2010 Middle District PSN Training (09-30-10)


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  • GREAT Referrals – usually no crime has occurred. Types of referrals include: communicating threats, classroom behavior, adjustment/transition concerns, traumatic grief, family discord.
  • NCCRI has received referrals for a variety of incidents and violence exposure. Depicted here are the breakdowns of the crimes and incidents associated with referral to NCCRI (332 cases from July 2009 to May 2010). As seen here, the primary referral was due to DV. 27% of Durham youth referred to NCCRI were exposed to domestic violence. Other includes a lot of runaway and behavior management issues.
    Also add gang if can?
  • Hard to reach. Protocol to make at least 3 HV attempts, plus phone calls, can send letter.
  • NCCRI works closely with DPD partners to engage in training activities to enhance officer skills in responding to violence and to build capacity for the program. An additional part of NCCRI’s mission is to help other communities form and cultivate police/mental health partnerships.
    NCCRI also collects information about referrals and interventions in order to evaluate the program’s effectiveness.
  • Audience
    All patrol officers and supervisory staff
    Specialized units (Investigations, GREAT)
    Initial training – presentation, case studies, quizzes
    Web-based training – presentation, quizzes
    Advanced training – observation of therapeutic activities in our clinic
  • In spring 2009, 114 members of DPD were surveyed (NCCRI and non-NCCRI districts)
    Examined effects of NCCRI on a variety of topics. Found some interesting differences in:
    Perceptions of community resources
    Officers in NCCRI districts were more likely to agree that they knew where to refer children who need mental health services than officers in non-NCCRI districts.
    Understanding child trauma
    Officers in NCCRI districts were able to identify more symptoms of child trauma than officers in non-NCCRI districts.
    Understanding of mental health needs
    Vast majority of all officers agreed with the statement, “As an officer, I see many families who would benefit from mental health services.”
    Of NCCRI officers, majority agreed that it was “good for families to see me with a mental health clinician on a follow up.”
    Officer activity/behavior on scene
    Officers who participated in NCCRI were significantly more likely (than non-participants) to report that they would refer a case to a supervisor if a child witnessed violence.
    Re: rates of witnessing – could be combination of increased awareness as well as higher crime rates in the early NCCRI districts?
  • Example of community outreach.
    Also describe Montana – reaching out to other partners in a national network of trauma providers
  • 2010 Middle District PSN Training (09-30-10)

    1. 1. Child Response Initiative Programs in North Carolina NC PSN Middle District Conference September 30, 2010 1
    2. 2. 2 Overview  Introduction to Child Response Initiative Overview, history of the model Why do communities need CRI?  Durham’s NCCRI  Replicating the model in NC  Greensboro’s CRI  Comments and questions
    3. 3. 3 Child Response Initiatives (CRI) are partnerships that brings together law enforcement, mental health, medical, child protection, and juvenile justice professionals around the needs of children exposed to violence. What is the Child Response Initiative?
    4. 4. 4 What is the CRI? - HISTORY  The Child Response Initiative programs build on other evidence-informed models:  Based on the Child Development Community Policing model, first launched in New Haven, Connecticut, in 1991  Incorporates elements of other evidence-based models, such as Psychological First Aid.
    5. 5. What is the CRI? - HISTORY  In 2004, Durham’s NCCRI began working in Durham Police Department’s District 1 targeting children who witnessed or were exposed to family and community violence. In 2006, we expanded to District 4.  In 2009, NCCRI expanded to all districts in the city, and broadened its referral base to include children at risk for gang involvement and siblings of gang members.  More than 1,000 families have been referred to NCCRI since its inception. 5
    6. 6. 6  What cities have similar programs? What is the CRI? – National Approaches  Chelsea, MA  New Haven, CT  Rochester, NY  Baltimore, MD  Nashville, TN  Cleveland, OH  New Orleans, LA  Durham, NC  Greensboro, NC  Charlotte, NC  Clearwater, FL  Spokane, WA  Minneapolis, MN  Sitka, AK  Boston, MA
    7. 7. 7 Why do communities need CRI?
    8. 8. 8  Child Trauma  Child trauma is an experience that brings about feelings of terror, horror, or helplessness in a child.  Examples of traumatic events include  School shootings  Natural disasters such as tornados, hurricanes, etc.  Death of a loved one  A serious accident (car, airplane, etc.)  Physical or sexual abuse (one time or ongoing)  Domestic violence (one time or ongoing)  War and other forms of political violence  Neighborhood violence (e.g., gangs)  Others Why do communities need CRI?
    9. 9. 9 Why do communities need CRI?  Many children are exposed to trauma  Lifetime prevalence in 12- to17-year-old children (Hanson et al., 2006)  8.2% sexual assault  22.5% physical assault or abuse  39.7% witness violence  9- to16-year-old children in Western North Carolina (Costello, Erkanli, Fairbank, & Angold, 2002)  25% at least one potentially traumatic event  6% within past three months.  Traumatic events do not occur in isolation, and many children experience multiple traumas and co-occurring risk factors (Dong et al., 2004; Finkelhor et al., 2007).
    10. 10. Why do communities need CRI?  Exposure to violence can lead to impairments in emotional, behavioral, social, educational, health, and developmental functioning (Anda et al., 2006; Cicchetti & Toth, 2000)  Children exposed to violence are also more likely to be victims again or eventually perpetrate similar crimes (Classen et al., 2005)  The more violence exposure and risk factors experienced, the worse the outcomes for children (Appleyard et al., 2005). 10
    11. 11. 11  Trauma and Gang Involvement  Traumatic experiences can increase the risk of youth becoming gang-involved, such as  Early childhood trauma, particularly abuse & neglect  Exposure to community violence  Once in gangs, youth are more likely to experience more life-altering traumatic events than peers who are not gang-affiliated. Why do communities need CRI?
    13. 13. 13  To provide crisis intervention and referrals in order to  Facilitate access to evidence-based practices and community services  Reduce crime victimization  Prevent gang activity  Reduce the negative impacts of exposure to violence  To engage in training, collaboration, and dissemination activities to promote a more trauma-informed community What are the goals of NCCRI?
    14. 14. 14  Patrol officers Leave a copy of the police report or a detailed note in the NCCRI box at any police substation Call, email, or fax any NCCRI clinician Refer through the NCCRI website www.nccri.org  GREAT officers speak to parents and school administrators and then refer  Representatives from each district and investigative division bring cases to a weekly meeting How are Families Referred to NCCRI?
    15. 15. 15  Telephone consultation to on-scene officers  Immediate response or next-day follow up with officers to families’ homes What does NCCRI provide?
    16. 16.  A Durham police officer and an NCCRI clinician ride together to the family’s home to provide the following:  Safety planning and restoration of security  Education about common reactions to traumatic events  Invitation for free mental health assessment and recommendations for treatment  Connections to appropriate community resources 16 What does NCCRI Provide?
    17. 17.  Assessment & Treatment  Free mental health assessment at our office or nearest DPD substation  Interviews of child and parent and completion of standardized measures  Four to six sessions at no cost  Referral information for long-term treatment  Connection with additional resources 17 What does NCCRI Provide?
    18. 18. What does NCCRI Provide?  Referrals to resources CCFH treatments and programs  TFCBT, PCIT, CPP, SPARCS, Healthy Families, Early Head Start Other community resources  Durham Crisis Response Center, Project BUILD, legal & child custody resources
    19. 19. 19 Referrals: Who is Referred to NCCRI? (07/01/09 – 05/31/10) Frequency of Incidents Referred to NCCRI (07/01/09 - 05/31/10) 105 12 3 5 5 23 22 30 1 27 70 76 0 20 40 60 80 100 120 DV -Intim ate partner DV -parentchild DV -otherfam ily Psychiatric crisis -adult Psychiatric crisis -child Child sexualabuse Child neglect Child physicalabuse Survivorofhom icide victim Suicide attem pt Suicide com pletion Robbery Assault O ther Note: Sum is more than total number of referrals, since some referrals included more than one incident type.
    20. 20. Engagement: How are Families Responding? (07/01/09 – 05/31/10)  332 families have been referred to NCCRI  274 families (83%) have received either a follow up home visit or phone call  Of the 274 served  61 families (22%) have either received direct referral to CCFH or other community services  21 families (8%) have accepted a full assessment by an NCCRI clinician in our clinic
    21. 21. Engagement: What Services does NCCRI Provide? (07/01/09 – 05/31/10)  81% of families received psychoeducation on the effects of violence on young children and ways to help them cope  74% received assistance and follow up from an officer  48% were reported to the Department of Social Services  21% received safety planning  Other services included assistance with medical and mental health needs and other basic needs, such as housing  Note: Percents are based on 322 closed cases
    22. 22. Other Ways NCCRI Increases Its Reach and Community Collaboration  Community Outreach Health fairs, community canvassings  Training activities  Dissemination and evaluation efforts 22
    23. 23. Why does NCCRI Provide Training to Police Partners?  Training needs  Police officers are often first responders to calls complicated by trauma and mental health issues – and children are often present.  Police partners need tools to recognize and respond effectively to the needs of children exposed to violence.  Training goals  Clinicians provide training to law enforcement on trauma- informed care and engagement strategies for this difficult- to-reach population.  Law enforcement representatives provide knowledge to clinicians about police practice and experience in the community.
    24. 24. How does NCCRI Provide Training to Police Partners?  Agenda  Overview of NCCRI program and services  Types of traumatic events experienced by children  Signs and symptoms of traumatic responses  Developmental aspects influencing children’s response to trauma  Role of police in restoring safety and security and how to respond effectively to violent calls when children are present  Introduction to mental health system and evidence- based treatments for children following trauma
    25. 25. Impact: How are Police Partners Responding? Joanna Bauer – Masters project  Survey of officers found differences between officers in NCCRI districts versus non-NCCRI districts in:  Perceptions of community resources  Knew where to refer for help  Understanding of child trauma  Identified more symptoms of trauma in children  Understanding of mental health service needs  Agreed it was good for families to see them with a mental health provider  Officer activity/behaviors on scene  More likely to refer a case to a supervisor if a child witnessed violence
    26. 26. Other Achievements and Accomplishments to Increase Reach  Conducting trainings and sharing resources with other NC communities  Consulting with other agencies interested in starting a program (including PSN partners)  Presenting at national conferences  Project Safe Neighborhoods  Publishing articles about the program and its impact  Police Chief international journal  Developing a website for community and police partners
    27. 27. CASE EXAMPLE
    28. 28. Contact Information  Jim Bjurstrom, Deputy Chief  Durham Police Department  (919) 560-4322 X 29201  Jim.Bjurstrom@durhamnc.gov  Karen Appleyard, Ph.D.  Center for Child and Family Health  (919) 419-3474 X 252  karen.appleyard@duke.edu  Katie Smith, LCSW  Center for Child and Family Health  (919) 419-3474 X 233  kathryn.smith@duke.edu  Jennifer Candon, LPC- Board Eligible  Center for Child and Family Health  (919) 419-3474 X 234  Jennifer.candon@duke.edu
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