Introduction to Jail Diversion


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Introduction to Jail Diversion

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Introduction to Jail Diversion

  1. 1. Jail Diversion<br />Together We Stand, Educating Our Vision for the Future!<br />Coastal Bend Rural Health Partnership<br />October 8-9, 2010<br />Texas A&M University – Kingsville, Texas<br />Gilbert R.Gonzales<br />Director, Communications and Diversion Initiatives<br />The Center for Health Care Services<br /><br /><br />
  2. 2. OVERVIEW<br /><ul><li>Define Jail Diversion
  3. 3. The Problem
  4. 4. Bexar County Safety Net
  5. 5. How the Program Works
  6. 6. The Benefits to you</li></li></ul><li>Jail Diversion Mission Statement<br />To divert persons with mental<br /> illness from inappropriate<br /> Incarceration<br />What is Jail Diversion?<br />“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.<br />
  7. 7. CRAZYby Pete Earley<br />“Wherever I go, I take myself with me, and that always spoils it.”<br /> Susan Sheeham<br />
  8. 8. History of Mental Illness in America<br />Lobotomies were introduced in 1945 by sticking an ice pick into the frontal lobes of the brain. The invention received a Nobel Prize.<br />
  9. 9. History of Mental Illness in America<br />Early 1800’s - A Reverend found an inmate in Boston Jail in a closet for 9 years. He had not broken any laws.<br />Historical treatment options included:<br />Electroshock (ECT)<br />Insulin injections<br />Metrazol (induced seizures)<br />Hydrotherapy <br /> (wet sheets and continuous baths)<br />Fever therapy (injecting patients with disease in order to cause a fever)<br />
  10. 10. “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 <br />
  11. 11. The Problem<br />The American Jail Association estimates that over 650,000 bookings each year involve persons with mental illness.<br />The national average in jail for this population is 16% and 64% arrested for public acts of bizarreness or non-violent minor charges.<br />Inmates with mental illness serve an average of 15 months longer for the same crime, compared to other prisoners.<br />
  12. 12. “ If you’ve seen ONE jail diversion program,<br /> you’ve seen ONE jail diversion program “<br />
  13. 13. The Problem<br />Criminalization of Mentally Ill<br />Inappropriate Cost to Society<br />20% + in jail<br />Increase use of emergency rooms<br />Homelessness<br />Public Safety Net<br />Consumers at risk<br />Law Enforcement at risk<br />Public at risk<br />
  14. 14. If No Programs Are In Place<br />Continued Increase/Overcrowding in Jail Population<br />Continued Increase/Overcrowding in Prison Population<br />Increased and Inappropriate <br /> Use of Emergency Rooms<br />
  15. 15. Collaboration: It’s an unnatural act between…<br />…two or more unconsenting adults.<br />
  16. 16. A mouse, a cat and a dog.<br /><br />
  17. 17. Strategies for Success<br />Don’t let them go to jail in the first place<br />Diversion in all appropriate settings<br />Set up:<br />Primary Diversion/Intervention<br />Pre booking services<br />Cross match of jail population<br />In jail screening/services<br />Secondary Diversion/Intervention<br />Post booking services<br />Intensive outpatient treatment for probation/parole (Genesis)<br />Residential MH services (MIOF)<br />Continuity of Care<br />Intensive ongoing case management<br />Timely updates to Judges<br />MH/Judicial joint staffing<br />
  18. 18. How We Started<br />Community Partnership<br />The Jail Diversion Planning <br />& Advisory Committee<br />City of San Antonio <br />Bexar County<br />University Hospital District <br />Private Hospitals<br />San Antonio State Hospital<br />Law Enforcement<br />Criminal/Civil Courts<br />Advocacy – NAMI<br />Consumers<br />Mental Health Partners<br />The Jail Diversion Over-sight<br />Committee<br />Community Medical Directors <br />Roundtable<br />Private Sponsorship<br />Aztrazeneca<br />
  19. 19. The Model<br />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.<br />
  20. 20. Judicial/Courts<br />Magistrate, <br />County, <br />District<br /> Civil and Criminal<br />System Entry Points<br />County<br />City-wide<br />CIT/Law <br />Enforcement<br />Detention/Jail<br />Mental Health<br />Public and Private<br />Providers<br />Crisis Care Center<br />Psychiatric and<br /> Medical<br />Clearance<br />Treatment<br />Continuity of Care<br />Police, Sheriff<br />Probation, Parole<br />Emergency<br />Services<br />Community<br />Data exchange through<br /><ul><li> Community Collaborative
  21. 21. Crisis Care Center
  22. 22. CIT/DMOT
  23. 23. Jail and Juvenile Detention
  24. 24. Statewide CARE Match</li></ul>Dynamic<br />Information Exchange<br />
  25. 25. The Diversion Process<br />Point of Contact with Law Enforcement<br />CIT/Deputy Mobile Outreach Team<br />Emergency Transport to Hospital<br />24/7 Crisis<br />Services<br />*Pre-Arrest Diversion<br />Referrals to Community Providers<br />Magistrate Court<br />Post-Booking Diversion<br />Arrested<br />Bexar County Jail<br />Community-based Wraparound Care<br />Pre-Trial Diversion<br />Genesis<br />Probation, Incarceration, Parole<br />Treatment in lieu of Incarceration<br />Residential Respite<br />
  26. 26. Bexar County<br />Public Safety Net<br />Crisis Care <br />Center<br />Jail Diversion <br />Initiatives<br />The Restoration <br />Center<br />
  27. 27.
  28. 28. Crisis Care Center<br />Law Enforcement Services<br /><ul><li> 24 / 7 Operations
  29. 29. Medical Clearance
  30. 30. Psychiatric Services
  31. 31. Administrator on Call</li></li></ul><li>C I T<br />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<br /> meetings with MH and Community Stakeholders.<br />
  32. 32.
  33. 33.
  34. 34. Jail Diversion Initiatives <br />Pre-Trial Services<br />Mental Health Bond<br />Involuntary Outpatient <br />Commitment<br />Genesis – Manos Programs <br />Parole & Probation Referrals<br />MIOF Program<br />Intensive 90 day <br />residential probation<br /> Court Ordered Program<br />Palo Alto <br />Forensic ACT Team<br />24/7 Intensive psychiatric services<br />
  35. 35. Show me the DATA !!!<br />
  36. 36. Impact on WAIT TIME <br />for LAW ENFORCEMENT<br />Now<br /><ul><li>The wait time for Medical Clearance/ Screening at the Crisis Care Center is 45 minutes.
  37. 37. Wait time for Medical Clearance/Screening and Psychiatric Evaluation is 60-65 minutes.</li></ul>Then(prior to Sept 2005)<br /><ul><li>Wait times for Medical </li></ul> Clearance/ Screening at <br /> UHS ER - 9 hours, 18 min.<br /><ul><li>Wait times for Medical </li></ul> Clearance/ Screening and Psychiatric Evaluation was between 12 and 14 hours.<br />
  38. 38. Emergency Room Utilization (Medical Clearance)<br />Emergency Room utilization has dropped 40% since the inception of the Crisis Care Center.<br />40% of (7619 total seen at CCC) 3048 <br />Persons diverted from the ER (in 2006 first year) X $1545<br />Cost Savings relative to ER Utilization $4,709,160<br />Source: Jean R. Setzer, Ph.D., University Health System<br />
  39. 39. Combined CCC and Restoration Documented and Immediate Cost Avoidance<br />
  40. 40. BENEFITS OF JAIL DIVERSION <br /><ul><li> Decriminalization of persons with mental illness
  41. 41. Overrepresentation of people with mental illness </li></ul> in the criminal <br /> justice system is addressed<br /><ul><li> Reduced hospitalization
  42. 42. Increased public safety
  43. 43. Reduction of inappropriate incarceration of persons with </li></ul> mental illness<br /><ul><li> Length of stay in jail is shortened in lieu of increased access </li></ul> to treatment<br /><ul><li> Greater efficiency in the use of law enforcement
  44. 44. Violence and victimization is reduced
  45. 45. Costs incurred by taxpayers when a person with mental </li></ul> illness is arrested, incarcerated, and/or hospitalized is <br /> addressed<br />
  46. 46. Thank you !<br /><br />Leon Evans, Executive Director<br />The Center for Health Care Services <br />San Antonio, Texas<br />For additional information please contact: Gilbert Gonzales<br />Email:<br />Blog<br />