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GAINS TAPA Center for Jail Diversion
Easy Access Net/Teleconference
March 27, 2006
C.I.T. in a Rural Community
Brown County, Ohio’s Experience
Colleen Chamberlain, LSW, M. Ed
CIT Project Director
Brown County, Ohio
* Population = 42,890
* Total square miles = 492
* Population per square mile = 86
* Per capita income = $17,100
* Medical facilities = 1 hospital with 35 beds
* Psychiatric facilities = none
* Detention facilities = 1 with 36 beds
Before CIT: Us and Them
* Lack of Understanding about Mental Illness
* Lack of Understanding about Mental Health Services
* Lack of Understanding about Law Enforcement’s Role and Responsibility
More Reasons Not to Get Along
* Lack of Historical Cooperation
* Resistance to Change
* Territorialism
* Scarce Resources and Little Funding
The Cast of Collaboration
You must have the Key Stakeholders involved from the very beginning.
* Brown County Prosecutor
* Brown County Sheriff’s Office*
* Brown County Community Hospital
* Brown County Juvenile Court
* Brown County EMT’s
* Brown County Municipal Court Probation Department
* Brown County Counseling
* Brown County Common Pleas Court
* Brown County Board of Alcohol, Drug Addiction and Mental Health Services
*represented law enforcement in the county as they are the largest agency
The Background
* Police Perspective and Goals
* Increase officers’ awareness of mental illness and mental health crisis
* Increase safety for officers and individuals in crisis
* Reduce return calls to residences on other days and other shifts by making an appropriate disposition initially
* Increase the tools available to officers dealing with a mental health crisis
Making C.I.T. Viable
* Inventory of Services
* Adapting an Urban Model
* Supporting CIT
* Implementation
Inventory of Services
* Community Resources as the Foundation
* General Community Hospital
* Telephone Helpline
* Counseling Center
* State Psychiatric Hospital
* Psychiatric Beds in Neighboring Counties
Adapting an Urban Model
* Poor Fit with Urban Best Practice Model
• Community resources available
• Training opportunities and obstacles
• Geography
• Law enforcement demographics within the county
* Making Modifications
• Assessing what will work
• Gaining consensus
• Maintaining commitment
• Ensuring sustainability
• Maintaining fidelity to the intent and purpose of CIT
Supporting CIT
* Train officers
• Develop CIT curriculum for rural county and adapt urban model for local community
* Jail Boundary Spanner
• Work with requirements for jails and hire RN that has psychiatric experience
• Develop screening tool for mental health and substance abuse issues
• Develop operational policies
• Linkage to community services
Supporting CIT (Continued)
* Expanded Helpline Services
* Provide direct cell phone access for officers to mental health responders
* Provide 30 minute response time to secure triage site
* Psych Triage Sites
• Establish relationship with community hospital to provide a safe environment for assessment
• Set up area at the jail for psych triage that is pre-booking
• Security provided by transporting officer
• Crisis Responders follow case through disposition
Supporting CIT (Continued)
* Psychiatrist for Consultation
• Consultation services for jail inmates who can’t be diverted, but are presenting symptoms of mental illness
* Crisis Stabilization
• Contract with facilities that have crisis services
* Issues continue with distance and transportation
Implementation
* Develop contracts
* Develop protocols
* Develop policies
* Develop CIT curriculum, recruit speakers, begin training
* Set up outcome monitors
* Prepare for Murphy’s Law
Contact Information
Colleen Chamberlain, LSW, M. Ed
Associate Director
CIT Project Director
85 Banting Dr.
Georgetown, OH 45121
937-378-3504
Implementing Jail Diversion in
Virginia’s New River Valley
Victoria Huber Cochran, JD
Amy Forsyth-Stephens, MSW
Mental Health Association of the New River Valley
Blacksburg, Virginia
* 1,458 square miles
* Population 165,000
* Four counties
* One small city (pop. 15,000)
* Ten towns
* Fourteen Law Enforcement Agencies
* Two jails (one regional, one local)
* Two public universities
* One community college
Montgomery County Jail
Booked approximately 4,400 individuals in 2005
* ~60% non-violent crimes
* ~75% released w/in 72 hrs.
* ~150 potentially eligible for post-booking jail diversion
New River Valley Regional Jail
Average Daily Census: ~500 inmates
* About half within catchment's service area
* 16% anticipated to have MI/co-occurring SA disorders
Mental Health Services in the New River Valley
* Public mental health needs met by one community service board agency
* No public mental health in-patient beds available in the NRV
* Nearest state hospital facility is two hours away
* One private, proprietary medical facility with an in-patient behavioral health unit—Carilion New River Valley Medical Center
Our Mantra:
“It’s All About Change!”
The Mechanisms for Making Change…
* Identifying the needs
* Targeting the programmatic solutions
* Identifying and organizing the stakeholders
* Identifying the leaders/power brokers
* Acknowledging barriers
* Allowing ownership in developing solutions
* Providing consistent organizational support throughout the process
The Criminal Justice Continuum and
Mental Health Intervention Intersections:
* Pre-booking
* Post-booking
* Trial
* Post-Trial
* Post-Incarceration (prisoner re-entry)
Two SAMHSA Community Action Grants for Consensus Building, Planning and Implementation of CIT
(April 1, 2002 - September 30, 2005)
One SAMHSA Targeted Capacity Expansion
Grant to Enhance CIT and Create a New Post-Booking Diversion Program (The Bridge)
(October 1, 2005 – September 30, 2008)
Pre Booking Diversion:
The Crisis Intervention Team
Making Change in Our Community
Post Booking Diversion:
The Bridge Program
Putting the Puzzle Together
Organized 65 Stakeholders into 3 “Strands”
* Mental Health
* Law Enforcement
* Consumer/Community
* Leaders from 14 law enforcement agencies
* Representatives from 5 separate governmental entities
* Consumers, family members and advocates
* Public and private mental health care providers
* Magistrates
* Community organizations
Basics of Rural CIT Implementation
* Centralized CIT Program coordination with a neutral agency
* Assemble local volunteer CIT Faculty
* Conduct at least two trainings per year
* Reduce/eliminate training fees as resources allow
* Establish goal for all agencies to train 20%
* Allow each agency to establish own CIT policies
* Establish ongoing quarterly meetings of chiefs and sheriffs
* Train dispatchers
* Establish centrally located CIT triage facility
MORE OBSTACLES WE ALL FACE
* Identifying resources for support services e.g., housing, transportation
* Overcoming consumer resistance
* Addressing criminal justice systems needs
* Obtaining judicial buy-in
* Obtaining prosecutorial buy-in
… and on top of THAT because we’re RURAL!
* Coordinating 14 Law Enforcement Agencies and 2 Jails
* Coordinating multiple public and private service providers
* Closest public psychiatric hospital is two hours away (Marion)
* Enlisting support from a local private hospital to develop a modified triage facility
* Distance/transportation issues
* Appalachian cultural mindset/values
AND THAT’S NOT ALL!
* Complicated, multi-faceted interpersonal relationships
* Historical suspicion of change
* Resentment of inequitable resource distribution
* Multiple court levels, jurisdictions, judges and prosecutors in relatively autonomous court sub-systems
Recognizing the needs
Identifying the solutions
Creating the context for change
Turning obstacles into opportunities
Thank you for joining us!
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