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Creating a Behavioral Creating a Behavioral Health Safety “Net”Health Safety “Net”
Enhancing CollaborationEnhancing Collaboration
Facilitation byConnie Milligan Bluegrass MH-MR Board, Inc.Ray Sabbatine Sabbatine & Associates
What does your data say?
How big is the problem?Where are people falling through the cracks?
Recommend the GAINS Center workshops “Developing Community Partnerships” and “Cross Systems Mapping”
Is Mental Health TX adequately funded?
How well are people with SMI integrated into treatment?
ACT and active case management Mobile crisis teams
Supervised apartmentsHospital beds - especially forensic
Collaboration options
We have to move out of our Silos of care…
• Mental health cross trained with police, and jail personnel• Mental health working with police• Mental health in the jails• Mental health in the courts• Links with pretrial, probation and parole• Data crosswalk between jail and mental health
Constitutional Constitutional Custody DutyCustody Duty
To provide a reasonable degree of To provide a reasonable degree of protection to those we incarcerate from;protection to those we incarcerate from;
AssaultAssault
SuicideSuicide
Preventable illness (SMI)Preventable illness (SMI)
We cannotWe cannot “Prevent” “Prevent”
what we cannot what we cannot “Predict”“Predict”
“Who is at Risk?”“Who is at Risk?”
““Prevention” requires Prevention” requires “knowledge” “knowledge”
of a risk and the of a risk and the “identification”“identification”
of those of those “at Risk”“at Risk”
Risk can beRisk can be“observed”“observed”
but is unlikely to be but is unlikely to be “understood”“understood”
SMISMI
Law enforcement and Law enforcement and corrections officers corrections officers
are trained to are trained to respond to a respond to a
“perceived risk” “perceived risk” with the appropriatewith the appropriate
“use of force” “use of force”
The “use of force” The “use of force” continuum begins continuum begins
with a “verbal with a “verbal command” to gain command” to gain
compliancecompliance
SMISMI
When compliance is When compliance is not gained, “force” is not gained, “force” is
escalated;escalated;Verbal DirectiveVerbal Directive
OCOCTaser > Taser > RestraintRestraint
““Excited Delirium”Excited Delirium”or a state of or a state of
“extreme agitation”“extreme agitation” may be caused by may be caused by
PsychosisPsychosisIllicit Drug UseIllicit Drug Use
SMISMI
Sound familiar?Sound familiar?SMISMI
SMISMI++
Excited DeliriumExcited Delirium++
TaserTaser>>
Restraint= Restraint= “Serious Injury or “Serious Injury or
Death”Death”
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BH Safety “Net”BH Safety “Net”
SMI Education of Justice AgenciesSMI Education of Justice Agencies
PolicePolice
DetentionDetention
ProsecutionProsecution
JudiciaryJudiciary
Corrections/ Probation/ParoleCorrections/ Probation/Parole
CJ Education LevelsCJ Education Levels
AdministrationsAdministrations
Training ComponentsTraining Components
Professional OrganizationsProfessional Organizations
NSA, IACP, FOPNSA, IACP, FOP
ACA, AJAACA, AJA
Local/State/ Federal Judiciary/ Local/State/ Federal Judiciary/ ProsecutorsProsecutors
Training CurriculumTraining Curriculum
What is SMIWhat is SMI
What behaviors are indicative of SMIWhat behaviors are indicative of SMI
What alternative “uses of force” may be What alternative “uses of force” may be employed to gain successful complianceemployed to gain successful compliance
If a an ECD (Taser) is used what If a an ECD (Taser) is used what emergency response is necessaryemergency response is necessary
Identification of RiskIdentification of Risk
Observed/ Educational EffortsObserved/ Educational Efforts
Screened/ Uniform screening Screened/ Uniform screening instrumentsinstruments
Reported/ Voluntary DatabaseReported/ Voluntary Database
Historical record/ Institutional Alert filesHistorical record/ Institutional Alert files
Identification of RiskIdentification of Risk
How can we assure that criminal justice How can we assure that criminal justice agencies have sufficient notice that a agencies have sufficient notice that a persons suffers from “a serious mental persons suffers from “a serious mental illness”?illness”?
Voluntary NotificationVoluntary NotificationSystem (VNS)System (VNS)
Create a NAMI managed web Create a NAMI managed web based/encrypted/password protected based/encrypted/password protected data base that identifies persons data base that identifies persons suffering from SMI. Contact information suffering from SMI. Contact information would be available to assist justice would be available to assist justice agencies in the management of SMI agencies in the management of SMI arrestees and notification of guardians of arrestees and notification of guardians of custody statuscustody status
NAMI VNSNAMI VNS
Although NAMI would host the site, Although NAMI would host the site, consumers would be totally responsible consumers would be totally responsible for voluntary entry, update and deletion for voluntary entry, update and deletion of informationof information
SAMPLE DATA ENTRYSAMPLE DATA ENTRY
Name:Ray SabbatineName:Ray SabbatineAddress: 110 Royal CourtAddress: 110 Royal CourtGeorgetown, KY 40324Georgetown, KY 40324Contact Phone: 859-806-0935Contact Phone: 859-806-0935
SMI:SMI: Mania ManiaCommunity MH Agency: BGRMHCommunity MH Agency: BGRMHContact:Contact: BGRMH Crisis Line BGRMH Crisis Line1-800-638-08761-800-638-0876Action:Action: Advise of custody status Advise of custody statusCaution:Caution: No Coffee & Dark Chocolate No Coffee & Dark ChocolateMedication non-compliantMedication non-compliantWill bite when hungryWill bite when hungry
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Contact InformationQuestions ?
Connie Milligan [email protected] Sabbatine [email protected]