Creating a Behavioral Health Safety “Net” Enhancing Collaboration Facilitation by Connie Milligan Bluegrass MH-MR Board, Inc. Ray Sabbatine Sabbatine & Associates

What does your data say? How big is the problem? Where are people falling through the cracks? Recommend the GAINS Center workshops “Developing Community Partnerships” and “Cross Systems Mapping ”

Is Mental Health TX adequately funded? How well are people with SMI integrated into treatment? ACT and active case management Mobile crisis teams Supervised apartments Hospital beds - especially forensic

Collaboration options We have to move out of our Silos of care… Mental health cross trained with police, and jail personnel Mental health working with police Mental health in the jails Mental health in the courts Links with pretrial, probation and parole Data crosswalk between jail and mental health

Constitutional Custody Duty To provide a reasonable degree of protection to those we incarcerate from; AssaultSuicide Preventable illness (SMI)

We cannot “Prevent” what we cannot “Predict” “Who is at Risk?”

“Prevention” requires “knowledge” of a risk and the “identification” of those “at Risk”

Risk can be “observed” but is unlikely to be “understood” SMI

Law enforcement and corrections officers are trained to respond to a “perceived risk” with the appropriate “use of force”

The “use of force” continuum begins with a “verbal command” to gain compliance SMI

When compliance is not gained, “force” is escalated; Verbal Directive OC Taser > Restraint

“Excited Delirium” or a state of “extreme agitation” may be caused by Psychosis Illicit Drug Use SMI Sound familiar? SMI

SMI + Excited Delirium + Taser > Restraint= “Serious Injury or Death”

BH Safety “Net” SMI Education of Justice Agencies PoliceDetentionProsecutionJudiciary Corrections/ Probation/Parole

CJ Education Levels Administrations Administrations Training Components Professional Organizations NSA, IACP, FOP ACA, AJA Local/State/ Federal Judiciary/ Prosecutors

Training Curriculum What is SMI What behaviors are indicative of SMI What alternative “uses of force” may be employed to gain successful compliance If a an ECD (Taser) is used what emergency response is necessary

Identification of Risk Observed/ Educational Efforts Screened/ Uniform screening instruments Reported/ Voluntary Database Historical record/ Institutional Alert files

Identification of Risk How can we assure that criminal justice agencies have sufficient notice that a persons suffers from “a serious mental illness”?

Voluntary Notification System (VNS) Create a NAMI managed web based/encrypted/password protected data base that identifies persons suffering from SMI. Contact information would be available to assist justice agencies in the management of SMI arrestees and notification of guardians of custody status

NAMI VNS Although NAMI would host the site, consumers would be totally responsible for voluntary entry, update and deletion of information

SAMPLE DATA ENTRY Name:Ray Sabbatine Address: 110 Royal Court Georgetown, KY Contact Phone: SMI: Mania Community MH Agency: BGRMH Contact: BGRMH Crisis Line Action: Advise of custody status Caution: No Coffee & Dark Chocolate Medication non-compliant Will bite when hungry

Contact Information Questions ? Connie Milligan Ray Sabbatine