At NACo’s Western Interstate Region 2019 Conference county leaders from Spokane County, Wash., and Mariposa County, Calif., addressed a packed room of county commissioners and supervisors on the issue of mental illness in jails. An estimated two million annual jail admissions involve a person with a serious mental illness. Counties big and small are looking for innovative, impactful and cost-effective solutions to address this crisis.
Mariposa County – a rural county located at the edge of Yosemite National Park in California – has taken a holistic approach to serving residents with complex needs.
Chevon Kothari, the director of the county’s health and human services agency, outlined the unique needs that many people involved in the criminal justice system face, including adverse childhood experiences (ACES) and trauma, as well as poor social determinants of health such as housing and transportation. The county identifies and scores these unique needs to inform the care, interventions or support that might be best appropriate for an individual.
Through community partnerships and leveraging state and federal funding streams, Mariposa County provides resources and services to people, while they are being held in jail and when they are reentering the community.
In addition to providing jail-based services such as competency restoration and medication-assisted treatment, the county has two collaborative courts: a drug court and a behavioral health court. These collaborative courts take an intensive team approach designed to evaluate, monitor and provide coordinated and comprehensive services that offer integrated treatment for mental health and substance use disorders, with ancillary services. The goals are to improve outcomes for individuals and the community, including: increased public safety, a reduction in recidivism, a reduction in substance use disorders and a reduction in law enforcement involvement.
As housing is a recognized need for people with mental illnesses, this is also a major focus of these efforts. The county provides a coordinated entry system into housing, along with behavioral health transition housing and permanent supportive housing for those with complex needs.
Joining Mariposa County for the session were three speakers from the conference home county of Spokane. Maggie Yates, the administrator for the county’s Regional Law and Justice Department, presented on some of the larger reform efforts of the county and how they got started.
Spokane County was a recipient of a MacArthur Foundation Safety and Justice Challenge award that has helped to jumpstart its efforts to rethink jails as the solution to social problems. Spokane County is also part of Stepping Up: A National Initiative to Reduce the Number of People with Mental Illnesses in Jails.
Ms. Yates discussed the council the county created, which includes law enforcement agencies, the fire department, pretrial services, prosecutors and defenders, judges and county and city elected officials and administrators, as well as community members who have been previously incarcerated.
Spokane County offers programs and services for people with mental illness and substance use disorders across the criminal justice continuum – from arrest to post-conviction supervision and reentry.
Joining Ms. Yates was Dave Ellis, the county’s undersheriff, who highlighted the county’s law enforcement training programs and co-deployed teams, which partner a law enforcement officer with a behavioral health provider to respond to calls for service involving a mental health crisis. Both the City of Spokane Police Department and the Spokane County Sheriff’s Department offer co-deployed teams, which have seen significant results: Of the 215 contacts the Sheriff’s co-deployed team had in March and April 2019, only two resulted in arrest. The Department estimates that the program has saved more than 170 hours in law enforcement time since being implemented.
Undersheriff Ellis also spoke about the county’s crisis stabilization center, a 16-bed facility designated for law enforcement as a place to take people experiencing a mental health crisis, rather than arresting them. Admission to the facility is voluntary and charges are not filed on the individual upon satisfactory completion of treatment and no new law enforcement contacts.
Judge Maryann Moreno from the Superior Court spoke about the various diversion and specialty court options available within the county. The county offers mental health diversion that is a voluntary program with intensive case management where charges are dismissed if the person completes treatment. The prosecutor’s office also offers diversion for people charged with first-time, low-level felonies that can result in community service, full restitution and dismissal of charges. In addition, the county has four therapeutic courts: drug court, mental health court, veterans court and community court.
Finally, Spokane County received a Bureau of Justice Assistance grant to implement a reentry program to serve 200 people over two years. With the program, individuals leaving the jail are paired with community health workers to identify and address needs and also have the opportunity to meet with a housing specialist. The City of Spokane also has a Resource Center available that has 25 co-located providers to serve as a one-stop shop for obtaining services.
Mariposa County and Spokane County are just two of many examples of counties building sustainable and data-driven policies, practices and programs to help reduce the number of people with mental illnesses in their jails and improve outcomes for some of their most vulnerable residents. More county examples are available here.
For more information and resources on getting started with your own efforts to address this challenge, check out the national Stepping Up initiative at www.StepUpTogether.org.
Stepping Up is a national initiative to reduce the number of people with mental illnesses in jails and the result of a partnership between NACo, the Council of State Governments Justice Center and the American Psychiatric Association Foundation.