Building A Reformed Criminal Justice System: The Sequential Intercept Model

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1 Building A Reformed Criminal Justice System: The Sequential Intercept Model Mark Gale Criminal Justice Chair, NAMI Los Angeles County Council Ratan Bhavnani Board Member, NAMI California

2 Historical Context Deinstitutionalization Community-based mental health care was never appropriately developed Trans-institutionalization from state hospitals to jails and prisons Is there risk of the re-criminalization of people with serious mental illness? 2

3 Commitment to Decriminalization of Individuals With SMI Is Inadequate Still Waiting for Whatever it Takes Diversion Collaborative-problem solving mental health courts CIT: Training for first responders Emphasis is on back-end of the system (reentry) after the catastrophe of criminalization has already occurred Must keep justice-involved offenders with SMI out of jail in the first place 3

4 The Question! Why is the percentage of offenders with serious mental illness in jails and prisons not declining? And why is this acceptable? Is your county s response adequate, strategic, and well-planned? Are we planning for Whatever it Takes? 4

5 We Must Develop a County Strategic Plan How can we debate spending billions of dollars on new jail facilities construction in the absence of a comprehensive, fully developed strategic plan that addresses the entire criminal justice continuum from first responder to discharge and linkage to community services? 5

6 Jail Construction Statewide Counties are receiving construction funds to reduce overcrowding caused by realignment and mental health populations Some advocacy groups are opposing jail construction and demanding diversion programs only What will happen to those offenders with SMI who remain in jail and are ineligible for diversion? 6

7 Sequential Intercept Model (SIM) Organizes targeted strategies for justice-involved individuals with SMI SIM mapping process Identifies populations, opportunities, process, decision makers, stakeholders 7

8 Criminal Justice/Mental Health System of Care Each encounter is an opportunity for treatment engagement as detailed in the Sequential Intercept Model (SIM) Each intercept is an opportunity for linkage to services, and prevention of further penetration into the criminal justice system 8

9 The Sequential Intercept Model Points of Interception Intercept One Intercept Two Intercept Three Intercept Four Intercept Five Community First Responders Post Arrest Courts Jail Community Reentry Community Supports 9

10 10

11 Intercept One First Responders Law Enforcement Crisis Intervention Teams (CIT) Second Responders Psych. Mobile Response Teams (PMRT) SMART/PERT (One officer, one clinician) 11

12 Crisis Intervention Team Training Basic Goals Improve officer and consumer safety Redirect individuals with mental illness from the Judicial System to the Health Care System First responder model of police-based crisis intervention with community, health care, and advocacy partnerships University of Memphis, CIT Model, Core Elements, Sept

13 Building a CIT Program Ventura County Model 40-hour Memphis model 3 Training Academies each year 50 Officers per class Mental health education, role-plays, panel discussions. 13

14 CIT - Ventura County Model Mental Health Topics Mood Disorders Personality Disorders Psychotic Disorders Children & Adolescents Substance Use Disorders Medications & Mental Health Developmental Disabilities Alzheimer's Disease 14

15 CIT - Ventura County Model Other Topics Non-Violent Communication Suicide by Cop Suicide Intervention Legal Issues Cultural Awareness Practice using role-play scenarios How to properly write a 5150 application 15

16 CIT - Ventura County Model Statistics 38 CIT Academies since people trained 1008 in-county officers/deputies 50 out-of-county officers 102 dispatchers 49 probation officers 73 non-sworn & mental health professionals Approximately over 70% of patrol trained 16

17 CIT - Ventura County Model Outcomes 17

18 CIT - Ventura County Model Why Does It Work? 18

19 NAMI LACC & CIT Training NAMI participation in Crisis Intervention Team training for 1,500 LASD custody deputies in 18 months 45 Independent police departments LAPD CHP Development of a trained NAMI volunteer training workforce 19

20 Pre-Booking Diversion Programs Pre-Booking Diversion Quality of life offenses Trespassing, public nuisance, public intoxication SB 82 assets Urgent Care Centers Crisis Residential Units Mobile Response Teams If diverted to treatment, no arrest and no prosecution 20

21 Intercept Two Post arrest Arraignment: Decision to file charges Second chance diversion Criminal or non-criminal Early in the process May or may not include criminal conviction 21

22 Intercept Three Courts/Post Arrest/Alternatives to Incarceration/Jail Mental Health Services Post-Booking Diversion Mental Health Courts Provides incentive for offender and system to choose treatment over incarceration Voluntary programs 22

23 Intercept Three, Cont d Alternatives to Incarceration Split-sentencing Combination of custody and supervision Linkage through Jail Mental Health Services Incompetent to Stand Trial Felony competency restoration-state hospitals Misdemeanor IST (MIST) 23

24 Mental Health Courts Problem-solving collaborative court model Focus on rehabilitation and positive outcomes vs. convictions Collaboration from the DA, Court System, Probation, and Public Defender Substance abuse and mental health treatment programs (day and residential) Community services and supports 24

25 Mental Health Courts Co-Occurring Disorder Court (COD) Veterans Courts Mental Health Court Linkage Program Caseworker in the Court Additional options Traditional Mental Health Court Dedicated calendars (Ventura County) 25

26 Jail Jail in-reach programs (IOOV) Substance abuse treatment programs Anger management and therapeutic programs Educational Based Incarceration programs (EBI) Pre-release and discharge planning Benefits eligibility processed prior to discharge Crisis Intervention Team Training, CIT for Custody (National Institute of Corrections) 26

27 Intercept Four Community Reentry Prison Reentry Jail Reentry Discharge planning include jail in-reach A place to live, support themselves, and access to mental health and other health services, and community services 27

28 Discharge and Community Linkage Discharge M-F during business hours SB 833 allows additional 16 hours after release eligibility Pre-release and discharge planning for all inmates with SMI Linkage to community services. Transportation to hubs Linkage is our weakest link! Crisis hubs Homeless shelters Mental health clinics Pharmacy 28

29 Intercept Five Community support after transition from jail to the community Continued access to resources Permanent supportive housing Ongoing peer and family support Supervision Parole or probation 29

30 Probation Under realignment, probation is the center of the universe Training on mental illness for all officers in the field Understanding challenges faced by offenders with SMI PRCS linkage to community services starts with probation Specialized teams for mental health clients 30

31 NAMI Advocacy If we are serious about keeping offenders with SMI out of our jails and prisons, we must expand our program capacity to meaningful levels that truly move the needle Help our county find the political will to develop a cohesive, integrated longterm plan and locate the resources to implement 31

32 Criminal Justice Mental Health Advisory Board LA County District Attorney Jackie Lacey Convened the entire criminal justice system District Attorney s Criminal Justice Mental Health Advisory Board Hired Policy Research Associates as consultants Visited Memphis Model, Miami Dade County s Judge Stephen Leifman, Bexar County, TX Building the plane while in flight First comprehensive planning process for Los Angeles County 32

33 NAMI and Criminal Justice System Partners Future goals In addition to law enforcement, a NAMI Criminal Justice Training Program could train Judges District Attorneys Public Defenders Probation Officers All criminal justice partners should be trained about mental illness 33

34 Whatever it Takes! These are not new ideas We know how to do this! Time has come to implement best practices and EBP from across our nation that provide positive outcomes We need to reinvent our criminal justice/mental health continuum Spend our resources wisely 34

35 Building A Reformed Criminal Justice System: The Sequential Intercept Model Mark Gale Criminal Justice Chair, NAMI Los Angeles County Council Ratan Bhavnani Board Member, NAMI California

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