Crisis Intervention Teams (CIT)

CIT in Action

March 2008: Vol. 3, Issue 3

Feature Story: Criminal Justice Leaders Develop Plan to Transform Florida’s Mental Health System

Contributor: Laura Usher

In response to a crisis in community mental health care, compounded by a growing population of people with serious mental illnesses in Florida's jails and prisons, the Supreme Court of Florida has produced a proposal for the reform of Florida's criminal justice/mental health system. The report, entitled "Mental Health: Transforming Florida’s Mental Health System," focuses on improving care for Floridians most at risk for criminal justice involvement. This report is the product of a criminal justice/mental health partnership that benefited from unprecedented leadership from the highest levels of the Governor’s office and the judiciary.

The report argues persuasively that, in the absence of an adequate system of community mental health care, jails and prisons have become warehouses for people with the most severe mental illnesses. Calling jails and prisons "the asylums of the new millennium," the report paints a stark picture of the history of mental health "care": cycling from prisons, to asylums, to hospitals, and back to prisons.

The proposal argues for evaluating people receiving mental health services for a history of justice involvement, and those with certain factors that make them at risk for justice involvement – including a history of repeated use of crisis services, co-occurring substance abuse, and history of treatment non-compliance. Once identified, these groups would receive targeted treatment and services designed to avoid future justice involvement. For those coming out of jails, prisons and psychiatric hospitals, services would involve in-reach prior to release, and coordination of housing, community services and access to medications, both before and after release.

The plan calls for a 6 year, phased roll-out, during which Integrated Specialty Care Networks (ISCN) would be developed. ISCN’s would employ highly-qualified providers to deliver targeted services to people with a history or risk of justice involvement. In the first two years, implementation would be limited to three sites, with no more than a 1000 participants per site. Over the course of implementation, the goal would be to serve about 25,000 annually.

The report proposes to fund these efforts through Medicaid, and through general funds from the Department of Children and Families. The justices propose maximizing enrollment in Medicaid and SSI/SSDI using promising practices that increase the initial acceptance rates for applications. In addition, they suggest recalling $48 million currently contracted to invest in forensic competency restoration, and investing that money instead in preventive services.

The report also offers a vision for how communities can plan for locally appropriate services, and addresses issues relating to acute care, emergency holds, and evidence-based practices. The justices refers to a variety of existing models, including the Criminal Justice Mental Health Consensus Project Report, and the Sequential Intercept Model, a framework for engaging people at every stage of criminal justice involvement.

The report calls for effective services for youth involved in juvenile justice, foster care and child protective services. Because children involved in all of these systems experience significant emotional problems and are especially vulnerable, the justices propose a coordinated response designed to address mental health needs and reduce the risk of later justice involvement. The justices support the recommendations of Florida’s Blueprint Commission on the juvenile justice system, and the National Center for Mental Health and Juvenile Justice’s report on comprehensive services for youth with mental illnesses involved in the criminal justice system.

Because mental illnesses and substance abuse disorders underlie so many of the cases in criminal, family, juvenile justice and other courts, the justices call for judges to be educated on mental illnesses and the mental health system. They also call for further education throughout the judicial system, including for lawyers and court personnel. Finally, the report calls on judges to take a leadership role in the creation of community collaborations around mental health and criminal justice issues.

The Florida Supreme Court’s report on transforming the mental health system presents a powerful vision for future action. The combined efforts of stakeholders across Florida, and leadership by the Florida Supreme Court, promise to create a more effective, responsive system that keeps people with mental illnesses out of the criminal justice system. We look forward to updating you on their progress.

Advocacy Spotlight: State Legislation Related to CIT

State Legislation Related to CIT

Currently, there are no state laws mandating CIT programs. However, a few states have taken legislative steps to recognize or fund CIT or other specialized police training programs. A Kentucky law establishes CIT as a best practice and requires that CIT training be made available to interested law enforcement departments. A Texas law requires that all police officers receive 16 hours of training in de-escalation and crisis intervention techniques – not CIT, but a step in the right direction. Finally, Florida law establishes a grant program that funds a variety of projects at the intersection of mental health and criminal justice, including CIT and mental health courts. Click here to learn more, or read these bills.

Tip: If you need assistance in your state advocating for legislation related to CIT or other criminal justice issues, contact the NAMI CIT Resource Center by emailing laurau@nami.org. If you need assistance with other state legislative efforts, contact NAMI’s Director of State Policy, Angela Kimball, by emailing angelak@nami.org.

News and Announcements

Bureau of Justice Assistance Announces 2008 Justice and Mental Health Collaboration Grants

The Bureau of Justice Assistance (BJA), U.S. Department of Justice, has released its solicitation for fiscal year 2008 applications for Justice and Mental Health Collaboration Program grants. Grant applicants should demonstrate that their programs increase public safety through innovative cross-system collaborations that improve responses to people with mental illnesses who come into contact with the criminal justice system. Eligible applicants are states, units of local government, Indian tribes, and tribal organizations. Types of grants include Planning, Planning and Implementation, and Implementation and Expansion. For more information, visit the Bureau of Justice Assistance website. To apply for this and other US government grants, visit www.grants.gov. If you have questions, contact Ruby Qazilbash at (202) 305-6982 or Ruby.Qazilbash@usdoj.gov. The deadline for applications is May 6, 2008 at 8:00 p.m. Eastern Time.

SAMSHA Announces 2008 Jail Diversion and Trauma Recovery Grants

The Center for Mental Health Services at the Substance Abuse and Mental Health Services Administration (SAMHSA) is accepting applications for fiscal year 2008 Jail Diversion and Trauma Recovery Program - Priority to Veterans grants. The purpose of this program is to support local implementation and statewide expansion of trauma-integrated jail diversion programs to reach the growing number of individuals with post traumatic stress disorder (PTSD) and trauma related disorders involved in the justice system. In recognition of the dramatically higher prevalence of trauma related illnesses among veterans, this program will prioritize eligibility for veterans. Visit the SAMHSA website for more information and an application. If you have program-related questions, contact David Morrissette at (240) 276-1912 or david.morrissette@samhsa.hhs.gov. If you have grants management questions, contact Gwendolyn Simpson at (240) 276-1408 or
gwendolyn.simpson@samhsa.hhs.gov. The deadline for applications is May 8, 2008.

Senate Judiciary Committee Approves MIOTCRA Reauthorization

On March 6^th, the Senate Judiciary Committee approved the Mentally Ill Offender Treatment and Crime Reduction Reauthorization and Improvement Act (MIOTRCA). The bill, which has already passed the House of Representatives, will now go before the full Senate. MIOTCRA authorizes funding for grants programs through the Bureau of Justice Assistance which support a variety of mental health and criminal justice collaborations, including CIT and mental health courts.

Kansas Public Radio Story on CIT Features NAMI Kansas

Kansas Public Radio’s Brian Thompson reported on the benefits of CIT to residents of Johnson County. The story features interviews with Rick Cagan, Executive Director of NAMI Kansas, and Wichita police officer John Ryan. The story offers an officer’s perspective on an encounter with a person with mental illness, and describes the extent of the problem that officers face. CIT exists in Johnson County in Kansas, and is planned for Wichita. To listen to the story, visit the Kansas Public Radio website.

Helpful Links

2008 CIT National Conference
Check out details of this year’s conference!

Ohio Criminal Justice Coordinating Center of Excellence
Learn more about CIT in Ohio.

NAMI Maine’s Criminal Justice Website
Read their new report on CIT in Correctional Facilities.

Comments or Suggestions?

Please let us know what you think we should include in future editions of CIT in Action by emailing Laura Usher at laurau@nami.org.

To unsubscribe: This newsletter is distributed via NAMI’s forensic list-serv, which includes periodic announcements and information about jail diversion, CIT and other forensic issues. If you wish to unsubscribe, please send an email to laurau@nami.org.

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