Board of County Commissioners

Jennifer Roberts, ChairParks Helms, Vice ChairKaren BentleyJ. Daniel BishopDumont ClarkeBill JamesNorman A. Mitchell, Sr.Dan RamirezValerie C. Woodard

Board of County CommissionersBoard of County CommissionersJail Diversion Model ProgramJail Diversion Model Program

February 20, 2007February 20, 2007

Area Mental Health Authority Vision“A community system that empowers and supports individuals to lead healthy and independent lives”

County ManagerHarry L. Jones, Sr.

General ManagerJanice Allen Jackson

Area Mental Health Authority (AMHA)Grayce Crockett, Director

Provided Services Organization (PSO)Connie C. Mele, Director

Why Jail Diversion?Why Jail Diversion?

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

The ModelThe 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.

CollaborationCollaboration

Active partnership with all stakeholders Sheriff’s Office CMPD Area Mental Health Mobile Crisis Behavioral Health Center-Randolph Mental Health Court Public Defender’s Office National Alliance of Mentally Ill Homeless Services Network

Features of the ModelFeatures 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.

Goal of the ModelGoal 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.

General StatisticsGeneral 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)

General StatisticsGeneral Statistics People with mental illness spend two to

five times longer in jail (at a cost of $109 per day) and often can’t 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.

National Program National Program StatisticsStatistics

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.

National Program National Program StatisticsStatistics

• Phoenix, Arizona: 9% Recidivism Rate

• Chicago, Illinois/Thresholds Jail Program: 30 individuals that completed the program were followed for 1 year with these results:

1. Decreased days in jail by 2,200 days2. Decreased days in hospital by 2,100

days3. Savings realized for Chicago:

$1,204,000

North Carolina North Carolina StatisticsStatistics

The 2007NC Jails and Inmates with

Mental Illness and Developmental Disabilities

Studyrecommended that Programs

are needed to prevent unnecessary incarceration

AMH Jail Data ReportAMH 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

Mecklenburg County Jail Study Mecklenburg County Jail Study #1#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.

Mecklenburg County Jail Study Mecklenburg County Jail Study #2#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

What’s Wrong With This What’s Wrong With This Picture?Picture?

Crisis Intervention

Team

Mental Health Court

Treatment

Services

Crisis Center

Residentia

l

Stabilizatio

n

Housing Mobile Crisis

Team

Case

Managem

en

t

Crisis Intervention TeamCrisis 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.

Crisis Intervention Team

The overall goal is to treat mental illness as a disease not a crime

Mobile Crisis TeamMobile Crisis Team

Responds when called by CIT or CMPD patrol officers

Provides on-scene response, assessment, interventions and determination of need for other services

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

Crisis CenterCrisis 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

Crisis Center

Residential StabilizationResidential Stabilization

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

Length of Stay: Up to 90 days

Residential

Stabilization

Case Managemen

t

Housing/TreatmentHousing/Treatment

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

A multi level program that provides residential housing

treatment services designed to promote independent living

Housing

Treatment Services

Mental Health CourtMental 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

Mental Health Court

Post Booking Services/MH CourtPost Booking Services/MH Court

Jail Diversion LiaisonAssesses the mentally ill person admitted to

jail to determine appropriate service and Mental Health Court involvement

Social Worker in Public Defender’s OfficeAssesses and refers mentally ill,

developmentally disabled and substance abusing defendants so they can receive appropriate treatment services while in the criminal justice system

(For Persons Already in Jail)

The Complete PictureThe Complete Picture

Housing

Crisis Center

Residential Stabilization

Mobile Crisis Team

Crisis Intervention Team

Treatment Services

Mental Health Court

Case Managemen

t

NEXT STEPSNEXT 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 ContinuumPresent funding proposal for 2008 budget approval