A Supervised Diversionary Program for People with Psychiatric Disabilities

CT. InitiativesCT. Initiatives

A Supervised A Supervised Diversionary Diversionary

Program for People Program for People with Psychiatric with Psychiatric

DisabilitiesDisabilities

CTCT

• Mental Health Unit In ProbationMental Health Unit In Probation• ASISTASIST• Jail Re-InterviewJail Re-Interview• CRESTCREST• Jail Diversion*Jail Diversion*

•Supervised Diversionary Supervised Diversionary ProgramProgram

Failure Rate on Failure Rate on Community Community SupervisionSupervision

2 to 12 to 1

Probation Mental Health Probation Mental Health UnitUnit

Policy Policy The Court Support Services The Court Support Services Division (CSSD) will establish Division (CSSD) will establish Mental Health Probation Officers to Mental Health Probation Officers to provide intensive supervision for provide intensive supervision for clients with identified mental health clients with identified mental health disorders. These officers will work disorders. These officers will work collaboratively with DMHAS staff to collaboratively with DMHAS staff to ensure access to an expanded ensure access to an expanded service continuum for psychiatric service continuum for psychiatric and co-occurring disorders. and co-occurring disorders.

MH UnitMH Unit

•Address treatment needsAddress treatment needs•Address criminogenic and basic Address criminogenic and basic

needsneeds•AdvocateAdvocate•Build a relationship/trustBuild a relationship/trust•Fair but firmFair but firm•Collaborate with treatment Collaborate with treatment

providersproviders

MH UnitMH Unit• 10 Probation Officers in 8 locations10 Probation Officers in 8 locations

– Bridgeport*Bridgeport*– Hartford *Hartford * (2 officers) (2 officers) – Waterbury*Waterbury*– New Haven*New Haven* (2 officers)(2 officers)– MiddletownMiddletown– New BritainNew Britain– New LondonNew London– Norwich Norwich * 4 biggest * 4 biggest

citiescities

MH UnitMH Unit

• All the officers have received All the officers have received specialized training from NAMI, specialized training from NAMI, CABLE, DMHAS, and CSSDCABLE, DMHAS, and CSSD

• All the officers have received All the officers have received CITCIT training with their police partnerstraining with their police partners

• Work closely with providers and Work closely with providers and natural supportsnatural supports

• Smaller caseloadsSmaller caseloads

MH UnitMH Unit

• Central CT State University is Central CT State University is conducting an independent conducting an independent evaluation of the programevaluation of the program

• Outcomes should be available in the Outcomes should be available in the spring of this yearspring of this year

ClientsClients• Sentenced probationersSentenced probationers• Have to reside in one of the 8 locationsHave to reside in one of the 8 locations• Referrals based on the results of our Referrals based on the results of our

assessments, involvement with assessments, involvement with DMHAS and observed behaviors DMHAS and observed behaviors

• Most clients have Serious Mental Most clients have Serious Mental IllnessIllness

• Clients can stay with the MHPO for the Clients can stay with the MHPO for the length of their probation or until they length of their probation or until they appear stable for a period of timeappear stable for a period of time

Advanced Advanced Supervision and Supervision and

Intervention Intervention Support Team Support Team

(ASIST)(ASIST)

• Multi-Agency CollaborationMulti-Agency Collaboration

– CSSD, DOC, and DMHAS CSSD, DOC, and DMHAS

• Located at 7 AICs statewideLocated at 7 AICs statewide

– Hartford, Middletown, New London, Hartford, Middletown, New London, Waterbury Bridgeport, New Britain/Bristol Waterbury Bridgeport, New Britain/Bristol and New Haven and New Haven

• $1,710,000 in braided funding to provide $1,710,000 in braided funding to provide LMHA staff at AICs, psychiatric services, LMHA staff at AICs, psychiatric services, case management and ABHScase management and ABHS

ASISTASIST

ASIST Target PopulationASIST Target Population

Clients to be served - Clients to be served -

• Adults (age18 and older)Adults (age18 and older)

• Serious to moderate Axis I psychiatric diagnosis; Serious to moderate Axis I psychiatric diagnosis; often with a co-occurring substance abuse disorderoften with a co-occurring substance abuse disorder

• Criminal Justice involvementCriminal Justice involvement

• Goals:Goals: 1. 1. Reduce incarceration Reduce incarceration

2. 2. Increase AIC access/appropriatenessIncrease AIC access/appropriateness

12 IAR Specialists – Statewide Coverage12 IAR Specialists – Statewide Coverage

15,555 defendants re-interviewed in 200915,555 defendants re-interviewed in 2009

Of that number- 10,465 were released Of that number- 10,465 were released (67%)(67%)

290 average Dept. of Correction bed days 290 average Dept. of Correction bed days saved per monthsaved per month

7,848 successfully completed the program 7,848 successfully completed the program in 2009 (75%)in 2009 (75%)

4/104/10

Jail Reinterview ProgramJail Reinterview Program

Community Reporting Community Reporting Engagement Support Engagement Support and Treatment Center and Treatment Center

(CREST)(CREST)• For SMI adults referred by Parole, For SMI adults referred by Parole,

Probation, Court, and the Probation, Court, and the Department of Correction Department of Correction

• Day reporting center with access to Day reporting center with access to vocational, educational, social and vocational, educational, social and psychiatric rehabilitation servicespsychiatric rehabilitation services

• Open 7 days/wk, 3 evenings/wkOpen 7 days/wk, 3 evenings/wk• State funded – 2008 Crime BillState funded – 2008 Crime Bill

CRESTCREST

• Provides intensive case management, Provides intensive case management, criminogenic assessment and criminogenic assessment and treatment, skill development, case treatment, skill development, case management and supervision management and supervision

• Capacity of 30 individuals served by Capacity of 30 individuals served by New Haven area court. LOS 3-6 monthsNew Haven area court. LOS 3-6 months

• Program outcome evaluation by Central Program outcome evaluation by Central CT State University. CT State University.

• In last 12 months 83% of participants In last 12 months 83% of participants completed the program and avoided completed the program and avoided incarceration. incarceration.

Jail DiversionJail Diversion• In every CT Superior Courts In every CT Superior Courts • Improve options to community Improve options to community

services for adults with psychiatric services for adults with psychiatric disabilities in the Criminal Justice disabilities in the Criminal Justice systemsystem

• Provide brief clinical screening of Provide brief clinical screening of clients at any point from arraignment clients at any point from arraignment through sentencing.through sentencing.

• Offer a treatment option to the client Offer a treatment option to the client and court in lieu of incarceration.and court in lieu of incarceration.

• Provide community case Provide community case management to improve engagement management to improve engagement in treatment services, obtain in treatment services, obtain entitlements, obtain housing, etc.entitlements, obtain housing, etc.

A Diversionary Program for People with Psychiatric Disabilities

Supervised Supervised Diversionary Program Diversionary Program

(SDP)(SDP)• CGS 54-56CGS 54-56l l formerly PA 08-1 (Eff. formerly PA 08-1 (Eff.

Oct. 1, 2008)Oct. 1, 2008): Created a diversionary : Created a diversionary program that combines behavioral health program that combines behavioral health treatment with probation supervision for treatment with probation supervision for defendants with psychiatric disabilities.defendants with psychiatric disabilities.

• PurposePurpose: To reduce the number of : To reduce the number of clients with psychiatric disabilities clients with psychiatric disabilities incarcerated or insufficiently served incarcerated or insufficiently served while aiding in recovery. while aiding in recovery.

Supervised Diversionary Supervised Diversionary ProgramProgram

• Modeled after CT’s Pre-trial Modeled after CT’s Pre-trial Accelerated Rehabilitation Program Accelerated Rehabilitation Program (AR)(AR)– Defendants charged with less serious Defendants charged with less serious

offenses can be diverted from prosecution offenses can be diverted from prosecution and a criminal recordand a criminal record

– Placed on probation supervision for a Placed on probation supervision for a maximum of two (2) yearsmaximum of two (2) years

– If the client completes supervision If the client completes supervision successfully, the case is dismissed.successfully, the case is dismissed.

SDP & ARSDP & AR• Supervised Diversionary Program Supervised Diversionary Program

(SDP)(SDP)– Unlimited period of probation supervisionUnlimited period of probation supervision– Can be granted twiceCan be granted twice– Can have a criminal record Can have a criminal record – Previous use of some diversionary programs Previous use of some diversionary programs

will not make you ineligible for the program will not make you ineligible for the program

• Pretrial Accelerated Rehabilitation Pretrial Accelerated Rehabilitation (AR)(AR)– Maximum 2 years of probation supervisionMaximum 2 years of probation supervision– Can be granted only onceCan be granted only once– Cannot have a criminal recordCannot have a criminal record– Previous use of some diversionary programs Previous use of some diversionary programs

can make you ineligible for ARcan make you ineligible for AR

Supervised Diversionary Supervised Diversionary ProgramProgram

• Psychiatric disability is defined in Psychiatric disability is defined in the statute as a mental or the statute as a mental or emotional condition, other than emotional condition, other than solely substance abuse, that has solely substance abuse, that has substantial adverse effects on the substantial adverse effects on the defendant’s ability to function and defendant’s ability to function and requires care and treatment.requires care and treatment.

Mental Health and Mental Health and IncarcerationIncarceration

• 758 unsentenced inmates (Mental Health 3’s)758 unsentenced inmates (Mental Health 3’s)

(Data received from Department of Correction (Data received from Department of Correction on 1/4/07)on 1/4/07)

• 157 unsentenced inmates (Mental Health 4’s)157 unsentenced inmates (Mental Health 4’s)

(Data received from Department of Correction (Data received from Department of Correction on 9/14/07) on 9/14/07)

EligibilityEligibility• Defendant must be amenable to treatment Defendant must be amenable to treatment

• Not more than 1 prior use of the SDP Not more than 1 prior use of the SDP

• Excluded charges are consistent with Excluded charges are consistent with provision set forth in 54-56e sub. (c), provision set forth in 54-56e sub. (c), Pretrial Accelerated Rehabilitation Pretrial Accelerated Rehabilitation

• Client found to have a psychiatric disability Client found to have a psychiatric disability who would benefit from treatment. who would benefit from treatment.

EligibilityEligibility

•Can have a prior criminal Can have a prior criminal recordrecord

•Proposal being submitted to Proposal being submitted to make the program length a make the program length a maximum of two yearsmaximum of two years

Referral ProcessReferral Process

• The mental health provider (ABH, Jail The mental health provider (ABH, Jail Diversion, or current provider) will Diversion, or current provider) will determine if the defendant has a determine if the defendant has a psychiatric disability requiring psychiatric disability requiring treatmenttreatment

• The provider will submit a The provider will submit a recommended plan for services to CSSD recommended plan for services to CSSD for all eligible clients for all eligible clients

• CSSD staff will supply the Court with CSSD staff will supply the Court with the plan for services.the plan for services.

•The client agrees to waive The client agrees to waive their right to a speedy trial.their right to a speedy trial.

•The client must agree to The client must agree to comply with the conditions of comply with the conditions of the program.the program.

Referral ProcessReferral Process(Continued)(Continued)

Probation OfficersProbation Officers• Clients will be supervised by a Clients will be supervised by a

specially trained probation officer who specially trained probation officer who has the appropriate training or has the appropriate training or previous experience. All the officers previous experience. All the officers have received specialized training from have received specialized training from NAMI, CABLE, DMHAS, and CSSDNAMI, CABLE, DMHAS, and CSSD

• All the officers have received a All the officers have received a modified 3 day CIT training modified 3 day CIT training

• Caseloads of 35 clientsCaseloads of 35 clients

Case DismissalCase Dismissal• The Judge will dismiss the case when the client The Judge will dismiss the case when the client

successfully completes their period of successfully completes their period of supervision.supervision.

• CSSD will provide the court with a report CSSD will provide the court with a report detailing the clients compliance with treatment detailing the clients compliance with treatment and all other court ordered conditions of and all other court ordered conditions of supervision.supervision.

• CSSD can return a client back to court early CSSD can return a client back to court early when the client has exhibited a pattern of non-when the client has exhibited a pattern of non-compliance with the treatment plan and special compliance with the treatment plan and special conditions.conditions.

BenefitsBenefits

•Diverts some clients from pre-Diverts some clients from pre-trial incarceration.trial incarceration.

• Improve treatment access and Improve treatment access and provide community supervision.provide community supervision.

•Expunged record can benefit Expunged record can benefit the client as they re-integrate the client as they re-integrate into the community.into the community.

CSSD Mandates per CSSD Mandates per CGSCGS

• CSSD has developed a database CSSD has developed a database concerning people admitted into the concerning people admitted into the program that is be available to local and program that is be available to local and state police when responding to incidents. state police when responding to incidents.

• The database needs to be maintained for 5 The database needs to be maintained for 5 years beginning at the person’s entry into years beginning at the person’s entry into the programthe program

• CSSD will keep all Police/Incident reports CSSD will keep all Police/Incident reports in the event that the court wants to review in the event that the court wants to review such when a defendant applies for a such when a defendant applies for a second time.second time.

GoalsGoals

•Keep the client in treatment in Keep the client in treatment in the communitythe community

•Promote and support recoveryPromote and support recovery•Link clients to appropriate Link clients to appropriate

community treatmentcommunity treatment•Enhance community safetyEnhance community safety•Eliminate some systems barriersEliminate some systems barriers

OUTCOMESOUTCOMES Supervised Diversionary ProgramSupervised Diversionary Program

Diversion program for individuals with Diversion program for individuals with psychiatric disabilities implemented in psychiatric disabilities implemented in October 2008:October 2008:

Program Investigations Program Investigations = = 658 658 (cases) (cases)

Granted Granted = = 336 (clients)336 (clients)

Active Clients Active Clients = = 351351

Successful Completions Successful Completions = = 26 26

Unsuccessful Completions = Unsuccessful Completions = 7 7 As of 4/10As of 4/10

QUESTIONSQUESTIONS??

Glossary of TermsGlossary of Terms(for this presentation)(for this presentation)

• CSSD- State agency that houses CSSD- State agency that houses probationprobation

• DMHAS- State agency for serving DMHAS- State agency for serving serious mentally ill CSSD- State serious mentally ill CSSD- State agency that houses probationagency that houses probation

• ABH- CSSD contracted providers- ABH- CSSD contracted providers- offer MH servicesoffer MH services

• AIC- CSSD contracted providersAIC- CSSD contracted providers• IAR- CSSD employeeIAR- CSSD employee

Brian CocoBrian Coco

•Work – (860) 721-2176Work – (860) 721-2176•Work cell- (860) 550-Work cell- (860) 550-58475847

•[email protected]@jud.ct.gov