County Examples & Solutions

Reducing Mental Illness in Rural Jails Case Study: Merrimack County, N.H.

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    Reducing Mental Illness in Rural Jails Case Study: Merrimack County, N.H.

    Merrimack County, N.H.

    • population (147,171)[1]
    • average daily jail population (187)[2]
    • jail capacity (237)[3]

    The Opportunity for Change

    Like many counties, Merrimack County struggles with a high percentage of people with mental illnesses in its jail. Fifty five percent of people in the 237-bed jail have a co-occurring mental illness and substance use disorder.  Recognizing the need to do something about this crisis, in 2011, Merrimack County Department of Corrections partnered with the courts, law enforcement and mental health providers to develop a series of programs to help reduce these numbers and provide better services for people with mental illnesses in the jail and leaving the jail. One such program involved the development of the only jail-based Crisis Intervention Team (CIT) in the State of New Hampshire.

    Merrimack County’s Model

    Traditionally utilized with law enforcement officers, an increasing number of counties across the country have implemented the Crisis Intervention Team (CIT) model with correctional officers. Three officers from the Merrimack County Department of Corrections were trained in the CIT model by the U.S. Department of Justice, National Institute of Corrections and serve as “train the trainers” for staff.  These trainers then brought the concept of CIT to the entire Corrections staff, providing an overview presentation to 100 officers, medical and support staff.  

    In January 2013, the trainers provided the advanced training to 12 staff members, as well as representatives from local municipal police departments and the Merrimack County Sheriff’s Office for a total cost of $5,000.  In addition to classroom instruction, officers-in-training participate in real-life scenarios and spend a day visiting the state mental health hospital and the Secure Psychiatric Unit at the New Hampshire State Prison for Men. Officers who graduate from this 40-hour training program are highly skilled and operate as part of the regular cadre of staff on each shift.

    In the Merrimack County jail, CIT skills are invaluable, as the jail employs the direct supervision model for inmate management.  This model typically has one officer locked in an inmate housing unit to provide inmate supervision.  Armed with only a radio and communication skills, the CIT trained officer is able to effectively manage their housing unit.  The CIT training allows officers to recognize and respond in a more effective and compassionate manner to individuals with mental illnesses and seek appropriate strategies to help them.

    In addition to providing CIT training, the Merrimack County Department of Corrections has partnered with the courts, law enforcement and the state hospital to develop a mental health court, provide case management and psychiatric services to individuals while in custody and enhance alliances with courts, attorneys, prosecutors and mental health providers in the community.  The Merrimack County Sixth Circuit-District Diversion – Concord Mental Health Court was established through a $250,000 grant from the U.S. Department of Justice, Bureau of Justice Assistance and provides case disposition alternatives to individuals with mental illnesses and/or intellectual disabilities and substance use disorders charged with misdemeanor criminal offenses.  The Court holds its participants accountable for their behavior, provides them with support and assistance and works collaboratively with service providers for quality care and treatment.

    “I couldn’t be more proud of the work Merrimack County Department of Corrections is doing with its staff and its collaboration with community partners to reduce recidivism and better serve people with mental illnesses who come into contact with our jail,” says Merrimack County Commissioner Bronwyn Asplund-Walsh.  “My hope is that ours will become a model for the rest of New Hampshire and the nation on how to treat people with mental illnesses.”

    They are currently in the process of re-purposing the old jail facility into a community corrections reentry center for men and women that would offer work release, gender-specific treatment and services and SOAR (SSI/SSDI Outreach, Access and Recovery) to better connect people to community-based services for their behavioral health needs.[4]  Merrimack County also recently passed a resolution to participate in the national Stepping Up initiative.

    Successes and Outcomes

    Although it is difficult to quantify success as a result of the CIT trainings, the Merrimack County Department of Corrections is proud to be the only secure correctional facility in the State of New Hampshire with a cadre of officers trained in CIT.   The Department recently installed a new inmate management system that will be able to provide more accurate information about individuals in custody and allow them to track interventions and evaluate outcomes.

    The Mental Health Court has seen significant success. As of 2013, a total of 44 referrals were made to the program, with 28 participating.  In the first 17 months of operation, six individuals graduated from the program.  As the program is still new, they are still gathering data on the impact of these programs on recidivism.

    The Department feels that through these efforts, and in partnerships with community providers and the courts, they have been able to keep individuals with mental illnesses in the least restrictive and most behaviorally appropriate settings as possible.  They are also realizing fiscal savings by utilizing less costly community-based services rather than incarceration, when possible.  The public/private partnerships they have established with agencies in the county help to serve residents with mental illnesses in a dignified and humane manner to help them in their recovery.

    Resource

    Ross L. Cunningham
    Assistant Superintendent, Merrimack County Department of Corrections
    603-796-3602
    rcunningham@mcdoc.net

    [1] U.S. Census Bureau, State & County QuickFacts. http://quickfacts.census.gov/. Accessed November 24, 2015.

    [2] The average daily population of the county's jail facilities for July 1, 2012 to June 30, 2013. 2015 NACo Analysis of Bureau of Justice Statistics - Annual Survey of Jails, 2013.

    [3] http://www.merrimackcounty.net/departments/corrections

    [4] For more information on SOAR, visit http://soarworks.prainc.com/

    Merrimack County, N.H. population (147,171)[1]
    2016-02-16
    County Examples & Solutions
    2017-03-30

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