Fall Miami Site Visit Schedule Announced

Task Force and Task Force Member Activities

Fall Miami Site Visit Schedule Announced Three dates have been secured for site visits to Miami: October 26-27, November 17-18, and December 15-16.  Up to 25 slots will be available for these guided visits to experience the Miami Model. Hosted by Judge Steve Leifman, each event 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 visit the new one-stop Miami Center for Mental Health and Recovery.  Registration will be available shortly. For more details contact Rick Schwermer.

More New Task Force Resources Released

  • Leading Change Guide for State Court Leaders This leading change guide is intended to be a practical tool for convening stakeholders across state-level systems and developing a plan to address mental health needs in your state.
  • Leading Change Guide for Trial Court Leaders This guide provides a national perspective for mental health responses at the local as well as the state court level by providing judges across the country with a guide to develop mental health plans for their local jurisdictions.
  • Promoting Well-Being in Domestic Relations Court This effort convened a multidisciplinary committee with broad expertise to set forth recommendations regarding judicial and staff responses that are trauma-preventive and assist with transition and referral to services. This committee also identified how judicial system responses may exacerbate or contribute to mental health issues and make recommendations to mitigate that unintended outcome.
  • Access to Treatment for Adolescents Recommendations for improving access to care include reducing stigma, addressing logistical barriers, and ensuring privacy.
  • Excerpts from: Helping Children Impacted by Parental Substance Use Disorder Fortunately, there are effective ways for adults to respond to children impacted by parental addiction and begin the process of helping them on a better path. There are also innovative programs and services available to help.
  • Psychiatric Advance Directives Courts and judges should encourage the use of PADs and, within the parameters of their state law, incorporate the provisions of an individual’s PAD into relevant court orders.
  • Comprehensive Overview of Leading Change Guides and Behavioral Health Resources As leaders of their courts and communities, judges are in a unique position to expand and improve the response to individuals with mental health issues in the community and in the justice system. For decades, courts have gained experience in convening diverse stakeholders to tackle complex problems both within and outside of the justice system.
  • Prevalence of Serious Mental Illness and Substance Use Disorders (Updated) An updated look at SMI and SUD prevalence across the country.

A New Model for Collaborative Court and Community Caseflow Management Traditional criminal case processes are not meeting the needs of the individuals we serve, and a new comprehensive, collaborative approach is necessary to ensure public safety, control costs, and create fair and effective criminal justice and caseflow management systems that meet the challenges of individuals with behavioral health needs. The full model is outlined here.

Please be sure to encourage your colleagues and networks to sign up for behavioral health alerts here.

Research and Resources

Hiding in Plain Sight: Youth Mental Illness Longtime WETA production partner Ken Burns is the executive producer of a major new public television documentary, Hiding in Plain Sight: Youth Mental Illness. The film, which premiered in June 2022, gives voice to the experiences of young people who struggle with mental health challenges and focuses on the importance of awareness and empathy.

Persons Living with Dementia in the Criminal Legal System Together with the American Bar Association and UVA, NRI’s Criminal Justice & Mental Health Research Center recently completed a year-long research study on people with dementia in the criminal legal system. This mixed methods research included data analysis, law case review, and interviews with people who work in law enforcement, correctional facilities, the court system, and geriatric health in order to develop policy recommendations that will improve the experiences of people living with dementia in the criminal legal system.

Recommendations include developing civic pathways for diversion; evaluating and amending laws and policies that prohibit placement in otherwise appropriate care settings; institute screening for dementia for people over age 50 who are arrested and/or in correctional facilities; develop trainings for criminal legal actors to identify the signs of dementia; and develop and fund community-based placements that can facilitate the decarceration of this population.

Mental Health First Aid: Assessing the Evidence for a Public Health Approach to Mental Illness Since the 1960s, the prevailing strategy for addressing mental illness has not been treatment but a public health approach that devotes resources to education and prevention. This approach is manifest in Mental Health First Aid (MHFA)—an increasingly popular program originally implemented to prevent mental illness-related tragedies, theoretically by teaching everyday citizens “how to identify, understand, and respond to signs of mental illnesses and substance abuse disorders.” The evidence that MHFA achieves this goal is lacking. Two decades of research show that it does not improve outcomes on relevant metrics, such as fewer crises or tragedies, reduced prevalence or disease burden of mental illness, or greater access to high-quality treatment and services.

Journal for Advancing Justice Volume IV: "Achieving Evidence-Based Practices in Community Corrections to Promote Recovery" More than three decades of research have demonstrated that treatment courts and other community corrections models work to reduce crime and substance use, lead people into recovery, and reunite families. However, as with any program, continued research is necessary to ensure ongoing adherence to evidence-based best practices in this ever-evolving space. Funded by the White House Office of National Drug Control Policy and guest edited by Dr. John R. Gallagher of Morgan State University, this volume provides an in-depth look at the impact of several strategies to improve outcomes for individuals involved in the justice system, including opioid intervention courts, peer recovery specialists, post-incarceration housing, jail sanctions, and HIV education. In addition to furthering research on these and other strategies, the journal calls for broadening our understanding of substance use and mental health disorder recovery.

Mental Health Care and Intimate Partner Violence: Unasked Questions This article addresses the overlap of trauma and mental disability, the failure of behavioral health services systemically to screen for domestic or intimate partner violence, the risk that abusive partners may manipulate the civil commitment system, and the likelihood that people with mental illness who experience domestic or intimate partner violence fail to receive sufficient trauma-informed treatment for their mental illness or other behavioral health needs.

988 Lifeline Transition Begins July 16 To help our partners communicate about 988, SAMHSA has added downloadable print files for wallet cards, magnets, and posters to its 988 Partner Toolkit. The toolkit already includes logo and brand guidelines, key messages, frequently asked questions, fact sheets (English and Spanish), radio PSA scripts (English and Spanish), and more.

Peer Support Specialists: Connections to Mental Health Care When integrated into health care teams alongside treatment for mental illness or substance misuse, peer support specialists expand access to care by extending the reach and capacity of existing providers; complement the role of other health professionals; and offer acceptance, understanding and validation necessary to support the recovery and wellness journey. Research has found that patients receiving peer support services are less likely to be readmitted into a hospital, spend less time in inpatient care and have lower overall costs of services than those receiving standard care.

Diversion in the Juvenile Justice System Alternatives to formal processing like diversion can occur prior to arrest, at the prosecutorial level or during court intake. For example, school-based diversion models connect youth and their families with services that do not involve law enforcement, which in turn can reduce the number of school-based arrests. These services often include access to mental health care as studies have shown that the majority of justice-involved youth present with mental health needs.

Emerging Mental Health Courts: The Intersection of Mental Illness, Substance Use, Poverty, and Incarceration By examining how these intersectional factors are inextricably interconnected, this Note will illuminate the urgent need to establish operational and effective MHCs in every state, advocate for increased federal funding for MHCs specifically, and encourage the adoption of a set of comprehensive, uniform guidelines for the creation and operation of local MHCs to best serve some of the most vulnerable, at-risk members of our nation.

University of Louisville Law Journal, Spring 2022 This volume of the Louisville Law Journal contains a number of mental health and justice articles, including “We Don't Talk About Bruno:” Of Mental Health, Honesty and Openness, and The Legal Profession; Inoculating the Next Generation of Lawyers: Mandating Substance Use and Mental Health Education; and Trust Without Trauma: Reducing Re-Traumatization Throughout the Justice System.

Using Crisis Stabilization Models to Improve Mental Health Care: Proposed Changes to State and Federal Law Amending state laws to address the factors that impede crisis stabilization models will allow for an increase in crisis stabilization models around the country, thereby decreasing healthcare costs, reducing racial and socioeconomic inequities in care, and providing for better quality mental health care services. This article will first provide an overview of the shift towards community-based care, how crisis stabilization models work, and why they are important. Next, this article will examine how the Emergency Medical Treatment and Labor Act (“EMTALA”) and different state laws impede crisis stabilization models. Finally, this article will propose necessary amendments to state laws for the successful implementation of these models. (Westlaw link)

How to Use an Integrated Approach to Address the Mental Health Needs of Youth in the Justice System More than 65 percent of youth who are arrested every year have mental health conditions, which amounts to more than two-thirds of boys and three-quarters of girls. Often, these needs have gone untreated or misdiagnosed, leading to engagement in the juvenile justice system. This brief identifies the collaborative role that juvenile justice stakeholders can play in helping to prevent and/or reduce involvement in the justice system by addressing youth’s mental health needs.

Spanish Language Resources Address Mental Health Needs of Underserved New Yorkers The Columbia Department of Psychiatry in partnership with The New York Public Library and Black Health, has released a series of Spanish language videos to raise awareness and spark conversations about mental health in the Latinx/a/o community. The 10 short, animated videos focus on mental well-being and self-care.

In Transition: Strategies to Promote Housing throughout the Reentry Process People experiencing mental and substance use disorders may need additional but varying levels of support as their needs evolve throughout the process of transitioning back into the community and throughout their recovery. This SAMHSA webinar will explore three approaches to addressing the housing needs of individuals with mental and substance use disorders following incarceration as they transition through the reentry process and as their needs change. Local programs ranging from a shelter program for individuals with acute housing needs to landlord partnership programs to help house individuals ready for independent living will be featured.

Homelessness and Opioid Use Disorder: Best Practices for Whole-Person Care In this webinar, panelists will provide a brief overview of the forthcoming toolkit, Whole-Person Care for Individuals Experiencing Homelessness and Opioid Use Disorder (OUD): Part 2. This toolkit expands upon Part 1, (released in August 2021), and covers a recovery-oriented framework for OUD treatment, community-level coordination, and supporting housing stability. Panelists will engage in a roundtable discussion of best practices and participants are encouraged to submit questions in advance of the session.

Working Toward Successful Reentry: Enhancing Career Development and Employment Opportunities This webinar will explore how providing workforce development programming and linkages to meaningful employment opportunities are essential in helping individuals to overcome the barriers to long-term job retention and reducing the risk of recidivism. Equally important is the need to support individuals create a career path that will lead to long-term success.

NRI Newsletter This edition includes one of the 15 new State Mental Health Profiles, Provision and Funding of Evidence-Based Services. Also included is Early Interventions for Psychosis: First Episodes and High-Risk Populations, and a report of a study that finds that the majority of boys and men who die by suicide have no known mental health conditions.

CSG Justice Center: State of Justice Articles include: Mental health at the forefront of a new police wellness program, Massachusetts Mental health clinician is 1st to support police response full-time, and How to use an integrated approach to address the mental health needs of youth in the justice system.

In the News

Behavioral Health Crisis Care’s Carpe Diem Moment One of the greatest disparities in health care is the way in which our society addresses behavioral health emergencies. Fortunately, multiple catalysts have converged to create the right conditions for transformative change:

  • The pandemic and its associated stresses have elevated awareness of the importance of behavioral health care. Relief packages and other pending legislation contain increased funding for expanded behavioral health services, infrastructure, and workforce, often with broad bipartisan support.
  • The new 988 mental health crisis line goes live in July. While the initial soft launch is focused on improving access to suicide hotline services, 988 represents the first step in a much-needed expansion in behavioral health crisis care, similar to how 911 precipitated the development of emergency medical systems (EMS) and trauma care.

When Can the Government Forcibly Medicate a Defendant? The question before the court was complex—and, attorneys said, never before litigated. The circumstances in question were not those of the crime itself, but the defendant’s competency and willingness to take antipsychotic medications ahead of the trial. At issue: How many doses was it OK to skip before the government had to step in? In Sell, the Supreme Court ended up solving the central dilemma of the case with a four-prong test, outlined in an opinion written by Justice Stephen Breyer. In the majority opinion, Breyer predicted it would be “rare” for cases to meet those four requirements. But in practice, studies have found forcible medication has actually become routine. Since the 2003 ruling, more than 130 federal district court decisions involving Sell hearings have been published. In 62 percent of those cases, the motion for forcible medication was granted.

California at odds over solving most intractable problems “Mental illness. Substance abuse. Homelessness. These are all existential crises we have to address with urgency.” That was Gov. Gavin Newsom’s response to a key legislative committee on Tuesday passing his controversial proposal to allow courts to compel people with serious mental illnesses and substance use disorders into treatment — the state’s latest attempt to mitigate spiraling homelessness and drug overdose epidemics that are top of mind for many voters as the November general election approaches. But although many state leaders, interest groups and activists may broadly agree on the set of “existential crises” facing California, they don’t always agree on how to address them — as illustrated by the controversies surrounding a pile of proposals aiming to help and protect the state’s most vulnerable residents.

The complicated path to expand Illinois’ Behavioral Health System of Crisis Care Over the past six months, the Illinois Supreme Court Mental Health Task Force (Task Force) hosted a series of five judicially led, multidisciplinary Regional Councils and Resource Mapping Workshops throughout five statewide regions. Notably, the Illinois Department of Human Services, Division of Mental Health and many state and local system partners (including several Task Force Members) are currently engaged in implementing comprehensive behavioral health crisis system reforms operating at Intercepts Zero (Community Services) and One (Law Enforcement) of the SIM.

Denver’s program to house people who were homeless was so successful, the federal government is offering millions more to expand it Five years ago, Denver made a list of people most often involved with jail, detox centers and emergency rooms — and then offered them housing. The program was so successful at keeping people in stable housing and out of jail, that the U.S. Treasury Department has offered the city more than $6 million in new federal aid, if the program can demonstrate a comparable drop in Medicare and Medicaid billings over the next seven years.

Denver jail lacks strategy to deal with mental health, fails to adequately monitor array of contracts, audit says The Denver jail keeps unreliable data on its mental health programs, is failing to adequately monitor its contracts with mental health providers and could not show whether its transgender inmates are housed according to their preference, according to an audit released Thursday. The Denver Sheriff Department offers an array of programs to help inmates deal with mental health and substance abuse but lacks an overall strategy that would lead to a bigger impact, says the report from Denver Auditor Timothy O’Brien.

The imprisoned are living with mental illness. States are ill-equipped to help More than half (56 percent) of the people now in America’s state prisons have reported mental health issues, but only a handful ever receive treatment, underlining the need for states to shore up their safety net programs, new data shows. Fourteen percent of those who reported a mental health issue said they’d suffered serious psychological stress in the last month, while 43 percent of incarcerated people said they’d been living with a previously diagnosed mental health issue, according to data compiled by the Prison Policy Initiative. But only about a quarter, 26 percent, said they’d received professional help for their issue since entering state custody.


Lawyers’ Mental Health Remains in Crisis, But Awareness Is Growing The proportion of respondents who agree that mental health problems and substance abuse are at a “crisis level” in the legal industry has grown each year since 2019, reaching 44% in the most recent survey. Even though the overall data are undeniably bleak, the survey does include some indications of progress. The proportion of respondents who agreed that their “workplace is a safe environment to raise concerns about mental health and substance abuse” has risen from 40% in 2019 to 45% in 2022. Still far too low, but at least moving in the right direction. The survey also indicates that more firms are taking tangible action to provide more comprehensive mental health support: in 2022, 61% of attorney respondents reported that their firm offered an Employee Assistance Program including assistance for mental health or substance abuse, up from 54% in 2019.

Why Vacations are Important In this video, Erin Engle, PsyD, assistant professor of medical psychology in the Department of Psychiatry at Columbia, explains why taking time off from work is essential to well-being. “What we don’t realize is that stress accumulates over time, making it difficult to manage even the most mundane tasks and challenges,” she says. Even short breaks—going to the movies or visiting a city park—can help us de-stress and recharge.

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