Task Force and Task Force Member Activities

Summary of the Convenings of National Organizations and Foundations for the National Judicial Task Force to Examine State Courts’ Response to Mental Illness This summary by the Meadows Mental Health Policy Institute identified several themes that emerged from the recent convenings of national mental health thought leaders:

The critical leadership role of the judiciary
Development and continued reliance on strategies within the justice system
The emergence of a broader systemic framework
The emergence of philanthropic interest in creating solutions that can be brought to scale
Strengthen collaboration with non-traditional stakeholders to improve outcomes
Promote greater access to evidence-based treatment

Roadmap to the Ideal Crisis System An extensive new report from the Committee on Psychiatry and the Group for the Advancement of Psychiatry (GAP), and released by the National Council for Behavioral Health, outlines the steps we must take now – before the launch of 9-8-8 – to ensure people in crisis receive the high-quality behavioral health services they need. The report, “Roadmap to the Ideal Crisis System - Essential Elements, Measurable Standards and Best Practices for Behavioral Health Crisis Response,” provides a detailed vision for communities creating mental health crisis systems to guide this important work. The committee was co-chaired by Task Force member Dr. Ken Minkoff, and also included Task Force members Judge Steve Leifman and Dr. Margie Balfour.

Research and Resources

JPLI News Stories, Publications, and Resources This Judges and Psychiatrists Leadership Initiative newsletter highlights equity and inclusion training, an equity and inclusion toolkit, and the Improving Case Processing and Outcomes for People with Behavioral Health Needs brief.

The Prosecutor's Role in Deflecting Those with Behavioral Health Issues Away from the Criminal Justice System Join us for a conversation to discuss the prosecutor’s role in deflecting those with behavioral health issues away from the criminal justice system. This conversation will feature two panelists who are currently engaged in this work, Deschutes County, Oregon District Attorney John Hummel, and Melissa O’Mara, Assistant Prosecutor at the Burlington County Prosecutor’s Office in New Jersey.

TAC Research Weekly: March Research Roundup This month’s Research Roundup is dedicated to selected data and research from our latest evidence brief on serious mental illness and co-occurring substance use disorders.

Opioid Response Network The Opioid Response Network’s local consultants and partner organizations are providing: Training for justice/corrections/law enforcement on evidence-based practices for the prevention, treatment and recovery of substance use disorders with a focus on opioid use disorder and stimulant use, resources communities and organizations can use, such as promising care models, trainings, educational materials, and guidance on implementation of treatment modalities. Individuals make a request by completing a TA request form.

Reducing Homelessness for People with Behavioral Health Needs Leaving Prisons and Jails This report highlights 5 areas where people with behavioral health needs leaving California prisons and jails experience the greatest challenges in accessing housing. It also provides 10 complementary recommendations for actions that state, county, and local leaders can take to reduce homelessness among this population.

PRA eNews Policy Research Associates newsletter highlighting a rerelease of Practical Advice on Jail Diversion, and The National Center for Youth Opportunity and Justice (NCYOJ) recently released a joint publication with the Child Health and Development Institute of Connecticut, Inc. (CHDI). Children's Behavioral Health and Implementation of the School Responder Model is intended to help schools and communities meet the behavioral health needs of students while reducing youth involvement in the juvenile justice system.

Speaking Out to End Stigma Stigma, shame, and fear. These obstacles frequently play a major role in an individual’s decision not to seek help when suffering from mental health and substance use disorders. Too often, lawyers, judges, and law students find themselves wrestling privately with frustration and despair as an addiction or mental health problem dominates their life and threatens their career. To raise awareness about the nature of addiction and mental health distress in our profession and to challenge the biases and stigma that surround those problems, the ABA’s Commission on Lawyers Assistance Programs (CoLAP) created a profession-wide anti-stigma campaign that will feature a series of videos highlighting the personal recovery stories of lawyers, judges, and law students who have overcome these issues. This first three-and-a-half minute video is worth a look.

Request for Applications: The IMPACT Network PRI is soliciting applications from communities interested in participating in a minimum of a year-long behavioral health and criminal justice focused expansion of the John D. and Catherine T. MacArthur Foundation’s Safety and Justice Challenge: the IMPACT Network. The IMPACT Network expansion will engage both a group of current SJC sites and up to eight communities not receiving SJC funding to maximize what SJC sites have learned about how to accelerate behavioral health reform and diversion across the criminal justice system, with an emphasis on local jails, and with a commitment to pursue community-driven race-conscious solutions to reduce harm to populations overrepresented in, or disparately impacted by, the criminal justice system.

NASMHPD Update News and resources from the National Association of State Mental Health Program Directors.

CSG Justice Briefing How one Massachusetts county uncovered vaccine concerns among their jail population; a new resource for local prosecutors to understand and manage risks for people with behavioral health needs; and a new 50-state analysis on the role of juvenile court judges.

CSG Justice Briefing Includes a new toolkit for policymakers to reduce barriers to opportunity for people with juvenile records; an upcoming community of practice; a new series on COVID-19, racism, and the justice system; and one state’s $10 million investment to improve behavioral health outcomes.

Apply Now to Join Stepping Up’s Set, Measure, Achieve Community of Practice The Council of State Governments (CSG) Justice Center is hosting a virtual Community of Practice focused on positioning Stepping Up counties for success in Set, Measure, Achieve, the Stepping Up initiative’s latest call to action. Set, Measure, Achieve encourages counties to establish and reach measurable goals that demonstrate reduced prevalence of serious mental illness (SMI) in jails. The Community of Practice will be led by CSG Justice Center policy and research staff, with featured presentations from peer counties.

Reconnect Wrap - This Week in Criminal Justice Includes links to current funding opportunities including Byrne Criminal Justice Innovation Program, Second Chance Act Pay for Success Initiative, Adult Drug Court and Veterans Treatment Court Discretionary Grant Program, and Smart Probation: Innovations in Supervision Initiative.

NCYOJ Eye on the Field National Center for Youth Opportunity and Justice newsletter that features an issue brief on expanding access to evidence-based children’s behavioral health treatments through a train-the-trainer approach, and a new resource Children’s Behavioral Health and Implementation of the School Responder Model, which provides guidance on implementing a school responder model as part of a multi-tiered systems of support framework.

SAMHSA Upcoming Webinars SAMHSA's GAINS Center is covering essential topics through its upcoming national webinars, Virtual Learning Community webinars, and Community of Practice National Webinars.

SAMHSA Headlines Your one-stop source for the latest from SAMHSA.

Dual Diagnosis: Serious Mental Illness and Co-occurring Substance Use Disorders People living with serious mental illness face numerous barriers to living a life unencumbered by their disorder. Many have the added challenge of a dual diagnosis – experiencing co-occurring serious mental illness and a substance use disorder. Evidence-based treatments to target concurrent substance use disorder and mental illness do exist. However, most individuals face substantial barriers to accessing quality treatment. Policy solutions should include the better integration of the mental health and substance use treatment systems and an increase in the availability of integrated dual-disorder treatment programs.

Curated Library about Opioid Use for Decision-Makers CLOUD strives to be a centralized repository of information to assist decision-making and enhance collaboration across all who are working to tackle opioid use. This newsletter highlights several new and relevant resources featured on the site.

COSSAP Webinar: Becoming Trauma-Informed—An Essential Element in Justice Settings This event was held on March 17, 2021 and was part one of a 3-part series. Part one focused on understanding the ACE study, and that presentation is linked here.

Recording Link for NAMI Ask the Expert: Help, Not Handcuffs Part 2 This webinar featured an overview of 988 legislation and an overview of one model of community crisis response, CAHOOTS (Crisis Assistance Helping Out on the Streets), developed by the White Bird Clinic in Oregon.

Mental Health Training for Juvenile Justice (MHT-JJ) Virtual Train-the-Trainer 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.

SOAR Webinar: Improving Equity and Inclusion in SOAR Programs Ensuring equity in SOAR program implementation requires providers to consider how implicit bias may contribute to disparities in how SOAR services are accessed by and delivered to diverse groups. On this webinar, the SAMHSA SOAR TA Center will address barriers to equity in SOAR implementation and present strategies to overcome them.

Addiction & Mental Health As The Nation Moves Toward Recovery from COVID-19 The Kennedy Forum is proud to join Discovery Institute and The Voices Project in sponsoring a virtual town hall and discussion on this important topic.

Research Weekly: A Year of Living with the COVID-19 Pandemic In recognition of all that has happened in the past year, included is a list of all the Research Weekly blogs the Office of Research and Public Affairs has written about COVID-19 and severe mental illness.

Here’s What Jails are Costing Your City Though jail populations have declined by 28 percent over the last decade, spending on jails has actually increased by 13 percent–and cost local governments $25 billion a year. Now you can find the cost of jails in 48 major US cities with our new interactive tool: What Jails Cost.

COVID-19 Strategy 101: How to Improve Mental Health As the coronavirus pandemic shines a light on stress, anxiety, depression and more, HR leaders and other experts share ways to help.

In the News

Ted Talk: What if Mental Health Workers Responded to Emergency Calls? When you report an emergency in the US, police, firefighters or paramedics answer the call. What if mental health professionals responded, too? Colorado State Representative Leslie Herod shares a straightforward and research-backed approach that brings heart and humanity to criminal justice rather than unnecessary fines and arrests -- and keeps crises from escalating into traumatic, or even deadly, events.

Homeless, Mentally Ill and Behind Bars The homeless suffer from mental illness at a rate far higher than that of the general population. And to make matters worse, the homeless regularly lack access to care providers and facilities; instead, they too often wind up locked away in jail cells. Lifetime arrest rates for the homeless number between 62.9 percent and 90 percent. The homeless need our help. While it will take time to change the way America handles mental illness, the best place we can start is with reform of the criminal justice system that disproportionately criminalizes and incarcerates the homeless.

Why Judges, Lawyers and Court Employees Need More Mental Health Support The Supreme Courts of Illinois and Arizona recently became members of the One Mind at Work employer coalition, indicating that leaders within the industry recognize the need to take action. Prioritizing the mental health of judges, clerks, lawyers and court administrators improves the culture of the profession and ultimately generates a positive feedback loop that also improves the experience of individuals going through the justice system itself – a huge step in the right direction for those with mental illness.

Plan to fix Florida’s Baker Act would make it more powerful, raising alarms A reform bill would broaden the criteria for involuntarily holding someone for mental-health reasons. Civil rights advocates fear that would harm vulnerable people. Judge Steve Leifman believes the Baker Act fails to help those who suffer from serious mental illnesses because it doesn’t get invoked until they’re in the midst of a major crisis. “You basically have to be at a point where your life is at risk,” Leifman said. Caitlyn Clibbon, a policy analyst for Disability Rights Florida, agrees that the Baker Act clearly needs to be reformed. But she believes expanding its criteria will only exacerbate its problems.

WAITING FOR A CRISIS: Why criminal justice officials say the system has to change Milt Mack was a long-time judge in Wayne County and is now on a national task force dealing with mental health. Mack said courts need to look at all available options, not just jail, or hospital. “A-O-T, also known as assisted outpatient treatment, is basically court-ordered treatment on an outpatient basis, supervised by a psychiatrist. “And it calls for medication, it calls for group therapy, individual therapy, possibly substance abuse, there’s a variety of treatment modalities that are available,” Mack said.

'Kafkaesque' emergency room boarding practice for mental health patients probed in state Supreme Court In oral arguments before the state Supreme Court on Thursday morning, attorneys sparred over the state’s obligation to people who have been involuntarily committed to hospitals but are waiting for a scarce mental health treatment bed. Doe and her attorney, Gary Apfel, argue the state should have given her a hearing within three days of her admission, while an attorney representing the state Department of Health and Human Services is arguing the state does not need to provide a hearing until patients are admitted to a psychiatric hospital. A lower court found in Doe’s favor, and the state appealed to the New Hampshire Supreme Court.

Concussion Criminality: Many ‘criminals’ suffer from brain injuries Jails and prisons have disproportionately incarcerated the brain-injured population for decades in the U.S. The alarming correlation between traumatic brain injury (TBI) and incarceration rates cannot be overlooked in the analysis of the criminal justice system’s troubles. Damage to areas of the frontal lobe results in loss of inhibition and self-regulation. Impulse control, lack of interpersonal sensitivity and reactive aggression are the resultant characteristics. “Oh, it’s behavior. That’s the line people use a lot, but there is much more to it,” Galloway said. “It’s about brain damage that cannot be repaired that easily — it is not just a matter of a person’s willpower.”

Justice eyes court reforms to serve those on autism spectrum Pennsylvania Supreme Court Justice Kevin Dougherty thought of himself as a forward-thinking judge when, some time ago, a juvenile came before him in a Philadelphia courtroom. “The juvenile was nonresponsive. I asked him to look me in the eye and he wouldn’t,” Dougherty told The York Dispatch. “I was finding his behaviors as being incorrigible and borderline delinquent.” Now, as a justice on Pennsylvania’s highest court, Dougherty wants to see change throughout the commonwealth that allows courts to better understand and serve those on the autism spectrum, he said, whether they be defendants, victims, witnesses, jurors or other participants.

Medicaid Inmate Exclusion Policy continues to pose challenges for inmate health care The need to amend the Medicaid Inmate Exclusion Policy (MIEP) is even greater with the COVID-19 pandemic exacerbating existing barriers to treatment and healthcare services for justice-involved individuals, according to Sen. Edward Markey (D-Mass.). The report includes three recommendations related to health care and Medicaid:

Medicaid should be expanded to ensure that incarcerated and previously incarcerated individuals have access to health care services.
Correctional officials, in collaboration with public officials and community organizations, should develop individualized re-entry plans.
Health systems in the community should be better prepared for justice-involved individuals’ return.

Veterans treatment courts seek to rehabilitate veterans in lieu of punishment after an arrest Going from serving your country to facing criminal charges is a dramatic change, but there is a way you can get through this situation and come out better afterwards. The veterans treatment courts (VTC) were started in 2008 and have since established a total of 461 courts as of 2016. These are specialized courts that look to assist those who have served and offer them treatment for issues they may have from their time serving.

To truly reform criminal justice, women need more access to diversion programs | Opinion Historically, reentry and criminal justice reform efforts are focused on men. Diversion programs are no exception. Women must have better access to these programs, and the programs must be designed for women to be able to complete them successfully. For example, programs should not require payment of exorbitant court fines and costs, include lengthy probation terms, or include many program requirements that are infeasible, particularly for women who are caregivers, and programs must provide transportation and childcare support or accommodations so that people are not boxed out due to financial or time constraints.

Governor Laura Kelly Announces KDADS Awarded $4 Million Grant to Strengthen Outpatient Treatment Services for Kansans with Serious Mental Illness The funds will support five AOT pilot sites to reduce the incarceration and/or hospitalization of people with SMI in their communities through court ordered outpatient treatment.

Pierce County Passes Behavioral Health Tax Starting July, there will be an additional sales tax of 0.1%. The tax will fund: A Mobile Community Intervention Response Team: Crisis Services for Adults, expanding crisis intervention and crisis residential services; Assisted Outpatient Treatment, so those in need of help don't have to use expensive inpatient crisis services; Behavioral Health Services for Veterans; and Criminal Justice Diversion Services, a program to help the mentally ill by diverting them away from the criminal justice system and into treatment.

Georgia’s Crisis System Transformation and Lessons Learned in Anticipation of 988 The Georgia Crisis and Access Line or GCAL is a call center integrated into the local healthcare system with 24-hour mobile crisis response coverage within 100 miles of every community. It’s allowed the state to react quickly to Covid challenges and is a striking match for the vision of 988. Judy Fitzgerald, the commissioner of DBHDD, and Debbie Atkins, director of Crisis Coordination at DBHDD, share Georgia’s crisis system transformation and the lessons they’ve learned in anticipation of 988.

Southern Poverty Law Center Reports on Child Baker Act Use More than 37,000 children were sent for involuntary psychiatric exams in the 2018-19 fiscal year. The number has grown every year for the past decade. The Southern Poverty Law Center is the latest organization to call out the Baker Act’s use on children.

The Pandemic Illustrates How Important it is to Understand and Address ACEs We know how important it is for clinicians to treat ACEs and toxic stress as early as possible because it can present life-long implications for a person’s health and welfare. If medical professionals are unable to diagnose and treat conditions that surface at an early age, children are likely to suffer from them throughout their lives. “What the data tells us is that early detection and early intervention improves outcomes,” Dr. Burke Harris said in a recent interview. Meanwhile, in a recent survey conducted by the Centers for Disease Control and Prevention (CDC), 63% of 18- to-24-year-olds reported symptoms of anxiety or depression, with 25% reporting increased substance use to deal with that stress and 25% saying they had seriously considered suicide.

California’s Conservatorship Crisis In California, the fifty-four old Lanterman-Petris-Short Act (LPS) governs conservatorship – the appointment by a judge of a guardian or protector to manage the daily life of another due to mental limitations. Now, a new report demonstrates that California’s conservatorship law is creating incentives to hospitals, mental health professionals, and law enforcement to use the streets as the dumping grounds of California’s mentally ill. According to Barnard, communities are electing to put fewer people into long-term conservatorships and, instead, are using more short-term ‘holds.’

St. Louis County court has to give back federal money intended for treatment programs St. Louis County’s presiding judge is blaming Prosecuting Attorney Wesley Bell for having to turn back unused federal money meant for the 21st Circuit Court's alternative treatment courts. Earlier this month, Burton emailed Bell with concerns about a drop in treatment court referrals that he says has triggered the return of $83,477 in unused federal money since 2019. Bell's current pace of referrals, Burton said, would force the surrender of an additional $54,000 this year if nothing is done.

“Recovery Colleges” Could Fill A Gap Between Community Treatment And Long-Term Hospital Beds Most mental health treatment is focused on emergent or urgent care followed by the notion that the next level of care is community-based. On discharge from a hospital with a prescription for medication the patient may have an appointment with a community mental health professional in a few weeks but little else. A chasm opens. Too frequently, this approach results in repeated hospitalizations and a state of chronicity sets in.

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