Virginia Beach Department of Human Services Adult Correctional Services. Bridget A. Manyak, M.S Supervisor, Adult Correctional Services

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1 Virginia Beach Department of Human Services Adult Correctional Services Bridget A. Manyak, M.S Supervisor, Adult Correctional Services

2 Forensic Services In-Jail Restoration to Competency Services Discharge Planning Services Peer Support Services SOAR (SSI/SSDI Outreach, Access, and Recovery) Wellness Recovery Action Plan (WRAP) Mental Health Supervision Program Jail Educational Services Drug blocks Wellness Recovery Action Plan (WRAP) Continuing Care Group Not Guilty by Reason of Insanity Case Management Services State Hospital Discharge Planning Community Case Management There are 193 clients currently receiving services from DHS ACS.

3 Advocacy for seriously mentally ill inmates In-jail or outpatient Restoration to Competency services for seriously mentally ill inmates, some of whom may need to be transferred to state hospitals Monitoring and Crisis Intervention Linkage to Case Management, Day Program, Medication Management, housing, entitlements State hospital Re-entry services Peer Support Services

4 A Forensic Peer Specialist (FPS) is a specialized position for trained peer staff with a history of mental illness and incarceration Instills hope and serves as a model for recovery Provides recovery-oriented, direct services to other peers with similar histories Helps individuals to engage in treatment and support services and to anticipate and address the psychological, social, and financial challenges of reentry. A FPS assists other peers in becoming fully integrated into all aspects of community life

5 Provides transportation from the jail for high risk clients Provides support by transporting and accompanying clients to initial appointments upon release Probation Office Social Security Social Services MHSA Treatment Food and Clothing Bank 12 step and other abstinence-based support groups

6 Provides educational services to inmates in VBCC who have substance use or co-occurring disorders Court Ordered and Voluntary Participation 20 week curriculum-based modules Relapse Prevention/Recovery Tools Intensive Re-entry Planning Wellness Recovery Action Plans (WRAP)

7 Continuing Care Group-Outpatient Transitional services from VBCC into the community for voluntary or court-ordered clients and for those inmates returning from the Department of Corrections (DOC) who participated in Jail Educational Services Substance use or co-occurring disorders diagnosis 12 week outpatient Group Therapy Sessions Linkages to more intensive treatment, psychiatric evaluations, medication management Linkages to programs for women with children and Fathers In Training, as needed

8 Virginia Beach Correctional Center average daily inmate census is There are currently 294 inmates prescribed psychotropic medications; 50% are prescribed antidepressants, 25% are prescribed mood stabilizers and 20% are prescribed antipsychotics. The other 5% are prescribed anxiety/other medications. The Mental Health POD houses 49 male inmates and the female Mental Health Unit houses 5 female inmates. There were 302 inmates admitted to DHS JES services. There were 218 inmates admitted to DHS Forensic services.

9 31 inmates received in-jail restoration to competency services 52 clients received WRAP services 28 clients received Peer Support Services 10 clients were enrolled in the community based Mental Health Supervision Program 17 clients applied for Social Security 31 clients received housing assistance 41 clients applied for Food Stamps/Medicaid

10 The term Jail Diversion refers to programs that divert individuals with serious mental illness and often co-occurring substance use disorders, away from jail and provide linkages to community-based treatment and support services. The individual avoids arrest or spends a significantly reduced time period in jail.

11 Identifying a target group for diversion, Identifying the individual as early as possible in their processing by the criminal justice system, Negotiating community-based treatment alternatives to incarceration, and Implementing linkages to comprehensive systems of care and appropriate supervision consistent with the disposition of the criminal justice contact.

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13 A conceptual framework for communities to use when considering the interface between criminal justice, mental health, and substance abuse systems. The model envisions a series of points of interceptions at which an intervention can be made to prevent individuals from entering or penetrating deeper into the criminal justice system.

14 Prevent initial involvement in the criminal justice system Decrease admissions to jail Engage individuals in treatment as soon as possible Minimize time spent in jail Link individuals to community treatment upon release from incarceration Decrease the rate of return to the criminal justice system

15 Law Enforcement/Emergency Services Booking/Initial Court Hearings Jail/Forensic Evaluations/Forensic Commitments/Court Dispositions Re-entry Community Support/Community Corrections

16 Virginia Beach CIT Intensive training (40 hours) to Police Officers and Deputies CIT officers respond to or take over calls involving individuals with mental illness. Individuals are referred to mental health treatment when it is an alternative to incarceration.

17 Virginia Beach Psychiatric Center Designated Assessment Center Staffed 24/7 with mental health and security personnel Custody can be surrendered allowing the police officer to return to the streets No refusal policy Linkage to community services for those who do not meet criteria for inpatient commitment. Goal: Make it as easy to refer someone to treatment as it is to arrest and book into the jail.

18 ACS Forensic Team reviews daily the roster of all Virginia Beach arrests within the last 24 hours. The roster is cross-referenced with DHS database to determine which inmates are DHS clients. Referral forms are received from Jail Medical Social Workers, Pretrial, DHS Case Managers, The Sheriff s Department, Office of the Public Defender, Office of the Commonwealth s Attorney, Judges, Private Attorneys and the community.

19 ACS Forensic Team attends arraignment hearing. Advises the court of a potential mental health substance abuse diagnosis Provides either in jail or community treatment recommendations Provides diversion alternatives Advocates for the psychotic inmate who is eligible, but unable to request the services of a Public Defender Bond hearings for possible diversion inmates are usually scheduled within days of the arraignment hearing.

20 Emergency Services and Forensic Staff are available to coordinate civil TDO if the Magistrate sets bond contingent on psychiatric hospitalization. Pretrial interviewer completes an investigation to include a Substance Abuse Assessment and a Mental Health Screening and informs the Forensic Team when a potential diversion candidate has been identified.

21 ACS Forensic Team collaborates with attorneys to divert by means of bond hearing. Conditions of bond could include: Compliance with Mental Health Substance Use Treatment in the Community Pretrial Supervision Civil TDO Restoration to Competency Services

22 Most mentally ill inmates remain in jail and receive treatment from Jail Medical Services, Con Med. In certain situations, an inmate s symptoms are severe enough that inpatient treatment is required.

23 If, because of mental illness, the inmate cannot be safely managed in the jail environment, the inmate may be considered for an Emergency Treatment Order (ETO). Inmate s mental state is such that there is a considerable risk to their own safety or that of others.

24 Self injuring behavior: suicide attempt, head banging (severe), refusal of food/fluids Persistent and severe violent behavior towards others Inmate may have been placed in restraint bed at some point

25 Forensic Team works closely with the Office of the Public Defender, Jail Medical, Forensic Evaluator, State Hospitals, Case Management, Emergency Services, Community Corrections Pretrial and family members to determine possible diversion strategies and treatment recommendations to the court.

26 Once an inmate has been found to be incompetent to stand trial, restoration to competency services are offered by the Forensic Team. In-jail restoration to competency services shortens or eliminates waits for transfer to state forensic hospitals. Outpatient restoration services allows inmate to be released a bond while receiving restoration to competency services and mental health substance use treatment in the community.

27 Goals: Reduce Jail Time Promote Due Process Improve Service to the Courts Criteria for DHS Competency Restoration Services Program: Resident of Virginia Beach or homeless in Virginia Beach Eligible for DHS services Charges do not have to be in Virginia Beach

28 Restoration services include educational information and training and/or clinical intervention including medications. Includes the use of: Photos DVDs Adult Restoration Training Manual Slides Role playing

29 Forensic Staff provide intensive hospital discharge planning. Forensic Staff provide treatment recommendations at trial or sentencing. Fast track inmates with co-occurring disorders who are stabilized on medication into the Substance Abuse educational Services POD at VBCC. Participate regularly in DHS Clinical Treatment Team staffings and VBCC Social Workers staffings.

30 Inmates may be court ordered into the Mental Health Supervision Program. Inmates may be released on a deferred finding contingent on Mental Health Substance Abuse treatment in the community. Community Correction and Probation Officers consult with Forensic staff for treatment recommendations If charges are dismissed and inmates meet TDO criteria, civil commitments are pursued.

31 Prior to release Forensic clients are given an appointment to: Intake (most of which now occur prior to release) Medication Management Case Management Day Program Temporary housing is arranged with a Licensed Provider, Board and Care Placement, shelter or motel. Bus tickets are placed in inmate s property

32 Diverts seriously mentally ill people from jail by means of bond, at point of disposition or sentencing. Provides the court with an alternative to incarceration for eligible seriously mentally ill persons. Provides the most effective intervention in the least restrictive setting, coupled with enhanced probation supervision without compromising community safety. Inmates released into the Mental Health Supervision Program are placed on state or local probation.

33 The Mental Health Supervision Program provides: Housing Weekly Case Management contact Weekly psychotherapy or groups Peer Support Specialist Services Daily Monday-Friday Day Program Services Monthly Supervision Team Meetings One specialized CCP/Pretrial or State Probation Officer

34 William, a Caucasian 50 year old male, was diagnosed with Schizophrenia in his early 20 s. William has a long history of drug and alcohol use, homelessness and incarceration. William was incarcerated for his second felony arson charge in Upon incarceration, he was homeless, not receiving entitlements and had been off his medication for several years. William was placed in the Mental Health Supervision program as a condition of his suspended prison sentence in While in the program, William has gained Social Security, Food Stamp and Medicaid entitlements. He has progressed into independent housing in which he is able to cook, clean and do his laundry on his own. He has remained stable, drug and alcohol free and has not committed any new offenses since his enrollment in the program. As a result of the Mental Health Supervision Program, William has gain confidence, learned daily living skills, developed social skills, supportive relationships, and has sense of purpose.

35 Ken, a Caucasian 40 year old male, was diagnosed with Schizophrenia in his early 20 s. He was raised by a mother, who was also seriously mentally ill. Ken spent the last 20 years of his life homeless. He has a long history of incarcerations and hospitalizations. Upon incarceration, he was homeless, not receiving entitlements and had been off his medication for several years. Ken was incarcerated in 2010 for assault and battery and a probation violation. Ken was placed in the Mental Health Supervision Program in Ken started in the program in a highly structured residential placement where he learned how to cook, maintain good hygiene, and budget money. As a result of the Mental Health Supervision program, Ken gained entitlements, housing, life skills and independence. Ken was transitioned into independent subsidized housing where he continues to live a productive and gratifying life.

36 Keith, a 30 year old African American was diagnosed with Depressive Disorder with Psychotic features in his early 20 s. Keith has a long history of serious assaultive behaviors and significant substance use issues, which resulted in Keith serving prison time. Due to his criminal behavior, substance use and noncompliance with medication Keith lost custody of his children and housing. Keith was incarcerated in 2011 for probation violation and a weapons charge. Keith was placed in the Mental Health Supervision Program in Since his placement, Keith has remained drug and alcohol free and has not committed any new offenses. As a result of his placement in the program, Keith has obtained entitlements, stable housing, and vocational training and has gained full custody of his children.