NAMI NC 112707

Slide1: 

2007 NAMI North Carolina Decriminalizing Mental Illness Institute The Jericho Project: Overcoming jail diversion barriers for persons with serious mental illness & serious criminal justice involvement Stephen C. Bush Supervising Attorney/Special Litigation Shelby County Public Defender System 201 Poplar, Suite 2-01 • Memphis, TN 38103 901-545-5835 • Fax 901-545-2527 stephen.bush@shelbycountytn.gov

Slide3: 

“The Jericho experiment sought to create a consumer driven public health jail diversion model based on principles of recovery and resilience, relying on best practice transition planning to access integrated treatment and services, understanding that relationships, peers and community are paramount on the journey to recovery.” SAMHSA Grants 5 H79 SM55058-02 & 1 H79 TI6384-01 A C Wharton, Jr Mayor, Shelby County, Tennessee

High end target population: 

High end target population Serious Mental Illness – Axis I Bipolar Disorder Schizophrenia spectrum Major Depression … Co-occurring substance use – 74% Felonies, misdemeanors, kitchen sink Taps free leverage With dignity and minimal stigma

Eligibility: 

Eligibility Serious mental illness Stable on medication Willing to embrace treatment Seeking to serve persons whose contact with the justice system is related to untreated mental illness

Jail DiversionQuick Reference GuideReference: Sequential Intercept Model: 

Jail Diversion Quick Reference Guide Reference: Sequential Intercept Model Pre-booking jail diversion Crisis Intervention Teams – law enforcement Mobile Crisis Models – mental health Blended models Post-booking jail diversion Fast track supervised release Mental Health specialty courts Non-specialty courts - Jericho Re-entry – from Jails & Corrections

The Sequential Intercept Model Munetz & Griffin, 2006: 

The Sequential Intercept Model Munetz & Griffin, 2006 Conceptual framework Series of points of interception Prevent deeper penetration of CJS Organizing tool for systematically addressing decriminalization Develop targeted strategies to increase diversion & linkage

Systems Barriers: 

Systems Barriers Inadequate community services Waiting lists for treatment & services Lack of adequate housing Fragmentation among MH, SA, housing, social services & health care Stigma, discrimination, NIMBY

Jericho in a Box: 

Jericho in a Box Best Practice Transition Planning Community Linkage Plans Conditional Release Strategies Independent, Layered Supervision Integrated Treatment Bridge Case Management Mainstream Services

Jericho in a Box: 

Jericho in a Box Best Practice Transition Planning Community Linkage Plans Conditional Release Strategies Free Independent, Layered Supervision Free Integrated Treatment Bridge Case Management Mainstream Services Free

APIC for Transition PlanningOsher, Steadman & Barr, 2002: 

APIC for Transition Planning Osher, Steadman & Barr, 2002 APIC-model best practice transition planning Assess clinical and social needs Plan for treatment and services Identify community programs Coordinate transition plan to avoid gaps in care Key Domains of Services Developed by Recovery Support Specialists “Boundary Spanners” per Steadman Result is the Community Linkage Plan \\Scfntdata1\vol1\PBDF\MyDocuments\stephen.bush\Art & Templates\Jericho sample CLP.doc

Insert pdf of checklist: 

Insert pdf of checklist

Recovery Toolkit: 

Recovery Toolkit Case management resources Treatment options Rental assistance Transportation resources Bridge medication resources Temporary identification Housing – transitional to permanent

Slide14: 

PD Special Litigation Section Pretrial Services Jail Medical Community Providers Multiple Referral Streams Confirm Diagnosis & Meds Jericho Roundtable Housing Medications Benefits Case Mgt Transportation Treatment Consumer Input

Conditional Release Strategies: 

Conditional Release Strategies Many forms of conditional release Supervised pretrial release Probation: county, state, private Avoiding revocation on probation Supervision is layered over CLP Independent eyes and ears Material noncompliance reported

Relationships: 

Relationships Relationships Relationships Relationships

Successes: 

Successes Improved quality of life Reduced severity of symptoms Reduced jail days Reduced arrests Judges approve over 95% of CLPs

Successes: 

Successes Referrals from prosecutors Referrals from judges High tolerance of relapse Better, faster dispositions The branding of Jericho

Outcomes: 

Outcomes At 6 months 76% no adverse CJ contact 25% bump up against the system 25%, usually new offenses, result in reincarceration Overall more than half no further arrests Overall 99 fewer jail days per divertee/year

Systems Impact, n=55: 

Systems Impact, n=55 Jail days dropped from 13,946 in the year preceding linkage to 6,159 in the year following 7,787 fewer days @$91= $708,617 $708,617 / 55 = $12,884 per detainee Overall divertees averaged 99 fewer days per year in jail after linkage

Comparision : 

Comparision Conditional Release All courts No preset limitations Driven by dynamics of adversarial system Bottom up Mental Health Courts One division Usually nonviolent, low grade offenders Driven by judge Top down

Looking Forward: 

Looking Forward Gender-specific, trauma-centered Targeted resources for homelessness Consumer Peer Specialists & WRAP Supportive Employment Transitional Housing Gideon – IMS and early intervention

Factors for Success: 

Factors for Success Interagency collaboration Active stakeholder involvement Effective boundary spanner(s) Strong leader or change agent Quality transition planning Incorporate evidence-based practices Specialized case management services

Values Statement: 

Values Statement Recovery is real and possible. Relationships are important. Listen to persons with mental illness. They know what what works for them. Services should be comprehensive, integrated & evidence-based. Overcome stigma through education and example. Access to treatment should not compromise due process. Avoid artificial limits on eligibility.

Why Jericho?: 

Why Jericho? For 3000 years a place of safety Food, water, and protection A safe place in the desert Metaphor of bringing down walls Bringing down barriers to recovery

Resources : 

Resources The National GAINS Center www.gainscenter.samhsa.gov Council of State Govts Mental Health Consensus Project Report www.csg.org www.consensusproject.org SAMHSA www.samhsa.gov National Registry of Evidence-based Px & Prgms