Download Utilizing Evidence Based & Peer Programs as Jail Diversion in

Utilizing Evidence Based & Peer
Programs as Jail Diversion in
Problem Solving Courts
Judi Evans, Executive Director
NAMI Florida
Karen Levy, Mental Health Advocate
What are problem solving courts?
(NOT)
Problem solving courts represent a shift in
the way the justice system traditionally
handles offenders with issues involving
substance abuse, mental health or other
behavioral health issues. The goal of
these courts is to achieve long-term
quality recovery and prevent repeat
criminal behavior.
The nation's first problem solving court
was implemented in 1989, with the
establishment of the first drug court in
Miami, Florida. The first mental health
court was established in 1997 in Broward
County by Judge Ginger Lerner Wren
Court personnel work with prosecutors, public
defenders, probation officers, social workers
and other justice system partners to develop
strategies to provide positive reinforcement
for offenders who successfully complete a
treatment program and abstain from
repeating the behaviors that brought them to
court. Each problem-solving court effectively
targets offender groups with appropriate
levels of supervision and treatment.
Features of a Problem Solving Court
Judge oversees, provides accountability
Judge frequently, directly and intimately
involved
Dedicated court calendar
Referrals from multiple sources
Specially trained court personnel
Dedicated clinical, resource and
supervisory personnel
Features of a Problem Solving Court
Court-based treatment plan and supervision
Intensive services, ACT services, wrap-around
services
Frequent court appearances/reviews
Graduation and rewards
Jail Diversion
The Jail Diversion Program helps individuals
whose legal involvement may be a result
of untreated mental illness or cooccurring mental health and substance
abuse disorders. This is a short-term
program designed to help stabilize and
link clients to more traditional treatment
methods in order to reduce their
incidence and length of incarceration.
Services Include:
 Face-to-face assessments
transportation
 transitional housing
 psychiatric evaluations and treatment plans
 prescription medication therapy
intensive case management
 court liaison and finding additional community resources.
The program provides access to community-based health
and substance-abuse treatment services. Clients receive
treatment services, case management, housing and
medications.
Peer Services – Peer-to-Peer
The Benefits
The cost per day to house an inmate in the
Pinellas County Jail is $90. Mentally ill
clients, however, generate a higher cost per
day than the other inmates in terms of
medication, treatment and disruption. The
placement of these mentally ill patients in
mental health facilities has resulted in
considerable cost savings to the jail. Longrange benefits include a decrease in
recidivism rates and re-offenses.
The Benefits
Perhaps the most important benefit of the
program is decriminalizing mental illness and
providing treatment in an appropriate medical
setting. If the concept of mental health
evaluation at the time of booking is shown to be
effective, state funding and statutory change
requiring this type of intervention could follow.
The benefits to the safety of the community and
the resulting impact to the criminal justice
system would be substantial.
Jail Diversion Outreach Team
(JDOT)
Salt Lake City Utah has a multidisciplinary
team includes a social worker, case
manager, nurse, peer mentors, and a APRN
to serve individuals who have been
unsuccessful in mental health treatment in
the past, are homeless, in poverty, and have
cycled through the jail. This collaborative
effort between Mental Health Services,
Criminal Justice Services, the County jail,
housing, and NAMI has been very successful
in reducing participants’ jail time.
(JDOT)
 The team provides intensive, community-based
services to a minimum of 60 criminal-justice
involved persons with mental illness. Services
emphasize integrated mental health and substance
abuse interventions.
 As part of the jail diversion services provided in Salt
Lake County, JDOT is showing impressive outcomes
in keeping individuals with serious and persistent
mental illness out of the jail and in the community,
with the goal of helping them to be contributing
members of society.
(JDOT)
Here are some of the findings from the Salt Lake
County 2009 Human Services Budget Report:
Pre JDOT
With JDOT
Total Bookings for
new office
433
6
Total jail bed days
12,281
103
Average bookings/
person
21
0.3
Average days in
jail/person
585
5
Why Integrate Consumers as Staff and Experts in Jail
Diversion Programs?
Consumers offer a critical perspective
People who have “been there” can offer
the most relevant perspective on how
systems fail and what meaningful
alternative(s) should be in place.’
 (Bazelon Center for Mental Health Law (2003)
President’s New Freedom Commission
Report on Mental Health (July 2003)
 Goal 2 Mental health care is consumer and
family driven
 Consumers working as providers help expand
the range and availability of services and
supports that professionals offer
 Consumer providers bring different attitudes,
motivations, insights, and behavioral qualities
to the treatment encounter
Benefits of Peer Provided Services
To individuals receiving them
Improved social functioning
Improved self-esteem and social support
Improved quality of life
Reduced use of hospitalization and/or crisis
services (Solomon, 2004)(2004)
Strengthening Self-Advocacy
Wellness Recovery Action Plan (WRAP)
Access to self help resources (Mead, et.al, 2001)
Peer to Peer
Benefits of Peer Provided Services
To service delivery system
 CostCost-savings due to decreased
hospitalization/shorter hospital stays
 Alteration of negative attitudes of service providers
 Provide mechanism for offering services to people in
need of services who are alienated from the
traditional mental health system (e.g. people who are
homeless)
 Improve the effectiveness of the traditional mental
health delivery system (Solomon, 2004)
 Greater optimism among professional staff about
clientsGreater clients’’chances of recovery (Felton, et
al, 1995)
Roles for Consumers in Jail Diversion &
Re Entry Programs
 Peers hired as direct service staff
 Jail diversion program planning & oversight
 Focus groups, planning committees, dialogue groups
 Participation in Boards of Directors and
Advisory/Steering Committees
 Research and evaluation
 Hire peers as research assistants
 Consumer satisfaction surveys
 Hire as observers/monitors in court and jail setting to
ensure clients rights are protected
 Delivery of Peer Support programs in jail & community
 Provider Trainers
 Advocacy e.g. Re Entry And Beyond (RAB)
Why NAMI ??
What is NAMI’s Peer-to-Peer Program?
Peer-to-Peer is a unique, experiential
learning program for people with any
serious mental illness who are
interested in establishing and
maintaining their wellness and recovery.
Why NAMI ??
What does the course include?
 Peer-to-Peer consists of ten two-hour units and is taught by a team of
two trained “Mentors” and a volunteer support person who are
personally experienced at living well with mental illness.
 Mentors are trained in an intensive three day training session and are
supplied with teaching manuals.
 Participants come away from the course with a binder of hand-out
materials, as well as many other tangible resources: an advance
directive; a “relapse prevention plan” to help identify tell-tale feelings,
thoughts, behavior, or events that may warn of impending relapse and
to organize for intervention; mindfulness exercises to help focus and
calm thinking; and survival skills for working with providers and the
general public.
"Peer to Peer has given me a sense of who I am. I
understand what is going on with me and I am able to cope.
I have gained employment and committed to my recovery.
I've come a long way since I've started.“
"I am now able to look at myself in more depth with less
fear. I can try to build bridges with the relationships that
were interrupted by my illness.”
"Peer to Peer has allowed me to take the focus off my
illness and learn to balance it with the rest of my life.. By
engaging in recovery I am able to be more relaxed and
productive."
NAMI Connection is a weekly recovery
support group for people living with
mental illness in which people learn from
each others’ experiences, share coping
strategies, and offer each other
encouragement and understanding.
The vision is that every person in this
country who lives with a mental
illness will have, within reasonable
driving distance, a NAMI
Connection Recovery Support
Group to attend.
"For so long my illness has been a disability. Now I
can see how my experience enables me to help
others. It makes what I went through worth while".
Connecticut
"When I was in crisis, a dear friend said, "Don't
worry, we will be your life preserver, we won't let
you sink!"
With my friends, family and NAMI I built a support
safety net. I feel with the NAMI Connection program
that my support net has gotten stronger. Look at all
the support I am now connected to!"
Why NAMI ??
What is NAMI’s Family-to-Family Program?
The NAMI Family-to-Family Education Program
is a free, 12-week course for family caregivers of
individuals with severe mental illnesses.
The course is taught by trained family members
All instruction and course materials are free to
class participants
Over 115,000 family members have graduated
from this national program
"I have a greater understanding of mental illness and
also how to deal with the many issues I deal with on
a daily basis with my ill family member.”
"It has been extremely helpful to me in my job with
the LPD (Lakeland Police Department). I can better
relate to families when called to a situation where
mental illness is involved. All law enforcement
officers and firemen, etc. should have to take this
course.”
"Sometimes I felt as if nobody understood, but this
course helped in every area I was interested in and
gives me hope for my relative and me!”
"Family members who take the Family-to
Family course are better equipped to work with
mental health clinicians and other
professionals in a collaborative manner... It will
help you learn to cope successfully with a
major challenge in your life, and that, in turn,
will help your loved one as he or she works
towards recovery.“
--Peter Weiden, M.D., author of Breakthroughs
in Antipsychotic Medications