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