1. Mental Health: Crisis Intervention Challenges and Solutions In West Texas August 9, 2007

2. Challenges in 2007 “Untreated mental illness is a public safety issue” 1.The crisis response system is in crisis! 2.More individuals with mental illness now reside in jail & prison than anywhere else – so fundamentally, do we believe in care or confinement? 3.And if we determine to provide care, does the mental health system need reform or resources?

3. West Texas Challenges Public Hearing – February 23, 2006 Big Spring State Hospital DSHS Crisis Services Redesign Committee 1. Distance 2. Transportation 3. Lack of professionals 4. Population-based resource shifting (equity) 5.If not to jail, then where? (5 of 21 listed challenges)

4. Show Me the Money! Safety and Savings for all Texans Cost / Benefit Analysis: The daily average cost for outpatient mental health care is $11 per day. The daily average cost to house a state prisoner is $40 per day. The daily average cost to house a local jail inmate is $35-50 per day. So, significant cost savings result from reduced incarceration days.

5. The Texas Solution! The 80 th Legislature understood the challenges, listened to informed opinions, and ACTED! When the dust settled, $82.1 million NEW general revenue dollars were invested in community-based, mental health crisis redesign strategies. Appropriations (Rider 69)

6. The Texas Solution! 32% will be used to improve equity among LMHAs that have below average per capita funding levels. 36% will be divided proportionally among all LMHAs. 30% will be offered through a competitive process (with a 25% local match requirement) for the development of Psychiatric Emergency Hub Sites and/or Outpatient Competency Restoration Services – SB 867 Duncan.

7. The Texas Solution! 27.3 million will be allocated in FY 08 – contracts will be sent to LMHAs in September, return of the crisis plans in October, and the new local crisis services begin in December. 54.7 million will be allocated in FY 09. It is expected that the new funds will be used to improve the current crisis services and not replace the current services.

8. The Texas Solution! The Department of State Health Services & legislative expectation for the use of new funding: Must implement – hotline services certified by the American Association of Suicidology & mobile outreach teams. Optional Enhanced Crisis Services – up to 48 hour psychiatric emergency services, 16 bed crisis stabilization unit, crisis outpatient services, crisis residential or respite services, in-home crisis resolution, transportation, or CIT/MH deputies.

9. The Texas Solution! So what about those already involved in the criminal justice system? The 80 th Legislature hit another homerun!

10. The Texas Solution! Funding was increased for the Texas Department of Criminal Justice: TCOOMMI (Texas Correctional Office on Offenders with Medical and Mental Impairments) was given an additional $10 million to provide mental health services, medications, and continuity of care to juvenile and adult offenders with mental impairments.

11. The West Texas Solution! Next steps for our West Texas communities?  As time allows, go to www.dshs.state.tx.us/mhsacsr/mhsacsr.pdf to review the complete Crisis Services Redesign Report, completed in September 2006. www.dshs.state.tx.us/mhsacsr/mhsacsr.pdf  Be sure that your local MHA (community center) knows you want to be involved in planning how the new dollars are spent.

12. The West Texas Solution!  Be expectant – for us to invest $82 million dollars, expect results! We can do better…  The Concho Valley experience indicates that positive results (not perfect results) can happen…

13. The West Texas Solution! Concho Valley Mental Health Crisis Services –  Long-standing collaborative partnership (7 years)  Award-winning Mental Health Deputy Unit under the leadership of Constables Smith and Hester  Successful pre-booking diversion strategies  Jail/CARE data cross-matching, screening & assessment  15-bed Crisis Respite Services  Local Crisis inpatient Services up to 72 hours via contracts with River Crest and Shannon Behavioral

14. The West Texas Solution – Concho Valley MH Crisis Services (continued)  Valued State Hospital services  Seasoned Continuity of Care Services  Community Supervision for both adult and juvenile special needs offenders in conjunction with CSCD probation officers  Special law enforcement training sessions

15. The West Texas Solution! For more information on Jail Diversion strategies designed to slow or reverse the growing trend of the incarceration of our friends and neighbors with mental illness, please contact Mr. Lynn Rutland or any of the community center CEOs located throughout the West Texas region. Mr. Rutland can be contacted at lrutland@mhmrcv.org or by calling 325-658-7750. lrutland@mhmrcv.org

16. The West Texas Solution! “May none of our family & friends know what the inside of jail looks like simply because of their illness.” Lynn Rutland