assessing the need in pennsylvania kirk heilbrun ed mulvey carol schubert katy winckworth-prejsnar...

Assessing the Need in Pennsylvania

Kirk Heilbrun

Ed Mulvey

Carol Schubert

Katy Winckworth-Prejsnar

11/26/12

Funded By: Pennsylvania Commission on Crime and

Delinquency (PCCD) Department of Public Welfare Office of

Mental Health and Substance Abuse Services (OMHSAS)

Oversight by the Mental Health and Justice Advisory Committee of PCCD

Collaboration between Drexel University

and Western Psychiatric Institute and Clinic University of Pittsburgh Medical School

Center of Excellence Staff Edward P. Mulvey, Ph.D., Co-Director

Professor of Psychiatry, University of Pittsburgh School of Medicine Kirk Heilbrun, Ph.D., Co-Director

• Professor and Head, Department of Psychology, Drexel University Carol A. Shubert, M.P.H., Senior Consultant

• Research Program Administrator, Law and Psychiatry Program, Western Psychiatric Institute and Clinic

David DeMatteo, J.D., Ph.D., Senior Consultant

• Assistant Professor, Department of Psychology, Drexel University Co-Director, JD/PhD Program in Law and Psychology, Drexel University

Patricia A. Griffin, Ph.D., Senior Consultant • Consultant for a variety of agencies and organizations including

the CMHS National GAINS Center & TAPA Center for Jail Diversion, the Philadelphia Dept. of Behavioral Health, and the Montgomery Dept. of Behavioral Health

Amanda Cross, Ph.D, Senior Research Associate Katy Winckworth-Prejsnar, Project Coordinator Sarah Filone, M.A., Project Coordinator

The Problem

Many of the same people in multiple systems:

Mental health Substance abuse Criminal justice Other social services

Expensive - high service users, people who cycle and recycle through the system

SOLUTION: Cross-Systems Coordination

Pennsylvania Center of ExcellenceGoals & Tools Diversion

- Technical Assistance- Sequential Intercept Model - Cross Systems Mapping and Action Planning

Workshops

Education- Presentations- Consultation- Website

Web-based Resource

Centerwww.pacenterofexcellence.pitt.edu

Sequential Intercept Model

as our Organizing Tool

Sequential InterceptsThe Ultimate Intercept

I. Law Enforcement/Emergency Services

II. Post-Arrest: Initial Detention/Initial Hearings

III. Post-Initial Hearings: Jail/Prison, Courts, Forensic Evaluations and Commitments

IV. Re-Entry From Jails,State Prisons, &Forensic Hospitalization

V. CommunityCorrections &CommunitySupport

Munetz & GriffinPsychiatric Services 57: 544–549, 2006

Identifies Existing local services and systems Issues considered important to local

stakeholders Data Diagnosis

Strengths to be built upon

Helps everyone see “big picture” & how they fit Helps diverse groups from various systems

understand where/how everything fits Intercepts provide “manageable” venues and

opportunities for systems interventions

Useful Organizing Tool

Five Key Points of Interception

1. Law enforcement / Emergency services

2. Booking / Initial court hearings

3. Jails / Courts

4. Re-entry

5. Community corrections / Community support

13

Cross-Systems MappingWorkshops

Workshop Tasks

1. Nurture cross-system collaboration

2. Map the local system

3. Inventory current resources, gaps, and opportunities

4. Agree on priorities

5. Build an Action Plan

Washington County Cross Systems Map

19

Final Report

Cross-systems picture Available for wide distribution

Provided in PDF and Word formats County-Specific Narrative for

each intercept Gaps and Opportunities Action Plan Support for future funding

applications Reference/resource materials

included

Drexel University & University of Pittsburgh

Blair County Report of the Cross-Systems Mapping Workshop

June 8th and 9th , 2011

Transforming Services for Persons with Mental Illness in Contact with the Criminal Justice System

Cross Systems Mapping Workshops

What We’ve Learned About Pennsylvania

Common Gaps in Service

Intercept 1• Law enforcement agencies have limited time for training• Law enforcement officers spend hours waiting with individuals at local

hospital• Lack of detoxification and sobering services

Intercept 2• Lack of pretrial services• Problems with video arraignment equipment

Intercept 3• Many jail admissions requiring detoxification • Lack of treatment staff• Medical Assistance benefits terminated after admission

Intercept 4• Significant gaps in aftercare medication• Limited continuity of care• Limited re-entry efforts • Few systematic efforts to reinstate or start MA and/or SS benefits

Intercept 5• Not enough housing

What We’ve Learned About PA Many opportunities as well:

Support for Training at Intercept 1

Collaborative efforts among systems (CJABs, Problem Solving Courts, Forensic Treatment Teams)

Growing interest in Peer Support Services for forensic settings

Individuals dedicated to change

What We’ve Learned About PA

Most Common County Priorities

Training at Intercept One

Formalized detoxification procedure

Reduce strain on hospitals, jails, and law enforcement

Continuity of care from local jails to community

Aftercare Meds

Re-activation of benefits

Psychiatric Appointments

Housing

Information sharing across systems

23/27 identified SPR as a top priority 3 already has some type of SPR training in place

Specialized Police Response (SPR) Training :

Crisis Intervention Training (CIT) Advanced CIT addressing veterans, military

culture, and trauma topics Mental Health First Aid (MHFA) -12 hour MHFA – Public Safety 8 hour Crisis Intervention Specialist (CIS) Police

School Family Training and Advocacy Center

(FTAC) training

Specialized Police Response to People with Behavioral Health Problems in PA: A Survey of

the Commonwealth

A summary of results

Background Survey developed by the COE regarding

specialized police responses in PA Counties Requested by Judge Zotolla and members of

the Mental Health and Justice Advisory Committee (MHJAC)

Three groups targeted: Law enforcement County Office of Mental Health Criminal Justice Advisory Board (CJAB)

Distributed with the assistance of PCCD and OMHSAS

Reflects views between December 2010-January 2011

What the survey covers

Respondent information Activities taken to address responses to

people with behavioral health challenges Training provided in the area of behavioral health

Cross-system collaboration to address problems related to individuals with behavioral health challenges

Resources needed to better respond to people with behavioral health challenges

Opportunities for and barriers to change related to improving response to individuals with behavioral health challenges

Who Responded Law Enforcement

84 responses 33 counties (1-9 responses per county)

Mental Health 31 responses 27 counties (1-3 responses per county)

CJAB 21 responses 16 counties (1-4 responses per county)

Responses: Training

Law Enforcement Mental Health CJAB0

10

20

30

40

50

60

70

80

90

100

44

8186

(received training onbehavioral health issues)

(provided training onbehavioral health issues)

(training provided to lawenforcement on behavioralhealth issues)

Perc

en

t of

resp

on

ses

Responses: Collaboration

Law Enforcement Mental Health CJAB0

10

20

30

40

50

60

70

80

90

55

84 81

(Collaboration with non-lawenforcement agencies)

(Collaborate with law enforcement)

Perc

en

t re

port

ing

colla

bora

tion

Responses: Needed Resources (to improve responses to people with

behavioral health challenges)

In forced responses - over 80% in all 3 groups identified Additional training on mental health issues Crisis mental health services

In open-ended responses – all 3 groups identified More training Better access to crisis intervention services Better system collaboration in the county

Responses: Barriers (to improving the response to people with

behavioral health challenges)

Law Enforcement

Mental Health CJAB

Funding (49%) Funding (63%) Funding (88%)

Manpower shortage/time (33%)

Lack of cooperation/understanding (37%)

Manpower issue within police departments (31%)

Access to training (21%)

Housing (19%) Lack of time/understanding (13%)

For more information

www.pacenterofexcellence.pitt.edu

Contact: Katy Winckworth-Prejsnar

Research Coordinator

kw494@drexel.edu