1. Criminal Justice – Behavioral Health Partnerships Promoting Integrated Healthcare A Program for Governments, Hospitals, Specialty Care Providers and Advocates
Creating a New System
Dan Abreu, Policy Research Associates
Gilbert Gonzales, Bexar County Mental Health
Regina Huerter, Division of Behavioral Health Strategies

2. Sequential Intercept Model
People move through the criminal justice system in predictable ways
Illustrates key points, or intercepts, to ensure:
Prompt access to treatment
Opportunities for diversion
Timely movement through the criminal justice system
Engagement with community resources

3. Development
Mark Munetz MD and Patty Griffin PhD
(and Hank Steadman PhD)
People move through criminal justice system in predictable ways
Illustrates key points to “intercept,” to ensure:
Prompt access to treatment
Opportunities for diversion
Timely movement through criminal justice system
Linkage to community resources

4. The “Unsequential” Model
Arrest
Community Supervision
Initial Hearings
Prison
Jail
Community
Mental
Health
Courts
Substance
Use
Reentry

5. Sequential Intercept Model

6. A Series of Points
Series of points to potentially intercept individuals
Each point has possibilities for intervention
Interventions to prevent individuals from entering or penetrating deeper into criminal justice system
Community can develop targeted strategies
Strategies evolve over time to increase diversion and linkage to community treatment and support services

7. Introducing Intercept 0

8. Police Authority to Act
Parens Patriae Doctrine
Parens patriae is a doctrine that allows the state to step in and serve as a guardian for children, the mentally ill, the incompetent, the elderly, or disabled persons who cannot care for themselves.
Police Power
The right of states to make laws governing safety, health, welfare, and morals is derived from the Tenth Amendment, which states,

9. Warrior vs. Guardian Sue Rahr Executive Director Washington State Criminal Justice Training Commission
In 2012 we began asking the question, “Why are we training police officers like soldiers?”
Although police officers wear uniforms and carry weapons, the similarity ends there:
The missions and rules of engagement are completely different.
The soldier’s mission is that of a warrior: to conquer.The rules of engagement are decided before the battle.
The police officer’s mission is that of a guardian: to protect. The rules of engagement evolve as the incident unfolds.
Soldiers must follow orders. Police officers must make independent decisions.
Soldiers come into communities as an outside, occupying force. Guardians are members of the community, protecting from within.

10. Report Findings Disseminate baseline models of CIT
Involve peer counselors when appropriate
LE should engage multidisciplinary team approaches
POSTS should make CIT available for basic recruit and in- service training
Congress should appropriate funds to support CIT

11. Law Enforcement/Emergency Services
Cross-Systems Mapping & Taking Action for Change
10/07
Police-based Crisis Intervention Teams
Co responder model:
MH professionals employed by police
department or police-mobile crisis
co-response
Los Angeles/CA MEU: SMART, CAMP, Triage Unit
SAMHSA Early Diversion Grantees, Knoxville, Boulder, CT
Houston PD MH Division (Homeless, Consumer Stab. 10 Co- response Teams
Population specific models:
Atlanta HOT Teams (Homeless)
Seattle LEAD Teams (low level drug offenders)
Mobile mental health crisis teams
Facilitator Note:
The next five slides review the five key intercepts
Describe each intercept briefly (offer clarification only)
Briefly describe innovative programs that operate at each intercept
Police-based Crisis Intervention Teams
Often referred to as specialized police response
Involves police officers with MH training who provide crisis intervention services and act as liaisons to the formal mental health system
Memphis, TN Crisis Intervention Team—pioneered development of CIT
Resource:
Police-based Specialized Mental Health Response
MH consultants hired by police departments to provide on-site and telephone consultation to officers responding to mental health crisis
Framingham, MA—clinicians based at police headquarters respond with officers to calls where mental illness a factor
Mental Health-based Specialized Response
Involves mobile crisis teams based in community MH system
These operate via special relationship with police department who contact teams to respond to special MH needs at site of incident
Knoxville, TN—operates a mobile crisis team, which responds to calls in groups of two, 24/7
NOTES FRANKLIN CO WA
What looks encouraging on a national basis
You are not going to cure the system today, but you’ll get
400 – 500 CIT programs in the country
Specialized police officers, 25j%, 40 hrs of training at de-escalation and crisis skills, to decrease the amount of violence during incidents, and to decrease numbers who go to jail
Lower rates of arrest, decreased officer injury, decrease injury to civilians and consumers
Example: Philadelphia
There is always more than one way to solve issues; there is no one way; you have to do what works best for you locally; there are many ways to approach
Another approach … second bullet
LA – SMART program; mh & specially trained police officer
The population you most want out of jail, winds up staying the longest
Diversion – what does cjs do differently AND what does the tx team do differently AND how do they work together differently

12. Intercept 0 Intercept 1 Intercept 2 Intercept 3 Intercept 4
HIPAA Exemptions
HIE with Jails Health Dept.
HIE with Jails
In-reach reentry
Co-location
Data Sharing
FUSE Initiatives
Data Matching to enhance screening
ACA enrollment
SOAR enrollment
Co-Response Teams
Health Homes
Certified BH CC’s