Board of County Commissioners

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Board of County Commissioners Jail Diversion
Model Program February 20, 2007
Board of County Commissioners Jennifer Roberts,
Chair Parks Helms, Vice ChairKaren Bentley J.
Daniel BishopDumont ClarkeBill JamesNorman A.
Mitchell, Sr.Dan Ramirez Valerie C. Woodard
County Manager Harry L. Jones, Sr. General
Manager Janice Allen Jackson Area Mental Health
Authority (AMHA) Grayce Crockett,
Director Provided Services Organization
(PSO) Connie C. Mele, Director
Area Mental Health Authority Vision A community
system that empowers and supports individuals to
lead healthy and independent lives
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Why Jail Diversion?

• Incarceration is a poor and an expensive solution
  for addressing mental illness/substance abuse
  when there are best practice models available.

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The Model

• The Mecklenburg County Jail Diversion Model is a
  comprehensive, coordinated delivery system which
  will identify, divert from incarceration, and
  treat the mentally ill/substance abuser who is
  placed, or about to be placed, within the
  Criminal Justice System.

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Collaboration

• Active partnership with all stakeholders
• Sheriffs Office
• CMPD
• Area Mental Health
• Mobile Crisis
• Behavioral Health Center-Randolph
• Mental Health Court
• Public Defenders Office
• National Alliance of Mentally Ill
• Homeless Services Network

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Features of the Model

• Early Intervention (Crisis Intervention Team)
• Early Screening Assessment (Mobile Crisis)
• Crisis Center (Up to 7 days)
• Residential Stabilization (Up to 90 days)
• Housing/Treatment Services (multi-level program)
• There will be integrated coordination with Mental
  Health/Substance Abuse and Judicial points of
  access, including Mental Health Treatment Court.

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Goal of the Model

• The Jail Diversion Model will divert the mentally
  ill/substance abuser from incarceration to the
  appropriate services that will treat the illness
  in the least restrictive and most clinically
  appropriate setting while also addressing legal
  issues and criminal behavior.

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General Statistics

• 64 of County jail inmates report having a
  mental health problem.
• (Bureau of Justice Statistics, September 6,
  2006)
• It is estimated that 70 of people in state
  prisons and local jails have abused drugs
  regularly, compared with 9 of the general
  population.
• (Charlotte Observer, August 31, 2006)

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General Statistics

• People with mental illness spend two to five
  times longer in jail (at a cost of 109 per day)
  and often cant make bail. About 1/3 of people
  with mental illness in jail were homeless before
  incarceration.
• More than 72 of people with severe mental
  illness who are in jail have a co-occurring
  substance abuse disorder.
• More than 4 of men in jail suffer from
  Schizoprehenia or Bipolar Disorder compared to 1
  of the general population.

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National Program Statistics

• Seattle, Washington 1.1 million spend in one
  year for 20 seriously mentally ill patients
  repeatedly jailed, hospitalized or admitted to
  crisis centers. (55, 000 per person)
• Miami, Florida 18-20 recidivism rate (typical
  70)
• San Antonio, Texas A recent report from a
  diversion program stated that they saved the
  county 4 million in incarceration costs and has
  diverted 4,100 people since September 2005.

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National Program Statistics

• Phoenix, Arizona 9 Recidivism Rate
• Chicago, Illinois/Thresholds Jail Program 30
  individuals that completed the program were
  followed for 1 year with these results
• Decreased days in jail by 2,200 days
• Decreased days in hospital by 2,100 days
• Savings realized for Chicago 1,204,000

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North Carolina Statistics

• The 2007
• NC Jails and Inmates with Mental Illness and
  Developmental Disabilities Study
• recommended that Programs are needed to prevent
  unnecessary incarceration

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AMH Jail Data Report

• On July 2, 2007
• 2,688 inmates in jail at the time of the report
• 1,087 inmates in the AMH Data System (currently
  in treatment or recently in treatment)
• 36 of the inmates had a mental health diagnosis
  or a co-occurring diagnosis

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Mecklenburg County Jail Study 1

• Inmate Self Report Needs Survey
• (October, 2006)
• A face-to-face survey with 352 randomly selected
  inmates booked into the Mecklenburg County Jail
• 23 received mental health services
• 17 were hospitalized for mental health issues
• Of the inmates with mental health issues, 60 had
  a history of drug problems 41 had a history
  of alcohol problems
• Based on the above data, an estimated 13,700
  inmates would require mental health treatment
  over the course of a year.

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Mecklenburg County Jail Study 2

• Chronic Offender Study
• (January 2007)
• Analysis of 81 offenders booked into the
  Mecklenburg County Jail an average of nine times
  during 2005
• 783 bookings for 1,567 charges
• 7,440 days incarcerated
• 85 given credit for time served (3 days) when
  guilty
• 83 had a history of services with AMH
• Estimated 2005 cost 1.12 to 1.58 million

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Whats Wrong With This Picture?
Residential Stabilization
Mental Health Court
Case Management
Crisis Intervention Team
Mobile Crisis Team
Housing
Crisis Center
Treatment Services
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Crisis Intervention Team
Crisis Intervention Team

• Crisis Intervention Team (CIT) is a model that
  will be implemented in partnership with CMPD as a
  specialized police response team for situations
  involving the mentally ill.

The overall goal is to treat mental illness as a
disease not a crime
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Mobile Crisis Team
Mobile Crisis Team
Mobile Crisis Team (MCT) works with the Crisis
Intervention Team (CIT) to determine if a
consumer is appropriate for the Crisis Center

• Responds when called by CIT or CMPD patrol
  officers
• Provides on-scene response, assessment,
  interventions and determination of need for other
  services

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Crisis Center
Crisis Center

• A secure facility which acts as a portal of entry
  for assessment and stabilization of the mentally
  ill and/or substance abuser in crisis
• Staffed 24/7 with an interdisciplinary treatment
  team
• Linkage to other community services after crisis
  stabilization

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Residential Stabilization
Residential Stabilization
Length of Stay Up to 90 days

• Services Provided at the Facility
• Medication Stabilization and Management
• Case Management
• Mental Health/Substance Abuse Treatment
• Life Skills/Vocational Support
• AA/NA 12-Step Group

Case Management
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Housing/Treatment
Housing
A multi level program that provides residential
housing treatment services designed to promote
independent living

• Services Provided May Include
• Medication Management
• Case Management
• Mental Health/Substance Abuse Treatment
• Life Skills/Vocational Support

Treatment Services
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Mental Health Court
Mental Health Court

• Increases consumer compliance with mental health
  treatment
• Decreases jail and treatment costs to mentally
  ill offenders by providing coordination of
  services among all agencies

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Post Booking Services/MH Court
(For Persons Already in Jail)

• Jail Diversion Liaison
• Assesses the mentally ill person admitted to jail
  to determine appropriate service and Mental
  Health Court involvement
• Social Worker in Public Defenders Office
• Assesses and refers mentally ill, developmentally
  disabled and substance abusing defendants so they
  can receive appropriate treatment services while
  in the criminal justice system

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The Complete Picture
Residential Stabilization
Mobile Crisis Team
Crisis Intervention Team
Crisis Center
Mental Health Court
Case Management
Housing
Treatment Services
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NEXT STEPS

• Visit Wake County Crisis Intervention Team (CIT)
  Program in March 2007
• Visit a program that has an effective Jail
  Diversion Continuum
• Cost Analysis of Continuum
• Present funding proposal for
• 2008 budget approval