Task Force and Task Force Member Activities

2022 Texas Tech Mental Health Law Symposium Webinar This symposium will address practical legal and policy issues that can contribute to improvements in our public mental health system and help address the significant challenges faced by our criminal justice system and law enforcement with regard to alleged offenders with mental illness. The program is specifically designed to be of benefit to practicing lawyers and judges. Presenters include Task Force members Judge Steven Leifman, Dr. Kenneth Minkoff, Judge Milton Mack, and Dr. Debra Pinals.

New Task Force Resources Now Available The following resources have been approved and added to the Task Force website:

Research and Resources

National Research Shows Support for Virtual Court Hearings, Services in Diversion Programs Virtual hearings and services in drug courts and other court-led diversion programs should continue, according to new national research released by the National Center for State Courts (NCSC) and Rulo Strategies. Developed in partnership with senior justice and behavioral health researcher Bradley Ray, Ph.D., the two studies, Adoption of Virtual Services in Judicially Led Diversion Programs: Final Findings and Virtual Services in Judicially Led Diversion Programs: Participant Findings examine opinions about barriers and benefits of virtual court hearings, team meetings, treatment and community supervision since the start of the pandemic in March 2020.

HHS's Fast Facts for Covered Entities A quick guide to HIPAA for covered entities with myth-busters like:

The Privacy Rule does not require you to obtain a signed consent form before sharing information for treatment purposes
The Privacy Rule does not cut off all communications between you and the families and friends of patients
The Privacy Rule is not anti-electronic

Most Patients Considered Good Candidates for Telemedicine, Psychiatrists Report Psychiatrists view telemedicine as a tool to facilitate engagement with care, encourage patients to keep appointments, and improve adherence with treatment, according to a report published yesterday in Psychiatric Services in Advance.

A Review of the Work: States' Efforts to Improve Competence to Stand Trial and Competence Restoration Processes A Review of the Work: States' Efforts to Improve Competence to Stand Trial and Competence Restoration Processes," was held on December 13, 2021, and hosted by SAMHSA's GAINS Center. The webinar materials are now available, including keynote and presenter panel slides, a link to the PRA competency microsite, and a link to download the Texas Eliminate the Wait toolkit.

TAC Research Weekly: Further Evidence of Association Between Cannabis Use and Psychotic Disorders The findings on the association of cannabis use and self-reported psychosis adds to the growing literature that suggests there is a relationship between marijuana use and psychotic disorders. The authors note that these findings are useful for physicians and clinicians to know which of their patients may be more likely to be at risk for developing a psychotic disorder. It is also important information for individuals who might already be at risk for a psychotic disorder due to family history, indicating that marijuana could potentially increase this risk for developing a psychotic disorder.

The Consequences of Medicaid Expansion under the Affordable Care Act for Police Arrests Evidence in this paper suggests that expanded Medicaid insurance reduced police arrests, particularly drug-related arrests. Combined with research showing the harmful health consequences of chronic policing in disadvantaged communities, greater insurance coverage creates new avenues for individuals to seek care, receive treatment, and avoid criminalization. As police reform is high on the agenda at the local, state, and federal level, our paper supports the perspective that broad health policy reforms can meaningfully reduce contact with the criminal justice system under historic conditions of mass criminalization.

Mental Health Care Health Professional Shortage Areas (HPSAs) This state by state report updates the HPSAs as of September 2021. Health Professional Shortage Area (HPSA) designations are used to identify areas and population groups within the United States that are experiencing a shortage of health professionals. There are three categories of HPSA designation based on the health discipline that is experiencing a shortage: 1) primary medical; 2) dental; and 3) mental health. The primary factor used to determine a HPSA designation is the number of health professionals relative to the population with consideration of high need. Federal regulations stipulate that, in order to be considered as having a shortage of providers, an area must have a population-to-provider ratio of a certain threshold. For mental health, the population to provider ratio must be at least 30,000 to 1 (20,000 to 1 if there are unusually high needs in the community).

Grant Announcement: Targeted Capacity Expansion The purpose of this SAMHSA grant program is to implement targeted strategies for the provision of substance use disorder (SUD) or co-occurring disorder (COD) harm reduction, treatment, and/or recovery support services to support an under-resourced population or unmet need identified by the community. The applicant will identify the specific need or population it seeks to support through the provision of evidence-based SUD or COD harm reduction, treatment, and/or recovery support services.

NAMI Options for Seeking Mental Health Resources for Black/African American Individuals What happens at the intersection of mental health and one’s experience as a member of the Black community? While the experience of being Black in America varies tremendously, there are shared cultural factors that play a role in helping define mental health and supporting well-being, resiliency and healing.

Applying the RNR Model to Community Supervision: The Case of STICS Hosted by Dr. James Bonta, this webinar will explore how the Strategic Training Initiative in Community Supervision (STICS) model can help community supervision officers use RNR more effectively with their caseloads. Dr. Bonta will explore “the various evaluations of STICS and similar training programs together with a large-scale implementation of STICS.”

CCBHCs and the Justice System: Saving Time, Money and Lives Across the country, partnerships between CCBHCs and criminal justice agencies are providing pre-arrest deflection, 911 support and helping people in the justice system maintain recovery while under community supervision. It’s more than just a service to the community – it’s a CCBHC model requirement. Join public safety and public health experts at a National Council webinar on Wednesday, February 23, from 3-4 p.m. ET as we explore the use of CCBHCs in justice systems.

Local Justice System Responses to Methamphetamine This COSSAP webinar will showcase the steps Sacramento County, California has taken in response to persistent high rates of methamphetamine and other drug use among individuals involved in the criminal justice system. It will feature five speakers that represent efforts across justice system intercepts including jail diversion, drug courts, in-custody programming, and re-entry supports. Speakers will share the approaches that have helped decrease overdose fatality rates in Sacramento County despite recent significant increases in statewide overdose deaths.

Two Sides to Every Bench: Utilizing Trauma-Informed Court Practices to Promote Dignity and Reconciliation SAMHSA’s GAINS Center for Behavioral Health and Justice Transformation is committed to sharing information that elevates the voices of people with lived experience and taps into the expertise of practitioners in the field. This article is a unique blend of both strategies. Sarai Flores, Esq., is a returning eNewsletter contributor. She participated in a Q&A on her lived experience with trauma and justice system involvement and authored an article on advancing trauma responsiveness in the courtroom. The Honorable Michael Aloi is a prior participant in SAMHSA’s GAINS Center How Being Trauma Informed Improves Criminal Justice System Responses training. The following is an edited transcript of a conversation between the two about Judge Aloi’s approach towards those with a trauma history who end up on the other side of his bench.

CSG Justice System Stepping Up’s "Set, Measure, Achieve" Community of Practice opportunity, and a new CSG resource, Embedding Clinicians in the Criminal Justice System.

NRI Newsletter includes State Mental Health Agency (SMHA) Organization And Structure In State Government, the 2022 Report to Congress on the Mental Health Parity and Addiction Equity Act, and more.

NASMHPD Newsletter This issue highlights SAMHSA’s new COVID and crisis response resources, and more.

The Stepping Up Minute Announcing new Stepping Up and Innovator counties, upcoming webinar and training, a Mental Health Professional Development Grant mental health resources, and more.

In the News

Care Not Cuffs: Demand Health Care for Health Needs Each year 11.2 million people in the U.S. are incarcerated, and more than 80% of those serving time need care for mental health and substance use. Anticipating the nationwide launch of the 9-8-8 crisis number, Care Not Cuffs is a national campaign dedicated to building healthier, safer communities by rallying the nation to respond to those who suffer from unmet mental health needs with health care instead of criminalization and imprisonment. The Campaign includes a growing coalition of public defenders, prosecutors, judges, law enforcement officials, policymakers, health professionals, and activists uniting to ensure we respond to unmet mental health needs with healthcare instead of punishment.

Pennsylvania Courts Illegally Kept Opioid Users From Treatment Meds: DOJ Pennsylvania courts illegally blocked opioid users from using medications to treat their addictions, according to a recent finding from the US Department of Justice (DOJ). The DOJ found last week that multiple courts in the state violated the Americans with Disabilities Act (ADA) by demanding that those with opiate use disorder (OUD) discontinue their medications as a condition of compliance for drug courts, mental health courts, DUI courts and probation and parole programs.

What American Mental Health Care Is Missing Our science was looking for causes while the effects of these disorders were playing out with more death and disability, incarceration, and homelessness, and increasing frustration and despair for both patients and families. Indeed, many of the most refractory social issues of the decade—homelessness, incarceration, poverty—could be tracked, in part, to our nation’s failure to care for people with mental illness.

The Health and Reentry Project Bipartisan legislation under consideration in Congress would establish Medicaid coverage for eligible individuals 30 days before release from prison or jail. Even as federal policymakers consider this change, a handful of states have asked the Biden Administration to make similar policy changes administratively through Medicaid’s 1115 demonstration waiver process. Whether through statute or administrative action, it appears likely that changes extending Medicaid coverage to incarcerated individuals will occur in 2022.

Don't Deny Me Campaign Updates A recent report to Congress from the Department of Labor, Department of Health and Human Services, and Department of the Treasury shows practices such as illegally denying insurance coverage for autism therapy, nutritionists for individuals with eating disorders, and Medication-Assisted Treatment (MAT) for those with opioid use disorder are indeed commonplace. That’s why it’s critical for everyone to understand what illegal denials look like, as well as the steps one can take to challenge such denials.

NAMI Idaho Announces 2022 Kathie Garrett IMPACT Award NAMI Idaho is pleased to announce the 2022 Kathie Garrett IMPACT Award goes to the honorable and esteemed team of Governor Brad Little, the Legislature of the State of Idaho, the Supreme Court of the State of Idaho, and the Idaho Behavioral Health Council, et.al. This award is given for its significant and positive influence on improving the lives of those impacted by mental illness. In 2019, Sara Omundson, Administrative Director of the Courts, and Dave Jeppesen, Director of Idaho Department of Health and Welfare, communicated their Idaho Behavioral Health Council vision. In 2020, Governor Brad Little, all five Idaho Supreme Court Justices, and legislators gathered to sign documents establishing and supporting the Idaho Behavioral Health Council.

23rd Judicial District program emphasizes outpatient treatment for mentally ill The 23rd Judicial District is implementing a new court program to keep people with mental illness in the community and out of hospitals and jails. Assisted Outpatient Treatment is a preventive program to help people with severe and persistent mental illness from a cycle of hospitalization and acute mental health episodes, said District Judge Tom Drees. Participants who are under outpatient treatment orders would normally be seen in court once every three to six months, but under assisted outpatient treatment, the participant would be seen in court once a month.

California Is Fighting to Make It Easier to Put People Under Conservatorships “Conservatorship allows us to provide the wraparound services needed to stabilize people suffering from severe mental health and substance use issues, and help them begin their recovery to get their lives back on track,” San Francisco Mayor London Breed said in 2019. “Allowing them to deteriorate on our streets when they are incapable of caring for themselves is not humane.” Civil rights advocates and many people with disabilities counter that long-term conservatorship is unethical and illegal, particularly in the absence of voluntary access to housing, medication, and drug treatment.

Milwaukee Mental Health Emergency Center Targeted to open in early 2022, the Mental Health Emergency Center will offer 24/7 crisis mental health assessment, stabilization, treatment, and transition care management for children, adolescents and adults. Construction and start-up costs for the new center are projected to be $18 million, with the County covering 50% of those costs and the health systems covering the other half. Once open, the center is expected to deliver care with an operating loss of $12 million annually. Operating shortfalls will be similarly split 50/50 between the County and the health systems.

On cusp of $25 million settlement over jail conditions, a new voice is heard: the incarcerated Whatever the outcome of a lawsuit targeting conditions at the lockup, something unusual, perhaps unprecedented, has occurred in the case: The inmates’ voices have been heard in court. For five hours Thursday, U.S. Magistrate Judge Nathanael Cousins of San Jose, who had ordered the hearing, heard remotely from 39 people speaking from the jail in Dublin. Most are being held before trial or conviction, many have mental health problems, and all of them opposed the settlement. “The jail doesn’t need to hire more sheriffs. They need to hire more mental health professionals,” one said, a sentiment shared by most of his fellow speakers.

Court Approves Consent Decree in Federal Class Action Regarding Mental Health Care at Santa Rita Jail The Babu case is a federal class action lawsuit challenging: the adequacy of mental health care and treatment at the Jail; suicide prevention and the use of safety cells; overuse of isolation and adequacy of out-of-cell time; access to programs, services and activities especially for persons with mental health disabilities; discharge planning for people with mental health disabilities; sufficiency of accommodations in disciplinary proceedings and in pre-planned use-of-force incidents for persons with mental health disabilities; and the overall policies, procedures, and practices regarding COVID-19 on behalf of all people incarcerated at the Jail.

New diversion program being pursued by OKC criminal justice reform advocate “You’d still have your drug courts and mental health courts and all the other programs; we’re not saying get rid of those things," she said. “We're saying this group of folks right here, who aren't committing serious felony offenses, who are cycling in over and over again, let's meet them where they're at because they deserve help, too.”

Sheriff’s Association President Blasts Texas Over Growing Mental Hospital Waitlist “I’m going to direct a question to you since you’re new to our group: I speak for the Sheriff’s Association of Texas … and those of us who run county jails, we simply want to know what the plan is,” Wilson said. “As of [Jan. 24], there were 2,127 individuals sitting in county jails court ordered by a district judge to receive state services,” he went on, voice growing louder. “And I’m telling you up front, the system is gonna break soon, because the counties can’t find the employees … to give the services that are court ordered, from the state.” Wilson’s sharp response to the state commissioner channeled frustrations local advocates and families of those with mental illness have been voicing for months.

Wellbeing

Many courts are focusing now more than ever on the wellbeing of judges and court employees. This new section of Behavioral Health Alerts will highlight timely news and resources that address this important issue.

Identifying, Preventing, and Managing Professional Burnout in Working with Justice-Involved Veterans NADCP's Justice For Vets is hosting an important webinar on addressing professional burnout when working with Justice-Involved veterans and the different coping strategies used to prevent and resist compassion fatigue. Navigating the path to serve the Justice-Involved Veteran population brings with it its own unique risks of developing compassion fatigue, secondary traumatic stress, vicarious traumatization, and professional burnout which can lead to deleterious effects on personal and professional well-being. This presentation will focus on better understanding these conditions including their related signs and symptoms and practical steps to take to prevent and mitigate their impact.

‘Mental Health First Aid’ Training Prescribed for Public Sector Workers County leaders from around the nation are encouraging local governments to train their employees to administer “mental health first aid” to coworkers and others. According to a NACo fact sheet, the training helps county employees recognize signs of substance abuse and mental health challenges, including suicidal thoughts, among coworkers, relatives and members of the public. The training also teaches participants how to have difficult conversations about mental health.

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