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Westchester County – New York State Police Mental Health Outreach and Coordination

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Presented by: Mark Giuliano, MSW Director of Community Support

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Page 1: Reaching Beyond CIT

Westchester County – New York State

Police Mental Health Outreach and Coordination

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Westchester County Department of Community Mental Health

Mark Giuliano, MSWDirector of Community Support(914) [email protected]

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Westchester County, New YorkPopulation: 940,807

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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

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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.

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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

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Origins of CIT in WestchesterTragedy

Grant Incident

Ridley Incident Politics

HomelessnessRevitalization

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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

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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

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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

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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

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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

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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

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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

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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

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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

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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

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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?

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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.

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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

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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

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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

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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

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Questions?

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