2019 Pilot Summit Thursday, August 29, 2019 Michigan Mental Health - - PowerPoint PPT Presentation

Wayne State University Center for Behavioral Health and Justice 1 2019 Jail Diversion Pilot Summit – Thursday, August 29th, 2019

Michigan Mental Health Diversion Council & Wayne State University Center for Behavioral Health and Justice

Thursday, August 29, 2019

Michigan Mental Health Diversion Council

2019 Pilot Summit

Wayne State University Center for Behavioral Health and Justice 2 2019 Jail Diversion Pilot Summit – Thursday, August 29th, 2019

In Intercept 1: : Law Enforcement

Panel Discussion: Be Best t Practices es, Promising Practices, and Les Lessons Lea Learned

Law Enforcement officers and/or emergency services are the first responders for people experiencing a mental health crisis or emergency, which can be an intervention point to avoid formal entry to the criminal justice system. Intercept 1 includes all prearrest diversion options and concludes when someone is arrested.1

Promising Practices in

Cross ss-Sector Relationships

Featuring

Chad Surque

Lifeways Community Mental Health Authority - Jackson County

Promising Practices in

Standardized Referrals

Featuring

Adria Cla lark

Monroe Community Mental Health Authority

Lessons Learned in

Im Implementi ting a Div iversion Room

Featuring

Lynn Jo Johnson

Pathways Community Mental Health Marquette County

Lessons Learned in

Developing a Crisi isis Center

Featuring

Ross Buit itendorp

Network 180 Kent County

Best Practices in

Crisi isis In Interv rvention Training for Offic ficers

Featuring

Dan Holloway

Oakland County Health Network

Officers in Oa Oakland Cou County trained in CIT CIT were

3x more likely

to use the Cri Crisis Ce Center

than untrained officers.

Visit https://behaviorhealthjustice.wayne.edu/reports-publications-resources to view reports and publications for data sources.

Wayne State University Center for Behavioral Health and Justice 3 2019 Jail Diversion Pilot Summit – Thursday, August 29th, 2019

In Intercept 2: : Initial Detention/ Initial Court Hearings

Panel Discussion: Be Best t Practices es, Promising Practices, and Les Lessons Lea Learned

Init nitial ial Detentio ion/I /Init itia ial l Cour Court Hea Hearin rings aims to avoid the costly collateral consequences of incarceration and connect people to services, and encompasses postarrest diversion options including diversion to treatment instead of incarceration or prosecution.1

Best Practices in

Cross ss-System Data Match ching for Tim Timely In Interventi tion

Featuring

Bob Butkiewic icz

Kalamazoo Community Mental Health and Substance Abuse Services

Best Practices in

Im Implementi ting Standardized Scr creens at t Bookin ing

Featuring

Majo jor

Troy Goodnough

Monroe County Jail

Promising Practices in

Standardized Scr creening and Foll llow-up

Featuring

Lis isa Ianitell lli

Community Mental Health and Substance Abuse Services of St. Joseph County

100% of individuals

booked into the Monroe County Jail receive a stan

andardized

• pioid misuse and

mental health sc screen.

flagged by the notification system received their first post-release service

with thin a a wee eek.

• f KCMHSAS clients

63%

Visit https://behaviorhealthjustice.wayne.edu/reports-publications-resources to view reports and publications for data sources.

Wayne State University Center for Behavioral Health and Justice 4 2019 Jail Diversion Pilot Summit – Thursday, August 29th, 2019

In Intercept 3: : Jails/Courts

Panel Discussion: Be Best t Practices es, Promising Practices, and Les Lessons Lea Learned

Ja Jails ils/Co /Court rts focuses on people being held in pretrial detention and awaiting the disposition of their criminal cases, and concludes when someone is sentenced to incarceration or community supervision.1

Promising Practices in

Boundary ry Spanning and Data Sharin ing

Featuring

Dane Beckford

Riverwood Center - Berrien County

Best Practices in

Ja Jail-Based Id Identi tificati tion, Referral and Servi vices

Featuring

Nik ikole Skip ipp

Kent County Correctional Facility Mental Health Unit

identified as having a mental health need were referred to services; asse assess ssment or ser servic ice.

100% of individuals 98%received an

Visit https://behaviorhealthjustice.wayne.edu/reports-publications-resources to view reports and publications for data sources.

Wayne State University Center for Behavioral Health and Justice 5 2019 Jail Diversion Pilot Summit – Thursday, August 29th, 2019

2019 Michigan Mental Health Diversion Council Pilot Summit

Wayne State University Center for Behavioral Health and Justice

Building from Baseline Data

Wayne State University Center for Behavioral Health and Justice 6 2019 Jail Diversion Pilot Summit – Thursday, August 29th, 2019

We envision communities in which research, data, and best practices are used by multiple stakeholders to enhance the optimal well-being of individuals with mental illness and/or substance use disorders who come in contact with the criminal/legal system.

TECHNIC HNICAL L ASSIS SISTANCE NCE

The Center for Behavioral Health and Justice works with six Stepping Up communities to gather sufficient data to properly identify the target population, select and implement appropriate interventions, and develop a sustainable system to track and monitor impact.

We serve as consultants and evaluators for the Council’s pilot programs currently underway in ten

• counties. Our staff also help the

Diversion Council identify state-level policy and practice improvements.

Wayne State University Center for Behavioral Health and Justice 7 2019 Jail Diversion Pilot Summit – Thursday, August 29th, 2019

2019 K6 Mental Health Screen

(N=3,802)

Wayne State University Center for Behavioral Health and Justice 8 2019 Jail Diversion Pilot Summit – Thursday, August 29th, 2019

Kessler 6 (K6) Screening Instrument

Wayne State University Center for Behavioral Health and Justice 9 2019 Jail Diversion Pilot Summit – Thursday, August 29th, 2019

Kessler 6 (K6) Screening Instrument

Wayne State University Center for Behavioral Health and Justice 10 2019 Jail Diversion Pilot Summit – Thursday, August 29th, 2019

Total Booking and K6 Usable Screens

5,2 5,261 6,1 6,143 3,3 3,356 3,8 3,802

1000 2000 3000 4000 5000 6000 7000

2017 2019* Booking K6 Usuable

*Booking numbers estimated for one county. Data Source: K6 Collection 2017 & 2019

• Total jail bookings during the

study period increased between 2017 and 2019*.

• Equal proportions of ‘usable’

K6 screens were gathered in 2017 (64%) and 2019 (62%).

Wayne State University Center for Behavioral Health and Justice 11 2019 Jail Diversion Pilot Summit – Thursday, August 29th, 2019

Total Booking and K6 Usable Screens By County 2019

272 272 846 846 839 839 576 576 480 480 630 630 738 738 503 503 423 423 836 836 161 161 325 325 353 353 425 425 391 391 514 514 487 487 432 432 306 306 408 408

100 200 300 400 500 600 700 800 900 Cty A Cty B Cty C Cty D Cty E Cty F Cty G Cty H Cty I Cty J

Booking* K6 Usuable

• Proportion of

‘usable’ K6 screens ranged from 38% to 86%.

*Booking numbers estimated for one county Data Source: K6 Collection 2017 & 2019

Wayne State University Center for Behavioral Health and Justice 12 2019 Jail Diversion Pilot Summit – Thursday, August 29th, 2019

Positive K6 – Serious Mental Illness (SMI)

Positive SMI, 23% 23% Negative SMI, 77% 77%

2019 Collection* (n=3,802)

24 24% 20 20% 21 21% 15% 17% 19% 21% 23% 25% 2015 2017 2019

K6 SMI Over Time (n=3,222**)

* Includes two counties not included in 2017 collection ** Includes only the original 8 counties for comparison purposes Data Source: K6 Collection 2015, 2017, and 2019

Wayne State University Center for Behavioral Health and Justice 13 2019 Jail Diversion Pilot Summit – Thursday, August 29th, 2019

SMI by County, Over Time

18 18% 27 27% 0% 10% 20% 30% 2017 2019

Cou County ty

A

22 22% 25 25% 0% 10% 20% 30% 2017 2019

Cou County ty

B

21 21% 22 22% 0% 10% 20% 30% 2017 2019

Cou County ty

D

18 18% 16 16% 0% 10% 20% 30% 2017 2019

Cou County ty

E

21 21% 22 22% 0% 10% 20% 30% 2017 2019

Co County ty

J

19 19% 32 32% 0% 10% 20% 30% 40% 2017 2019

Co County ty

I

22 22% 19 19% 0% 10% 20% 30% 2017 2019

Cou County ty

H

16 16% 12 12% 0% 10% 20% 30% 2017 2019

Cou County ty

G

Data Source: K6 Collection 2017 & 2019

Wayne State University Center for Behavioral Health and Justice 14 2019 Jail Diversion Pilot Summit – Thursday, August 29th, 2019

23% 23% 21% 21% 19% 19% 34% 34%

0% 5% 10% 15% 20% 25% 30% 35% SMI Overall Metropolitan Urban Rural

SMI by County Size* (n=3,802)

*Difference statistically significant

Data Source: K6 Collection 2019

• Rural jails have a higher

proportion of individuals with SMI in their jails (34%), compared to metropolitan (21%) or urban jails (19%).

Wayne State University Center for Behavioral Health and Justice 15 2019 Jail Diversion Pilot Summit – Thursday, August 29th, 2019

Substance Misuse, Opioid Preference & Withdrawal Concern (n=3,802)

Withdrawal Concern* 9% 9% No Concern 91% 91% Opioid Preference* 9% 9% No Preference 91% 91% Substance Misuse 55% 55% No Substance Misuse 45% 45%

* Includes only 9 counties Data Source: K6 Collection 2019

Wayne State University Center for Behavioral Health and Justice 16 2019 Jail Diversion Pilot Summit – Thursday, August 29th, 2019

SMI and Substance Misuse

17 17-24 24

White individuals

were more likely to report

• pi

pioid pr preference, al alcohol l misuse & drug rug misu suse

than People of Color*. 25 25-30 30 31+ 31+

Older individuals

were more likely to report

• pi

pioid pr preference & al alcohol l misu isuse

than younger individuals*.

Females

were more likely to report

• pi

pioid pr preference & drug drug misu suse

than males*.

Males

were more likely to report

alc lcohol l misuse

than females*.

Individuals with SMI

were more likely to report

• pi

pioid pr preference, al alcohol l misuse & drug rug mis isuse

than individuals without SMI*.

Data Source: K6 Collection 2019

*Difference statistically significant

Wayne State University Center for Behavioral Health and Justice 17 2019 Jail Diversion Pilot Summit – Thursday, August 29th, 2019

9% 9% 10% 10% 9% 9% 11% 11%

0% 2% 4% 6% 8% 10% 12% Opioid Preference Metropolitan Urban Rural

Opioid Preference by County Size (n=3,802)

Difference NOT statistically significant

Data Source: K6 Collection 2019

• Individuals reported no

difference in opioid preference by county size.

Wayne State University Center for Behavioral Health and Justice 18 2019 Jail Diversion Pilot Summit – Thursday, August 29th, 2019

9% 9% 12% 12% 7% 7% 9% 9%

0% 2% 4% 6% 8% 10% 12% 14% Withdrawal Concern Metropolitan Urban Rural

Withdrawal Concern by County Size* (n=3,802)

*Difference statistically significant

Data Source: K6 Collection 2019

• Individuals in metropolitan

counties (12%) are more likely to report withdrawal concern than individuals in urban counties (7%).

Wayne State University Center for Behavioral Health and Justice 19 2019 Jail Diversion Pilot Summit – Thursday, August 29th, 2019

9% 9% 20% 20% 6% 6%

0% 2% 4% 6% 8% 10% 12% 14% 16% 18% 20% Withdrawal Concern SMI+ SMI-

Withdrawal Concern & SMI* (n=3,802)

*Difference statistically significant

Data Source: K6 Collection 2019

• Individuals with SMI are more

likely to report withdrawal concern (20%) than individuals who do not have SMI (6%).

Wayne State University Center for Behavioral Health and Justice 20 2019 Jail Diversion Pilot Summit – Thursday, August 29th, 2019

Withdrawal Concern & Substance Misuse (n=3,802)

*Difference statistically significant

Data Source: K6 Collection 2019

Withdrawal concern is more likely to be reported by:

• Individuals who reported
• pioid preference (45%)

than those who did not report opioid preference (5%).

• Individuals who reported

drug misuse (17%) than those who did not report drug misuse (6%).

• Individuals who reported

alcohol misuse (13%) than those who did not report alcohol misuse (7%).

Opioi ioid Preference* Dr Drug Misu isuse se* Alc lcohol Mis isuse* 9% 9% 45% 45% 5% 5% 17% 17% 6% 6% 13% 13% 7% 7%

0% 5% 10% 15% 20% 25% 30% 35% 40% 45% 50%

Withdrawal Concern Opioid Preference No Opioid Preference Drug Misuse No Drug Misuse Alcohol Misuse No Alcohol Misuse

Wayne State University Center for Behavioral Health and Justice 21 2019 Jail Diversion Pilot Summit – Thursday, August 29th, 2019

Withdrawal Concern by Demographics (n=3,802)

9% 9% 6% 6% 12% 12% 5% 5% 7% 7% 12% 12% 8% 8% 13% 13%

0% 2% 4% 6% 8% 10% 12% 14% Withdrawal Concern POC White 17-24 25-30 31+ Men Women

Ra Race* Age* Se Sex*

*Difference statistically significant

Data Source: K6 Collection 2019

• White individuals (12%) are

more likely to have a withdrawal concern than People of Color (6%).

• Older individuals (12%) are

more likely to have a withdrawal concern than younger individuals (17-24= 5%; 25-30= 7%).

• Women (13%) are more

likely to have a withdrawal concern than men (8%).

Wayne State University Center for Behavioral Health and Justice 22 2019 Jail Diversion Pilot Summit – Thursday, August 29th, 2019

• Proportion of individuals with SMI in 8 county jails has decreased from 24% in 2015

to 21% in 2019.

• Communities with continued dialogue and collaboration have seen the largest

decreases.

• Rural communities need more resources and continued innovation to decrease rates of

SMI in jail.

• Individuals with SMI are much more likely to select opioids as their drug of choice

and to be concerned about withdrawal during their jail stay.

• Medication Assisted Treatment (MAT) in jails provides an evidence-based treatment
• pportunity to individuals at risk for serious health and social consequences.
• Dialogue can maximize resources and efficiencies between systems and decrease

barriers to sustainability.

K6 Data Takeaway Points

Wayne State University Center for Behavioral Health and Justice 23 2019 Jail Diversion Pilot Summit – Thursday, August 29th, 2019

OUD Screen

• The Rapid Opioid Dependence Screen

(RODS)1 includes 11 questions and takes approximately 2 minutes to complete.

• Includes questions about substance use in the

last 12 months, current medication assisted treatment for opioids (MAT), and social consequences of opioid use disorder.

• Utilizing a standardized screen enhances the

detection of Opioid Use Disorder, and therefore the ability to treat.

• Questions to consider:
• Do you screen for OUD?
• Do you have a standard protocol for withdrawal?

21(1), 12–26. doi:10.1177/1078345814557513

Wayne State University Center for Behavioral Health and Justice 24 2019 Jail Diversion Pilot Summit – Thursday, August 29th, 2019

Next Steps

• Current: Jail-based services analyses.
• Upcoming: Site visits (potentially Fall and Winter) and start of integrated report.
• Next Spring: Long-term outcomes:
• Discharge Planning.
• Treatment Engagement.
• Jail Recidivism.
• Courts: Specialty & Traditional.
• Comparison with 2017 Baseline Data.
• Technical assistance for jail diversion sites.
• Support communities as evaluators/research partners on federal grants.

Wayne State University Center for Behavioral Health and Justice 25 2019 Jail Diversion Pilot Summit – Thursday, August 29th, 2019

Data Integration

• Data integration is the process of bri

ringin ing together in inform rmatio ion fr from mult ltip iple le so sources so it can be examined to provide holistic knowledge.

• Track trends over time & regular updates/feedback

from stakeholders.

• Establish sources of data & assist in the

definition of variables.

• CBHJ will create template file with codebook &

specific instructions on each variable.

• Data Integration process will begin with site

visits to assess specific needs & to establish a timeline.

Wayne State University Center for Behavioral Health and Justice 26 2019 Jail Diversion Pilot Summit – Thursday, August 29th, 2019

Data Integration

Organization A Organization B

Da Dataset 1A Da Dataset 1B

Gatekeeper Organization in integrates data

Da Dataset 2A Da Dataset 3A Da Dataset 2B Da Dataset 3B

Dataset 1A 1A Dataset 1B 1B Dataset 2A 2A Dataset 3A 3A Dataset 2B 2B Dataset 3B 3B

Glo lobal Dataset

Wayne State University Center for Behavioral Health and Justice 27 2019 Jail Diversion Pilot Summit – Thursday, August 29th, 2019

Data Integration Utility

• Track trends over time & provide regular updates/feedback to

stakeholders.

• Enhances data-driven decision making to better identify resource gaps

& other issues that contribute to incarceration/recidivism.

• Integrated Model of Prevention.
• Could be used to identify unintended consequences of policy

implementation & inform policy change.

• Increases competitiveness to apply and obtain future funding
• pportunities.

Wayne State University Center for Behavioral Health and Justice 28 2019 Jail Diversion Pilot Summit – Thursday, August 29th, 2019

Erin Comartin, Ph.D., LMSW

Associate Professor of Social Work & Data Director of the Center for Behavioral Health and Justice Wayne State University at9766@wayne.edu

Liz Tillander, LMSW

Deputy Director of the Center for Behavioral Health and Justice Wayne State University Liz.tillander@wayne.edu

Sheryl Kubiak, Ph.D.

Dean Of WSU School of Social Work & Founding Director of the Center for Behavioral Health and Justice Wayne State University spk@wayne.edu

Grant Victor III, Ph.D., MSW

Integrated Reporting Consultant / Post Doctoral Fellow Center for Behavioral Health and Justice Wayne State University grantvictor100@gmail.com

Wayne State University Center for Behavioral Health and Justice 29 2019 Jail Diversion Pilot Summit – Thursday, August 29th, 2019

In Intercept 4: : Reentry

Panel Discussion: Be Best t Practices es, Promising Practices, and Les Lessons Lea Learned

Visit https://behaviorhealthjustice.wayne.edu/reports-publications-resources to view reports and publications for data sources.

Reentry addresses the continuity of care between correctional facilities and community behavioral health providers as people return to their communities, and concludes when someone is released from jail or prison and start community supervision1.

Best Practices in

Usin sing Evid vidence-Based Practi tices for Conti tinuity of f Care

Featuring

Steve Stuckey

Central City Integrated Health Wayne County

Participants in Central City Integrated Health’s FACT based program were in jail a total of

256 256 days fewer

after intervention. Promising Practices in

Dis ischarge Pla lanning

Featuring

Ashley Ja James

Barry County Community Mental Health Authority

Promising Practices in

Usin sing Peer Support t for Dis ischarge Pla lanning

Featuring

Matt Faust

Livingston County Community Mental Health Authority

Lie ieutenant

Je Jeff LeVeque

Livingston County Sheriff’s Office

Wayne State University Center for Behavioral Health and Justice 30 2019 Jail Diversion Pilot Summit – Thursday, August 29th, 2019

In Intercept 5: Community Corrections

Panel Discussion: Be Best t Practices es, Promising Practices, and Les Lessons Lea Learned

Com Communit nity Cor Correctio ions encompasses probation and parole1.

Best Practices in

Coll llaborati ting with ith Community ty Corrections

Featuring

Bo Bob Bu Butkie iewic icz

Kalamazoo Community Mental Health and Substance Abuse Services

Promising Practices in

Developing a Div iversion Council

Featuring

Heather r Wie iegand

HealthWest Muskegon County

Promising Practices in

Community ty Corr rrec ections

Featuring

Marl rlene Coll llic ick

Genesee County Community Corrections

• f those identified

by the K6 as having a mental health concern entered the jail on

vio viola latio ion charges.

11% 11% of a subsample

Visit https://behaviorhealthjustice.wayne.edu/reports-publications-resources to view reports and publications for data sources.

Wayne State University Center for Behavioral Health and Justice 31 2019 Jail Diversion Pilot Summit – Thursday, August 29th, 2019

Panel Discussion: Be Best t Practices es, Promising Practices, and Les Lessons Lea Learned

In Intercept 0: : Community Services

Com

• mmuni

unity Services is considered a gate-keeper to formal interaction with the criminal justice system. It encompasses the early intervention points for people with mental health issues before they are arrested and involves entities outside the criminal justice system1.

Promising Practices in

Pas assin ing a a Mental l Health Mill illage

Featuring

Marib ibeth Leonard

Lifeways Community Mental Health Jackson and Hillsdale Counties

Promising Practices in

Pas assin ing a a Publi lic Sa Safety & Mental l Health Mill illage

Featuring

Sherif iff

Je Jerry ry Cla layt yton

Washtenaw County Sheriff’s Office

Tri rish Cortes

Washtenaw County Community Mental Health

Visit https://behaviorhealthjustice.wayne.edu/reports-publications-resources to view reports and publications for data sources.

Wayne State University Center for Behavioral Health and Justice 32 2019 Jail Diversion Pilot Summit – Thursday, August 29th, 2019 Michigan Mental Health Diversion Council

Lieutenant Governor

Garlin Gilchrist II

Wayne State University Center for Behavioral Health and Justice 33 2019 Jail Diversion Pilot Summit – Thursday, August 29th, 2019

Questions & Discussion

Michigan Mental Health Diversion Council

Wayne State University Center for Behavioral Health and Justice 34 2019 Jail Diversion Pilot Summit – Thursday, August 29th, 2019 Michigan Mental Health Diversion Council

Wayne State University Center for Behavioral Health and Justice 35 2019 Jail Diversion Pilot Summit – Thursday, August 29th, 2019