Restorative Justice & Policy for People with SMI & SED

Task Force and Task Force Member Activities

Restorative Justice & Policy for People with SMI & SED This New England Federal Collaborative on Recovery for People with Serious Mental Illness and Serious Emotional Disturbance (SMI/SED) webinar includes a moving contribution by Task Force member Connecticut Chief Justice Richard Robinson. His comments begin at the 48-minute mark of the session recording. This session was sponsored by SAMHSA Region 1.

Panel: National Judicial Task Force to Examine State Courts’ Response to Mental Illness Hon. Paula M. Carey, National Judicial Task Force Member (Moderator),Hon. Richard Robinson, Chief Justice (CT), Co-Chair, Criminal Justice Work Group, and Hon. Loretta H. Rush, Chief Justice (IN), Co-Chair, Education, Partnerships, and Implementation Work Group describe the national landscape of delays and deficiencies of the behavioral health and justice response to individuals with serious mental illness followed by discussion of the work underway in the respective Task Force work groups to address those challenges. Thank you to the National Association for Presiding Judges and Court Executive Officers (NAPCO) for sharing this Annual Meeting session with us!

Keynote Address: Trauma Awareness and Response – What Can Courts Do? Dr. Debra A. Pinals, Clinical Adjunct Professor, University of Michigan Law School, and Director, Program on Psychiatry, Law and Ethics, University of Michigan Medical School shares important information about what trauma can do to us, how it manifests, and how courts can take on a "trauma-informed" role to help bring greater healing and better outcomes to encounters with individuals before the court. This is another session from the NAPCO Annual Meeting August 2021.

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Research and Resources

Examining Implementation of the Los Angeles County Office of Diversion and Reentry Supportive Housing Program | RAND The Office of Diversion and Reentry (ODR) in Los Angeles County operates jail-based clinical diversion programs designed to help individuals with serious mental health diagnoses. Given the community's interest in providing alternatives to incarceration, eliminating racial disparities in incarcerated and jailed mental health populations, and addressing the overwhelming rates of homelessness in Los Angeles County, continuing to expand and refine this model will be important in supporting the county's "care first, jails last" vision.

Forensic Assessment in the Time of COVID-19: The Colorado Experience in Developing Videoconferencing for Evaluating Adjudicative Competency In this article, we briefly discuss how competency to proceed evaluations are conducted within the state of Colorado, the impact that COVID-19 had on forensic evaluations within the Colorado forensic services system, and the acquisition and adoption of videoconferencing (VC) capabilities. We then shift to an in-depth consideration of how VC forensic evaluations are facilitated in four different contexts: for adult defendants in custody, on bond, and in hospitals, and for juvenile defendants. Challenges and limitations are also addressed.

Forensic Evaluators’ Opinions on the Use of Videoconferencing Technology for Competency to Stand Trial Evaluations After the Onset of COVID-19 We surveyed practicing forensic psychologists in the United States after the onset of COVID-19 pandemic to obtain their opinions about using videoconferencing for competence to stand trial evaluations. The survey included a broad range of questions to identify perceived concerns about, and benefits of, videoconferencing. Evaluators expressed concerns that the results of videoconferencing evaluations were slightly less reliable than in-person evaluations but agreed that videoconferencing has the potential to make the evaluation process more efficient for evaluators (77.2%) and to reduce evaluation wait times for defendants (83.8%).

TAC Research Weekly: Mothers with Severe Mental Illness Involved in the Criminal Justice System Share Experiences with Parenting Mothers with severe mental illness and involvement in the criminal justice system center their lives and recovery around their identities as mothers. Despite long-term and complex mental health needs, the maternal identities of these women are at the forefront of their experiences, according to a recent study published in Crime & Delinquency, a policy-oriented peer-reviewed journal.

TAC Research Weekly: 2021 Top 10 List of Severe Mental Illness Research Includes the research recaps on Outcomes of Assisted Outpatient Treatment; Digital Health and SMI Treatment; and Co-occurring SMI and Substance Use Disorders.

Improving Behavioral Health Services in the Time of COVID-19 and Racial Inequities - National Academy of Medicine The emergence of coronavirus disease 2019 (COVID-19), coupled with the increasing awareness of racial inequity in the United States, as sparked by the killing of George Floyd at the hands of police officers, has led to a moment of reckoning regarding health inequities in the United States. This reckoning has also helped to shine a light on structural racism and racial inequities in the behavioral health system (i.e., the substance use disorders [SUDs] and mental health care treatment systems).

New Medicaid Option Promotes Enhanced Mental Health, Substance Use Crisis Care While several states have community-based mobile crisis intervention services in place, the ARP grants CMS new authority to provide states with additional resources and tools to enhance these programs. The ARP provides additional federal funding to states for qualifying mobile crisis intervention services for three years. This new Medicaid option also offers flexibility for states to design programs that work for their communities, allowing states to apply for this new option under several Medicaid authorities.

SAMHSA’s GAINS Center Announces Criminal Justice Learning Collaboratives The GAINS Center is currently soliciting applications from jurisdictions interested in collaborating with subject-matter experts through Criminal Justice Learning Collaboratives (LCs) designed to explore three topics:

  • Integrating Civilian-Led, Co-response, and Specialized Police Response Models
  • Equity and Inclusion in Drug Treatment Courts
  • Transition Reentry Strategies

Expanding First Response: New Toolkit for Community Responder Programs Jurisdictions across the country are now reimagining their approach to public safety by investing in community responder programs that position health professionals and community members trained in crisis response as first responders. Once advocated mostly by grassroots activists, health professionals, and community members, these programs have emerged as an effective way to improve outcomes for people in need and reduce reliance on law enforcement.

PEW: 911 Crisis Response Program Shows Promise 40% of crisis calls fielded by Dallas' multidisciplinary teams that have led to a connection to a housing, health, or other service.

SAMHSA Newsletter includes SAMHSA staff picks for the best resources of the past year, information on upcoming learning collaboratives, and more.

CSG Justice Briefing How states changed supervision practices during the pandemic; supporting Justice and Mental Health Collaborations; preparing 911 dispatch personnel for new first responder teams; and more.

CSG Justice Briefing Justice Counts national launch; new resource for community responder programs; job opportunities; and upcoming events.

Jail Medical Contracting: Best Practices for Supporting Stepping Up Goals One challenge for obtaining baseline data on SMI in jails centers on contracted private medical providers and their role in collecting and sharing data on SMI. This virtual discussion will equip participants with knowledge about the role contracted medical providers have in either screening for SMI, assessing for SMI, or both; collecting and sharing data with jail administration and how contracts can support this process; and best practices for screening, assessment, and collecting and sharing data for contracts with third-party medical providers.

Mental Health Training for Juvenile Justice (MHT-JJ) Train-the-Trainer 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. The MHT-JJ provides research-based instruction that increases juvenile justice practitioner knowledge and develops and enhances skills to support effective and safe interactions with youth.

COSSAP Webinar: Updates On New Methamphetamines and Cocaine Health Risks—Improved Screening and Action To Save Lives Much higher purity, longer-term use, and growing contamination of methamphetamine and cocaine with synthetic opioids, primarily fentanyl, resulted in record-high overdose deaths in the United States during the last year.  Screening and treatment protocols are available to help corrections services, emergency department staff, first responders, and related personnel address this life-threatening situation.

Considerations for Deflection and First Responder Diversion Programs: Taking a Trauma-Informed Approach For first responders, minimizing repeated trauma in children through a trauma-informed approach is critical. Because the overwhelming share of children in the justice system have experienced or have been exposed to trauma,4 preventing children’s exposure to additional traumatic experiences that can have such extreme effects is important. To this end, deflection programs based on the five pathways model5 can make a huge difference, by keeping individuals out of the justice system through early identification and intervention at family and school levels.

How Community Responder Programs Can Conduct Needs Assessments: A Q&A with the CAHOOTS Program in Eugene, OR The Council of State Governments Justice Center spoke with CAHOOTS Director of Consulting Timothy Black, Coordinator Ebony Caprice Morgan, and Consulting Associate Abbey Carlstrom about their experiences conducting needs assessments and their advice for other jurisdictions looking to develop these programs.

Racism in Public Health Series Part 3: How to Address Health Disparities This episode features guest Dr. Paul Halverson, DrPH, FACHE, Founding Dean of the Richard M. Fairbanks School of Public Health, University of Indiana. this is the third episode in our Racism in Public Health Series. Listen in on ways we can address health disparities and cultivate more equitable communities.

Incentives, Sanctions, and Therapeutic Adjustments Training NDCI, in partnership with the Bureau of Justice Assistance, Office of Justice Programs, U.S. Department of Justice, developed a training program based on Standard IV of the Adult Drug Court Best Practice Standards: Incentives, Sanctions, and Therapeutic Adjustments (ISTA). The ISTA training is designed to provide knowledge and skills practice in the creation and/or improvement of an existing treatment court’s incentives, sanctions, and therapeutic adjustments behavior modification program.

A Model for Defunding: An Evidence-Based Statute for Behavioral Health Crisis Response This article proposes a model law (the Model Behavioral Health Response Team Act) that can be tailored to meet the needs of local and state policymakers endeavoring to create a new institution to replace the police in responding to mental health, substance use, and housing crisis. The institution created by this model act is evidence-based, person-centered, and community-driven.

New Course on Building Practitioner-Researcher Partnerships to Demonstrate Program Outcomes Research Partnerships for Public Safety and Health is a free, online course designed to support justice-system and behavioral health professionals seeking to address the challenges posed by substance use. The course also aims to support practitioners who are working with researchers or are considering partnering with researchers by providing strategies and approaches to expand capacity in health and justice settings.

Protecting Youth Mental Health - The U.S. Surgeon General’s Advisory The Advisory includes essential recommendations for the institutions that surround young people and shape their day-to-day lives—schools, community organizations, health care systems, technology companies, media, funders and foundations, employers, and government. They all have an important role to play in supporting the mental health of children and youth.

In the News

HHS Announces Critical Investments to Implement Upcoming 988 Dialing Code for National Suicide Prevention Lifeline With funds from the Biden-Harris Administration’s Fiscal Year (FY) 2022 budget and additional funds from the American Rescue Plan, SAMHSA’s $282 million investment will support 988 efforts across the country to shore up, scale up and staff up, including $177 million to strengthen and expand the existing Lifeline network operations and telephone infrastructure, including centralized chat/text response, backup center capacity, and special services (e.g., a sub-network for Spanish language-speakers), and $105 million to build up staffing across states’ local crisis call centers.

Appeals Court Rules State Must Pay When People With Disabilities Wait in Jail for Services The Washington State Department of Social and Health Services (DSHS) won’t appeal a ruling by state Court of Appeals that could enable people held in jails for weeks while awaiting mental health evaluations to receive financial compensation for their lengthy, and possibly unconstitutional, confinement.

Attorneys for inmates praised a sweeping ruling issued Monday by a federal judge that will require Alabama’s prison system to make changes in inmate mental health care U.S. District Judge Myron Thompson issued a sometimes scathing 600-page opinion that often focused on the prison system’s lack of progress in meeting an earlier directive to boost staffing and also on the number of suicides that have occurred behind bars. The Monday order spelled out corrective measures and comes after Thompson in 2017 ruled that Alabama’s “horrendously inadequate” care of mentally ill inmates violated the U.S. Constitution’s ban on cruel and unusual punishment.

Even with beds empty, patients can’t get into Ga. state mental hospitals In 2022, a bipartisan group of Georgia lawmakers intends to address the state’s glaring shortage of mental health professionals. If they are to succeed, one of the greatest challenges might be finding — and keeping — staff at the state-run psychiatric hospitals. A dearth of workers now leaves patients waiting days, weeks or even months to be admitted. On Thursday, more than 300 people were waiting to be treated, officials said, while well over 100 state beds sat empty.

State hospital gets outside help for admitting mentally ill people under judges’ orders Oregon State Hospital is getting help from an out-of-state expert to meet a weeks-passed deadline to start admitting people with mental illnesses for court-ordered treatment on time. To address the hospital’s capacity issues, the state in December contracted with Dr. Debra A. Pinals, the medical director of behavioral health and forensic programs for the Michigan Department of Health and Human Services.

Utah Police Shootings Often Involve a Person in a Mental Health Crisis. Here is How Law Enforcement and Advocates Respond When Utah police shoot at someone, it is often a person in a mental health crisis. A new Salt Lake Tribune data analysis, a first for the state, shows that at least 42% of police shootings in the past decade involve a person in crisis or who is suicidal.

Lawmakers agree: Little change in CA's mental health care system In a lengthy, often emotional legislative hearing on California’s badly broken mental health system, lawmakers and dozens of witnesses agreed that very little has changed, despite decades of new laws and huge infusions of public funds. Despite billions in public funding — and innumerable reports, studies, task forces, government reorganizations and legislation — increasing numbers of seriously ill mentally ill people continue to suffer and die on the streets, in jails, prisons and overwhelmed hospital emergency rooms ill-equipped to help them.

Georgia General Assembly will consider bill to change mental health law The proposed law would change the standard for a police officer to take someone to a hospital against their will. Currently, the law requires the threat of “imminent harm” to oneself or another. As a practical matter, that required a police officer to witness an act of violence or the threat of it – an arrestable offense. The law would change to allow a police officer to take someone to medical care against their will if that officer had “a reasonable expectation that a life-endangering crisis or significant psychiatric deterioration will occur in the near future.”

Unintended Consequences of Civil Commitment Criteria In 2010, Drs. Megan Testa and Sara G. West published a well-researched paper that chronicles the abuses that led to the dangerousness criteria and the unintended consequences that criteria has created. Strict adherence to dangerousness has increased homelessness and incarceration of individuals with serious mental illnesses, they conclude. Evelyn Burton, TAC board member, published an editorial this month in The Baltimore Sun arguing that Maryland’s civil commitment laws need to be reformed.

Colorado’s mental health system is “broken.” An audit could reveal why, and what to do about it As state policymakers and media outlets scrutinize Colorado’s mental health system, the head of a trade group representing 17 community mental health centers is calling for an audit. The CEO of the Colorado Behavioral Healthcare Council, which advocates for the community clinics across the state, wants an audit not just of those 17 centers but the entire behavioral health system.

Opinion: It’s time to stop throwing young people with undertreated mental health conditions issues in jail Two mothers whose sons have been incarcerated at Rikers Island call for supporting legislation that expands eligibility for treatment, instead of locking up young people.

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