Presentation given by Stephen Bush and Josh Spickler on April 20, 2015 at APA Innovations in Criminal Justice Symposium III in Los Angeles.

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Law Offices of the Shelby County Public Defender
Established 1917
Stephen Bush - Chief Public Defender
Josh Spickler - Assistant Public Defender

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1915

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Dyer County

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Memphis

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1917

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Law Offices of the Shelby County
Public Defender
35,000
cases in
FY2016
80+ Lawyers
vs.

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The Revolving Door

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Add link to clip of
aretha

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ELIGIBILITY
Serious mental illness
Stable on medication
Willing to embrace treatment
Seeking to serve persons whose contact with the justice
system is related to untreated mental illness

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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

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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

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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

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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

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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

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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

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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

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RELATIONSHIPS
Relationships
Relationships
Relationships

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EVALUATION
 Improved quality of life
 Reduction in severity of symptoms
 Fewer jail days
 Fewer arrests
 Judges approve over 95% of CLPs

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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

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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

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SUCCESSES
 Referrals from prosecutors
 Referrals from judges
 High tolerance of relapse
 Better, faster dispositions

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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

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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

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A Top Ten List
Of (Mostly Free) Creative Things You Can Do to
Sustain Cross Systems Collaboration

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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

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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

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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

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PublicDefender@shelbycountytn.gov
@DefendShelbyCo
facebook.com/DefendShelbyCo
www.DefendShelbyCo.org
Law Offices of the Shelby County Public Defender
Established 1917