Trauma’s Impact and What Communities Can Do

Task Force and Task Force Member Activities

Trauma’s Impact and What Communities Can Do Task Force member Judge Theresa Dellick participates in an American Psychiatric Association Foundation podcast on how trauma impacts our community and our juvenile justice system and what can be done about it.

Addressing the Stigma Around Substance Use Disorders Stigma creates barriers to healthcare and leads to lower engagement and retention in addiction treatment. This session aims to help educate judges and court staff on the latest research on the intersection between addiction and criminal justice stigma. Participants will learn about the different types of stigma, the social construct of stigma at structural and individual levels, and innovations to respond to sigma in health and justice settings. This course was developed by the National Judicial Task Force to Examine State Courts’ Response to Mental Illness, Addiction Policy Forum, and JCOIN, and features leading experts on stigma within the substance use disorder and criminal justice fields. Chief Justice Loretta Rush makes opening remarks.

Registration Now Open for Miami Model Site Visit The National Judicial Task Force to Examine State Courts’ Response to Mental Illness is sponsoring a site visit opportunity in Miami January 21 and 22. Up to 25 slots will be available for this guided visit to the Miami Model, hosted by Judge Steve Leifman, which will include observation of and interaction with their jail diversion programs, competency restoration alternatives, extensive CIT initiative, AOT program, peer specialist initiative, and a chance to see the new one-stop Miami Center for Mental Health and Recovery just before it opens. Contact Lillian Wood for registration details.

Research and Resources

Staying Off the Sidelines: Judges as Agents for Justice System Reform In the Yale Law Journal article, Michigan Chief Justice Bridget McCormack argues there is no ethical obstacle to judges working to improve the justice system. To the contrary: although ethical constraints limit the form of their advocacy, effective law reform depends on judges’ contributions and they are ethically obligated to improve the judicial system over which they preside. This article is also the topic of a conversation with Chief Justice McCormack in this recent NCSC Tiny Chat.

Cops, Clinicians, or Both? Collaborative Approaches to Responding to Behavioral Health Emergencies How a community responds to behavioral health emergencies is both a public health issue and social justice issue. Individuals experiencing a behavioral health crisis often receive inadequate care in emergency departments (EDs), boarding for hours or days while waiting for treatment. Such crises also account for a quarter of police shootings and >2 million jail bookings per year. Racism and implicit bias magnify these problems for people of color. Growing support for reform provides an unprecedented opportunity for meaningful change, but solutions to this complex issue will require comprehensive systemic approaches.

Competence to Stand Trial Assessment: Practice-Based Views on the Role of Neuroscience This article is a discussion of practice guidelines, caselaw, competence-related orders, commentaries, and recommendations related to using neuroscience as part of assessing competence to stand trial. Neuroscience has at times been involved in competence assessments and adjudications particularly in cases in which lawyers have had the knowledge and resources to work with neuroscientists. This involvement also requires a judge willing to permit introduction of the evidence.

Psychiatric Advance Directives Approximately half of U.S. states have enacted legislation for a new type of advance directive, generally referred to as a mental health care advance directive or psychiatric advance directive (PAD). The first half of this article summarizes the Uniform Health-Care Decisions Act (UHCDA) and the features of state PAD statutes. The second half summarizes support for and criticism of PADs and advocates for a model uniform PAD act.

Comparing Efficacy of Telehealth to In-Person Mental Health Care in Intensive-Treatment-Seeking Adults This study compares the clinical outcomes of a matched sample of patients who received in-person, intensive psychological treatment prior to the COVID-19 pandemic to the outcomes of a distinctive group of patients who received telehealth treatment during the pandemic. Results suggest telehealth as a viable care alternative with no significant differences between in-person and telehealth groups in depressive symptom reduction, and significant increases in self-reported quality of life across both groups.

SAMHSA Treatment Improvement Protocol (TIP) 33: Treatment for Stimulant Use Disorders This updated TIP reviews what is known about treating the medical, psychiatric, and SUD-related problems associated with the use of cocaine and methamphetamine, as well as the misuse of prescription stimulants. The TIP offers recommendations on treatment approaches and maximizing treatment engagement and retention, and strategies for initiating and maintaining abstinence.

Webinar Nov. 16: Behavioral Health Equity: National CLAS Standards in Action On November 16, the HHS Office of Minority Health (OMH) and the Substance Abuse and Mental Health Services Administration (SAMHSA) will host the Advancing Behavioral Health Equity: National CLAS Standards in Action webinar, highlighting real-world examples of behavioral health service providers using the National Standards for Culturally and Linguistically Appropriate Services and the Behavioral Health Implementation Guide (PDF). Presenters include Miriam Delphin-Rittmon, Ph.D., Assistant Secretary for Mental Health and Substance Use, HHS SAMHSA.

Expanding the Evidence Base for the Crisis Care Continuum: Call Centers, Mobile Teams, and Stabilization Units Crisis response programs that serve as alternatives to traditional police response have drawn widespread attention. However, there remain significant barriers to defining, implementing, and evaluating high-quality crisis services. In this SMI Adviser webinar, the presenter will summarize the current landscape of crisis services research, highlighting gaps in identifying best practices and in accessing meaningful data to inform quality and equity aims. Next, we will review implementation science research methods that can help circumvent the unique challenges of crisis services research.

Responding to Familiar Faces in Crisis Part 2: Engagement Challenges and Strategies This webinar series features three Stepping Up Innovator counties that are also MacArthur Foundation Safety and Justice Challenge sites. On November 18, representatives from these sites will share how to effectively serve and increase engagement with people who frequently cycle in and out of jails, emergency departments, homeless shelters, and other community-based settings.

APA November 16 Webinar: Diversion Excursion: Engaging Prosecutors in Sustainable Diversion Efforts APA, in partnership with the Bureau of Justice Assistance (BJA) and the Council for State Governments (CSG) Justice Center, invites you to participate in a webinar on engaging prosecutors in diversion efforts. This virtual roundtable will provide participants with basic strategies to initiate collaboration with prosecutors and highlight prosecutor-led programs that are being implemented in diverse jurisdictions across the country.

The Stepping Up Minute This CSG newsletter includes links to two recent webinars: Innovative Programming for Veterans in the Criminal Justice System, and Stepping Up 101–A Primer for Veterans Justice Outreach Specialists.

Partner Webinar: Mental Health Crisis Response: A Case Study in Reducing Arrests and Coordinating Care Law enforcement is often placed in the position of responding to individuals experiencing a behavioral health crisis, whether a serious mental illness or substance use disorder. Thriving Mind South Florida, a behavioral health and substance use provider network, has partnered with local law enforcement to coordinate care for individuals in crisis. The program has led to better care and outcomes for individuals in the community and reduced the crisis response responsibilities of law enforcement.

Core Competencies and the Intersection of Criminal Justice, Disparities, and Early Psychosis While many Coordinated Specialty Care (CSC) Programs have staff with extensive knowledge of psychosis and experienced in managing risk of violence, they may be less experienced in interacting with the criminal justice system and unfamiliar with the sequential intercept model. Individuals in the early stages of psychosis are at heightened risk of violence and disproportionately likely to experience criminal justice involvement compared to their peers. It is crucial that CSC workforce are aware of opportunities to intervene at the intersection of the mental health and criminal justice systems. An SMI Advisor educational module.

A New Approach: A Prosecutor’s Guide To Advancing A Public Health Response To Drug Use This week’s Prosecution, Drug Use & Public Health panel discussion focused on the current state of drug prosecution, the recommendations put forth in the IIP's newly launched guide A New Approach: A Prosecutor’s Guide to Advancing a Public Health Response to Drug Use, and how prosecutors can uplift treatment over incarceration. Includes a link to both the webinar and the guide.

SAMHSA's GAINS Center Invites Communities to Apply for SIM Mapping Workshops SIM Mapping Workshops are designed to bring together a local, cross-system, multidisciplinary group of key stakeholders from a particular jurisdiction (typically a county) to facilitate collaboration and to identify and discuss ways in which barriers between the criminal justice and behavioral systems can be reduced through the development of integrated local strategic action plans. SIM Mapping Workshop participants are expected to be drawn, in large part, from local criminal justice and behavioral health agencies and organizations.

CSG Justice Center Misconceptions about mental health and violence; funding opportunities to support youth experiencing homelessness, Certified Community Behavioral Health Clinic (CCBHC) models, and more.

CSG Justice Briefing This edition features how the pandemic impacted reentry service providers and the people they serve; updated American Rescue Plan resources; examining state prison population declines before and during the pandemic; and upcoming events.

PTACC Ticker this Police, Treatment and Community Collaborative newsletter includes links to PEW research about first responder dispatch issues, and NIJ publication Desistance from Crime: Implications for Research, Policy, and Practice, and a Deflection and Pre-arrest Diversion to Prevent Opioid Overdose Resource Packet.

Reimagine Crisis Quiz Take this quiz to test your knowledge of mental health in the U.S.

In the News

Most States Have Not Yet Acted to Support New 988 Behavioral Health Lifeline States are now largely responsible for implementing the number—including building the infrastructure, training staff, and integrating it with 911 and other emergency services—but the federal government has given them little funding or guidance to do so. The Pew Charitable Trusts assessed legislation enacted so far in the nation’s statehouses. As of Oct. 12, nine states had passed binding legislation, taking a variety of approaches, but only four authorized or imposed a surcharge to support 988 operations. Two states directed their Medicaid agencies to submit waiver applications or Medicaid state plan amendments that would allow for federal reimbursement of a portion of crisis services delivered to Medicaid beneficiaries.

In an overcrowded justice system, mental health diversions work | Editorial Unlike 22 other states, New Jersey doesn’t have a network of mental health courts, where defendants who commit nonviolent, petty crimes can be diverted to treatment programs if they have a mental illness. Those work much like our drug courts, which have shown that treatment and oversight are far more effective than incarceration and humiliation. But legislative efforts to create mental health courts have been stalled for years in our state, and our finest jurists have decided that this can no longer wait. A mental health diversion program adopted by Chief Justice Stuart Rabner was recently launched in Essex and Morris Counties, and it could become the model used throughout the rest of the state.

Destigmatizing Mental Illness: A Yolo County Judge Tells His Story of Managing Anxiety “I’d been on the bench four or five years. I was leaving a committee meeting in the Bay Area for the California Judges Association, and I got to my car and started the engine, and all of a sudden, my left shoulder and arm were numb. My first thought was a heart attack, and my second thought was a stroke, but then the numbness diminished. The doctor said it was stress, and I said, ‘What do you mean, stress?’ He said, ‘You don’t get it. Your job is at a stress level that most people don’t deal with, and you don’t recognize it because you’ve been dealing with it for a few years now’”

Why Are Jails Still Failing to Accurately Track Race and Ethnicity? Most states do not track race and ethnicity in a systematic way within local justice systems. The research shows that only one state, Alaska, tracks race and ethnicity consistently across all aspects of its prison population including parole and probation. Other states may be tracking this information but are not reporting on it publicly.

TAC's Fall Catalyst Newsletter Highlights include a story about efforts to improve assisted outpatient treatment laws in several key states, a moving Personally Speaking essay about a son's journey from schizophrenia diagnosis to college graduation, and an up close and personal conversation with Treatment Advocacy Center supporter and Oregon mental health court Judge Pat Wolke.

Oregon State Hospital sued in federal court, plans to add beds Monday In the latest escalation over admissions delays, the Oregon State Hospital is facing a federal lawsuit filed on behalf of two people ordered into state care months ago, but who have still not been able to access the facility. As of late last month, 26 people statewide found guilty except for insanity were waiting in jails for admission to the hospital, according to an Oct. 27 record filed by the state in a separate federal court case. At that time, 19 people had been waiting for more than 100 days. One person in Jackson County had been waiting 283 days, according to the document.

Florida Tech fills the void amid shortage of mental health evaluators in court A shortage of mental health professionals is causing delays in evaluations that are sometimes required to determine if defendants are competent to stand trial. That's where a cool new initiative by a Florida Tech professor is helping move cases along here locally in the 18th Judicial Circuit and also providing real-world experience for her students. Julie Costopoulos, associate professor in Florida Tech’s School of Psychology and director of the forensic emphasis area of the clinical psychology doctoral program, took action when she heard about the shortage. Two doctoral students get to do parts of the actual evaluation, working closely with Costopoulos.

Tent removals begin in Boston as temporary court holds session at Suffolk County jail The dismantling of the temporary shelters came the same day that a temporary remote virtual court session began operating at the nearby Suffolk County jail. The new court was set up as part of a proposal from Sheriff Steve Tompkins aimed specifically at people with outstanding warrants from the area of the city known as “Mass. and Cass.” Individuals will be processed in what he called a “stabilization court” with judges determining whether the person would be eligible to be sent to the jail’s new treatment facility. On Monday, demonstrators gathered outside the jail to protest the new court as individuals were escorted inside.

New study shows discrimination can lead to mental health issues A study published in the journal "Pediatrics" on Sunday from the University of California Los Angeles shows that people who faced discrimination in their youth are more likely to develop both short- and long-term behavioral and mental health-related issues later in life. Those risks may be cumulative, the study found, as those who faced more incidents of discrimination had an even higher risk of future problems.

Colorado’s governor funds new programs to add more youth psychiatric beds amid mental health crisis $12 million in emergency funding follows an onslaught of criticism aimed at the state Department of Human Services and is expected to create 45 additional youth treatment beds. Nearly every district attorney in the state signed a letter saying there are no beds for kids in distress who’ve been arrested but don’t deserve lockup.

Quick-fix approach does not work but makes our health crises worse A successful plan would involve state agencies in the behavioral health collaborative, judges, law enforcement, experts in recovery, peer support, architects, business and community input, building and repositioning existing buildings for residential mental health and drug treatment centers, building transitional long-term affordable housing, post-incarceration drug and mental health treatment, housing for those who just need to get back on their feet with jobs skills to become self-sufficient and healthy, and, most of all, drug prevention programs in all schools to prevent any more of our youth from getting hooked.

Man shot by trooper among many with mental illness history What led to the police shooting on Nov. 6 remains under investigation. But Price is already part of a glaring statistic: More than one in five people who’ve been fatally shot by police since 2015 have been known to have mental illness, according to a Washington Post database.

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