What We Know Now About Mental Health and the Courts: Grasping the Challenge

Task Force and Task Force Member Activities

What We Know Now About Mental Health and the Courts: Grasping the Challenge This month is the first of five podcast episodes from the National Association for Court Management. They will be spread out over the coming winter and spring discussing the National Judicial Task Force to Examine State Courts’ Response to Mental Illness. The panel for episode 1 includes The Honorable Steve Leifman, Judge of the Eleventh Judicial Circuit Court in Miami, Florida, and Patti Tobias, Principal Court Management Consultant with the National Center for State Courts in Denver, Colorado.

A Review of the Work: States’ Efforts to Improve Competence to Stand Trial and Competence Restoration Processes This virtual summit will feature national experts along with state and local stakeholders to present and discuss common barriers in the competence process and strategies for improving evaluation, restoration, and treatment. Presenters include Task Force members Dr. Debra Pinals and Judge Nan Waller.

Mental Health Facts in Brief: Treatment Considerations in Correctional Settings This Mental Health Facts in Brief provides an orientation to circumstances that have led jails to be used as therapeutic settings for individuals with mental illness who become criminal justice-involved; the distinctions between true therapeutic settings and the realities of jail mental health care; and clinical outcomes related to their use. Alternatives to correctional settings for individuals who enter the criminal justice system as a result of unaddressed mental health conditions are identified.

Mental Health Facts in Brief: Connecting Care for Better Outcomes This Mental Health Facts in Brief reviews the meaning and significance of continuity of care for individuals moving among health, homelessness, criminal justice and other systems, and presents considerations for improving handoffs that may produce more beneficial individual and public outcomes.

Chief Justice and Illinois Mental Health Task Force to Host Mental Health Summit Report Release Web Event and Issue a Call to Action Improving the Court and Community Response to Persons with Mental Illness and Co-Occurring Disorders through Compassion and Hope, an initiative convened by Illinois Supreme Court Chief Justice Anne M. Burke, was held virtually over six sessions taking place from September-December 2020. As a final product the summit series issued the 2020 Illinois Mental Health Summit Report. The Illinois Supreme Court and National Center for State Courts are hosting a Report Release Web Event: A Call to Action on Tuesday, December 7, 2021, from 12:15 p.m. to 1:00 p.m. to present an overview of national initiatives, report findings, and Illinois Mental Health Task Force next steps.

Norman Ornstein and Keith Ellison on Mental Health and the Criminal Justice System Judge Steve Leifman of Miami-Dade County, Florida, has transformed the way the criminal justice system and police in this huge county deal with those with serious mental illness, saving lives and saving money at the same time. The best practices he and his team have crafted, embodied in a film called Definition of Insanity (www.doifilm.com), can be adapted to the needs and resources of every community. In this webinar Judge Leifman will moderate a conversation with Minnesota Attorney General Keith Ellison and Norman Ornstein, whose family foundation spearheaded the documentary about criminal justice reform, police reform, and mental illness.

Research and Resources

National Report Offers Solutions to Overcome the Three Major Obstacles to Rural Mental Health Care The report, “Improving Behavioral Health Services for Individuals with SMI in Rural and Remote Communities,” is designed to provide a resource for practitioners and policymakers working in rural and remote areas to improve the availability, accessibility, and acceptability of behavioral health care for individuals with SMI. The report was developed by SMI Adviser in partnership with the National Association of State Mental Health Program Directors (NASMHPD) and the NASMHPD Research Institute (NRI).

Beyond Jails: Community-Based Strategies for Public Safety For decades, the United States has responded to social issues like mental health and substance use crises, chronic homelessness, and ongoing cycles of interpersonal violence with jail. This has disrupted the lives of millions of people—disproportionately harming Black and Indigenous people—without improving public safety. There’s a better way. This new Vera Institute publication describes it.

Building Treatment Court Tracks for Everyone: The Multi-Track Approach Decades of research makes clear treatment courts should focus on high-risk/high-need individuals to achieve the best outcomes. However, it may not always be possible for a treatment court to exclusively target this population, especially if the treatment court is the only alternative-to-incarceration program offered by a jurisdiction. This training is designed to expand knowledge, incorporate other tracks, enhance skills, and improve outcomes for the full spectrum of justice-involved individuals in your jurisdiction.

SAMHSA’s SMVF TA Center Now Accepting Applications for Crisis Intercept Mapping (CIM) Workshops SAMHSA’s Service Members, Veterans, and their Families Technical Assistance (SMVF TA) Center is currently soliciting applications from communities interested in participating in Crisis Intercept Mapping Workshops. Crisis Intercept Mapping (CIM) is designed to bring together an interagency group of key stakeholders from the community (typically a county or city) to identify barriers and gaps in the community’s crisis system serving SMVF and discuss ways in which best practices and partnerships can be implemented to close those gaps and reduce service member and Veteran suicide.

Court Programming and Funding from the Bureau of Justice Assistance Learn more about federal programming and funding opportunities available to state and local courts during a webinar at 2:00 p.m. ET on Thursday, December 16. Officials from the Bureau of Justice Assistance, Office of Justice Programs, U.S. Department of Justice will share information on relevant programming for courts, an outlook for the fiscal year 2022 grant season, highlights of administration priorities, and other training and technical assistance opportunities for courts.

JPLI Newsletter Ensuring equitable treatment for people with complex mental health needs, new resources for mental health professionals in the criminal justice system, and more from the Judges and Psychiatrists Leadership Initiative.

SAMHSA Headlines SAMHSA’s PATH Program Supports Services for People Experiencing Homelessness; Ohio Crisis Academy: Children’s Crisis Response—Virtual Presentation, and more.

CSG Justice Center This edition includes Creating Buy-In: Best Practices for Collaborating with Referral Sources for Crisis Stabilization Units, as well as seven new crisis and Intercept 1 resources released at the recent Taking the Call event.

CSG Justice Briefing How One Psychiatrist Ensures Equitable Treatment for People with Complex Mental Health Needs, A Week of Action to Reimagine Our National Response to People in Crisis and Responding to Familiar Faces in Crisis Part 2: Engagement Challenges and Strategies.

Bringing Your Sequential Intercept Model Mapping Workshop to Life: Part 2— Bringing Together a Complex, Fragmented, and Diverse System Bringing together a complex, fragmented, and diverse system requires the right people doing the right work at the right time with the right information who are able to make the right decisions. There are multiple components of success to take into consideration while working with a diverse system.

Virtual Mental Health Training for Juvenile Justice (MHT-JJ) Train-the-Trainer (T3) Event Developed for juvenile probation, detention, and corrections professionals, the MHT-JJ provides critical information and practical strategies for interacting with youth who are experiencing mental health, substance use, and traumatic stress conditions.

Non-Law Enforcement Responses to the Opioid Crisis Learn about first responder/non-law enforcement deflection, the Self-Referral Pathway, the Naloxone Plus Pathway, the Officer Prevention Pathway, and emergency medical services (EMS) specialization.  This article also highlights programs that exemplify deflection initiatives that enable fire and EMS personnel to go beyond naloxone administration and reliance on emergency departments and to actively link individuals to treatment and services.

In the News

APA Statement on the House Passage of the Build Back Better Act The Build Back Better Act includes significant needed investments in mental health and substance use disorder care. The American Psychiatric Association statement highlights several provisions, including one that would fund 4,000 new, Medicare-supported graduate medical education slots in 2025 and 2026, the largest increase in more than 25 years, and would allocate 15% of the new residency slots to psychiatry and other behavioral health training programs; and an increase in Medicaid funding for mobile crisis response that includes $75 million in funding for the National Suicide Prevention Lifeline to help expand programs as the Lifeline transitions to the new 9-8-8 number next summer.

A public mental health model in Italy earns global praise. Now it faces its demise The Trieste model is an approach dating back to the 1960s that is recognized by the World Health Organization as one of the most advanced, community-based mental health care systems. Unlike in the past when psychiatric patients were confined in institutions where they faced abuse, the Trieste model set out to treat people with mental illnesses with dignity, including them in the community and in daily activities. But now, it's being dismantled by the Friuli-Venezia Giulia region's administration led by the hard-right Northern League and other right-wing parties. Now prominent international psychiatrists have signed petitions to save one of the world's premier public mental health services from being handed over to the private sector.

CMS Proposes Permanent Payment for Telehealth Services Allowed During Pandemic The federal government is proposing to permanently allow payment under the Medicare program for “audio-only” mental health services for patients who do not have or do not wish to use video technology. These services have been temporarily reimbursed as part of the government’s response to the COVID-19 public health emergency. The proposed rule also would retain other temporarily reimbursed telehealth services through 2023 to provide more data for determining whether those services should be permanently added to the list of covered Medicare services.

The Reporting System 988 Estimates Haven’t Included There’s been much guesswork in determining the call volume 988 will experience, especially calls it could divert from 911. Americans make 240 million 911 calls per year, and behavioral health experts believe 988 could deflect at least 10%. But some communities have also thoroughly analyzed their local 911 call center data, revealing that the number of calls suitable for diversion might be closer to 20%, including behavioral health and quality of life calls.

County focuses more attention on mental health For the first time, San Diego County is poised to dispatch mobile teams of mental health professionals dedicated to responding to people in crisis instead of sending police officers and sheriff’s deputies. The county also created a network of “stabilization units,” where patients in the throes of crisis can speak to experts, stay for up to 23 hours and regain a sense of calm in an environment that is more conducive to recovery than a jail or hospital bed.

Changes to mental-health evaluations for offenders are making a difference in South Dakota A closer relationship that’s developed between South Dakota’s courts and mental-health services during recent years seems to be gradually paying off. One key goal was to expand the number of evaluators who can conduct competency evaluations. They’ve gone from six in 2017 to 33 in 2021. Recent efforts also involve steering state funding to regional facilities where people with mental health issues can receive care, rather than waiting in jail for space to open at the state Human Services Center in Yankton.

New bill seeks to speed access to treatment for people found incompetent to stand trial Oklahoma Senate Bill 1113, authored by Sen. Michael Bergstrom, R-Adair, would allow people with severe mental illness to receive treatment in county jails instead of waiting for a bed to open up at a state hospital. The bill would also require the Oklahoma State Department of Mental Health and Substance Abuse Services or another provider to begin treatment in jail for people found incompetent to stand trial if a bed doesn’t open up at a state hospital within 30 days

Proposed Colorado laws address intersection of mental illness, crime Next year, Colorado lawmakers will consider several bills that would change how the criminal justice system treats mentally ill people. Among the proposals:

  • Establish pretrial diversion programs to identify eligible defendants with mental health or substance use disorders and send them to community treatment programs rather than jail.
  • Allow a person to be hospitalized for an emergency 72-hour treatment and evaluation when the person’s apparent mental health disorder or disability could present an imminent or substantial risk of harm to themselves or others.
  • Expand training and technical assistance to help communities add supportive housing programs for people who have mental health or substance use disorders, who are homeless or at risk of becoming homeless, and who are involved with the criminal or juvenile justice systems.

A new Bangor effort is trying to get defendants out of jail and in mental health treatment The new program comes as Penobscot County struggles with chronic overcrowding at its Bangor jail, with many beds occupied by inmates in need of mental health treatment. Convening a group of people focused on criminal defendants’ mental health needs has been helpful, according to defense lawyers and others who have been involved so far. But it will remain difficult to connect defendants in need of intensive treatment with services as long as a statewide shortage of inpatient mental health treatment beds creates a bottleneck in the system.

North Dakota officials eye mental health courts as a tool to reduce recidivism South Dakota turned to mental health courts to deal with the problem of people with untreated or poorly managed mental illness repeatedly cycling into the criminal justice system, said Noreen Plumage, director of Problem-Solving Courts for the South Dakota Unified Judicial System. “They’re designed to intervene,” keeping participants in treatment and on their medications as well as in a stable living situation, she said. “We use the leverage of the court” with the possibility of court sanctions for noncompliance.

'A behavioral health response to a behavioral health crisis': Marcus Alert launches in Richmond, four other areas The system, once fully implemented across the state, is designed to use regional call centers to alert mental health teams to potential psychiatric emergencies, quickly assess risks and dispatch professionals to help the person in crisis by persuasion instead of force. New Medicaid rates will take effect Wednesday to ensure increased reimbursement for public and private organizations to provide a wider range of services during and after psychiatric emergencies.

New mental health program offers an alternative to jail in Walla Walla County A new program that assists people who are struggling with behavioral health issues and offers an alternative to jail is making a difference in Walla Walla County, officials said. Individuals are often referred to LEAD by the prosecutor’s office, local law enforcement agencies, courts or community partners. Participants might have unmet behavioral health needs, be homeless or otherwise in need of additional support.

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