Task Force and Task Force Member Activities

More New Task Force Resources Released

• What State Court Leaders Need to Know About State Behavioral Health Systems This Court Leadership Brief is intended to provide state court leaders an overview of state behavioral health systems based on research and analytics. Understanding the complexity of state behavioral health systems is an important step in strengthening the state courts’ relationship with your state behavioral health authority.
• Trauma and Trauma-Informed Responses When court professionals are aware of how traumatic experiences impact behavior, they can better understand how to effectively support the individual. Sometimes this means diverting the individual from the justice system entirely to a treatment option, and other times it means being intentional about how to interpret their actions, work with them, and manage cases.
• Secondary Trauma and the Courts Witnessing family tragedies, hearing stories of violence, and listening to difficult testimonies are recurring and persistent experiences for judicial officers and practitioners working in the justice system. In fact, 63 percent of judges have at least one symptom of vicarious trauma and 50 percent of child protection staff experience high or very high levels of compassion fatigue. It is easy to see how these daily interactions with individuals, children, and families who are reliving trauma takes an emotional toll on justice system practitioners and places them at high risk for experiencing secondary trauma.
• Trauma-Informed Practices and Jurors While many state courts have struggled with providing support to jurors who have listened to difficult testimony, the Executive Office of the Massachusetts Trial Court in partnership with the state Office of Jury Commissioner has done something about it! This innovation spotlight describes the Massachusetts approach and provides resources for other courts and jury commissions to consider.
• Peers in Courts All courts should consider hiring peers into their programs, services, and operations. This Court Leadership Brief describes different types of peers in court settings, the roles peers can play in court, lessons from the field with examples of peers in the courts and links to additional resources.

Upstream Resources:

• Social Determinants of Health Through an increased understanding of the Social Determinants of Health, judges and court leaders can be more aware of how social context affects families and are able to have a more comprehensive picture of the barriers and limitations to resources and supports that court- involved families experience.
• Benefits of Upstream for Child Welfare Agencies Child welfare agencies often are placed with full responsibility for addressing the needs of families, yet they are only one part of the solution. A coordinated effort with court and community stakeholders can result in shared accountability, shared resources, and increased access to supports within the community.
• Benefits of Upstream for Courts Every community has a range of agencies, organizations, and systems tasked with providing the resources and supports families need to thrive. Too often, the effectiveness of these entities is limited by inequitable service availability and accessibility, lack of coordination and collaboration, and inadequate community engagement. This results in missed opportunities to identify and address risk factors before child welfare or court involvement. Courts see the consequences of these missed opportunities every day and are in a unique position to convene community stakeholders with a focus on seizing those opportunities early on to improve outcomes for children and families.

Research and Resources

Trauma: Community of Color Exposure to the Criminal Justice System as an Adverse Childhood Experience Each childhood experience described in screening instruments, which were used over the years to identify trauma, has a direct and undeniable nexus to the justice system. This nexus is evident for the abuse survivor seeking to escape her abuser through an order of protection; for the divorcing parents in a bitter custody battle; for children who land in the foster care system when their parents are incapacitated by substance abuse disorders; for those who end up with criminal justice involvement for nonviolent offenses involving mere possession of drugs; and for the Black men and women who are sentenced to longer and more harsh sentences than their white counterparts at rates that are grossly disproportionate to the racial make-up of the overall population as well as the incidence of criminal behavior among all races.

404 Provider Not Found: Contributions and Solutions to Inadequate Provider Networks for Behavioral Health Care Despite the efforts of policymakers, access to in-network behavioral health care services has continued to lag relative to other types of health care. Several factors contribute to insurance networks’ paucity of behavioral health care providers, including low insurance reimbursement for behavioral health care services, inadequate regulation and enforcement, provider shortages, and a lack of access to telehealth services.

Psychosis And Mass Shootings: A Systematic Examination Using Publicly Available Data Mass shootings are often blamed on serious mental illness. This study assesses the role of psychosis in contributing to mass shootings along a continuum. The role of psychosis is compared with other motivations for mass shootings including employment issues, interpersonal conflict, relationship issues, hate, and fame-seeking. The findings show that symptoms of psychosis played no role in 69% of cases, but psychosis may have played a minor role in 11% of cases, a moderate role in 9% of cases, and a major role in 11% of cases. Perpetrators motivated by psychosis were similar to mass shooters with other motivations in terms of demographics and common risk factors for violence. The role of serious mental illness in mass shootings is complex. The data indicate that access to mental health care may help prevent mass shootings in a minority of cases, but this is far from the only solution to mass shootings.

Strengthening Community-Based Service Capacity through the Justice Reinvestment Initiative Through the Justice Reinvestment Initiative (JRI) process, multiple states have established goals, policy structures, and implementation strategies to provide and enhance community-based services related to safety and well-being, such as behavioral health treatment, violence prevention, victim services, and reentry support. This Urban Institute report focuses on 10 JRI states’ strategies for advancing public safety goals by collaboratively building community capacity to provide and enhance vital safety and well-being services.

Autism in the Courtroom With the explosion in autism diagnoses, it’s said that everyone knows someone who knows someone with autism. When handling a case with a victim or witness with autism, prosecutors should be ready to educate themselves and jurors about the disorder. With better education and compassion, we can handle these cases more effectively, allowing us to see justice done. This Texas Bar Journal article includes specific strategies for interviewing and communicating with people with autism a justice context.

New Survey: More Than 4 in 10 US Adults Who Needed Substance Use and Mental Health Care Didn’t Get Care While 43 percent of U.S. adults who say they needed substance use or mental health care in the past 12 months did not receive that care, just 21 percent of those who needed primary care and did not receive it, according to data from the new report, 2022 Access to Care Survey.

State Mental Health Agency Use of Medicaid to Provide Mental Health Services One of the 15 new State Mental Health Profiles report released by NRI focuses on State Mental Health Agencies (SMHAs) use of Medicaid to provide mental health services. In Fiscal year 2020, Medicaid represented over 50% of the $45.9 billion dollars SMHAs expended to provide mental health services to over eight million clients. How SMHAs use Medicaid to pay for mental health services varies from state to state, with states using different combinations of Medicaid options, waivers, managed care, and fee-for-service approaches.

Diversion in the Juvenile Justice System Approximately 34 states have enacted laws providing for at least one form of diversion or have codified certain diversion policies in statute. Some states have laws requiring certain types of cases to be offered a chance of diversion. This NCSL brief reviews those and other diversion efforts.

Diversion as a Pathway to Improving Service Utilization Among At-Risk Youth Despite the high rates of mental illness among youth in the juvenile justice system, many justice- involved youth do not receive adequate behavioral health services. We examined differences in health service utilization outcomes between youth who were diverted through a community-based, pre-complaint program, and youth with juvenile justice involvement in neighboring cities. Results suggest that pre-complaint diversion through Safety Net fosters access to outpatient behavioral health and primary care services that address the underlying issues that put youth in contact with police.

Webinar: Judicial Guardianship Evaluation Toolkit Developed for judges by judges in 22 states, the new Guardianship Evaluation Toolkit is a two-page fillable and printable PDF that contains a checklist of relevant factors designed to aid judges in integrating information from multiple sources. The tool also helps judges weigh potential risk factors for abuse in guardianships. An NCSC webinar.

Thinking Outside the Box Housing Webinar Series: Cross-Sector Strategies to Create Housing Opportunities for People with Behavioral Health Needs Leaving the Justice System This webinar will introduce participants to the basics of housing Continuums of Care (CoCs), CoC prioritization processes, and resources available through the American Rescue Plan. Speakers will include representatives from communities that are making this population a priority and rethinking their prioritization processes. Participants will leave this webinar with knowledge of the benefits and processes of connecting people to evidence-based housing and supportive service interventions.

Embedding Equity into 988: Leadership Summit Join the Kennedy-Satcher Center for Mental Health Equity (KSCMHE), in partnership with Beacon Health Options, for a critical discussion on ensuring equity is embedded into the upcoming national psychiatric crisis response line, 988.

Improving Medication Adherence in AOT: Long-acting Injectable Antipsychotics Long-acting antipsychotics have been shown to increase medication adherence in a number of settings, including assisted outpatient treatment. A study conducted in Summit County, Ohio with their AOT program showed better outcomes with LAIs. In this webinar Doug Smith, MD DLFAPA, the medical Director of the Summit County Alcohol, Drug and Mental Health Board will give general information on LAIs and then share the results of the study.

Don’t Just Wing It: Combining Clinical and Supervision Case Plans to Improve Outcomes in Veterans Treatment Courts Combined clinical and supervision case plans for Veterans in Veterans Treatment Courts can improve engagement, bring about behavior change, and increase success rates. This webinar will address common questions about combined case plans.

Emerging Issues in Neuroscience for Judges Numerous court cases involve persons accused of, or involved in, offenses related to addiction or violence. Neuroscience has also provided insights that have influenced the Supreme Court’s view of whether / when youth ought to be tried or punished as adults. In short, the nexus between science and law is of increasing importance and this webinar aims to enhance courts’ understanding of neuroscience for the administration of justice. On June 22, experts from the field of neuroscience will provide up-to-date, science-backed insights that are useful to courts in this free NJC webinar.

FY 2022 Improving Adult and Juvenile Crisis Stabilization and Community Reentry Program Through this opportunity, the Bureau of Justice Assistance seeks applications for funding to state, local, and tribal governments, as well as community-based nonprofit organizations, to enhance or implement clinical services and other evidence-based responses to improve reentry, reduce recidivism, and address the treatment and recovery needs of people with mental health, substance use, or co-occurring disorders who are currently involved in the criminal justice system or were formerly involved.

CSG Justice Center State of Justice Nevada is building behavioral health infrastructure, starting with new 988 hotline; people in jail face delays for mental health care before they can stand trial in Georgia; and the Washington Supreme Court tries to chart a different path on race.

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

In the News

Standing tall: A new stage for incompetency cases A growing number of people with serious mental illness are getting entangled in the legal system, often for minor crimes. Psychologists are figuring out how to get them essential mental health care instead. Mental health providers, researchers, judges, state and local leaders, and other stakeholders are beginning to tackle this problem from a variety of angles, some at larger systemic levels and others at more discrete entry points within the forensic and mental health systems.

How California shuffles its mentally ill prisoners In four years, one mentally ill prison inmate was transferred 39 times. Until the pandemic hit, then it stopped. Seven months later he was dead.

Call Centers Struggling to Hire for the New Nationwide Mental Health Crisis Line The people setting up 988 agree the counselors answering these calls, chats and texts will be critical to the new line achieving its goals. But with just six weeks before it goes live, hundreds of positions remain unfilled—putting those looking to the line for help at risk. It also makes it more likely that those who have been hired will end up overworked.

Strengthening behavioral health access will help Kansans and address far-reaching disparities The Governor’s Commission on Racial Equity and Justice examined behavioral health, seeking to understand how to address systemic issues that affect health outcomes, community vitality, crisis response and health care access. Behavioral health recommendations to address racial equity were included in the commission’s final report.

Science Shows How to Protect Kids’ Mental Health, but It’s Being Ignored Scientific advances have identified effective mental health practices, which have been largely ignored, and now is the time to act on them. Based on centuries-old and long disproven theories of physical and mental health as two independent systems, billions are invested annually on medical research and physician training, but staggeringly few resources are available to advance psychological science or the development of a mental health workforce.

How the county got a highly competitive grant to help with unique housing needs Minnehaha County was one of four communities nationwide selected to participate in a unique housing effort to help people who've been impacted by the justice system. Here's how it happened and what it means for people who live here. The goal is ultimately about helping people who've been impacted by the justice system find housing, but it's also about looking at reducing recidivism, reducing the jail population and reducing racial disparities among incarcerated people.

Inmates waiting months for mental health treatment, state's attorney says (Illinois) "DHS has left seriously ill inmates to languish without court-ordered treatment only to become more and more sick," said Sangamon County State's Attorney Dan Wright. "County jails cannot afford to absorb the statutory obligations of DHS where unambiguous court orders require the state to provide psychiatric treatment in an appropriate DHS facility. It is a grave disservice to the individuals who need mental health care, crime victims whose cases are further delayed by the state’s failure to act, inmates and jail staff whose safety is jeopardized, and taxpayers who expect state agencies to discharge their statutory duties without the threat of litigation."

Long wait for justice: People in jail face delays for mental health care before they can stand trial (Georgia) In Georgia, 368 people who have been deemed incompetent sit in local jails waiting to get treatment to stand trial, according to the state. More than 900 are waiting for just the first step in the process, a “forensic evaluation.” Similar delays have sparked litigation in many other states. The Indiana Protection and Advocacy Services Commission filed a lawsuit in May against state officials over the lag in psychiatric services, claiming the delays violate defendants’ due process rights. Oregon has faced strict time limits set through a 2002 court case, and its backlog stood at 55 people as of May 20.

• Alabama faces a consent decree, but “folks are still waiting, on average, a couple hundred days to be admitted to the facilities to undergo either those evaluations or the treatment,” said Shandra Monterastelli, a senior staff attorney at the Alabama Disabilities Advocacy Program.
• North Carolina’s waitlist for “restoration” treatment has risen to 140, while Colorado — another state under a consent decree — has 364 waiting. In Texas, the number is much higher — more than 2,000 — a backlog that has prompted a lawsuit. Montana has had dozens waiting as well.

Georgia mental health commission planning next round of reforms Georgia is starting “the decade of mental health reforms” Kevin Tanner, chairman of the state’s Behavioral Health Reform and Innovation Commission, said. Commission members identified mental health pay rates and workforce shortages, care coordination, and helping people with mental illness avoid the criminal justice system as key priorities for the next round of reforms.

Wellbeing

Boulder County to see behavioral health support for criminal justice advocates Gov. Jared Polis signed into law Senate Bill 188 on May 20, creating a prosecutorial and defense attorney behavioral health program. This bill appropriates $500,000 for the grant program. Recipients can use money for counseling services and peer support programs, as well as training and education programs that teach the symptoms of job-related trauma and how to prevent and treat it.

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