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Board of County Commissioners October 2, 2007

Community Mental Health & Justice Program. Treating Mental Illness As A Disease Not A Crime. Board of County Commissioners October 2, 2007. Board of County Commissioners Jennifer Roberts, Chair Parks Helms , Vice Chair Karen Bentley

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Board of County Commissioners October 2, 2007

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  1. Community Mental Health & Justice Program Treating Mental Illness As A Disease Not A Crime Board of County Commissioners October 2, 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 Grayce Crockett, Director Provided Services Organization Connie C. Mele, Director Area Mental Health Authority Vision “A community system that empowers and supports individuals to lead healthy and independent lives”

  2. Timeline February 20, 2007 Jail Diversion Program Presentation At that time concern was raised regarding the name; the new name is: “Community Mental Health & Justice Program” (CMHJ) The following information was presented . . .

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

  4. Why Community Mental Health & Justice? Incarceration . . . A poor and an expensive solution for addressing mental illness/substance abuse when there are best practice models available

  5. The CMHJ Model A comprehensive, coordinated delivery system to: • Identify • Assess • Treat

  6. 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

  7. National Statistics Nationally,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)

  8. National Statistics • Mentally ill stay 2-5 times longer in jail • 1/3 mentally ill are homelessbefore incarceration • >72% severe mentally ill in jail have a co-occurring substance abuse disorder • >4% men in jail suffer from Schizoprehenia or Bipolar Disorder

  9. National Program Statistics • Seattle, Washington:$1.1 million spent in one year for 20 seriously mentally ill patients repeatedly jailed, hospitalized or admitted to crisis centers. ($55,000 per person) • San Antonio, Texas:4,100 served; $4 million saved (Since September 2005) • Miami, Florida:18-20% recidivism rate (typical 70%)

  10. 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

  11. 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

  12. 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

  13. Mecklenburg County Jail Study Chronic Offender Study (Reported: January 2007) • Estimated Cost: $1.12 to $1.58 million • 81 offenders booked in the jail an average of nine times during 2005

  14. Timeline(Continued) • May 2007 – County approves $500,000 to begin implementation of Community Mental Health & Justice Program • September 2007 - KIMME & Associates Recommendations • Population reduction opportunities: • Extension of the range of arrest options for officers, especially with mentally ill offenders • Reduction in Jail bed days – KIMME estimate to be finalized

  15. The following slides will describe the services that will be implemented utilizing the $500,000 designated in this year’s budget for the CMHJ Program.

  16. Our Vision & Goal • Identify the mentally ill/substance abuser • Locate appropriate, less restrictive services to treat the illness • Use clinically appropriate settings • Address legal issues and criminal behavior • Assure that individuals are held accountable for the legal system

  17. Pre & Post Booking Services Pre Booking Program:Crisis Intervention Team (CIT) is a model that we anticipate will be implemented in partnership with CMPD as a specialized police response team for situations involving the mentally ill. Crisis Intervention Team Post Booking Program: A Mental Health Clinician acting as the Justice System Liaison will assess and refer mentally ill, developmentally disabled & substance abusing defendants so they can receive appropriate treatment services while in the criminal justice system.

  18. Residential Stabilization Length of Stay: Up to 180 days Services Provided at the Facility: • Medication Stabilization and Management • Case Management/Community Support • Mental Health/Substance Abuse Treatment • Life Skills/Vocational Support • AA/NA 12-Step Group Residential Stabilization • Priority to Chronic Offenders • Admissions = 60 Individuals • Initial Program Capacity = 30 Individuals • Average Length of Stay = 90 Days

  19. Housing A multi level program that provides residential housing designed to promote independent living with Case Management and/or Community Support Housing

  20. Budget Budget $ 94,500.00 Start Up Cost (Housing) + 10,000.00 CIT Training & Implementation $ 104,500.00 Total for AboveOne TimeCosts +410,346.26 Staff Salaries & Benefits + 90,000.00 Residential Stabilization + 36,000.00 Housing Level 1 + 11,375.00 Housing Level 2 $ 652,221.26 Total ofAll AboveCosts - 500,000.00 Board of County Commissioners Allocation $ 152,221.26 Reimbursable through Medicaid/State Funding

  21. The CMHJ Continuum Residential Stabilization Mobile Crisis Team Crisis Intervention Team Case Management Mental Health Court Housing Treatment Services Crisis Center

  22. Next Steps • Approve release of $500,000 from restricted contingency funding • Receive capital budget request for the Crisis Center during the upcoming capital budget process. This Center will serve not only CMHJ consumers but other populations with mental illness • To fully implement the continuum, a request for funds will be forth coming for operational implementation, expansion and enhancement of services and housing

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