Therapeutic Justice Model: The Integration of  Treatment and Justice   Presentation for the APPA Winter Training Institute...
Therapeutic Justice Model: The Integration of  Treatment and Justice  “Therapeutic Justice is defined as a systemic approa...
 
Collaboration Integration Restoration Transformation
The Problem
www.consensusproject.org Intercept Points <ul><li>Chapter IV: Incarceration and Reentry </li></ul><ul><ul><li>Introduction...
Collaboration:  It’s an unnatural act between… … two or more unconsenting adults .
Graphic by Seth Godin Sheriff’s Office SAPD CHCS Metro Health University Health System Adult Probation EMS CPS APS SASH NA...
Point of Contact with Law Enforcement Magistrate Court Bexar County Jail Post-Booking Diversion Community-based Wraparound...
Law Enforcement Detention/Jail CIT Judicial/Courts Magistrate, County, District Mental Health Public and Private Providers...
Mental Health  Forensic Flow a work in progress… Circa 2010,
Restoration Center <ul><li>Public Safety Triage  </li></ul><ul><li>Detox Facility </li></ul><ul><li>Outpatient Substance  ...
<ul><li>The patients served by the Center and by the local Hospital District (UHS) are the same individuals </li></ul><ul>...
New Generation Medication Program <ul><li>Contract with UHS initiated in 2002 </li></ul><ul><li>CareLink Patients NGM Cost...
The Crisis Care Center Psychiatric Screening Minor Medical Clearance 24/7 Access for Law Enforcement Circa 2005
<ul><li>Then   (prior to Sept 2005) </li></ul><ul><li>Wait times for Medical  </li></ul><ul><li>Clearance/ Screening at  <...
Public Safety Triage  Facility Restoration Center Grand Opening April 15 th , 2008 <ul><li>Detox Facility </li></ul><ul><l...
“ The immediate availability of detoxification  services is priceless…. ”   “ Providing treatment to those who  desperatel...
Therapeutic Justice Service Array
GI Forum Veterans Residential 1,000
 
Show me the DATA !!!
Forensic and Civil Court Programs 1.  Outpatient Competency Restoration   2.  Forensic Outpatient Commitments   3. Mental ...
Haven for Hope <ul><li>To increase the community capacity for mental health, substance abuse and detoxification services <...
Veteran’s  Services <ul><li>Multiple Collaboratives/Initiatives for Veterans based in Bexar County   </li></ul><ul><ul><ul...
Toolkit
Alternatives to Incarceration <ul><li>Crisis Care Center and Restoration Center </li></ul><ul><li>Involuntary Outpatient  ...
For additional information online <ul><li>Copies of this presentation and additional data on diversion initiatives can be ...
CIT SAVE THE DATE First International CIT Conference (Formerly the National CIT Conference) June 1 - 3, 2010 On site regis...
Gracias ! For Additional Information on this presentation please contact: Leon Evans, President and Chief Executive Office...
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Probation Parole Appa Jan Feb2010

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  • I am locked up in the Gwinnett County Detention Center and I'm a disable war veteran. The unnecessary torture perpetrated by deputies is evident that they are ignorant to the plight of mentally disable veterans. I suffer from PTSD, Bi Polar Disorder and Gulf War Syndrome. The only illness being treated by the jail is my Bi-Polar. I have a mental health counselor, who to this day I have only seen twice. I have been here since Dec. 27, 2011. Her name is Ms. Atkin.

    December 30, 2011 night watch officer Deputy Hartman kicks my food trap door closed startling me out of my sleep. I explained my medical condition and the lack of circulating air inside the cell when the trap door is closed. Hartman responded, 'Ican do what I want on my shift' I suffered torture and excessive use of force at the hands of their CERT or RTO team. I don't know which is which because they come 8 to 9 deep wearing Kevlar helmets and masks. I didn't resist but SGT. Augarillo broke protocol by taking the video camera from Deputy Hartman and entered the cell with it ( I'm naked because it is a strip cell) and stuck her fingers up my nose so I couldn't breath. I tried to prevent this hideous act but I was out numbered. I was placed in a restraint chair. I was strapped in so tight I could hardly breathe. I'm naked the whole time. Along with the straps I was handcuffed to the chair, hands pulled down below the bottom of the seat and my feet are shackled by leg irons; I still suffer scars. This is the same chair that made headline years ago when pictures of U.S. soldiers was posted showing them torturing, Iraqi prisoners at Abu Gharib prison in Iraq! Once I was strapped and handcuffed to the chair I was then pushed down to the shower and locked in for close to 5 hours. The temp. was between and 35 & 40 degrees. I was fed last, made to urinate on myself and naked. I'm a Gulf War Veteran with a mental disorder treated as if I'm in a 3rd world country.

    Words from Kelvin Barefield, currently in the Gwinnett County Detention Center.
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Probation Parole Appa Jan Feb2010

  1. 1. Therapeutic Justice Model: The Integration of Treatment and Justice Presentation for the APPA Winter Training Institute Austin, Texas Jan 31-Feb 3, 2010 Gilbert Gonzales Director, Communications and Diversion Initiatives The Center for Health Care Services Mental Health and Substance Abuse Authority Bexar County San Antonio, Texas [email_address] www.chcsbc.org Linda Tavel Director, Criminal Justice Substance Abuse Services Mental Health and Substance Abuse Authority Bexar County The Center for Health Care Services [email_address] www.chcsbc.org
  2. 2. Therapeutic Justice Model: The Integration of Treatment and Justice “Therapeutic Justice is defined as a systemic approach which insures a collaborative partnership between the Courts, the Criminal Justice System and the Behavioral Health system while providing that the public safety net is able to provide for the most efficient and effective support for persons who are in crisis and or are experiencing psychiatric and substance abuse disorders.” Leon Evans, President and CEO, CHCS Bexar County Mental Health Authority
  3. 4. Collaboration Integration Restoration Transformation
  4. 5. The Problem
  5. 6. www.consensusproject.org Intercept Points <ul><li>Chapter IV: Incarceration and Reentry </li></ul><ul><ul><li>Introduction: Incarceration and Reentry </li></ul></ul><ul><ul><li>Policy Statement 17: Receiving and Intake of Sentenced Inmates </li></ul></ul><ul><ul><li>Policy Statement 18: Development of Treatment Plans, Assignment to Programs, and Classification / Housing Decisions </li></ul></ul><ul><ul><li>Policy Statement 19: Subsequent Referral for Screening and Mental Health Evaluation </li></ul></ul><ul><ul><li>Policy Statement 20: Release Decision </li></ul></ul><ul><ul><li>Policy Statement 21: Development of Transition Plan </li></ul></ul><ul><ul><li>Policy Statement 22: Modification of Conditions of Supervised Release </li></ul></ul><ul><ul><li>Policy Statement 23: Maintaining Contact Between Individual and Mental Health System </li></ul></ul><ul><li>Chapter V: Improving Collaboration </li></ul><ul><ul><li>Introduction: Improving Collaboration </li></ul></ul><ul><ul><li>Policy Statement 24: Obtaining and Sharing Resources </li></ul></ul><ul><ul><li>Policy Statement 25: Sharing Information </li></ul></ul><ul><ul><li>Policy Statement 26: Institutionalizing the Partnership </li></ul></ul><ul><li>Chapter VI: Training Practioners and Policymakers and Educating the Community </li></ul><ul><ul><li>Introduction: Training Practitioners and Policymakers and Educating the Community </li></ul></ul><ul><ul><li>Policy Statement 27: Determining Training Goals and Objectives </li></ul></ul><ul><ul><li>Policy Statement 28: Training for Law Enforcement Personnel </li></ul></ul><ul><ul><li>Policy Statement 29: Training for Courts Personnel </li></ul></ul><ul><ul><li>Policy Statement 30: Training for Corrections Personnel </li></ul></ul><ul><ul><li>Policy Statement 31: Training for Mental Health Professionals </li></ul></ul><ul><ul><li>Policy Statement 32: Educating the Community and Building Community Awareness </li></ul></ul><ul><ul><li>Policy Statement 33: Identifying Trainers </li></ul></ul><ul><ul><li>Policy Statement 34: Evaluating Trainers </li></ul></ul><ul><li>Chapter VII: Elements of an Effective Mental Health System </li></ul><ul><ul><li>Introduction: Elements of an Effective Mental Health System </li></ul></ul><ul><ul><li>Policy Statement 35: Evidence-Based Practices </li></ul></ul><ul><ul><li>Policy Statement 36: Integration of Services </li></ul></ul><ul><ul><li>Policy Statement 37: Co-Occuring Disorders </li></ul></ul><ul><ul><li>Policy Statement 38: Housing for People with Mental Illness </li></ul></ul><ul><ul><li>Policy Statement 39: Consumer and Family Member Involvement </li></ul></ul><ul><ul><li>Policy Statement 40: Cultural Competency </li></ul></ul><ul><ul><li>Policy Statement 41: Mental Health Workforce </li></ul></ul><ul><ul><li>Policy Statement 42: Accountability </li></ul></ul><ul><ul><li>Policy Statement 43: Advocacy </li></ul></ul><ul><li>Chapter VIII: Measuring and Evaluating Outcomes </li></ul><ul><ul><li>Introduction: Measuring and Evaluating Outcomes </li></ul></ul><ul><ul><li>Policy Statement 44: Identifying Outcome Measures </li></ul></ul><ul><ul><li>Policy Statement 45: Collecting Data </li></ul></ul><ul><ul><li>Policy Statement 46: Disseminating Findings </li></ul></ul><ul><li>Chapter I: Involvement with the Mental Health System </li></ul><ul><ul><li>Introduction: Involvement with the Mental Health System </li></ul></ul><ul><ul><li>Policy Statement 1: Access to Effective Mental Health Services </li></ul></ul><ul><li>Chapter II: Contact with Law Enforcement </li></ul><ul><ul><li>Introduction: Contact with Law Enforcement </li></ul></ul><ul><ul><li>Policy Statement 2: Request for Police Service </li></ul></ul><ul><ul><li>Policy Statement 3: On-Scene Assessment </li></ul></ul><ul><ul><li>Policy Statement 4: On-Scene Response </li></ul></ul><ul><ul><li>Policy Statement 5: Incident Documentation </li></ul></ul><ul><ul><li>Policy Statement 6: Police Response Evaluation </li></ul></ul><ul><ul><li>Conclusion: Contact with Law Enforcement </li></ul></ul><ul><li>Chapter III: Pretrial Issues, Adjudication, and Sentencing </li></ul><ul><ul><li>Introduction: Pretrial Issues, Adjudication and Sentencing </li></ul></ul><ul><ul><li>Policy Statement 7: Appointment of Counsel </li></ul></ul><ul><ul><li>Policy Statement 8: Consultation with Victim </li></ul></ul><ul><ul><li>Policy Statement 9: Prosecutorial Review of Charges </li></ul></ul><ul><ul><li>Policy Statement 10: Modification of Pretrial Diversion Conditions </li></ul></ul><ul><ul><li>Policy Statement 11: Pretrial Release / Detention Hearing </li></ul></ul><ul><ul><li>Policy Statement 12: Modification of Pretrial Release Conditions </li></ul></ul><ul><ul><li>Policy Statement 13: Intake at County / Municipal Detention Facility </li></ul></ul><ul><ul><li>Policy Statement 14: Adjudication </li></ul></ul><ul><ul><li>Policy Statement 15: Sentencing </li></ul></ul><ul><ul><li>Policy Statement 16: Modification of Conditions of Probation / Supervised Release </li></ul></ul><ul><ul><li>Conclusion </li></ul></ul>
  6. 7. Collaboration: It’s an unnatural act between… … two or more unconsenting adults .
  7. 8. Graphic by Seth Godin Sheriff’s Office SAPD CHCS Metro Health University Health System Adult Probation EMS CPS APS SASH NAMI FIRE DA County Judge Area Hospitals University of Texas Criminal Justice Veterans Administration Pre Trial Services GI Forum DSHS Consumers And Families Magistration Facility City of San Antonio Bexar County Commissioner’s Court Law Enforcement Mental Health Partners Medical Directors Roundtable Children's Diversion Collaborative Juvenile Probation Criminal Courts Probate Courts Texas A&M DAPA SAMM Ministries Patrician Movement Connecting Community Leveraging Outcomes
  8. 9. Point of Contact with Law Enforcement Magistrate Court Bexar County Jail Post-Booking Diversion Community-based Wraparound Care CIT/Deputy Mobile Outreach Team Genesis Probation, Incarceration, Parole Emergency Transport to Hospital Pre-Trial Diversion Referrals to Community Providers *Pre-Arrest Diversion Residential Respite Arrested The Diversion Process Treatment in lieu of Incarceration 24/7 Crisis Services Circa 2002
  9. 10. Law Enforcement Detention/Jail CIT Judicial/Courts Magistrate, County, District Mental Health Public and Private Providers Crisis Care Center Jail Diversion Psychiatric and Medical Clearance Specialty Offender Services Community Dynamic Crisis Jail Diversion Information Exchange Police, Sheriff Probation, Parole Civil and Criminal Treatment Continuity of Care County City-wide Emergency Services <ul><li>Data exchange through </li></ul><ul><li>Community Collaborative </li></ul><ul><li>Crisis Care Center </li></ul><ul><li>CIT/DMOT </li></ul><ul><li>Jail and Juvenile Detention </li></ul><ul><li>Statewide CARE Match </li></ul>System County City-wide Entry Points System Level Circa 2006
  10. 11. Mental Health Forensic Flow a work in progress… Circa 2010,
  11. 12. Restoration Center <ul><li>Public Safety Triage </li></ul><ul><li>Detox Facility </li></ul><ul><li>Outpatient Substance </li></ul><ul><li>Abuse Services </li></ul><ul><li>Community Court </li></ul>
  12. 13. <ul><li>The patients served by the Center and by the local Hospital District (UHS) are the same individuals </li></ul><ul><li>We combine functions to integrate care for these individuals </li></ul><ul><li>Functional integration is the foundation of the best healthcare possible for the people we both serve </li></ul>Behavioral Healthcare Integration with Primary and Specialty Medical Care
  13. 14. New Generation Medication Program <ul><li>Contract with UHS initiated in 2002 </li></ul><ul><li>CareLink Patients NGM Cost paid by CHCS with General Revenue </li></ul><ul><li>CareLink Patients other Medication costs borne by UHS </li></ul><ul><li>Savings to CHCS of between $2.4 & $2.6 million </li></ul><ul><li>Savings funded the Crisis Services and Jail Diversion Initiative </li></ul>
  14. 15. The Crisis Care Center Psychiatric Screening Minor Medical Clearance 24/7 Access for Law Enforcement Circa 2005
  15. 16. <ul><li>Then (prior to Sept 2005) </li></ul><ul><li>Wait times for Medical </li></ul><ul><li>Clearance/ Screening at </li></ul><ul><li>UHS ER - 9 hours, 18 min. </li></ul><ul><li>Wait times for Medical </li></ul><ul><li>Clearance/ Screening and Psychiatric Evaluation was between 12 and 14 hours. </li></ul><ul><li>Now </li></ul><ul><li>The wait time for Medical Clearance/ Screening at the Crisis Care Center is 45 minutes. </li></ul><ul><li>Wait time for Medical Clearance/Screening and Psychiatric Evaluation is 60-65 minutes. </li></ul>Impact on WAIT TIME for LAW ENFORCEMENT
  16. 17. Public Safety Triage Facility Restoration Center Grand Opening April 15 th , 2008 <ul><li>Detox Facility </li></ul><ul><li>Community Court </li></ul><ul><li>Outpatient Substance </li></ul><ul><li>Abuse Services </li></ul>Circa 2008
  17. 18. “ The immediate availability of detoxification services is priceless…. ” “ Providing treatment to those who desperately need help will save taxpayers millions of dollars over the long run. ”   Gloria Padilla, Express News 9/13/2008 San Antonio Express News
  18. 19. Therapeutic Justice Service Array
  19. 20. GI Forum Veterans Residential 1,000
  20. 22. Show me the DATA !!!
  21. 23. Forensic and Civil Court Programs 1. Outpatient Competency Restoration 2. Forensic Outpatient Commitments 3. Mental Health Court 4. Drug Court 5. Civil – Involuntary Outpatient Commitment
  22. 24. Haven for Hope <ul><li>To increase the community capacity for mental health, substance abuse and detoxification services </li></ul>The Community Wide Initiative Haven for Hope and CHCS collaboration Goal:
  23. 25. Veteran’s Services <ul><li>Multiple Collaboratives/Initiatives for Veterans based in Bexar County </li></ul><ul><ul><ul><li>The San Antonio Veteran's Affairs Commission </li></ul></ul></ul><ul><ul><ul><li>The Military Coordinating Council for Behavioral Health </li></ul></ul></ul><ul><ul><ul><li>The Bexar County Veterans Service Office </li></ul></ul></ul><ul><ul><ul><li>Texas Resources for Iraq-Afghanistan Deployment, United Way </li></ul></ul></ul><ul><ul><ul><li>The Bexar County Veterans Service Office </li></ul></ul></ul><ul><ul><ul><li>Family Strong Advocacy </li></ul></ul></ul>
  24. 26. Toolkit
  25. 27. Alternatives to Incarceration <ul><li>Crisis Care Center and Restoration Center </li></ul><ul><li>Involuntary Outpatient </li></ul><ul><li>Commitment (IOPC) </li></ul><ul><li>Outpatient Competency Restoration </li></ul><ul><li>Mental Health and Drug Courts </li></ul><ul><li>Veterans Initiatives </li></ul><ul><li>Adult Parole/Probation </li></ul><ul><li>Partnerships </li></ul>
  26. 28. For additional information online <ul><li>Copies of this presentation and additional data on diversion initiatives can be found at: </li></ul><ul><li>http://www.diversioninitiatives.net </li></ul>
  27. 29. CIT SAVE THE DATE First International CIT Conference (Formerly the National CIT Conference) June 1 - 3, 2010 On site registration May 31, 2010 San Antonio CIT - Deep In The Heart of Texas! For Information and Registration : http://chcsbc.org/cit
  28. 30. Gracias ! For Additional Information on this presentation please contact: Leon Evans, President and Chief Executive Officer The Center for Health Care Services 210 731-1300, Email: [email_address] www.chcsbc.org Thank you for visiting !

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