The Crisis Care Continuum: Resources for Judges During and After the COVID-19 Pandemic

updated behavioral health banners

Task Force Activities

The Crisis Care Continuum: Resources for Judges During and After the COVID-19 Pandemic The purpose of this brief, developed jointly by the Task Force and by the CCJ-COSCA Rapid Response Team, is to acquaint court leaders with the opportunities to influence change in their courts and communities during these difficult times and to implement practices that will result in better outcomes for those with serious mental illnesses. Links to research and resources are provided at each stage of the crisis care continuum. A system assessment tool is also included and is recommended as a first step for courts and system partners.

Research and Resources

Emerging Best Practices in Law Enforcement Deflection and Community Supervision Programs Volume III of the Journal for Advancing Justice is now available. It addresses programs and interventions designed to assist individuals with mental health and substance use disorders who come to the attention of law enforcement and community corrections programs. It also analyzes community supervision practices in an effort to contribute to the research on effective strategies for probation, parole, and pretrial supervision programs.

SAMHSA’s Service Members, Veterans, and their Families Technical Assistance Center Presents: Best Practices and Systems of Support for Justice-Involved Veterans A number of emerging best practices, programs, and standards of care have been developed to address the unique challenges faced by justice-involved Veterans. This webinar will provide an overview of those emerging best practices and systems of support for justice-involved Veterans from the “front end” or initial point of contact with first responders to the point of reentry and readjustment with support from systems, programs, and peers.

CSG Justice Center - Justice Briefing New tools for police responding to behavioral health calls; five ways to incorporate mentoring into reentry programs; and new job opportunities.

NCBH Capitol Connector SAMHSA’s McCance-Katz resignation statement, CMS guidance on end-of-pandemic Medicaid changes, and Mental Health First Aid and CCBHC grant announcements.

How to Transform the U.S. Mental Health System - Evidence-Based Recommendations This RAND report provides recommendations to promote transformational change to improve the lives of the millions of Americans living with mental illness. To identify these recommendations, the authors conducted a broad review of policy ideas related to goals for the mental health system. They conducted an extensive analysis of mental health systems processes, policies, and solutions supported by evidence and received input from experts around the country.

Judges Are Stressed by Their Decisions, and 20% have at Least One Depressive Symptom, Survey Finds One in five judges who responded to a survey on job stress met at least one criteria for depressive disorder, according to survey results released late last month. The National Judicial Stress and Resiliency Survey was designed by the ABA Commission on Lawyer Assistance Programs. More than 1,000 judges responded to the survey, which was conducted before the COVID-19 pandemic.

Self-Care for Criminal Justice Professionals Across the Sequential Intercept Model: Considerations for Intercepts 3-5 Within Intercepts 3-5 of the Sequential Intercept Model (SIM), court, reentry, and community corrections personnel may experience stressors related to providing services and ensuring the safety of individuals experiencing crisis, mental or substance use disorders, or withdrawal symptoms. Many staff members face 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 3-5 and ways that agencies can support self-care as a protective factor against harmful responses to stress.

Shocking Injustices: Mental Healthcare & Black Americans This Kennedy Forum webinar, on the anniversary of Rev. Dr. Martin Luther King Jr.’s birthday, honors his legacy and continues his fight for justice. Dr. King stated in 1966, “Of all forms of inequality, injustice in health is most shocking and the most inhuman because it often results in death.”

CSG Justice Center - Justice Briefing Free support to improve outcomes at the intersection of criminal justice and behavioral health; funding for key programs; and new federal grant opportunities.

SAMHSA Grant Announcements Grant announcements for Project AWARE, Resiliency in Communities After Stress and Trauma, Building Communities of Recovery, and Grants to Prevent Prescription Drug/Opioid Overdose-Related Deaths.

OJJDP Family Drug Court Grant Announcement The Office of Juvenile Justice and Delinquency Prevention (OJJDP) is seeking applications for funding under the fiscal year (FY) 2021 Family Drug Court Program. This program furthers the Department’s mission by supporting states and communities as they develop and implement effective and coordinated substance use intervention programs.

NCBH Webinars Join the Center of Excellence for Integrated Health Solutions (CoE) for a two-part webinar series that will explore improving health outcomes for both individuals and populations, first by exploring care coordination practices, then by exploring population health management strategies.

Mental Health First Aid USA Webinar Experts from Mental Health First Aid USA will examine how to recognize the warning signs of mental health or substance use challenges and what steps to take if your loved one, friend or co-worker is in need.

Becoming Trauma Informed: An Essential Element for Justice Settings This NIC webinar series and related resources includes: The Association between ACEs and Criminal Justice Involvement, Trauma-Informed Treatment and Theory, and Becoming Trauma Informed and Moving to Trauma Responsive.

How Being Trauma Informed Improves Criminal Justice System Responses Training Program Solicitation The 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. Selected applicants will learn to facilitate the training via a virtual TTT event and subsequently deliver the training program in their local communities. is now “At you can find useful resources and see how better policy is being successfully put into practice by our partners across Texas. Connecting you with reliable data and guidance is central to who we are, and this new site, with its improved navigability, helps you find what you need.”

In the News

Ted‌ ‌Lutterman‌‌on‌ ‌How‌ ‌Comprehensive‌‌Crisis‌ ‌Services‌ ‌Registries‌‌Are‌ ‌a ‌Vital‌ ‌Part‌‌of‌ ‌the‌ ‌Crisis‌‌Continuum People in psychiatric crisis are often stuck in emergency rooms for hours or days waiting for placement. In other cases, there’s nowhere for them to go. Or worse, there are openings but no systemized way to find out where. The answer, says Lutterman, is a robust crisis continuum and a real-time comprehensive crisis services registry that helps match people to the appropriate level of services they need when they need them. In 2016, to further the use of registries in states, the United States Congress passed the 21st Century Cures Act. The act allows SAMHSA to fund states’ development of real-time psychiatric bed registries to improve timely access to mental health treatment.

‘A supreme form of advocacy’: When finding a psychiatric bed seems impossible, one state’s patients have a partner Massachusetts is home to a novel effort known as the Expedited Psychiatric Inpatient Admissions, or EPIA. Created in 2018 by the state’s mental health department, it is designed to cut the red tape to get psychiatric patients placed in appropriate care far faster. Among other changes, EPIA requires hospitals to expedite placement for patients after they’ve boarded in an ER for 60 hours — but it also provides critical logistical support to help make that possible. Once the clock starts ticking, BHN and the state’s other regional emergency service providers can immediately call on the state’s mental health department, insurance companies, and hospital administrators to escalate the admissions process and clear any barriers standing in the way of placing a patient.

Behavioral Health Community Crisis Center helped people who would otherwise face jail, and saved taxpayer money Though law enforcement receive training on how to respond to a mental health crisis through empathy, the center gave officers the option to take the individual to a place where they could receive help from people specialized in mental health crises, if the patient agrees to go to the center voluntarily. “After that initial contact, the after-steps are key,” Bonneville County Sheriff's Office Capt. Samuel Hulse said in 2014. “(Crisis center workers) will follow up with individuals after they have been released to make sure they are utilizing their resources.”

AOT Orders A Useful Tool During COVID Pandemic According to AOT recipient outcome data from the NYS Office of Mental Health (OMH) as of January 4, 2021, AOTs reduce psychiatric hospitalization by 65%, incarceration by 73%, and homelessness by 62%. OMH’s data also shows that AOTs increase service participation, increase engagement in services and adherence to medication, improve self-care and social and community functioning, and reduce incidents of harmful behavior.

Mom and Teen on Navigating Behavioral Health Crisis Care in Maryland Each of Chiang’s emergency room visits resulted in “a lot of sitting around” that ranged from hours to days of ER boarding. As a mental health leader, Enomoto says it was a stark firsthand experience of all the challenges she’d worked her entire career to address. “It was heartbreaking and also showed me how much has to change.”

Alpena criminal justice system struggles with lack of resources for those with mental illness To keep jails from being used as makeshift mental health clinics, Alpena County needs to treat mental illness as a community issue, said Milton Mack, a former state court administrator who in September was appointed to a national mental health task force. In counties where he sees improvement, judges routinely order mental health treatment such as medication and therapy instead of jail, hospitals know where to connect patients for help upon discharge, and police know what steps to take when confronted by someone with mental illness. That’s why Kieliszewski is trying to organize a crisis intervention team in Alpena County, the sheriff said.

‘Constant Breaking of Your Heart:’ How Utah Police Respond to Mental Health Crises In 2020, at least 40% of people Utah police shot at were experiencing a mental health event, according to a Salt Lake Tribune database that tracks police shootings. “Law enforcement should not be our crisis managers,” said Salt Lake County District Attorney Sim Gill, whose office reviewed more than half of 2020’s 30 police shootings.

Mixed-up meds & long waits: How understaffing hurts medical treatment at Allegheny County Jail Dr. Peter Hauber, a psychiatrist employed at the jail from 2016 to 2019, said medication errors were made frequently and without any repercussions. “If a hospital had those types of medication errors, they would be shut down,” Hauber said. Since the pandemic, the issue has worsened.

Bucks County moving forward with mental health court, forensic diversion center Ellis-Marseglia projects with the mental health court and diversion center, the county could see an 85% drop in jail admissions for defendants in need of mental health services.

Hello Idaho: Homelessness a risk for those dealing with mental illness Optum Idaho's Dr. Dennis Woody says an estimated 45% of Idaho's homeless population is dealing with mental health problems ranging from schizophrenia to anxiety.

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