County Examples & Solutions

Reducing Mental Illness in Rural Jails Case Study: Dunn County, Wisc.

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    Reducing Mental Illness in Rural Jails Case Study: Dunn County, Wisc.

    Dunn County, Wisc.

    • Population: 44,305[1]
    • Jail capacity: 156[2]
    • Average daily jail population: 75[3]

    The Opportunity for Change

    To address the increasing number of individuals with mental illnesses being admitted to hospital emergency departments and jails, Dunn County’s Criminal Justice Collaborating Council (CJCC) identified several mechanisms to support diversion to community services and supports. In addition to the two programs described below, Dunn County passed a resolution to participate in the Stepping Up initiative in May 2015. Since then, staff has been engaged in Stepping Up technical assistance resources and is developing a process for better calculating mental health prevalence rates and using this information to inform next steps for meeting the needs of this population before they come into contact with the justice system.

    Dunn County’s Model

    Dunn County has worked to address the needs of its residents with mental illnesses in a number of ways, including implementation of a mobile response team and an integrated treatment court.

    Crisis Call Center and Mobile Response

    In 2006, Dunn County received a state grant to develop a mobile crisis team within the County Department of Human Services (DHS) to help meet the increasing demand on emergency departments and the county jail of people experiencing mental health crisis.

    With this grant, DHS developed and staffs a 24-hour crisis call center that individuals experiencing a mental health crisis, family members and law enforcement officers can call for assistance. Law enforcement officers from across the county, including sheriff’s deputies, municipal police and university police, as well as County DHS staff, local medical center staff and university counseling services have been cross trained in crisis assessment so they know when it’s appropriate to call for crisis assistance.

    The call center can do an informal assessment over the phone to help determine the appropriate plan of action, whether it is to dispatch the mobile crisis team or approve an emergency detention.[4] In many cases, when an individual calls the crisis call center, the DHS staff member is able to work with him or her over the phone to calm the situation and set up an appointment to meet with a mental health provider. If law enforcement is involved, before the officer leaves he or she will work with the individual and the DHS staff member to develop a safety plan to ensure that the individual has what he or she needs before meeting with the provider.

    Prior to the crisis call center and mobile response teams, law enforcement officers would frequently be tied up for up to 10 hours for one call for service involving a mental health crisis. Officers reported that it often took this long to transport and process an individual for an emergency detention.

    Also as part of the grant, law enforcement officers from across the county, including sheriff’s deputies, municipal police, and university police, as well as County DHS staff, local medical center staff, and university counseling services were cross trained in crisis assessment. The Sheriff’s Office has since made this training part of their training for all law enforcement officers.

    Integrated Treatment Court

    In 2008, Dunn County established the first treatment court in Wisconsin for people with co-occurring mental illnesses and substance use disorders. The Treatment Court is a blending of mental health and drug court models that caters to individuals who were identified as being medium-high risk and medium-high need on a validated risk assessment instrument. Intensive treatment, supervision and accountability are provided during the 12-18 month long program and frequent and random alcohol and drug testing ensures participants are maintaining sobriety with treatment adjustments being made as necessary. A critical goal of the Court is to assist the participant in establishing a lifestyle of recovery where the participant is employed, sober, current on financial obligations and positively involved in the community by the time they graduate. So far, 51 people have participated in the court, 21 have graduated, 20 were terminated and 10 are still actively participating.  Of the total participants, 80 percent have co-occurring disorders.

    The Court Treatment Team is funded primarily by Dunn County, along with state and federal grants and consists of a part-time coordinator and part-time Integrated Treatment Specialist, along with representatives from the courts, probation and treatment providers that meet weekly before court and reviews progress made by each participant. Sanctions are used in the Treatment Court to address any incurred violation, and incentives are used to reward success.  Participants pay $750 to participate, $250 of which can be met by completing 25 hours of community service. Participants are encouraged to develop a payment plan early in the program to ensure that this fee is paid before graduation without being a significant burden to them. The Court holds graduation ceremonies to celebrate completion of the program. In addition, the Dunn County Treatment Court Advisory Work Group meets quarterly to discuss programmatic activities and challenges and opportunities for the court.

    “I fully support our county’s efforts to reduce the number of people with mental illnesses in our jail,” says Dunn County Chairman Steve Rasmussen. “This is fundamentally a medical issue; we wouldn’t lock up someone who was in a diabetic coma. It’s the right thing to do. It is also the enlightened, wise and compassionate people to do for our residents. It addresses the reality of the situation we face in our county and also has a side benefit of helping to manage the rising costs of our public safety system.”

    Successes and Outcomes

    Dunn County has seen a number of successes since implementing these two programs.

    • The crisis call center responded to 627 total contacts in 2014, and the mobile crisis team was dispatched 57 times.
    • An initial evaluation of the Treatment Court’s first three years of operation found that the county saved approximately $134,031 in jail incarceration costs as a result of the Court and that participants’ recidivism rates were below 10 percent over a three-year follow up period.
    • An evaluation of Treatment Court in December 2013, corresponding with the five year anniversary of the program and reflecting the addition of the Integrated Treatment Specialist staff, shows a 95 percent success rate based on those who have either successfully completed the program or who are presently engaged in the program and making positive progress (15 percent completion and 85 percent showing strong progression in the program). This rate is higher than the national success rate of 70 percent.
    • Dunn County recently conducted a recidivism study of the 51 program participants since its inception in 2008.  Of the 51 participants, 10 are still active, 21 graduated and 20 were terminated.  Of the terminations, the recidivism rate as measured by new criminal convictions (misdemeanor or felony) after the program is 50 percent. Of the 21 program graduates, 9.5 percent – only two participants – were convicted of a new crime after completing the program.

    Resource

    Sara Benedict, LPC, CRC
    Criminal Justice Coordinator
    Dunn County Criminal Justice Collaboration Division
    Phone: (715) 231-6686
    Email: sbenedict@co.dunn.wi.us

     

    [1] Dunn County, Wisconsin. U.S. Census Bureau. Available at http://quickfacts.census.gov/qfd/states/55/55033.html. Accessed September 16, 2015.

    [2] Correspondence with Sarah Benedict, September 4, 2015

    [3] Correspondence with Sarah Benedict, September 4, 2015

    [4] In Wisconsin, law enforcement may do an emergency detention, but County DHS must approve it.

    To address the increasing number of individuals with mental illnesses being admitted to hospital emergency departments and jails, Dunn County’s Criminal Justice Collaborating Council (CJCC) identified several mechanisms to support diversion to community services and supports.
    2016-02-19
    County Examples & Solutions
    2017-03-30

Dunn County, Wisc.

  • Population: 44,305[1]
  • Jail capacity: 156[2]
  • Average daily jail population: 75[3]

The Opportunity for Change

To address the increasing number of individuals with mental illnesses being admitted to hospital emergency departments and jails, Dunn County’s Criminal Justice Collaborating Council (CJCC) identified several mechanisms to support diversion to community services and supports. In addition to the two programs described below, Dunn County passed a resolution to participate in the Stepping Up initiative in May 2015. Since then, staff has been engaged in Stepping Up technical assistance resources and is developing a process for better calculating mental health prevalence rates and using this information to inform next steps for meeting the needs of this population before they come into contact with the justice system.

Dunn County’s Model

Dunn County has worked to address the needs of its residents with mental illnesses in a number of ways, including implementation of a mobile response team and an integrated treatment court.

Crisis Call Center and Mobile Response

In 2006, Dunn County received a state grant to develop a mobile crisis team within the County Department of Human Services (DHS) to help meet the increasing demand on emergency departments and the county jail of people experiencing mental health crisis.

With this grant, DHS developed and staffs a 24-hour crisis call center that individuals experiencing a mental health crisis, family members and law enforcement officers can call for assistance. Law enforcement officers from across the county, including sheriff’s deputies, municipal police and university police, as well as County DHS staff, local medical center staff and university counseling services have been cross trained in crisis assessment so they know when it’s appropriate to call for crisis assistance.

The call center can do an informal assessment over the phone to help determine the appropriate plan of action, whether it is to dispatch the mobile crisis team or approve an emergency detention.[4] In many cases, when an individual calls the crisis call center, the DHS staff member is able to work with him or her over the phone to calm the situation and set up an appointment to meet with a mental health provider. If law enforcement is involved, before the officer leaves he or she will work with the individual and the DHS staff member to develop a safety plan to ensure that the individual has what he or she needs before meeting with the provider.

Prior to the crisis call center and mobile response teams, law enforcement officers would frequently be tied up for up to 10 hours for one call for service involving a mental health crisis. Officers reported that it often took this long to transport and process an individual for an emergency detention.

Also as part of the grant, law enforcement officers from across the county, including sheriff’s deputies, municipal police, and university police, as well as County DHS staff, local medical center staff, and university counseling services were cross trained in crisis assessment. The Sheriff’s Office has since made this training part of their training for all law enforcement officers.

Integrated Treatment Court

In 2008, Dunn County established the first treatment court in Wisconsin for people with co-occurring mental illnesses and substance use disorders. The Treatment Court is a blending of mental health and drug court models that caters to individuals who were identified as being medium-high risk and medium-high need on a validated risk assessment instrument. Intensive treatment, supervision and accountability are provided during the 12-18 month long program and frequent and random alcohol and drug testing ensures participants are maintaining sobriety with treatment adjustments being made as necessary. A critical goal of the Court is to assist the participant in establishing a lifestyle of recovery where the participant is employed, sober, current on financial obligations and positively involved in the community by the time they graduate. So far, 51 people have participated in the court, 21 have graduated, 20 were terminated and 10 are still actively participating.  Of the total participants, 80 percent have co-occurring disorders.

The Court Treatment Team is funded primarily by Dunn County, along with state and federal grants and consists of a part-time coordinator and part-time Integrated Treatment Specialist, along with representatives from the courts, probation and treatment providers that meet weekly before court and reviews progress made by each participant. Sanctions are used in the Treatment Court to address any incurred violation, and incentives are used to reward success.  Participants pay $750 to participate, $250 of which can be met by completing 25 hours of community service. Participants are encouraged to develop a payment plan early in the program to ensure that this fee is paid before graduation without being a significant burden to them. The Court holds graduation ceremonies to celebrate completion of the program. In addition, the Dunn County Treatment Court Advisory Work Group meets quarterly to discuss programmatic activities and challenges and opportunities for the court.

“I fully support our county’s efforts to reduce the number of people with mental illnesses in our jail,” says Dunn County Chairman Steve Rasmussen. “This is fundamentally a medical issue; we wouldn’t lock up someone who was in a diabetic coma. It’s the right thing to do. It is also the enlightened, wise and compassionate people to do for our residents. It addresses the reality of the situation we face in our county and also has a side benefit of helping to manage the rising costs of our public safety system.”

Successes and Outcomes

Dunn County has seen a number of successes since implementing these two programs.

  • The crisis call center responded to 627 total contacts in 2014, and the mobile crisis team was dispatched 57 times.
  • An initial evaluation of the Treatment Court’s first three years of operation found that the county saved approximately $134,031 in jail incarceration costs as a result of the Court and that participants’ recidivism rates were below 10 percent over a three-year follow up period.
  • An evaluation of Treatment Court in December 2013, corresponding with the five year anniversary of the program and reflecting the addition of the Integrated Treatment Specialist staff, shows a 95 percent success rate based on those who have either successfully completed the program or who are presently engaged in the program and making positive progress (15 percent completion and 85 percent showing strong progression in the program). This rate is higher than the national success rate of 70 percent.
  • Dunn County recently conducted a recidivism study of the 51 program participants since its inception in 2008.  Of the 51 participants, 10 are still active, 21 graduated and 20 were terminated.  Of the terminations, the recidivism rate as measured by new criminal convictions (misdemeanor or felony) after the program is 50 percent. Of the 21 program graduates, 9.5 percent – only two participants – were convicted of a new crime after completing the program.

Resource

Sara Benedict, LPC, CRC
Criminal Justice Coordinator
Dunn County Criminal Justice Collaboration Division
Phone: (715) 231-6686
Email: sbenedict@co.dunn.wi.us

 


[1] Dunn County, Wisconsin. U.S. Census Bureau. Available at http://quickfacts.census.gov/qfd/states/55/55033.html. Accessed September 16, 2015.

[2] Correspondence with Sarah Benedict, September 4, 2015

[3] Correspondence with Sarah Benedict, September 4, 2015

[4] In Wisconsin, law enforcement may do an emergency detention, but County DHS must approve it.

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