1. @defendshelbyco
Law Offices of the Shelby County Public Defender
Established 1917
Stephen Bush - Chief Public Defender
Josh Spickler - Assistant Public Defender
19. @defendshelbyco
Target high end populations
Serious Mental Illness – Axis I
Schizophrenia spectrum
Bipolar Disorder
Major Depressive Disorder
Co-occurring substance use – 74%
Felonies, misdemeanors, kitchen sink
Taps free leverage
Safeguards individual rights & coercion
Minimizes stigma & promotes real recovery
20. @defendshelbyco
WHAT’S DIFFERENT?
Jericho Project
•All Courts
•No preset limitations
•Driven by the dynamics of
adversarial system
•Bottom up
Mental Health Courts
•One division
•Usually non-violent,
low-grade offenders
•Judge-led team approach
•Top down
21. @defendshelbyco
JERICHO IN A BOX
1. Best Practice Transition Planning
2. Community Linkage Plans
3. Conditional Release Strategies
4. Layered Supervisionupervision
5. Integrated Treatment
6. Bridge Case Management
7. Mainstream Public Health Services
22. @defendshelbyco
APIC model for transition planning
Mental Health Services
Substance Abuse Services
Medications
Health Care/Benefits
Housing
Food/Clothing
Income Support/Benefits
Transportation
Assess ● Plan ● Identify ● Coordinate
24. @defendshelbyco
CONDITIONAL RELEASE STRATEGIES
Many forms of conditional release
Supervised pretrial release
Probation: county, state, private
Avoiding revocation on probation
Supervision is layered over Community Linkage Plan
Independent eyes and ears
Disruptions in treatment communicated
25. @defendshelbyco
RECOVERY SUPPORT SPECIALISTS
“Boundary Spanners” per Steadman
Client engagement while in custody
Transition planning
Transitional case management
Progress reports to court
Minimum of 120 days
85% linkage success expected
Re-engagement following relapse
26. @defendshelbyco
SYSTEMS BARRIERS
Fragmentation - MH, SA, housing, social services & health care
Inadequate community services
Waiting lists for treatment & services
Navigating SSI, SSDI, Medicaid
Lack of adequate housing
Stigma, discrimination, NIMBY
29. @defendshelbyco
OUTCOMES
At 6 months 76% no further arrests
25% bump up against the system
25%, usually new offenses, result in
reincarceration
More than half have no further arrests
Overall, 99 fewer jail days per divertee/year
30. @defendshelbyco
IMPACT
Jail days dropped from 8540 in the year
preceding linkage to 2395 in the year
following
6145 fewer days @$91= $559,195
$12,427 per detainee
80/year = $1 Million
N=45
32. @defendshelbyco
KEY ROLES
Pretrial Services
Candidate locator
•Screening at arrest
Referral stream
Mental health expertise
Supervision
•Accountability
•Informed flexibility
Public Defender
Candidate locator
•IMS hitlists
Referral stream
Court delivery system
Natural advocates
Coercion safeguard
33. @defendshelbyco
KEY ROLES
Behavioral Health
Social work
Transitional case management
Outpatient treatment
Treatment relationships
Linkage to mainstream
services
Reengagement following
relapse
Judges & Prosecutors
Accountability
Incentives
Public Safety
Trusts Prosecutors
Trusts Judges
Respect for the
adversarial process
34. @defendshelbyco
A Top Ten List
Of (Mostly Free) Creative Things You Can Do to
Sustain Cross Systems Collaboration
35. @defendshelbyco
1. Build Brand
2. Exploit Technical Assistance
3. Tell a story! Make a movie!
4. Get advocates on your side
5. Look smart - get published, use
media, build credibility…
TOP TEN LIST
36. @defendshelbyco
TOP TEN LIST
6. Use your data effectively
7. Cultivate patrons
8. Find your local relevance
9. Be key to something bigger
10. Throw a big party
38. @defendshelbyco
RESOURCES
The Bazelon Center for Mental Health Law
www.bazelon.org
The National GAINS Center
www.gainscenter.samhsa.gov
Council of State Governments
Mental Health Consensus Project Report
www.csg.org
www.consensusproject.org
SAMHSA
www.samhsa.gov
National Registry of Evidence-based Px & Programs
www.nrepp.samhsa.gov