Behavioral Health and the Courts: What Should You Be Doing Right Now?

Task Force and Task Force Member Activities

Behavioral Health and the Courts: What Should You Be Doing Right Now? This month is the last of our five-episode discussion with members of the National Judicial Task Force to Examine State Courts’ Response to Mental Illness. Some of the topics we will explore include: What should judges and court administrators be doing right now to address this crisis? How do we educate the public about the realities of mental health? What kind of role will court staff play in this new model for courts? What advice do these panelists have for the rest of us? The panel includes:

  • The Honorable Christopher Goff, Justice on the Indiana Supreme Court
  • Scott Block, Statewide Behavioral Health Administrator for the Illinois Administrative Office of the Courts
  • Walter Thompson, Peer Recovery Support Specialist and retired non-commissioned officer in the United States Army, and
  • Patti Tobias, Principal Court Management Consultant for the National Center for State Courts

Registration is open for the October site visit to the Miami Model There is no better way to “put it all together” than to experience the continuum of innovative practices that comprise the Miami Model. Judge Leifman and his team have graciously agreed to host a series of visits to Miami, and the first one will be held October 26-27. Individuals and teams are welcome to attend, but space is limited for each visit. There is still room in October, but the November (17-18) and December (15-16) dates are full or almost full. Please contact Rick Schwermer at rschwermer@ncsc.org for registration information. November and December registration will open after September 15th.

Task Force Publications and Resources As the national judicial task force nears its end, this one-stop summary of Task Force resources serves as a near-final summary of the tangible work of the Task Force. Almost 100 new behavioral health/court resources are linked here.


Research and Resources

A Los Angeles Supportive Housing Program Interrupted the Cycle Between Jail and Homelessness—and Largely Paid for Itself In Los Angeles County, the Just in Reach Pay for Success project provided permanent supportive housing for more than 300 people diverted from county jail, achieving a one-year housing stability rate of 82 percent. RAND researchers found that savings generated by the program compensated for a large portion of its costs, providing policymakers with evidence on one way to improve the lives of unhoused people and their communities. The ODR supportive housing program consists of pre-release jail in-reach services, including psychosocial assessments and housing needs assessments, followed by connection to interim housing and intensive case management services immediately upon an individual's release from jail after being deemed appropriate for clinical diversion.

From Service through Reentry: A Preliminary Assessment of Veterans in the Criminal Justice System The reasons underlying veterans’ justice-system involvement are complex. They range from combat-related risk factors to “bad-paper” discharges that block access to Veterans Administration benefits such as mental health and substance abuse treatment. Ineffective procedures to identify veterans upon arrest, as well as inconsistent diversion mechanisms, also play a role. This report summarizes the current state of knowledge about veterans in the civilian justice system and serves as a foundation for the Veterans Justice Commission’s work.

Trauma-Informed Approaches Across the Sequential Intercept Model People in the criminal justice system experience alarming rates of trauma prior to and as a result of their involvement in the system. Yet criminal justice professionals have often struggled to recognize and respond to trauma among this population. This brief explores how criminal justice professionals can take a trauma-informed approach to their work at each point of contact in the justice system. By employing this approach, they can help to reduce recidivism and incidents of violence while also improving service engagement and recovery.

JPLI Newsletter This edition highlights the National Judicial Task Force’s report and resources, and the approval of the CCJ COSCA resolution. It also highlight recent. Task Force resources on judicial wellbeing, and the impact of stigma.

NAMD Highlights Opportunities to Address Mental Health and Substance Use in Letter to HHS and Federal Policy Brief The National Association of Medicaid Directors’ recent letter to the Secretary of Health and Human Services highlights opportunities to improve the behavioral healthcare system. The letter includes policy recommendations to strengthen the behavioral health workforce, drive integration, meet the needs of children and young people, develop crisis response systems, address substance use and overdose, and ensure access to inpatient and specialty care. Also included are links to the latest Federal Policy Brief and other Medicaid related resources.

Initiatives to Support Housing Services for Individuals with SMI and SED This National Research Institute summarizes survey responses from 46 states about housing resources for individuals with serious mental illness.

How to Connect People in Crisis to the Care They Need For people experiencing mental health- or substance use disorder-related crises, jails and emergency departments have become frequent landing places. But overusing these facilities in response to behavioral health emergencies can be problematic. This PEW fact sheet is one in a series outlining questions that local officials can ask and resources they can use to prioritize potential improvements to behavioral health emergency responses.

SAMHSA Advisory: Peer Support Services in Crisis Care This advisory discusses the role of peer support workers and models of peer support services that are available to assist individuals who are experiencing a crisis. Peer support services are a vital component of crisis care.

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.

Engaging Parents and Youth with Lived Experience: Strengthening Collaborative Policy and Practice Initiatives for Families with Mental Health and Substance Use Disorders The National Center on Substance Abuse and Child Welfare (NCSACW) prepared this document to outline key strategies collaboratives should consider when recruiting and engaging adults and youths with lived experience who were involved with the child welfare system due to a substance use disorder or other mental health challenge. Also included are resources and links to ensure collaboratives have the necessary information to support meaningful partnerships.

CSG Justice Center Justice Briefing This edition includes Advancing Fairness and Transparency: National Guidelines for Post-Conviction Risk and Needs Assessment, a critical resource for policymakers, practitioners, researchers, and agency administrators to help them make better decisions that support people’s success following a conviction. Also linked is a spotlight on Integral Care’s Expanded Mobile Crisis Outreach Team in Austin, Texas.

MindSite News, Ken Burns Presents and WETA present a FREE live back-to-school event: A Conversation About Youth Mental Health and the Making of Hiding in Plain Sight We invite you to join us for a MindSite News Live Interview focused on youth mental health. Our guests will be some of the people behind the brilliant new Ken Burns Presents documentary, Hiding in Plain Sight, a four-hour program being shown on PBS stations, and streaming free on PBS digital sites in September.

Introducing NACo's Opioid Solutions Center The National Association of Counties (NACo) is pleased to announce new resources to support and elevate county solutions to the opioid crisis. NACo’s Opioid Solutions Center is a comprehensive information hub to help empower local leaders to invest resources in effective treatment, recovery, prevention and other public health practices that can save lives and address the underlying causes of substance use disorders.

Law & Mental Health Conference: On Civil Commitment The Conference is designed for attorneys, law enforcement, public and private clinicians; public healthcare and hospital administrators, social workers, policy designers and legislators, and organizations and individuals involved with the care and welfare of people with mental illness, addiction, and alcoholism. Keynote addresses include Paul S. Appelbaum, MD, Professor of Psychiatry, Medicine and Law, and Director, Division of Law, Ethics and Psychiatry at Columbia University, and Sarah Y. Vinson, MD, Founder and Principal Consultant of Lorio Forensics, and an Associate Professor of Psychiatry and Pediatrics and Chair of the Department of Psychiatry at Morehouse School of Medicine.

Since you asked: How many people are released from each state's prisons and jails every year? To aid those who need these statistics to make the case for devoting more resources to reentry services, or simply wish to understand the scale of reentry in their state, we compiled the most recent available Bureau of Justice Statistics data about releases from both prisons and jails, by state.

Barriers and Facilitators of Jail-Based Medication-Assisted Treatment Programs: Setting up for Success This webinar will present the research of Dr. Noa Krawczyk and her team, which studied the barriers and facilitators of New Jersey’s statewide jail-based MAT initiative. The New Jersey Division of Mental Health and Addiction Services, which led the initiative, will share how jails are handling the reentry process and connecting participants with local providers. Camden County Jail, one of the study participants, will also present on the strategies they developed to provide MAT and better set up individuals leaving their jail for success in treatment delivery and retention.

Counties Enhance Safety and Improve Outcomes with Recovery Fund Investments in Jail Diversion Jail diversion reduces community members’ interactions with the criminal legal system through community-based services and alternatives to incarceration. Diversion can happen during interactions with police, at the time of charging or through court programs. These “exit ramps” at various points in the criminal legal system reduce racial and ethnic disparities and the collateral consequences of justice system involvement such as lost earnings, barriers to housing, education and employment and reduced access to social safety net programs.

Principles of Community-based Behavioral Health Services for Justice-involved Individuals: A Research-based Guide This SAMHSA resource is intended to assist community-based behavioral health providers in their clinical and case management practice with people with mental and substance use disorders who are currently involved with or have a history of involvement in the adult criminal justice system.

Mental Health Conservatorship Among Homeless People with Serious Mental Illness The purpose of this study was to examine associations between homelessness and length of psychiatric hospitalization and to explore the role of mental health conservatorship [guardianship] in determining discharge location for patients who are homeless and have a grave disability from serious mental illness. Conclusions: A mental health conservatorship can be a mechanism for helping homeless people with a grave disability from mental illness to transition from the streets to residential psychiatric treatment, but it requires substantial resources from facilities that initiate such conservatorships and does not guarantee resolution of long-term supportive housing needs.


In the News

Locking up People with Mental Health Conditions Doesn’t Make Anyone Safer Jails and prisons are fundamentally not therapeutic environments, and they are woefully ill-equipped to provide these services. About three in five people with a history of mental health conditions do not receive treatment while incarcerated. They are also more likely to face discipline and spend three times longer in solitary confinement. The trauma of incarceration, compounded by a lack of adequate treatment and reentry resources, creates a revolving door in which people with mental health conditions are unable to stabilize their lives.

People with mental disorders likelier to be criminals? IMH doctor debunks myth, talks about forensic psychiatry work “In most cases, a crime is not due to or related to a psychiatric disorder. It is substance and alcohol use that increases the risk of people running afoul of the law when they are intoxicated,” she clarified. “For example, some patients may have schizophrenia, but it does not mean that it is because of their psychiatric illness that they committed the offence, (although) some might have done it when they had a relapse.

Judge: Oregon State Hospital stays to be strictly limited A federal judge has ruled that the Oregon State Hospital must impose strict limits on the length of time it treats patients accused of crimes who need mental health treatment. Judge Michael W. Mosman’s ruling seeks to ease the psychiatric hospital’s overcrowding, speed up patient admission and stop people waiting for admission from languishing in jail. Effective immediately, the hospital must release “aid-and-assist” patients accused of misdemeanors within 90 days of admission, and those accused of felonies within six months of admission. Aid-and-assist are patients found by a judge unable to participate in their own defense at trial. The judge’s decision overrules an Oregon law that says the hospital can hold an aid-and-assist patient for up to three years, or the maximum amount of time that a person could have been sentenced to prison for their alleged crime, whichever is shorter.

New mental health data show 'unsustainable' burden on NC hospitals Rising mental health-related emergency room visits, more involuntary commitments and longer wait times for psychiatric hospital beds are symptoms of much larger problems within the state's mental health system, health experts say. These crisis services are supposed to be last resort options. But when people can’t find community mental health services, or when the wait time for a therapist is months long, these become the norm.

Funding Community Responder Programs: A Q&A with the CAHOOTS Program in Oregon The Council of State Governments (CSG) Justice Center and Vital Strategies launched a groundbreaking toolkit, Expanding First Response: A Toolkit for Community Responder Programs, and connected with several programs across the country to learn from their successes and their challenges. One program that was instrumental to the development of the toolkit is Crisis Assistance Helping Out On The Streets (CAHOOTS), which has been operating out of Eugene, Oregon for more than 30 years.

CARE Court plan gets backing from San Diego cities, county The city and county of San Diego have collaborated on better ways to deliver behavioral health services. We’ve invested in mobile crisis-response teams and created new facilities such as crisis-stabilization units and low-barrier shelters. CARE Court, however, presents us a new opportunity to help a small but highly visible segment of our homeless population — people who do not have the support they need to properly manage their mental health and get on a better path.

Embedded social workers help police in St. Paul, Coon Rapids and Blaine safely respond to mental health calls About a year ago, Amanda Terwey, a mental health professional and People Incorporated social worker, began working a split position in the Coon Rapids and Blaine police departments. Dressed in street clothes, she accompanies officers on daytime mental health calls, offering support, resources and information to people in crisis. She also does follow-up visits with people who’ve interacted with police when she wasn’t on the clock, making sure they get the help they need.


Wellbeing

An Introduction to Mental Wellbeing Often, the ways we care for our body can overlap with the ways we care for our mind. Use these tips from the Substance Abuse and Mental Health Services Administration (SAMHSA) and the National Institute of Mental Health to take care of your physical and mental wellbeing every day.

'It is Okay to Not Be Okay': The 2021 Survey of Law Student Well-Being This article discusses the results of the survey and includes recommendations for steps different stakeholders within legal education and the legal profession could pursue to better support law student well-being. With representation from 39 law schools across the country, including public, private, and religious law schools, as well as small, medium, and large law schools in terms of student enrollment, the findings of the 2021 SLSWB have implications for multiple stakeholders in legal education, including students, faculty, staff, and administrators, along with boards of law examiners.

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