WHAT IS THE ILLINOIS CENTER OF EXCELLENCE AND HOW DID IT START? MISSION STATEMENT The mission of the Illinois Center of Excellence for Behavioral Health and Justice is to equip communities to appropriately respond to the needs of persons with behavioral health disorders that are involved in the criminal justice system. The genesis for the Illinois Center of Excellence for Behavioral Health and Justice was a series of regional and statewide strategic planning meetings hosted by the Illinois Department of Human Services, Division of Mental Health in 2008. In April 2010, the Illinois Supreme Court named a Special Judicial Advisory Committee for Justice and Mental Health Planning. One of the charges to this committee was to consider how to maximize the use of court and community resources in aiding the rehabilitation and treatment of accused offenders with mental health and substance use issues. The Advisory Committee has studied, reviewed and collaborated on issues and matters related to mental illness, substance use and the justice system in order to make recommendations to the Illinois Supreme Court. One of the ideas discussed by the Committee was a Center of Excellence for Illinois. In December 2010, a multidisciplinary group of stakeholders convened, consisting of representatives from the Department of Human Services, Division of Mental Health; Illinois Criminal Justice Information Authority; Treatment Alternatives for Safe Communities; the Mental Health Court Association of Illinois; the Administrative Office of the Illinois Courts; and members of the Illinois Judiciary and Special Supreme Court Judicial Advisory Committee on Justice and Mental Health Planning to discuss the purpose and feasibility of a Center of Excellence in Illinois. After research and discussion, the group reached a consensus regarding the need for and the mission, structure and purpose of a Center of Excellence in Illinois. The Illinois Criminal Justice Information Authority awarded a $260,000 federal Justice Assistance Grant to Winnebago County for the creation of the Illinois Center of Excellence for Behavioral Health and Justice. The Illinois Criminal Justice Information Authority, Winnebago County and the Department of Human Services, collaborated to establish the Illinois Center of Excellence. The Illinois Center of Excellence for Behavioral Health and Justice is designed as an independent entity whose mission is to equip communities to appropriately respond to the needs of persons with behavioral health disorders that are involved in the criminal justice system. To that end, it will provide technical assistance, resources, and training
to improve systemic responses to persons with mental health and/or substance use disorders involved in the criminal justice system. It will also compile and disseminate information about evidence-based practices and conduct research. Evidence-based practices are approaches which have been empirically researched and proven to have measurable positive outcomes. The term evidence-based practices refers to interventions that have been rigorously tested, have yielded consistent, replicable results, and have proven safe, beneficial, and effective. Identifying what works and applying the evidence-based knowledge to program development is critically important to assure the use of practices in the delivery of behavioral health services. Too few people with behavioral health disorders who are justice involved receive comprehensive and appropriate services. The Center of Excellence will serve the entire state through a partnership with the County of Winnebago and the University of Illinois. It will be housed at the University of Illinois College of Medicine at Rockford, Illinois, and provide training at other sites for the University of Illinois located in Chicago, Peoria, Springfield and Urbana/Champaign. These multiple sites will allow statewide access and ease of training. The Center of Excellence s staffing plan consists of employing a full-time director, part-time administrative assistant, a field staff and part-time evaluators. The implementation of the Center of Excellence staffing and programming will occur over an 18 month time period. Different aspects of the program will be phased in over that time period. Within the first 6 months, the strategic planning and statewide mapping of resources done in 2008-2009 through the Division of Mental Health will be reviewed; evidence-based practices will be compiled; data will be collected; website development will continue; and specific training modules will be created. During the following 12 months, counties and circuits will receive training and service delivery. Services will also be available to treatment providers. An Advisory Board has been created to facilitate the functioning of the Center of Excellence. The role of the Advisory Board is to assist the Center of Excellence Board of Directors and Staff with advice and expertise and will include assuring that the mission statement is followed and setting priorities for the Center of Excellence. The Advisory Board shall include representatives from the Administrative Office of the Illinois Courts, Special Supreme Court Advisory Committee on Justice and Mental Health Planning, members of the Illinois judiciary, and the University of Illinois College of Medicine at Rockford. As the Center of Excellence moves forward, the Board of Directors plans to add members to the Advisory Board from law enforcement, a consumer/national Alliance on Mental Illness, and other community treatment provider representatives. This project was supported by Grant #10-DJ-BX-0015 awarded to the Illinois Criminal Justice Information Authority by the Bureau of Justice Assistance, Office of Justice Programs, U.S. Department of Justice. Points of view or opinions contained within this document are those of the authors and do not necessarily represent the official position or policies of the Authority or the U.S. Department of Justice.
WHY DOES ILLINOIS NEED PROBLEM-SOLVING COURTS? The nation s local jails have increasingly become the place of last resort for persons with mental illness. Beginning in the late 1950 s and early 1960 s, individuals with mental illness were released from state-run hospitals without alternative placement. Many of these individuals subsequently have committed repeat non-violent crimes, resulting in incarceration, release from jail, and repeat offense and arrest a cycle of recidivism. By default, jails in many communities have become the primary source of care for the mentally ill, a function for which they are neither equipped nor designed to handle. 1 While the factors contributing to this problem are complicated, the overrepresentation of people with mental illnesses in the criminal justice system has been well documented. 2 According to a 2009 study, 14.5% of male inmates and 31% of female inmates booked into local jails are estimated to have a serious mental illness. 3 Inmates with a mental illness also report a high rate of substance dependence or abuse in the year before their admission. Seventy-six percent of local jail inmates were dependent or abusing drugs or alcohol. Thirty-four percent of jail inmates said they had used drugs at the time of their offense. 4 A U.S. Department of Justice study from 1999 found that half of the inmates with mental illnesses reported three or more prior sentences. 5 Other research indicates that people with mental illnesses are more likely to be arrested than those without mental illnesses for similar crimes and stay in jail and prison longer than other inmates. 6 In 1999, the Los Angeles County Jail, Chicago s Cook County Jail, or New York s Riker s Island jail held more people with mental illnesses than the largest psychiatric inpatient facilities in the United States. 7 The criminal justice system is not equipped to deal with persons with mental illnesses or other behavioral health disorders. The result is that persons with behavioral health disorders, such as mental illness or substance use, spend more time in jail while the criminal justice system tries to figure out how to manage them. This current state of affairs, is not only inhumane, it is also extremely expensive. The criminal justice system stakeholders understand the need for alternatives to incarceration for persons with mental health and substance use disorders, such as diversion programs and problem- 1 Ending the Cycle of Recidivism: Best Practices for Diverting Mentally Ill Individuals from County Jails, National Association of Counties, June 2003. 2 For a comprehensive discussion, see the Criminal Justice/Mental Health Consensus Project report (New York, NY: Council of State Governments, 2002). 3 http://ps.psychiatryonline,org/article.aspx?articleid=100482, Henry Steadman, Ph.D., Fred Osher, M.D., Pamela Clark Robbins, B.A., Brian Case, B.A., Steven Samuels, Ph.D.; Prevalence of Serious Mental Illness Among Jail Inmates. Psychiatric Services. 2009 Jun;60(6):761-765. 4 http://bjs.ojp.usdoj.gov/index.cfm?ty=pbdetail&iid=789, Bureau of Justice Statistics, Special Report, Mental Health Problems of Prison and Jail Inmates, September 2006. 5 Ditton, Paula. Mental Health and Treatment of Inmates and Probationers, 1999. BJS Special Report, NCJ 174463, July 1999, www.ojp.usdoj.gov/bjs/pub/pdf/mhtip.pdf. 6 Linda Teplin, Keeping the Peace: Police Discretion and Mentally Ill Persons (Washington, DC: U.S. Department of Justice, 2000). 7 E.F. Torrey, Reinventing Mental Health Care, City Journal 9, no. 4 (1999), www.city-journal.org/html/9_4_a5.html.
solving courts. However, many jurisdictions are poorly resourced, do not have the information necessary to implement these interventions, and lack the resources to engage in system change without external technical assistance. Without adequate treatment while incarcerated or linkage to community services upon release, many people with mental illnesses and substance use disorders may cycle repeatedly through the justice system. This frequent involvement with the criminal justice system can be devastating for these individuals and their families and can also impact public safety and government spending. In response, jurisdictions have begun to explore a number of ways to address criminal justice/behavioral health disorders, including problem-solving courts. 8 Problem-solving courts, such as mental health courts and drug courts, are comprised of teams of specially trained judges, attorneys, probation officers and clinical specialists who provide wrap-around services and intensive monitoring of defendants who are in the criminal justice system primarily because of symptoms of their substance abuse, mental health, or co-occurring disorders. By combining access to treatment and court oversight and accountability, the participants in the problem-solving courts can achieve and maintain recovery and become contributing members of our communities and dramatically reduce their rates of recidivism. Problem-solving courts move beyond the criminal court s traditional focus on case processing to address the root causes of behaviors that bring people before the court. These courts work to improve outcomes for all parties, including individuals charged with crimes, victims, and communities. 9 Mental health courts serve a significant role within this collection of responses to the disproportionate number of people with mental illnesses in the justice system. A mental health court is a specialized court docket where participants are identified through mental health screening and assessments and voluntarily participate in a judicially supervised treatment plan developed jointly by a team of court personnel and mental health professionals. Incentives reward adherence to the treatment plan or other court conditions, nonadherence may be sanctioned, and success or graduation is defined according to predetermined criteria. 10 The goals of mental health courts are increased public safety for communities, increased treatment engagement by participants, improved quality of life for participants, and more effective use of resources for communities. A drug court is a specially designed court calendar or docket, the purposes of which are to achieve a reduction in recidivism and substance abuse among nonviolent substance dependent offenders and to increase the offender s likelihood of successful 8 Council of State Governments Justice Center, Bureau of Justice Assistance, Mental Health Courts: A Primer for Policymakers and Practitioners (2008). 9 Council of State Governments Justice Center, Bureau of Justice Assistance, Mental Health Courts: A Primer for Policymakers and Practitioners (2008). 10 Adapted by Henry J. Steadman from Henry J. Steadman, Susan Davidson, and Collie Brown, Mental Health Courts, Psychiatric Services 52 (2001): 457-458.
rehabilitation through early, continuous, and intense judicially supervised treatment, mandatory periodic drug testing, community supervision, and use of appropriate sanctions and other rehabilitation services. 11 In the 20 years since the first drug court was founded, there has been more research published on the effects of drug courts than on virtually all other criminal justice programs combined. Drug courts have been found to significantly reduce drug use and crime and are more cost-effective than any other proven criminal justice strategy. 12 A study has found that mental health courts meet the public safety objectives of lowering post treatment arrest rates and days of incarceration. Both clinical and criminal justice factors are associated with these outcomes. 13 These problem-solving courts and diversion initiatives are the results of effective partnerships and collaborations involving traditional and non-traditional stakeholders, such as consumers, family members of consumers, treatment providers, law enforcement and correction professionals, court legal personnel and members of the judiciary. They are part of solutions integrating effective elements of the mental health and substance use systems and the criminal justice system. They have proven to be the hope for breaking the revolving door syndrome. This project was supported by Grant #10-DJ-BX-0015 awarded to the Illinois Criminal Justice Information Authority by the Bureau of Justice Assistance, Office of Justice Programs, U.S. Department of Justice. Points of view or opinions contained within this document are those of the authors and do not necessarily represent the official position or policies 11 National Association of Drug Court Professionals, http://www.nadcp.org/learn/facts-and-figures. 12 National Association of Drug Court Professionals, http://www.nadcp.org/learn/facts-and-figures. 13 Henry J. Steadman, PhD, Effect of Mental Health Courts on Arrests and Jail Days: A Multisite Study, www.archgenpsychiatry.com, October 4, 2010.