reaching beyond cit
DESCRIPTION
Presented by: Mark Giuliano, MSW Director of Community SupportTRANSCRIPT
Westchester County – New York State
Police Mental Health Outreach and Coordination
Westchester County Department of Community Mental Health
Mark Giuliano, MSWDirector of Community Support(914) [email protected]
Westchester County, New YorkPopulation: 940,807
People with Mental Illness in the Justice SystemWe recognize that there is an over-
representation of people with mental illness in the justice system5.4% of the general population have mental
illnessApproximately 16% of people in
correctional settings, including community corrections have a mental illness
Ultimately…Westchester County would like to change the mental health crisis in our community from a challenge for law enforcement to a pro-active response from the mental health system.
Parole
COMMUNITY
COMMUNITY
Probation
Prison
Jail—Sentenced
Local Law Enforcement
Arrest
Initial Detention
First Appearance Court
Jail—PretrialSpecialty Court
Dispositional Court
Intercept 1
Law Enforcement Emergency Services
Intercept 2
Initial Detention
Initial Court Hearing
Intercept 3
Jails/Court
Intercept 4
Re-Entry
Intercept 5Community Corrections
Intercept 1
White Plains and Yonkers Police Outreach
WMC Crisis Team
Intercept 2
Inmate Mental Health Data Exchange
Intercept 3
CMHS
Mental Health Court
MHATI
Intercept 4
Probation MHU
Transitional Services
Medication Grant
Intercept 5
Forensic SCM
Homeless Outreach
Care Coordination
Origins of CIT in WestchesterTragedy
Grant Incident
Ridley Incident Politics
HomelessnessRevitalization
POLICE MENTAL HEALTH OUTREACHThe Westchester County Department of Community Mental
Health has developed collaborative partnerships with the City of White Plains Office of Public Safety and City of Yonkers Police Department to intervene in the lives of people who may be considered emotionally disturbed.
The core elements of intervention promote both officer safety and the safety of people in crisis and include:Law enforcement trainingPartnership with mental health resourcesA new role for law enforcement officers as well as mental
health professionals
Goals of CollaborationThe goals that we’ve informally established in our collaborative efforts include:Increase community safetyIncrease officer safetyIncrease safety for people in crisisRecovery for people with mental illness
TrainingAll recruits receive 16 hours of training on
working with people in emotional crisis at the academy level
Supervisors receive a 6 hour block on working with people in emotional crisis and law enforcement suicide
We offer 4-8 hour blocks of in-service training
We have held Regional CIT Academies for the Hudson Valley Region
White Plains and Yonkers Police DepartmentsIn the City of White Plains, over 30% of the officers have received CIT training. There are CIT Officers available 24 hours per day 7 days a week
In the City of Yonkers…we are working on it…The primary focus in Yonkers has been in the 4th Precinct
Partnership with Mental Health ResourcesThere has been a partnership with the
local mental health resources in the community
Westchester County DCMH has also placed a clinician into these two Police Departments. Both…Are placed into the Community Policing
Divisions of the respective Departments and provide assertive follow up on EDP calls
Can co-respond in calls which involve a mental health component as appropriate
Mental Health Service AccessWestchester County uses a Single
Point of Access in the provision of many non-emergent mental health servicesHousingCase managementAssertive Community TreatmentAssisted Outpatient Treatment
Homeless Subjects as “Suspects”2006 – 499 2007 – 401 2008 – 252
Homeless Suspects
499
401
252
0
100
200
300
400
500
600
2006 2007 2008
Calls for Service Involving Emotionally Disturbed Persons2006 – 299 calls 2007 – 279 calls 2008 – 281 calls
Emotionally Disturbed Persons
299
279281
265
270
275
280
285
290
295
300
305
2006 2007 2008
Resisting Arrest Charge for Emotionally Disturbed Persons:2006 – 6 arrest 2007 – 1 arrest 2008 – 1 arrest
Resisting Arrest Charge
6
1 1
0
1
2
3
4
5
6
7
2006 2007 2008
Mental Health Outreach Contacts and Referrals2006 – 60 2007 – 126 2008 - 225
Contacts and Referrals
60
126
225
0
50
100
150
200
250
2006 2007 2008
Harvey, a 50 year old man that has a significant history of mental illness and substance use, had a continuous pattern of homelessness and incarceration since for many years. He has had over 56 contacts with police and 46
incarcerations Intervention was provided to Harvey through our Police
Mental Health Outreach program. Due to his frequency of police contact he was enrolled in
the Care Coordination program. Prior to this intervention his services were fragmented and often offered in an emergent fashion.
In the first year of his participation in Care Coordination the frequency of his police contact diminished and over the past 10 months he has been arrest free.
Who are we talking about?
Complex Care CoordinationCare Coordination was developed to address the
needs of people with mental illness and co-occurring disorders that are high end users of service.Frequent contacts with emergency servicesFrequent contacts the criminal justice systemLong term inpatient psychiatric care
Participants in Care Coordination receive:ICM level of interventionSelf Determination funding to purchase non-traditional
items to support their recovery.Recovery Mentor to help support their recovery.
The Traditional Approach to Behavioral HealthSelf-determination comes after individuals have
successfully used treatment and achieved clinical stability
Compliance is valuedOnly professionals have access to information (plans,
assessments, records, etc.)Disabilities and deficits drive treatment; Focus is on
illnessLow expectationClinical stability or managing illness Linear progress and movement through an established
continuum of servicesProfessional services onlyFacility-based settings and professional supportersAvoidance of risk; protection of person and community
Person Centered Approach towards Behavioral HealthSelf-determination and community inclusion are
fundamental human rights of all peopleActive participation and empowerment is vitalAll parties have full access to the same
information – often referred to as “transparency.”
Abilities/choices define supports; Wellness/health focus
High expectations
Person Centered Approach towards Behavioral Health
Quality of life and promotion of recoveryPerson’s chooses from a flexible array of
supports and/or creates new support options with team
Diverse supports (professional services, non-traditional services, and natural supports)
Integrated settings and natural supporters are also valued
Responsible risk taking and growth
Traditional Treatment and The Person Centered ApproachRecovery for “Them”
Compliance with treatment Decreased symptoms Stability Better judgment Increased Insight…Accepts illness Follows team’s recommendations Decreased hospitalization Abstinent Motivated Increased functioning Residential Stability Use services
regularly/engagement Cognitive functioning Realistic expectations Attends the job
program/clubhouse, etc.
Wellness for “Us” A home to call my own Life worth living A spiritual connection to
God/others/self A real job, financial
independence Being a good mom, dad,
daughter Friends Fun Nature Music Pets Love…intimacy…sex Having hope for the future Joy Giving back…being needed Learning Recovery
Questions?