Commission on Criminal Justice and Sentencing Reform. Wednesday, June 3 rd, :00pm to 5:00pm

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1 Treatment Capacity in Illinois Commission on Criminal Justice and Sentencing Reform Wednesday, June 3 rd, :00pm to 5:00pm

2 Introduction What is the treatment capacity in Illinois? For mental health? For substance abuse? For forensic population? Where are the resources located? What are the data limitations? 2

3 Mental Health Treatment Capacity 3

4 Mental Health Treatment Numbers in Illinois Private Hospitals 113,781 admissions to 3,481 beds in 2010 State Hospitals 8,586 admissions to 1,324 beds in FY2012 Incarceration (Jails) 1,400 of the 9,600 inmates in Cook County Jail receive DMH-Funded psychiatric services Private Community-Based Currently researching for additional data Incarceration (Prisons) 11,300 with mental illness needs in FY2012 State Community-Based 136,047 receiving treatment in FY2012 Source: Illinois Department of Human Services, Illinois Mental Health Strategic Plan; Dr. Anderson Freeman and DMH staff. 4

5 Illinois Mental Health Facilities by Type 512 Respondents Residential treatment center for adults, 88, 17% Residential treatment center for children, 34, 7% Separate inpatient psychiatric unit of a general hospital, 58, 11% Outpatient, day treatment or partial hospitalization mental health facility, 291, 57% Psychiatric Hospital, 18, 4% Multi-setting (nonhospital) mental health facility, 23, 4% Source: SPAC analysis of N-MHSS data, SAMHSA,

6 14,000 12,000 10,000 8,000 6,000 Division of Mental Health State Hospital Services: Civil and Total Unduplicated Count of Individuals Receiving Services Civil Admissions 4,000 2, Fiscal Year Civil Presentations Civil admissions and presentations (sent to hospital, may not end in admission), as well as total served, are down almost 40%. Source: SPAC analysis of figures provided by Dr. Anderson Freeman and DMH staff. 6

7 Illinois has 222 hospitals spanning 80 counties in Illinois. 22 counties do NOT have a hospital. 80 hospitals have authorized psychiatric beds, for a total of 3,927 authorized psychiatric beds. 52 counties do NOT have authorized psychiatric hospital beds. 28 counties have inpatient behavioral health providers. 75 counties do NOT have inpatient behavioral health providers. Over half of Illinois counties lack sufficient numbers of psychiatrists. Source: Illinois Hospital Association, Facts & Figures,

8 Special Programs in Illinois Mental Health Facilities Percent of Facilities with Programs for Co-occurring Disorders No Co-occurring Programs, 58% Programs for Co-occuring Disorders, 42% Source: SPAC analysis of N-MHSS data, SAMHSA,

9 Substance Abuse Treatment Capacity 9

10 Admissions of Chicago Residents to Publicly Funded Treatment Programs, by Primary Substance: FY2007 FY ,000 25,000 Largest reduction: cocaine 66% 20,000 15,000 10,000 Cocaine Heroin Cannabis Alcohol 5,000 0 FY2007 FY2009 FY2010 FY2012 Source: Dr. Larry Ouellet of UIC, data from the Illinois Department of Alcohol and Substance Abuse 10

11 Declining Admissions for Substance Abuse 95,000 Unduplicated Number Served For Alcohol and Substance Abuse 90,000 85,000 80,000 75,000 70,000 65, Fiscal Year The number served declined over 21% since Declining admissions do not mean declining need. Source: Illinois Auditor General DHS Financial Audits. 11

12 47,500 45,000 Number of Clients in Community-Based Treatment as of March 30 th of Each Year 43,971 42,500 40,000 37,500 35,000 32,500 30, Source: N-SSATS Illinois State Profile, SAMHSA,

13 Geographic Distribution of Substance Abuse Treatment Facilities In Illinois 11 counties had no one respond to the survey. 638 facilities responded to a survey by the National Survey of Substance Abuse Treatment Services Survey (N-SSATS) out of 663 surveyed. Each red dot on the map represents one responding facility. Source: N-SSATS Illinois State Profile, SAMHSA,

14 50,000 40,000 30,000 20,000 Patients by Type of Facility 40,687 Outpatient Residential 10, , Care Facilities by Type Hospital Inpatient Outpatient Residential Hospital Inpatient Source: N-SSATS Illinois State Profile, SAMHSA,

15 Facilities Number of Illinois Facilities with Medication-Assisted Treatment for Opioid Dependence Source: N-SSATS Illinois State Profile, SAMHSA,

16 Persons in Treatment per 1,000 of Population Substance Abuse Treatment Rate per 1,000 Population New York California Florida Texas Illinois Treatment rate provides a metric to compare between states. Calculated by dividing the total number receiving treatment by the state population. Source: N-SSATS Illinois State Profile, SAMHSA,

17 Treatment Rate Comparison With Regional States 8.0 Persons in Treatment per 1,000 Population Illinois Missouri Indiana Wisconsin Source: N-SSATS Illinois State Profile, SAMHSA,

18 Forensic Population 18

19 Forensic admissions to state mental health hospitals have increased 15% since These admissions are for those found Unfit to Stand Trial (UST) or Not Guilty by Reason of Insanity (NGRI), and nearly 20% are for misdemeanor offenses. Waiting list for admission is 80+ persons, with wait times 30 to 40 days. Source: SPAC analysis of figures provided by Dr. Anderson Freeman and DMH staff. 19

20 Number of Special Programs in Treatment Facilities Co-occuring Disorder Criminal Justice clients DUI/DWI offenders Source: N-SSATS Illinois State Profile, SAMHSA,

21 Forensic Programs in Illinois Mental Health Facilities No 68% Yes 19% Unknown 13% Source: SPAC analysis of N-MHSS data, SAMHSA,

22 Impact of Reduction 22

23 190, , , , , , , , , ,000 Impact on Mental Health Capacity Number of Individuals Receiving Community-Based Mental Health Treatment: Historical and Predicted 135,197 The Bureau of Justice Statistics estimates that 55% of male inmates and 73% of female inmates have mental health needs. Applying this estimate to the reduction goal of 12,000 means an additional 7,000 individuals accessing mental health treatment in the community. 142, Fiscal Year That is a 5% increase over 2014 numbers. Source: SPAC analysis of figures provided by Dr. Anderson Freeman and DMH staff. 23

24 Impact on Substance Abuse Capacity Number in Substance Abuse Treatment: Historical and Predicted 60,000 53,571 50,000 43,971 40,000 30,000 20,000 10, The Centers for Disease Control and Prevention estimates that 80% of inmates have substance abuse problems. Applying that to the reduction goal would mean 9,600 individuals will have substance abuse issues and will need community-based treatment. That is a 21% increase in population served. 24 Source: N-SSATS Illinois State Profile, SAMHSA,

25 Funding 25

26 State appropriations to DHS has decreased 39% since Appropriations Amount (2015 Dollars) 6,000,000 5,000,000 4,000,000 3,000,000 2,000,000 1,000,000 0 State Appropriations to Department of Human Services (2015 Dollars) Spent (2015 Dollars) 900, , , , , , , , ,000 Division of Mental Health Expenditures: (2015 Dollars) Funding for DMH has decreased 10% since FY FY05 FY06 FY07 FY08 FY09 FY10 FY11 FY12 FY13 FY14 FY15 Source: SPAC analysis of figures provided by Dr. Anderson Freeman and DMH staff; Illinois Auditor General DHS Financial Audits 26

27 Primary Funding Source in Illinois Mental Health Facilities Other Medicare Private Insurance US Veterans Admin State Child Welfare 5.0% 2.0% 3.6% 4.6% 10.3% State Mental Health 26.5% Medicaid 48.0% 0.0% 10.0% 20.0% 30.0% 40.0% 50.0% 60.0% 512 Facilities Surveyed in Illinois Of 442 responses, 306 (69%) had one primary funding source that made up over half of their overall revenue. Source: SPAC analysis of N-MHSS data, SAMHSA,

28 General Sources This information is specific to the state of Illinois. Information was gathered from: Special thanks to Dr. Anderson Freeman and his staff at the Division of Mental Health for their data on funding and numbers served. Illinois Auditor General Financial Audits on Department of Human Services. the National Survey of Substance Abuse Treatment Services (N-SSATS) Survey. This annual survey collects information on all substance abuse facilities, including both alcohol and drug abuse, and in facilities private and public. They produce state profiles of their findings for 2002 through 2011, available on their website. the National Mental Health Services Survey (N-MHSS). Surveys all mental health facilities in US, both private and public, available for Both surveys are conducted by Substance Abuse and Mental Health Services Administration (SAMHSA). University of Illinois at Chicago (UIC) School of Public Health professor Larry Ouellette prepared the analysis of Illinois publicly-funded admissions for substance abuse. Illinois Hospital Association tallies the number of hospitals, authorized beds, and behavioral health providers by county across the state of Illinois. Other figures gathered from various sources such as the National Alliance on Mental Illness (NAMI), Illinois Department of Health Services, and Illinois Department of Public Health (Center for Rural Health). 28

29 References Slide 4: Illinois Department of Human Services, Illinois Mental Health Strategic Plan. Available at: https://www.dhs.state.il.us/onenetlibrary/27897/documents/mental%20health/marysmith/strategic plan/mentalhealthservicesfiveyearstrategicplan2013.pdf, p.3 of Appendix B. Slide 7: Illinois Hospital Association. (2015). Facts & Figures. Available at: Slide 7 map: Generated by IHA COMPdata informatics (April 02, 2014). Available at: Slide 8: Estimate of comorbidity: National Institute on Drug Abuse. (2010). Comorbidity: Addiction and Other Mental Illnesses. Research Report Series. Available at https://www.drugabuse.gov/sites/default/files/rrcomorbidity.pdf Slides 8-9: Substance Abuse and Mental Health Services Administration (SAMHSA). (2010). National Mental Health Services Survey (N-MHSS). Available at: Slide 12: Graph created by Dr. Larry Ouellet of UIC, with data from the Illinois Department of Alcohol and Substance Abuse. Slides 13-17: Substance Abuse and Mental Health Services Administration (SAMHSA). ( ). National Survey of Substance Abuse Treatment Services (N-SSATS) State Profiles. Available at: Slide 23: Estimate of mental health issues: Glaze, L.E. & James, D.J. (2006). Mental Health Problems of Prison and Jail Inmates. Bureau of Justice Statistics Special Report. Available at Slide 24: Estimate of 80% with substance abuse issues from CDC report. U.S. Centers for Disease Control and Prevention, Substance Abuse Treatment for Drug Users in the Criminal Justice System, (Aug. 2001), available at: 29

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