Mental Health & Criminal Justice: The Challenge to Provide For Justice Involved Virginians with Behavioral Health Issues

Nature of the Challenge – National Perspective The GAINS Center estimates approximately 1.1 million persons with serious mental illness are admitted annually to U.S. jails → Among these admissions, 72% also meet criteria for co-occurring substance use disorder 14.5% of male and 31.0% of female inmates recently admitted to jail have a serious mental illness

Nature of the Challenge – Virginia Perspective Per the 2015 Mental Illness in Jails Report by the Compensation Board – In June 2015 there were 7,054 individuals identified as having mental illness in the jails 16.81% of total jail population was reported as suffering from some form of mental illness 7.87% reported as suffering from “serious mental illness” Female inmates were disproportionately more likely to be identified as mentally ill compared to male inmates Per NIMH – 12 Month Prevalence of SMI in general population = 4.2%

Virginia’s Assets in Addressing the Challenge Virginia is only state known to conduct a yearly assessment & produce a report on mental illness in jails Virginia’s Governors and General Assembly have long recognized the challenge and have provided some funding to help address the challenges Virginia has a track record of creating/supporting effective criminal justice diversion programs There is an established history of cross agency and cross secretariat collaboration to address this challenge

Sequential Intercepts Best Clinical Practices: The Ultimate Intercept I. Law Enforcement/Emergency Services II. Post-Arrest: Initial Detention/Initial Hearings III. Post-Initial Hearings: Jail/Prison, Courts, Forensic Evaluations & Forensic Commitments IV. Re-Entry From Jails, State Prisons, & Forensic Hospitalization V. Community Corrections & Community Support

Virginia’s Diversion Programs Intercept 1: 37 CIT Programs & 32 CIT Assessment Sites Intercept 2: Four GF funded magistrate level booking programs Intercept 3: Five GF funded jail diversion programs including one funded MH Docket (10 Dockets total), Drug Courts (37), Regional Jail Team (re-investment funds) Intercept 4: Two GF funded jail diversion programs, seven forensic discharge planners Intercept 5: One GF funded specialized probation program

Evolution of the Center for Behavioral Health and Justice 2001 – 2004 Initial CIT development cross systems collaboration 2006 – 2011 (VT Tragedy) Commission on Mental Health Law Reform 2008 – present Statewide SIM project State supported jail diversion and CIT funding 2012 – 2013 Task Force on Crisis Response Governor’s Initiative to Create a CBHJ COE

Evolution of the Center for Behavioral Health and Justice April 8, Governor McAuliffe signed EO12 to continue the work of the Task Force on Crisis Response (task force established the previous December) Help improve Virginia’s mental health crisis services and help prevent crises from developing Review existing services and challenges in the mental health system and make recommendations for critical improvements to procedures, programs and services

Evolution of the Center for Behavioral Health and Justice October 1, 2014 – Task force delivered its report with 25 recommendations to the Governor One of the recommendations was the establishment of a Center of Excellence for Behavioral Health & Justice to help address the unique needs of individuals with behavioral health challenges who are involved in the criminal justice system

Establishing the Center for Behavioral Health and Justice Governor McAuliffe established the Center for Behavioral Health and Justice under Executive Directive 4 (2015) directing CBHJ pursue collaborative, multi-systems approach 1. Data collection and analytics 2. Evidence-based programs and practices 3. Education, outreach and training 4. Technical assistance and resource development

Structure for the Center for Behavioral Health and Justice Executive Committee established - First meeting held August 25, 2015 Lt. Governor Secretary of Public Safety and Homeland Security Secretary of Health and Human Resources Commissioner of the Department of Behavioral Health and Developmental Services Director of the Department of Criminal Justice Services

CBHJ Activities Convened a Center Advisory Group Sponsored a Behavioral Health & Justice Summit Have begun drafting strategic implementation plan for the next several years Hired a full-time Coordinator (co-funded by DBHDS & DCJS) Have created a subcommittee to look at high profile incident & offer recommendations