Diversion First: Progress-to-Date, and a Look to the Future: Fall 2016
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This document provides an overview and update on Fairfax County, Virginia's Diversion First program, which aims to divert individuals with mental illnesses or developmental disabilities away from the criminal justice system and into treatment programs whenever possible. The summary is: The document discusses the national context of high incarceration rates for those with mental illnesses. It then defines Fairfax County's Diversion First program, examines what happens when individuals are diverted from jails into treatment, and reviews early results showing over 25% of transports by law enforcement to the crisis center had potential criminal charges diverted to mental health services. Cost savings from diversion into treatment are also noted.
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Diversion First: Progress-to-Date, and a Look to the Future: Fall 2016
- 1. Progress-to-Date, and a Look to the Future Fall 2016
- 2. 2 www.naco.org/resources/behavioral-health-matters-counties Behavioral health issues are real and prevalent…
- 3. 3 Incarceration is not treatment. The needs are tremendous.
- 4. National Context • The United States accounts for 5% of the world’s population BUT 25% of the world’s prison population. • 356,000 people with mental illnesses are in U.S. prisons and jails vs 35,000 in state hospitals. • 850,000 people with mental illness are on probation or parole in communities across the country. This is not an issue unique to our community. 4Source: TAC Center
- 5. National Context Persons with mental illness remain incarcerated: • Four to eight times longer than those without mental illness for the exact same charge; • At a cost of up to seven times higher. The criminalization of mental illness is a social/health/justice issue and a financial burden for taxpayers. 5
- 6. Definition Diversion First offers alternatives to incarceration for people with mental illness or developmental disabilities, who come into contact with the criminal justice system for low level offenses. The goal is to intercede whenever possible to provide assessment, treatment or needed supports. People needing diversion may also have a substance use disorder, which often co-occurs with mental illness. Diversion First is designed to prevent repeat encounters with the criminal justice system, improve public safety, promote a healthier community and is a more cost effective and efficient use of public funding. 6
- 7. No Health without Mental Health • Behavioral health disorders negatively affect all of the issues that Fairfax County’s public safety and human services are designed to address. • Many of the impediments to an individual’s ability to achieve economic self-sufficiency, a healthy lifestyle, positive living and sustainable housing stem from behavioral health issues. • Treatment of behavioral health issues improves an individual’s ability to achieve success in all aspects of a healthy self-determined life. Prevention works. Treatment is effective. People recover. 7
- 8. What is Diversion? Decreasing the use of arrest and incarceration of people experiencing mental health behavioral crises by diverting them to treatment instead of bringing them to jail. • Intervene to help people access treatment at many points of contact. • Treat people in crisis with respect and provide needed support. It is not a crime to have an illness or disability. • Reduce the likelihood of physical confrontation and use of force. • Collaborate among law enforcement, other first responders and mental health services. • Follow best practices and evidence-based approaches. 8
- 9. What Happens When We Divert? • Specialized response by trained law enforcement officers and well-trained dispatchers. • Reduced time officers spend out of service awaiting mental health assessment and disposition and increased support for mental health staff. • Improved outcomes for individuals. • Cost savings to County. • Decreased need for mental health interventions in jail and decreased recidivism. 9
- 10. Cost Comparison • Incarceration is significantly more expensive than mental health treatment. It costs approximately $66,000 to incarcerate a person in the Fairfax County jail for a year. • In contrast, the average cost to provide one year of supportive community residential services (which usually includes housing plus treatment and support) through the Community Services Board (CSB) for an individual with serious mental illness is approximately $22,000 – one-third the cost of a year of incarceration. CSB intensive case management (without residential services) costs approximately $7,500 per year per person. 10
- 11. Sequential Intercept Model Intercept points are… • Predictable points of contact between offenders and the law enforcement/judicial systems; • An opportunity to divert to treatment, if we are equipped to take advantage of the opportunities; and • Effective mental health interventions. Five intercepts: • Pre-Arrest: Interaction with law enforcement/emergency services • Post-Arrest: Initial hearing - magistrate/ initial detention - jail intake • Jails & Courts: Jail-based evaluation and support, specialty court docket • Post-Jail: Community reentry with transition plan for treatment • In the Community: Probation, community-based health care and support 11
- 12. Sequential Intercept Model Predictable points of contact offering opportunities for intervention 12
- 13. Current Activities • Crisis Intervention Team training • Mental Health First Aid training • Fire & Rescue Department training/diversions • Diversion Court Services and specialty docket • Communications • Evaluation and data collection 13
- 14. Early Results In the first nine months: • 1,164 people were transported by law enforcement to Merrifield Crisis Response Center. • 294 or 25% had potential criminal charges but were diverted to mental health services. January 1 – September 30, 2016 14
- 15. Please Share If emergency mental health services are needed: • Call 911 if situation is immediately life- threatening. Ask for a Crisis Intervention Team (CIT) officer. • Otherwise, call Community Services Board (CSB) Emergency Services (ES): 703-573-5679. • Or go directly to the Merrifield Center, 8221 Willow Oaks Corporate Drive, Fairfax, VA 22031. Emergency Services entrance is on lower level. Staffed 24/7. 15
- 16. Want to Learn More? • Take Mental Health First Aid training, which is open to the public. • Take online suicide prevention training. It is free, and you can take it from home on your computer or tablet. • Check out the CSB’s new free, confidential online mental health screenings. Find these and more at www.fairfaxcounty.gov/csb 16
- 17. Stay Connected • Visit: www.fairfaxcounty.gov/diversionfirst • Next Diversion First Stakeholders meeting: October 17, 2016, from 7 to 9 p.m. Fairfax County Government Center 17
Editor's Notes
- - Look at the big picture: MH issues are a significant factor in our communities - Many people with MI receive no treatment and many have co-occurring SUD 1960s decision was made to close MH institutions in favor of community-based treatment of persons with MI Mental Institutions were closed, but community treatment was largely unfunded
- Jail diversion provides the path to treatment, and it’s being embraced nationally
- - As a result, America’s jails have become our mental hospitals
- Criminalization of MI is producing a humanitarian and financial crisis
- - To sum up the problem, mental illness has a measurable impact on the community and, of course, the MI person But, with treatment, recovery is possible. Prevention works, treatment is effective, people recover—and the community benefits in terms of: Improved outcomes for MI residents; Enhanced public safety and reduced costs to county taxpayers. As I mentioned a minute ago, jail diversion is the path to treatment, and last June the County formally embarked on that path by embracing the Stepping Up initiative and, ultimately, Diversion First. (Over to Laura)
- - Jail diversion is a system of best practices and evidence-based approaches employed to reduce the number of people with MI being arrested and incarcerated by diverting non-violent offenders to treatment rather than putting them in jail. It’s driven by intervening at logical points of contact between offenders and the LE system where opportunities for diversion are present Those logical points are embodied in the Sequential Intercept Model—more on that Improve outcomes for people with MI who come in contact with law enforcement Enhance public safety—for LE and citizens Enhance teamwork between first responders, MH services, courts, and community Proven successful in jurisdictions nationally Diversion First is Fairfax County’s jail diversion initiative
- Core of DF is a cadre of Crisis Intervention Team trained officers, deputies, and dispatchers, as well as other appropriately trained first responders, magistrates, and other county officials CIT-trained officers are taught to recognize signs of MI, de-escalate crisis situations, and steer offenders to MH treatment at CSB Merrifield Crisis Response Center MI offenders are assessed and treated, as appropriate Tangible benefits: Reduced cycle times for officers who can now transfer custody to LE personnel stationed at Merrifield means less time out of service But, also leads to better outcomes for people with MI Enhanced safety for LEOs and consumers Decreased recidivism Reduced costs for taxpayers
- CIT training provides first responders the tools to identify signs of mental illness and the skills to de-escalate crisis situations.
- The Crisis Intervention Team (CIT) Program is an evidence-based, first responder-based, mental health crisis response initiative. Interdisciplinary, collaborative, community program that enhances law enforcement capability to respond to situations involving individuals with symptomatic behavioral health issues. CIT includes a coalition of stakeholders Oversight and program guidance CIT Training 40 hours of advanced training for law enforcement, first responders and others. Eight CIT Trainings scheduled for 2016. Graduated four CIT classes in 2015. Two dispatcher trainings scheduled in January. CIT-First Responders can be quickly located and sent to mental health calls by dispatchers. Integration of CIT Officers/Deputies into Merrifield Crisis Response Center. Continuity of care for emergency cases. Immediate intervention for walk-in emergencies.