 Each country continues to struggle to meet the demand for care, in part, because the existing legislation fails to adequately provide for community-based treatment facilities and thousands of people continue to undergo involuntary commitment without due process of law. This article will briefly offer an overview of the history of care in the countries at issue and will offer a solution to a fragmented and often slow march to progress in achieving a mentally healthy society.

Supporting Continuity of Care Throughout Justice Involvement The first BJA/COSSAP webinar will focus on initiating and maintaining treatment upon entry into jail. The second webinar will focus on supporting jail in-reach by community-based treatment providers. The final webinar will cover effective and safe transitions to community-based treatment.

Bureau of Justice Assistance's Academic Training to Inform Police Responses Initiative Crisis Response for Rural Communities—Using Technology and Peer Support to Meet People in Crisis, Where They Are This webinar will feature two programs that have adapted crisis response for use in rural communities. Panelists will present the innovative approaches in crisis response implemented by their programs and discuss the challenges of ensuring the needs of individuals in crisis who live in rural communities are met. Additionally, the Academic Training project team will highlight key resources to support rural communities developing and implementing crisis response in their jurisdiction.

Updates on Deflection with PTACC Building Recovery Ecosystems; Reimagining Crisis Response; and CSG Conference: Taking the Call- Emergency Response.

NASMHPD Update New resources and news from the National Association of State Mental Health Program Directors.

CDC Mental Health Quiz There are still many harmful attitudes and misunderstandings around mental illness, which may make people ignore their mental health, fuel stigma, and make it harder to reach out for help. Take the following quiz and see if you can you separate the myths from the facts.

In the News

State Spending on Mental Health Rises. But for How Long? States have set aside millions of federal dollars for mental health and substance use disorder services, but the money must be spent by the end of 2026. Then, states will have to find other ways to fund the programs. Health officials in those states hope the influx of cash will be a game changer. They’re planning to spend it on everything from mental health awareness campaigns to mobile crisis teams and bonuses for psychiatric hospital staff. But State leaders need to make sure they don’t start a successful new program only to get rid of it five years later, said Dr. Brian Hepburn, executive director of the National Association of State Mental Health Program Director.

Armed With Growth Funding, Connections Health Solutions Aims to Take Crisis Stabilization Model Nationwide Phoenix-based Connections Health Solutions recently scored $30 million in its first-ever round of growth funding, which came from the private equity firm The Heritage Group. Connections provides crisis stabilization and outpatient behavioral health services to patients with mental health conditions and substance use disorders (SUDs) at its two Arizona locations. Next up on Connections’ to-do list is expanding its model nationwide with the addition of new centers.

DOJ Faults San Luis Obispo Jail “After carefully reviewing the evidence, we conclude that there is reasonable cause to believe that conditions at the San Luis Obispo County Jail violate the Eighth and Fourteenth Amendments to the United States Constitution and the Americans with Disabilities Act. Specifically, we have reasonable cause to believe that the Jail violates the constitutional and statutory rights of prisoners by its: (1) failure to provide constitutionally adequate medical care to prisoners; (2) failure to provide constitutionally adequate mental health care to prisoners; (3) use of prolonged restrictive housing under conditions that violate the constitutional rights of prisoners with serious mental illness; (4) failure to prevent, detect, or correct use of excessive force that violates the constitutional rights of prisoners; and (5) denial of equal access to prisoners with disabilities in violation of the ADA.”

Opinion: Time for Ga. to act on mental health Florida’s Miami-Dade County has seen great success in addressing mental health challenges in the criminal justice system through the 11th Judicial Circuit Criminal Mental Health Project. With more than 200,000 residents experiencing serious mental illness (SMI), the initiative diverts nonviolent SMI offenders away from prosecution and into treatment and support programs, which then create efficiency in procedures and cost measures. We should look to this model as a roadmap as we work to improve mental health services in Georgia.

Colorado lawmakers discuss mental health treatment in the criminal justice system “Jail is not a place for people to go heal. Jail is a horrible place for people to come with a mental health issue. It’s very hard, it’s very cold, it’s very secure,” Brown said. Many hospitals won’t accept these patients, so often times deputies have to try to send them to the state hospital in Pueblo for help. The drive to the facility can be upwards of six hours, and there is a long waitlist to be able to get a bed.

Mental health crisis response in California takes a huge step forward thanks to a $20 million funding commitment to launch 988 - Steinberg Institute This easy-to-remember number will transform our nation’s and our state’s mental health crisis system. The first critical step in this transformation is connecting the 988 number to crisis call centers across the country, building out the network on which the nation’s entire mental health crisis system will rest upon. This $20 million commitment will ensure critical investments in workforce expansion, training, capacity development, and coordination of county-run mobile crisis services for these call centers to adapt to the anticipated 300% increase in call volume in just the first year of implementation.

Mental health crises require mental health pros Due to a lack of funding for mental health resources and to a lack of properly equipped emergency response teams, we have seen far too many instances in which local police were dispatched to deal with mental or behavioral health crises that would be more appropriately handled by a trained behavioral health provider. These instances place an undue burden on law enforcement, including making their already difficult job more dangerous, while failing to provide the complex and compassionate care that those in crisis really need.

Reengineering LA County’s Crisis Systems In the report “Care First, Jails Last,” the Alternatives to Incarceration workgroup puts forth recommendations that incorporate key interception points: community services, community response and intervention services, law enforcement, first booking and court appearance, jail custody and court process, pre-release and release, and supervision in the community. The workgroup evaluated seven intercepts instead of six. “Even before Intercept 0, there are a whole host of health factors communities need to address like people’s employment status and social connections.”

‘No mental health bed’: why children end up on acute medicine wards “We’ve had children who have been brought in after almost killing themselves. It was correctly deemed that they weren’t safe to be looked after in the community because there was a high ongoing risk of self-harm, but they were admitted to us, an acute pediatric ward, because there wasn’t a mental health bed for them. Sometimes we’ve had them stay for months waiting for an appropriate bed on an inpatient mental health unit.”

Law scholarship to honor legacy of court pioneer Steve Goss “Judge Goss was a respected jurist who created one of the first mental health courts in our country. We hope this scholarship will help to increase access to justice and legal services across our state. We also look for it to motivate future lawyers to seek to serve our state and society in a manner similar to Judge Goss, thus ensuring his contributions to making our world a better place will continue.”

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