Creating a Behavioral Health Safety “Net” Enhancing Collaboration

Creating a Behavioral Creating a Behavioral Health Safety “Net”Health Safety “Net”

Enhancing CollaborationEnhancing Collaboration

Facilitation byConnie Milligan Bluegrass MH-MR Board, Inc.Ray Sabbatine Sabbatine & Associates

What does your data say?

How big is the problem?Where are people falling through the cracks?

Recommend the GAINS Center workshops “Developing Community Partnerships” and “Cross Systems Mapping”

Is Mental Health TX adequately funded?

How well are people with SMI integrated into treatment?

ACT and active case management Mobile crisis teams

Supervised apartmentsHospital beds - especially forensic

Collaboration options

We have to move out of our Silos of care…

• Mental health cross trained with police, and jail personnel• Mental health working with police• Mental health in the jails• Mental health in the courts• Links with pretrial, probation and parole• Data crosswalk between jail and mental health

Constitutional Constitutional Custody DutyCustody Duty

To provide a reasonable degree of To provide a reasonable degree of protection to those we incarcerate from;protection to those we incarcerate from;

AssaultAssault

SuicideSuicide

Preventable illness (SMI)Preventable illness (SMI)

We cannotWe cannot “Prevent” “Prevent”

what we cannot what we cannot “Predict”“Predict”

“Who is at Risk?”“Who is at Risk?”

““Prevention” requires Prevention” requires “knowledge” “knowledge”

of a risk and the of a risk and the “identification”“identification”

of those of those “at Risk”“at Risk”

Risk can beRisk can be“observed”“observed”

but is unlikely to be but is unlikely to be “understood”“understood”

SMISMI

Law enforcement and Law enforcement and corrections officers corrections officers

are trained to are trained to respond to a respond to a

“perceived risk” “perceived risk” with the appropriatewith the appropriate

“use of force” “use of force”

The “use of force” The “use of force” continuum begins continuum begins

with a “verbal with a “verbal command” to gain command” to gain

compliancecompliance

SMISMI

When compliance is When compliance is not gained, “force” is not gained, “force” is

escalated;escalated;Verbal DirectiveVerbal Directive

OCOCTaser > Taser > RestraintRestraint

““Excited Delirium”Excited Delirium”or a state of or a state of

“extreme agitation”“extreme agitation” may be caused by may be caused by

PsychosisPsychosisIllicit Drug UseIllicit Drug Use

SMISMI

Sound familiar?Sound familiar?SMISMI

SMISMI++

Excited DeliriumExcited Delirium++

TaserTaser>>

Restraint= Restraint= “Serious Injury or “Serious Injury or

Death”Death”

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BH Safety “Net”BH Safety “Net”

SMI Education of Justice AgenciesSMI Education of Justice Agencies

PolicePolice

DetentionDetention

ProsecutionProsecution

JudiciaryJudiciary

Corrections/ Probation/ParoleCorrections/ Probation/Parole

CJ Education LevelsCJ Education Levels

AdministrationsAdministrations

Training ComponentsTraining Components

Professional OrganizationsProfessional Organizations

NSA, IACP, FOPNSA, IACP, FOP

ACA, AJAACA, AJA

Local/State/ Federal Judiciary/ Local/State/ Federal Judiciary/ ProsecutorsProsecutors

Training CurriculumTraining Curriculum

What is SMIWhat is SMI

What behaviors are indicative of SMIWhat behaviors are indicative of SMI

What alternative “uses of force” may be What alternative “uses of force” may be employed to gain successful complianceemployed to gain successful compliance

If a an ECD (Taser) is used what If a an ECD (Taser) is used what emergency response is necessaryemergency response is necessary

Identification of RiskIdentification of Risk

Observed/ Educational EffortsObserved/ Educational Efforts

Screened/ Uniform screening Screened/ Uniform screening instrumentsinstruments

Reported/ Voluntary DatabaseReported/ Voluntary Database

Historical record/ Institutional Alert filesHistorical record/ Institutional Alert files

Identification of RiskIdentification of Risk

How can we assure that criminal justice How can we assure that criminal justice agencies have sufficient notice that a agencies have sufficient notice that a persons suffers from “a serious mental persons suffers from “a serious mental illness”?illness”?

Voluntary NotificationVoluntary NotificationSystem (VNS)System (VNS)

Create a NAMI managed web Create a NAMI managed web based/encrypted/password protected based/encrypted/password protected data base that identifies persons data base that identifies persons suffering from SMI. Contact information suffering from SMI. Contact information would be available to assist justice would be available to assist justice agencies in the management of SMI agencies in the management of SMI arrestees and notification of guardians of arrestees and notification of guardians of custody statuscustody status

NAMI VNSNAMI VNS

Although NAMI would host the site, Although NAMI would host the site, consumers would be totally responsible consumers would be totally responsible for voluntary entry, update and deletion for voluntary entry, update and deletion of informationof information

SAMPLE DATA ENTRYSAMPLE DATA ENTRY

Name:Ray SabbatineName:Ray SabbatineAddress: 110 Royal CourtAddress: 110 Royal CourtGeorgetown, KY 40324Georgetown, KY 40324Contact Phone: 859-806-0935Contact Phone: 859-806-0935

SMI:SMI: Mania ManiaCommunity MH Agency: BGRMHCommunity MH Agency: BGRMHContact:Contact: BGRMH Crisis Line BGRMH Crisis Line1-800-638-08761-800-638-0876Action:Action: Advise of custody status Advise of custody statusCaution:Caution: No Coffee & Dark Chocolate No Coffee & Dark ChocolateMedication non-compliantMedication non-compliantWill bite when hungryWill bite when hungry

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Contact InformationQuestions ?

Connie Milligan cpmilligan@bluegrass.orgRay Sabbatine Sabbatine@mac.com