Iowa Stepping Up Summit: Conducting Timely Screenings and Assessments Des Moines, Iowa October 24, 2017 Travis Parker, MS, LIMHP, CPC Senior Project Associate-Policy Research Associates

First Appearance Court Intercept 2 Initial Detention/Initial Court Hearings Initial Detention First Appearance Court Arrest

Importance of Intercept 2 Diversion Study of pretrial detention in Kentucky (N=155,000) Detention of low and moderate risk defendants increases their rates of new crimes When held 2-3 days, low risk defendants are 40% more likely to commit crimes before trial When held 8-14 days, low risk defendants are 51% more likely to commit crimes 2 years after case disposition.

NACo Analysis of Jail Populations Percent of jails owned by counties 87% Percent of confined jail population that is pretrial 67% Percent of jails that use a risk assessment 40% Percent of jail population assessed “low risk” among jails that use risk assessments 60%

Intercept 2 Essential Elements Identification and screening Court-based clinician Recovery-based engagement Proportional response

Identification and Referral Personnel Strategies Police officers Booking officers Jail medical staff Pretrial services Public defenders Prosecutors VJO specialist Data matching Mental health risk screen Potential diversion presented at arraignment Referral to?

Recommended Mental Health Screens Brief Jail Mental Health Screen (BJMHS) Designed for correctional officers to administer at booking Correctional Mental Health Screen (CMHS) Separate versions for male and female inmates Mental Health Screening Form III (MHSF-III) Designed for people being admitted into substance use treatment

Recommended Substance Use Screens Texas Christian University Drug Screen-V Past 12-month use based on DSM-V criteria; 17 items Consider combining with the AUDIT for alcohol use Simple Screening Instrument for Substance Abuse Past 6-month alcohol and drug use; 16 items Considering combining with the AUDIT for alcohol use Alcohol, Smoking, and Substance Involvement Screening Test Screens for lifetime use, current use, severity of use, and risk of IV use. Available from the World Health Organization and NIDA.

Brief Jail Mental Health Screen Cross-Systems Mapping & Taking Action for Change Brief Jail Mental Health Screen 10/07 3 minutes at booking by corrections officer 8 yes/no questions General, not specific mental illness Referral rate: 11% Men: 73.5% Women: 61.6% N=10,330 men & women; 4 jails See: Steadman et al. (2005) in Psychiatric Services 56(7) Steadman et al. (2005)

Jail Screening and Data Link Texas Cross reference local/state CJ & HHS Data Matches completed by local Jails w/in 72 hrs Kentucky Secondary level MH risk screening for all flagged with MH at booking/screening 14% eligible for diversion Illinois Mental Health Jail Data Link Project Screening has reduced national jail suicide rate (Hayes, Lindsay)

Screening for Veterans Veterans Reentry Search Service (VRSS) VA built a web-based system that will allow prison, jail, and court staff to quickly and accurately identify Veterans among their inmates or defendant populations.

About Johnson County, KS 20 cities 1,100 beds 750 avg. daily population 17 municipal & county law enforcement agencies

Thru entire court process Onto probation or other supervision How JIMS works A single database follows each person… Booking to county jail DA’s office review Thru entire court process Onto probation or other supervision

Co-responder screen

Brief jail mental health screen

JC-RION Brings together 17 law enforcement agencies: The Johnson County Regional Interagency Operating Network — utilizing the NicheRMS product. Brings together 17 law enforcement agencies: Olathe Police Westwood Police Overland Park Police Shawnee Police Leawood Police Mission Police Mission Hills Police Johnson County Sheriff Patrol Spring Hill Police Johnson County Park Police Merriam Police Prairie Village Police Fairway Police Roeland Park Police Lenexa Police Gardner Public Safety Department

Prior to BJMHS One-way match Jail Mental health

65% Prior to BJMHS Two key problems: Only captures the most vulnerable population Of our detainees are released in 48 hours or less

Because of our JIMS system We have the ability to: Compare the length of stay for detainees with mental illness symptoms Look at peak booking/release times for detainees with mental illness

Because of our JIMS system We have the ability to: Break down data from each police dept. Compare booking types Review charge descriptions

BJMHS items Prevalence of Mental Health Symptoms at booking — for the previous seven months

Implementation of screening tools Creates new opportunities We’re able to identify residents who likely struggle We have opportunity to engage at-risk persons We can improve the coordination of care

Hesitation for BJMHS More work to the booking process… What is the mental health center going to do with this information anyways?

Booking processes JIMS sends email to Johnson County Mental Health staff daily Screen results entered in JIMS by the Sheriff’s Office Mental health staff look up each person in Electronic Record

JIMS send an email to the outreach workgroup Upon release Our goals: Outreach to person within 24 hours Outreach attempts by phone First outreach within 24 hours of release Face-to-face efforts, when deemed necessary JIMS send an email to the outreach workgroup

Collecting outcome data Outcome information being collected: Mental Health Center status Number of persons contacted within 72 hours Number of persons linked to a specific service Number refusing service Number recycling through jail

372 Early results 15% current clients 52% 32% Mental health center status for outreach 15% current clients 52% have had contact with MHC 372 total referrals 32% Unknown to MHC Data from the Feb.-May 2017

50% Early results Percent of persons contacted within 72 hours approximately Percent of persons contacted within 72 hours 50% Data from the Feb.-May 2017

34% Early results Disposition info: Successfully connected to or referred to services Data from the Feb.-May 2017

Proactive approach Developed a predictive analytics model to identify people who are most likely to have a police encounter / jail booking in the next 12 months.