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Texas MH Presentation
This document provides an overview of a training on crisis intervention teams (CIT) and working with inmates with mental illness. It discusses the high prevalence of mental illness among jail and prison populations. It then reviews the history of deinstitutionalization and the inverse relationship between psychiatric beds and prison populations. The training teaches officers about signs and symptoms of mental illness, de-escalation techniques, and connects them to local mental health resources to help divert people in crisis from the criminal justice system.
Texas MH Presentation
- 1. MENTAL HEALTHMENTAL HEALTH CONFERENCECONFERENCE BringingCalm to ChaosBringing Calm to Chaos Stephen Lucente, Ph.D.Stephen Lucente, Ph.D. Correctional Behavioral HealthCorrectional Behavioral Health Durham, NCDurham, NC
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- 3. WHAT DOES ATRAINING ONWHAT DOES A TRAINING ON WORKING WITH MENTALWORKING WITH MENTAL ILLNESS HAVE TO DO WITHILLNESS HAVE TO DO WITH WORKING IN JAILS?????WORKING IN JAILS?????
- 5. An estimated 26.2percent of Americans ages 18 and older — about one in four adults — suffer from a diagnosable mental disorder in a given year (Kessler RC, Chiu WT, Demler O, Walters EE. Prevalence, severity, and comorbidity of twelve-month DSM-IV disorders in the National Comorbidity Survey Replication (NCS-R). Archives of General Psychiatry, 2005 Jun;62(6):617-27.)
- 6. The estimated percentageof inmates with mental health disorders within the incarcerated population: Males: 56% Females: 73% James, D.J. & Glaze, L.E. (2006). Mental Health Problems of Prison and Jail Inmates. Retrieved July 26, 2007, from http://www.ojp.usdoj.gov/bjs/pubs/pdf/mhppji.htm
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- 8. 1 in 17Americans (6%) live with a serious mental illness
- 9. Several studies concludethat between 15 and 20 percent of the jail and prison population qualify as having serious mental illness.
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- 11. Approximately 14.6% ofthe NCApproximately 14.6% of the NC prison population meet theprison population meet the criteria for Serious Mentalcriteria for Serious Mental IllnessIllness
- 12. Inmate population isInmatepopulation is 40,37940,379
- 13. The number of inmateswho are estimated to meet the criteria for SMI in North Carolina is….
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- 15. A very briefexplanation of how we got here……
- 16. If you wantto understand today, you have to search yesterday. ~Pearl Buck
- 17. Let’s Go BackIn TIMELet’s Go Back In TIME
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- 20. 1880 Census ofmentally ill1880 Census of mentally ill personspersons • Most comprehensive report up to this time • identified 40,942 “insane persons” in “hospitals and asylums for the insane.” • 397 “insane persons” in jails and prisons
- 21. 1930 Survey1930 Survey •Studied over 10,000 arrestees • Only 1.5 % were “insane” at the time of the arrest.
- 22. 19551955 • Population: 165,000,000 •Number of State Psychiatric Beds: 559,000
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- 24. Effects of Deinstitutionalization •In 1955 there were 340 public psychiatric beds per 100,000 people. • In 2005 there were 17 public psychiatric beds per 100,000 people. • 95 percent reduction
- 25. North Carolina Effects •In 1955 there were 232 psychiatric beds available per 100,000 people • In 2005 there were 17 psychiatric beds available per 100,000 people
- 26. Minimum Requirements • Aconsensus of experts polled for this report suggests that 50 public psychiatric beds per 100,000 population is a minimum number. • In North Carolina this would mean that we would need a total of 4,297 beds (or 2,836 beds then we have in total)
- 27. 19391939 • Lionel Penrose,British psychiatrist and mathematician, wrote paper on relationship between number of state psychiatric beds and that of prisons • Stated that they were inversely related: as one decreases, the other increases
- 29. Prevalence of MentalIllnessPrevalence of Mental Illness in Correctionsin Corrections Individuals displaying symptoms characteristic of mental illness were found to have a 67% higher probability of being arrested than individuals not displaying such symptoms (Teplin 1984, 2000)
- 30. Prevalence of MentalIllnessPrevalence of Mental Illness in Correctionsin Corrections A 2014 study “The Treatment of Persons with Mental Illness in Prisons and Jails: A State Survey” stated the following: •35,000 public-hospital patients Vs. •356,000 mentally ill inmates
- 31. 2014 Study “There isprobably no state where mental health services have deteriorated as much as they have in North Carolina over the last decade.”
- 32. North Carolina • 3psychiatric facilities • Largest is Central Regional Hospital with 398 beds • Mecklenburg County Jail (1,904) and Wake County Jail (1,568) both have as many mentally ill individuals as does the state hospitals.
- 33. Average Number ofInfractionsAverage Number of Infractions by Inmates in North Carolinaby Inmates in North Carolina Time Served 0-4 Months 5-8 Months 9-24 Months 25 or more Months Overall Prisoner with Mental Health Problems 2.1 2.7 4.5 11.8 6.5 Prisoner With NO Mental Health Problems 1.7 2.2 3.3 6.8 3.4
- 34. Crisis Intervention TeamCrisisIntervention Team C I TC I T CRISIS INTERVENTION TEAM:CRISIS INTERVENTION TEAM: A Frontline Response to WorkingA Frontline Response to Working with Mental Illness in Correctionswith Mental Illness in Corrections
- 35. What Is CrisisIntervention Team?What Is Crisis Intervention Team? (CIT)(CIT) • Effective crisis response for “first responders” • Began as a Patrol based; pre-booking diversion • Specialized training for law enforcement officers and correction officers for handling mental health crises • Built on a foundation of volunteer officers
- 36. What Is CrisisIntervention Team?What Is Crisis Intervention Team? (CIT)(CIT) • Officers have individual responsibility and overall accountability for the crisis situation • It is a PROGRAM with partnerships to the treatment system and with consumers and consumer advocates • A change in culture - attitudes and behaviors • A “Best Practice”
- 37. What’s the FieldSaying about CIT?What’s the Field Saying about CIT? http://www.youtube.com/watch? v=37Li1Z4D_To
- 38. Who Is CITFor?Who Is CIT For? • Persons with a mental illness • Including, those with co-occurring substance use disorders • Those “in crisis”
- 39. Core Elements ofCITCore Elements of CIT • Partnerships with mental health and advocates • Defined Policies and Procedures • Identified CIT Coordinator • Special selection of officers • 24 hours of training • Connection to mental health services • Data collection and evaluation of program • On-going in-service training • Recognition program
- 40. Why Become CITTrained?Why Become CIT Trained? • Ability to respond quickly • Decrease officer injury • Decrease inmate or probationer injury • Increased officer confidence in their skill • Increase chance for consumer to connect to mental health system • Reduce liability • Partnerships=Solutions
- 41. CIT Training: LearningCITTraining: Learning ObjectivesObjectives • Explain the signs and symptoms about serious mental illnesses • Describe the difference and similarities between the three main types of serious mental illness • Explain key parts of the brain and their connection to the development of mental illness.
- 42. CIT Training: LearningCITTraining: Learning ObjectivesObjectives • Learn new effective ways for managing stress and improve on self-care • Describe crisis intervention skills that are effective for people with mental illnesses in crisis • Practice new de-escalation skills
- 43. SPECIAL NEEDS DESERVESPECIALNEEDS DESERVE SPECIAL CARESPECIAL CARE C I T
Editor's Notes
- #21 constituting less than 1 percent (0.7 percent) of the jail and prison populatio
- #24 Began in the California in the late 1950’s as a means to conserve funds There were a lot of reasons (Clorpromazine….or Thorazine was the first truly effective anti-psychotic that was introduced) -Good reasons: freeing the individual to live in the community - -Have local community based treatment organizations work with these individuals.