Introduction to Jail Diversion

Jail Diversion
Together We Stand, Educating Our Vision for the Future!
Coastal Bend Rural Health Partnership
October 8-9, 2010
Texas A&M University – Kingsville, Texas
Gilbert R.Gonzales
Director, Communications and Diversion Initiatives
The Center for Health Care Services
www.chcsbc.org
http://www.diversioninitiatives.net

OVERVIEW
Define Jail Diversion
The Problem
Bexar County Safety Net
How the Program Works
The Benefits to you

Jail Diversion Mission Statement
To divert persons with mental
illness from inappropriate
Incarceration
What is Jail Diversion?
“Jail diversion" attempts to divert individuals with serious mental illness (and co-occurring substance use orders) that come into contact with the justice system and provide linkages to community-based treatment and support services.

CRAZYby Pete Earley
“Wherever I go, I take myself with me, and that always spoils it.”
Susan Sheeham

History of Mental Illness in America
Lobotomies were introduced in 1945 by sticking an ice pick into the frontal lobes of the brain. The invention received a Nobel Prize.

History of Mental Illness in America
Early 1800’s - A Reverend found an inmate in Boston Jail in a closet for 9 years. He had not broken any laws.
Historical treatment options included:
Electroshock (ECT)
Insulin injections
Metrazol (induced seizures)
Hydrotherapy
(wet sheets and continuous baths)
Fever therapy (injecting patients with disease in order to cause a fever)

“If you ask most people today where the mentally ill are in our society, they will tell you they’re in state mental hospitals. They’re wrong…they are in our jails and prisons.”Judge Steven Leifman Eleventh Judicial Circuit Miami, Florida

The Problem
The American Jail Association estimates that over 650,000 bookings each year involve persons with mental illness.
The national average in jail for this population is 16% and 64% arrested for public acts of bizarreness or non-violent minor charges.
Inmates with mental illness serve an average of 15 months longer for the same crime, compared to other prisoners.

“ If you’ve seen ONE jail diversion program,
you’ve seen ONE jail diversion program “

The Problem
Criminalization of Mentally Ill
Inappropriate Cost to Society
20% + in jail
Increase use of emergency rooms
Homelessness
Public Safety Net
Consumers at risk
Law Enforcement at risk
Public at risk

If No Programs Are In Place
Continued Increase/Overcrowding in Jail Population
Continued Increase/Overcrowding in Prison Population
Increased and Inappropriate
Use of Emergency Rooms

Collaboration: It’s an unnatural act between…
…two or more unconsenting adults.

A mouse, a cat and a dog.
http://www.youtube.com/watch?v=D85yrIgA4Nk

Strategies for Success
Don’t let them go to jail in the first place
Diversion in all appropriate settings
Set up:
Primary Diversion/Intervention
Pre booking services
Cross match of jail population
In jail screening/services
Secondary Diversion/Intervention
Post booking services
Intensive outpatient treatment for probation/parole (Genesis)
Residential MH services (MIOF)
Continuity of Care
Intensive ongoing case management
Timely updates to Judges
MH/Judicial joint staffing

How We Started
Community Partnership
The Jail Diversion Planning
& Advisory Committee
City of San Antonio
Bexar County
University Hospital District
Private Hospitals
San Antonio State Hospital
Law Enforcement
Criminal/Civil Courts
Advocacy – NAMI
Consumers
Mental Health Partners
The Jail Diversion Over-sight
Committee
Community Medical Directors
Roundtable
Private Sponsorship
Aztrazeneca

The Model
The Bexar County Jail Diversion Model is a comprehensive, coordinated delivery network which is tasked with identification, diversion from incarceration and treatment of the mentally ill for persons who are placed or who are about to be placed within the criminal justice system. The model is symptom based and is designed to cover 46 specific intervention points within the mental health/criminal justice system.

Judicial/Courts
Magistrate,
County,
District
Civil and Criminal
System Entry Points
County
City-wide
CIT/Law
Enforcement
Detention/Jail
Mental Health
Public and Private
Providers
Crisis Care Center
Psychiatric and
Medical
Clearance
Treatment
Continuity of Care
Police, Sheriff
Probation, Parole
Emergency
Services
Community
Data exchange through
Community Collaborative
Crisis Care Center
CIT/DMOT
Jail and Juvenile Detention
Statewide CARE Match
Dynamic
Information Exchange

The Diversion Process
Point of Contact with Law Enforcement
CIT/Deputy Mobile Outreach Team
Emergency Transport to Hospital
24/7 Crisis
Services
*Pre-Arrest Diversion
Referrals to Community Providers
Magistrate Court
Post-Booking Diversion
Arrested
Bexar County Jail
Community-based Wraparound Care
Pre-Trial Diversion
Genesis
Probation, Incarceration, Parole
Treatment in lieu of Incarceration
Residential Respite

Bexar County
Public Safety Net
Crisis Care
Center
Jail Diversion
Initiatives
The Restoration
Center

Crisis Care Center
Law Enforcement Services
24 / 7 Operations
Medical Clearance
Psychiatric Services
Administrator on Call

C I T
The Crisis Intervention Teams (CIT) – Officers trained by Law Enforcement and Mental Health Personnel via a 40 hour curriculum including role play demonstrations. Attends weekly operational
meetings with MH and Community Stakeholders.

Jail Diversion Initiatives
Pre-Trial Services
Mental Health Bond
Involuntary Outpatient
Commitment
Genesis – Manos Programs
Parole & Probation Referrals
MIOF Program
Intensive 90 day
residential probation
Court Ordered Program
Palo Alto
Forensic ACT Team
24/7 Intensive psychiatric services

Show me the DATA !!!

Impact on WAIT TIME
for LAW ENFORCEMENT
Now
The wait time for Medical Clearance/ Screening at the Crisis Care Center is 45 minutes.
Wait time for Medical Clearance/Screening and Psychiatric Evaluation is 60-65 minutes.
Then(prior to Sept 2005)
Wait times for Medical
Clearance/ Screening at
UHS ER - 9 hours, 18 min.
Wait times for Medical
Clearance/ Screening and Psychiatric Evaluation was between 12 and 14 hours.

Emergency Room Utilization (Medical Clearance)
Emergency Room utilization has dropped 40% since the inception of the Crisis Care Center.
40% of (7619 total seen at CCC) 3048
Persons diverted from the ER (in 2006 first year) X $1545
Cost Savings relative to ER Utilization $4,709,160
Source: Jean R. Setzer, Ph.D., University Health System

Combined CCC and Restoration Documented and Immediate Cost Avoidance

BENEFITS OF JAIL DIVERSION
Decriminalization of persons with mental illness
Overrepresentation of people with mental illness
in the criminal
justice system is addressed
Reduced hospitalization
Increased public safety
Reduction of inappropriate incarceration of persons with
mental illness
Length of stay in jail is shortened in lieu of increased access
to treatment
Greater efficiency in the use of law enforcement
Violence and victimization is reduced
Costs incurred by taxpayers when a person with mental
illness is arrested, incarcerated, and/or hospitalized is
addressed

Thank you !
www.chcsbc.org
Leon Evans, Executive Director
The Center for Health Care Services
San Antonio, Texas
For additional information please contact: Gilbert Gonzales
Email: ggonzales@chcsbc.org
Blog http://www.diversioninitiatives.net

Introduction to Jail Diversion

by Gilbert Gonzales on Oct 08, 2010

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Introduction to Jail Diversion — Presentation Transcript