Reaching Beyond CIT


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Presented by: Mark Giuliano, MSW
Director of Community Support

Published in: Health & Medicine
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  • Trainer Note: Direct participants to a copy of this map in the materials packet; it is a National GAINS Center brochure Briefly describe ACTION : Cross-Systems Mapping Direct participants to the program description
  • Reaching Beyond CIT

    1. 1. Westchester County – New York State Police Mental Health Outreach and Coordination
    2. 2. Westchester County Department of Community Mental Health <ul><li>Mark Giuliano, MSW </li></ul><ul><ul><li>Director of Community Support </li></ul></ul><ul><ul><li>(914) 995-5239 </li></ul></ul><ul><ul><li>[email_address] </li></ul></ul>
    3. 4. Westchester County, New York Population: 940,807
    4. 5. People with Mental Illness in the Justice System <ul><li>We recognize that there is an over-representation of people with mental illness in the justice system </li></ul><ul><ul><li>5.4% of the general population have mental illness </li></ul></ul><ul><ul><li>Approximately 16% of people in correctional settings, including community corrections have a mental illness </li></ul></ul>
    5. 6. Ultimately… <ul><li>Westchester County would like to change the mental health crisis in our community from a challenge for law enforcement to a pro-active response from the mental health system. </li></ul>
    6. 7. Parole COMMUNITY COMMUNITY Probation Arrest Specialty Court Prison Jail— Sentenced Local Law Enforcement Initial Detention First Appearance Court Jail—Pretrial Dispositional Court Intercept 1 Law Enforcement Emergency Services Intercept 2 Initial Detention Initial Court Hearing Intercept 3 Jails/Court Intercept 4 Re-Entry Intercept 5 Community Corrections Intercept 1 White Plains and Yonkers Police Outreach WMC Crisis Team Intercept 2 Inmate Mental Health Data Exchange Intercept 3 CMHS Mental Health Court MHATI Intercept 4 Probation MHU Transitional Services Medication Grant Intercept 5 Forensic SCM Homeless Outreach Care Coordination
    7. 8. Origins of CIT in Westchester <ul><li>Tragedy </li></ul><ul><ul><ul><li>Grant Incident </li></ul></ul></ul><ul><ul><ul><li>Ridley Incident </li></ul></ul></ul><ul><li>Politics </li></ul><ul><ul><ul><li>Homelessness </li></ul></ul></ul><ul><ul><ul><li>Revitalization </li></ul></ul></ul>
    8. 9. POLICE MENTAL HEALTH OUTREACH <ul><li>The Westchester County Department of Community Mental Health has developed collaborative partnerships with the City of White Plains Office of Public Safety and City of Yonkers Police Department to intervene in the lives of people who may be considered emotionally disturbed. </li></ul><ul><li>The core elements of intervention promote both officer safety and the safety of people in crisis and include: </li></ul><ul><ul><li>Law enforcement training </li></ul></ul><ul><ul><li>Partnership with mental health resources </li></ul></ul><ul><ul><li>A new role for law enforcement officers as well as mental health professionals </li></ul></ul>
    9. 10. Goals of Collaboration <ul><li>The goals that we’ve informally established in our collaborative efforts include: </li></ul><ul><ul><li>Increase community safety </li></ul></ul><ul><ul><li>Increase officer safety </li></ul></ul><ul><ul><li>Increase safety for people in crisis </li></ul></ul><ul><ul><li>Recovery for people with mental illness </li></ul></ul>
    10. 11. Training <ul><li>All recruits receive 16 hours of training on working with people in emotional crisis at the academy level </li></ul><ul><li>Supervisors receive a 6 hour block on working with people in emotional crisis and law enforcement suicide </li></ul><ul><li>We offer 4-8 hour blocks of in-service training </li></ul><ul><li>We have held Regional CIT Academies for the Hudson Valley Region </li></ul>
    11. 12. White Plains and Yonkers Police Departments <ul><li>In the City of White Plains, over 30% of the officers have received CIT training. There are CIT Officers available 24 hours per day 7 days a week </li></ul><ul><li>In the City of Yonkers…we are working on it… </li></ul><ul><ul><li>The primary focus in Yonkers has been in the 4 th Precinct </li></ul></ul>
    12. 13. Partnership with Mental Health Resources <ul><li>There has been a partnership with the local mental health resources in the community </li></ul><ul><li>Westchester County DCMH has also placed a clinician into these two Police Departments. Both… </li></ul><ul><ul><li>Are placed into the Community Policing Divisions of the respective Departments and provide assertive follow up on EDP calls </li></ul></ul><ul><ul><li>Can co-respond in calls which involve a mental health component as appropriate </li></ul></ul>
    13. 15. Mental Health Service Access <ul><li>Westchester County uses a Single Point of Access in the provision of many non-emergent mental health services </li></ul><ul><ul><li>Housing </li></ul></ul><ul><ul><li>Case management </li></ul></ul><ul><ul><li>Assertive Community Treatment </li></ul></ul><ul><ul><li>Assisted Outpatient Treatment </li></ul></ul>
    14. 16. Homeless Subjects as “Suspects” 2006 – 499 2007 – 401 2008 – 252
    15. 17. Calls for Service Involving Emotionally Disturbed Persons 2006 – 299 calls 2007 – 279 calls 2008 – 281 calls
    16. 18. Resisting Arrest Charge for Emotionally Disturbed Persons: 2006 – 6 arrest 2007 – 1 arrest 2008 – 1 arrest
    17. 19. Mental Health Outreach Contacts and Referrals 2006 – 60 2007 – 126 2008 - 225
    18. 22. <ul><li>Harvey, a 50 year old man that has a significant history of mental illness and substance use, had a continuous pattern of homelessness and incarceration since for many years. </li></ul><ul><ul><li>He has had over 56 contacts with police and 46 incarcerations </li></ul></ul><ul><ul><li>Intervention was provided to Harvey through our Police Mental Health Outreach program.  </li></ul></ul><ul><ul><li>Due to his frequency of police contact he was enrolled in the Care Coordination program. Prior to this intervention his services were fragmented and often offered in an emergent fashion. </li></ul></ul><ul><ul><li>In the first year of his participation in Care Coordination the frequency of his police contact diminished and over the past 10 months he has been arrest free. </li></ul></ul>Who are we talking about?
    19. 23. Complex Care Coordination <ul><li>Care Coordination was developed to address the needs of people with mental illness and co-occurring disorders that are high end users of service. </li></ul><ul><ul><li>Frequent contacts with emergency services </li></ul></ul><ul><ul><li>Frequent contacts the criminal justice system </li></ul></ul><ul><ul><li>Long term inpatient psychiatric care </li></ul></ul><ul><li>Participants in Care Coordination receive: </li></ul><ul><ul><li>ICM level of intervention </li></ul></ul><ul><ul><li>Self Determination funding to purchase non-traditional items to support their recovery. </li></ul></ul><ul><ul><li>Recovery Mentor to help support their recovery. </li></ul></ul>
    20. 24. The Traditional Approach to Behavioral Health <ul><li>Self-determination comes after individuals have successfully used treatment and achieved clinical stability </li></ul><ul><li>Compliance is valued </li></ul><ul><li>Only professionals have access to information (plans, assessments, records, etc.) </li></ul><ul><li>Disabilities and deficits drive treatment; Focus is on illness </li></ul><ul><li>Low expectation </li></ul><ul><li>Clinical stability or managing illness </li></ul><ul><li>Linear progress and movement through an established continuum of services </li></ul><ul><li>Professional services only </li></ul><ul><li>Facility-based settings and professional supporters </li></ul><ul><li>Avoidance of risk; protection of person and community </li></ul>
    21. 25. Person Centered Approach towards Behavioral Health <ul><li>Self-determination and community inclusion are fundamental human rights of all people </li></ul><ul><li>Active participation and empowerment is vital </li></ul><ul><li>All parties have full access to the same information – often referred to as “transparency.” </li></ul><ul><li>Abilities/choices define supports; Wellness/health focus </li></ul><ul><li>High expectations </li></ul>
    22. 26. Person Centered Approach towards Behavioral Health <ul><li>Quality of life and promotion of recovery </li></ul><ul><li>Person’s chooses from a flexible array of supports and/or creates new support options with team </li></ul><ul><li>Diverse supports (professional services, non-traditional services, and natural supports) </li></ul><ul><li>Integrated settings and natural supporters are also valued </li></ul><ul><li>Responsible risk taking and growth </li></ul>
    23. 27. Traditional Treatment and The Person Centered Approach <ul><li>Recovery for “Them” </li></ul><ul><li>Compliance with treatment </li></ul><ul><li>Decreased symptoms </li></ul><ul><li>Stability </li></ul><ul><li>Better judgment </li></ul><ul><li>Increased Insight…Accepts illness </li></ul><ul><li>Follows team’s recommendations </li></ul><ul><li>Decreased hospitalization </li></ul><ul><li>Abstinent </li></ul><ul><li>Motivated </li></ul><ul><li>Increased functioning </li></ul><ul><li>Residential Stability </li></ul><ul><li>Use services regularly/engagement </li></ul><ul><li>Cognitive functioning </li></ul><ul><li>Realistic expectations </li></ul><ul><li>Attends the job program/clubhouse, etc. </li></ul><ul><li>Wellness for “Us” </li></ul><ul><li>A home to call my own </li></ul><ul><li>Life worth living </li></ul><ul><li>A spiritual connection to God/others/self </li></ul><ul><li>A real job, financial independence </li></ul><ul><li>Being a good mom, dad, daughter </li></ul><ul><li>Friends </li></ul><ul><li>Fun </li></ul><ul><li>Nature </li></ul><ul><li>Music </li></ul><ul><li>Pets </li></ul><ul><li>Love…intimacy…sex </li></ul><ul><li>Having hope for the future </li></ul><ul><li>Joy </li></ul><ul><li>Giving back…being needed </li></ul><ul><li>Learning </li></ul><ul><li>Recovery </li></ul>
    24. 32. Questions?