1. Board of County Commissioners Jennifer Roberts, Chair Parks Helms, Vice Chair Karen Bentley J. Daniel Bishop Dumont Clarke Bill James Norman A. Mitchell, Sr. Dan Ramirez Valerie C. Woodard Board of County Commissioners Jail Diversion Model Program February 20, 2007 Area Mental Health Authority Vision “A community system that empowers and supports individuals to lead healthy and independent lives” 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

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

3. 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.

4. Collaboration 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

5. 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.

6. 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.

7. 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)

8. General 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.

9. 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.

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: 1.Decreased days in jail by 2,200 days 2.Decreased days in hospital by 2,100 days 3.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 #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.

14. 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

15. What’s Wrong With This Picture? Crisis Intervention Team Mental Health Court Treatment Services Crisis Center Residential Stabilization Housing Mobile Crisis Team Case Management

16. 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. Crisis Intervention Team The overall goal is to treat mental illness as a disease not a crime

17. Mobile 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

18. 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 Crisis Center

19. Residential 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 Management

20. Housing/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

21. 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 Mental Health Court

22. Post Booking Services/MH Court Jail Diversion Liaison Assesses the mentally ill person admitted to jail to determine appropriate service and Mental Health Court involvement Social Worker in Public Defender’s 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 (For Persons Already in Jail)

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

24. 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