Criminal Justice and Co- Occurring Disorders

The Situation 42-52% of people with serious m.i. have been arrested at least once % of people with serious m.i. have been arrested at least once. Among homeless population, 30-40% have a mental disorder and are often arrested for “nuisance” crimes. Among homeless population, 30-40% have a mental disorder and are often arrested for “nuisance” crimes. Estimated rate of m.i. in correctional facilities is 2-3 times than general population. Estimated rate of m.i. in correctional facilities is 2-3 times than general population. 16% were “significantly impaired” in one study; 16% were “significantly impaired” in one study; 19.5% required psychiatric services. 19.5% required psychiatric services.

Mental Disorders in Jail “The Prevalence of Co-Occurring Mental Illness and Substance Use Disorders in Jail” SAMHSA, Winter, 2004 Severe mental disorder-% during 2 week period 6.4% of males 12.2% of females Schizophrenia 2.7% of males 2.0% of females Mania 1.4% of males 1.4% of females Major Depressive Episode 3.9% of males 10.5% of females Substance Use Disorder 29.1% of males 53.3% of females Among those with severe mental disorders 72% have substance use disorders Among females with sud 14.9% had another mental d/o

Multiple Paths Within the System Civil Mental Health Court Civil Mental Health Court Not a criminal process Not a criminal process 72 hours, 14 days, 90 days 72 hours, 14 days, 90 days Criminal Mental Health Court Criminal Mental Health Court Misdemeanor crime Misdemeanor crime Serious mental illness Serious mental illness Voluntary Voluntary Only in certain cities/counties Only in certain cities/counties Not Guilty by Reason of Insanity Not Guilty by Reason of Insanity Felony Felony Results in a long hospital stay Results in a long hospital stay

Characteristics of Mental Health Courts Specialized court docket Specialized court docket Judicially supervised, community-based treatment plan Judicially supervised, community-based treatment plan Regular status hearings Regular status hearings Criteria defining completion Criteria defining completion

Key Principles Underlying Essential Elements Collaboration among criminal justice, mental health, chemical dependency and other relevant systems. Collaboration among criminal justice, mental health, chemical dependency and other relevant systems. The overrepresentation of mentally ill inmates in jail needs to be reversed. The overrepresentation of mentally ill inmates in jail needs to be reversed.

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Ten Essential Elements 1. Planning and Administration 2. Target Population is Clear 3. Timely Participant Identification and Linkage to Services 4. Terms of Participation are Clear 5. Informed Choice

Continued… 6. Treatment supports and Services 7. Confidentiality 8. Court Team 9. Monitoring Adherence to Court Requirements 10. Sustainability

Test #4 Review Personality disorders Personality disorders General criteria, descriptions of aspd and bpd General criteria, descriptions of aspd and bpd Tx guidelines/tips for aspd; key issues for bpd Tx guidelines/tips for aspd; key issues for bpd Youth disorders – what are they, describe Youth disorders – what are they, describe Service continuum for youth Service continuum for youth Principles of effective tx for youth Principles of effective tx for youth Criminal mental health court – who is served & characteristics Criminal mental health court – who is served & characteristics Civil mental health court Civil mental health court