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June 23, 2007 National Alliance on Mental Illness, San Diego 2007 NAMI National Conference San Diego Courts as Catalysts: Innovative Approaches to Jail.

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Presentation on theme: "June 23, 2007 National Alliance on Mental Illness, San Diego 2007 NAMI National Conference San Diego Courts as Catalysts: Innovative Approaches to Jail."— Presentation transcript:

1 June 23, 2007 National Alliance on Mental Illness, San Diego 2007 NAMI National Conference San Diego Courts as Catalysts: Innovative Approaches to Jail Diversion & Community Reentry The Honorable Tara Reilly Presiding Judge, San Bernardino Mental Health Court Stephen Bush Shelby County Public Defender’s Office

2 June 23, 2007National Alliance on Mental Illness, San Diego

3 June 23, 2007National Alliance on Mental Illness, San Diego The Jericho Project: Jail Diversion as Defense Strategy Overcoming barriers to diversion for persons with serious mental illness and serious felony offenses Stephen Bush Supervising Attorney/Special Litigation Shelby County Public Defender’s Office 201 Poplar Avenue, Suite 2-01 Memphis, TN

4 June 23, 2007National Alliance on Mental Illness, San Diego “The Jericho experiment sought to create a consumer driven public health jail diversion model based on principles of recovery and resilience, relying on best practice transition planning to access integrated treatment and services, understanding that relationships, peers and community are paramount on the journey to recovery.” SAMHSA Grants 5 H79 SM & 1 H79 TI A C Wharton, Jr Mayor, Shelby County, Tennessee

5 June 23, 2007National Alliance on Mental Illness, San Diego Values Statement Recovery is real and possible. Recovery is real and possible. Relationships are important. Relationships are important. Listen to persons with mental illness. They know what what works for them. Listen to persons with mental illness. They know what what works for them. Services should be comprehensive, integrated & evidence-based. Services should be comprehensive, integrated & evidence-based. Overcome stigma through education and example. Overcome stigma through education and example. Access to treatment should not compromise due process. Access to treatment should not compromise due process. Avoid artificial limits on eligibility. Avoid artificial limits on eligibility.

6 June 23, 2007National Alliance on Mental Illness, San Diego Systems Barriers to Recovery Inadequate community services Inadequate community services Waiting lists for treatment & services Waiting lists for treatment & services Lack of adequate housing Lack of adequate housing Fragmentation among MH, SA, housing, social services & health care Fragmentation among MH, SA, housing, social services & health care Stigma, discrimination, NIMBY Stigma, discrimination, NIMBY

7 June 23, 2007National Alliance on Mental Illness, San Diego High end target population Serious Mental Illness – Axis I Serious Mental Illness – Axis I –Bipolar Disorder –Schizophrenia spectrum –Major Depression … Co-occurring substance use – 78% Co-occurring substance use – 78% Felonies, misdemeanors, kitchen sink Felonies, misdemeanors, kitchen sink Taps free leverage Taps free leverage With dignity and minimal stigma With dignity and minimal stigma

8 June 23, 2007National Alliance on Mental Illness, San Diego Eligibility Serious mental illness Serious mental illness Willing to embrace treatment Willing to embrace treatment Seeking to serve persons whose contact with the justice system is related to untreated mental illness Seeking to serve persons whose contact with the justice system is related to untreated mental illness

9 June 23, 2007National Alliance on Mental Illness, San Diego Jericho in a Box 1. Best Practice Transition Planning 2. Community Linkage Plans 3. Conditional Release Strategies 4. Independent, Layered Supervision 5. Integrated Treatment 6. Bridge Case Management 7. Continuing Transition Planning

10 June 23, 2007National Alliance on Mental Illness, San Diego APIC for Transition Planning Osher, Steadman & Barr, 2002 APIC-model best practice transition planning APIC-model best practice transition planning –Assess clinical and social needs –Plan for treatment and services –Identify community programs –Coordinate transition plan to avoid gaps in care Key Domains of Services Key Domains of Services Developed by Recovery Support Specialists Developed by Recovery Support Specialists –“Boundary Spanners” per Steadman Result is the Community Linkage Plan Result is the Community Linkage Plan \\Scfntdata1\vol1\PBDF\MyDocuments\stephen.bush\Art & Templates\Jericho sample CLP.doc \\Scfntdata1\vol1\PBDF\MyDocuments\stephen.bush\Art & Templates\Jericho sample CLP.doc

11 June 23, 2007National Alliance on Mental Illness, San Diego Recovery Toolkit Case management resources Case management resources Treatment options Treatment options Rental assistance Rental assistance Transportation resources Transportation resources Bridge medication resources Bridge medication resources Temporary identification Temporary identification Housing – transitional to permanent Housing – transitional to permanent

12 June 23, 2007National Alliance on Mental Illness, San Diego PD Special Litigation Section Pretrial Services Correct Care Solutions Foundations Associates Comprehensive Counseling Multiple Referral Streams Confirm Diagnosis & Meds Jericho Roundtable Housing Medications Benefits Case Mgt Transportation Treatment Consumer Input

13 June 23, 2007National Alliance on Mental Illness, San Diego Conditional Release Strategies Many forms of conditional release Many forms of conditional release –Supervised pretrial release –Probation: county, state, private –Avoiding revocation on probation Supervision is layered over CLP Supervision is layered over CLP Independent eyes and ears Independent eyes and ears Material noncompliance reported Material noncompliance reported

14 June 23, 2007National Alliance on Mental Illness, San Diego Successes Judges approve over 95% of CLPs Judges approve over 95% of CLPs Improved quality of life Improved quality of life Reduced severity of symptoms Reduced severity of symptoms Reduced jail days Reduced jail days Reduced arrests Reduced arrests

15 June 23, 2007National Alliance on Mental Illness, San Diego Successes Referrals from prosecutors Referrals from prosecutors Referrals from judges Referrals from judges High tolerance of relapse High tolerance of relapse Better, faster dispositions Better, faster dispositions The branding of Jericho The branding of Jericho

16 June 23, 2007National Alliance on Mental Illness, San Diego Outcomes At 6 months 76% no adverse CJ contact At 6 months 76% no adverse CJ contact Overall: 50%, 25%, 25% Overall: 50%, 25%, 25% More than half no further contact More than half no further contact 25% bump up against the system 25% bump up against the system About 25%, usually new offenses, result in reincarceration About 25%, usually new offenses, result in reincarceration

17 June 23, 2007National Alliance on Mental Illness, San Diego Looking Forward Gender-specific, trauma-centered Gender-specific, trauma-centered Targeted resources for homelessness Targeted resources for homelessness Consumer Peer Specialists & WRAP Consumer Peer Specialists & WRAP Supportive Employment Supportive Employment Transitional Housing Transitional Housing Gideon – IMS and early intervention Gideon – IMS and early intervention

18 June 23, 2007National Alliance on Mental Illness, San Diego Why Jericho? For 3000 years a place of safety For 3000 years a place of safety Food, water, and protection Food, water, and protection A safe place in the desert A safe place in the desert Metaphor of bringing down walls Metaphor of bringing down walls Bringing down barriers to recovery Bringing down barriers to recovery

19 June 23, 2007National Alliance on Mental Illness, San Diego Factors for Success Interagency collaboration Interagency collaboration Active stakeholder involvement Active stakeholder involvement Effective boundary spanner(s) Effective boundary spanner(s) Strong leader or change agent Strong leader or change agent Quality transition planning Quality transition planning –Incorporate evidence-based practices Specialized case management services Specialized case management services

20 June 23, 2007National Alliance on Mental Illness, San Diego

21 June 23, 2007National Alliance on Mental Illness, San Diego Resources The National GAINS Center The National GAINS Center –www.gainscenter.samhsa.gov Council of State Govts Mental Health Consensus Project Report Council of State Govts Mental Health Consensus Project Report –www.csg.org –www.consensusproject.org SAMHSA SAMHSA –www.samhsa.gov –National Registry of Evidence-based Px & Prgms

22 June 23, 2007National Alliance on Mental Illness, San Diego Comparision Conditional Release Conditional Release –All courts –No preset limitations –Driven by dynamics of adversarial system –Bottom up Mental Health Courts Mental Health Courts –One division –Usually nonviolent, low grade offenders –Driven by judge –Top down


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