CIT Should be a Two-Way Street. 1. Mental Health Professionals Advise - - PDF document

CIT Should be a Two-Way Street.

• 1. Mental Health Professionals Advise First Responders How to De-escalate Interventions and Connect Individuals

to Services

• 2. First Responders Advise Mental Health Professionals on What Services are Needed to Reduce Likelihood of

Police Contact Officers who died or were wounded during interventions with seriously mentally ill the mental health system was not treating

July 5, 2017 Bronx, NY. NYPD Officer Miosotis Familia was ambushed and killed by Alexander Bonds, an untreated schizophrenic with a criminal history who four days earlier tried unsuccessfully to get into a psychiatric hospital May 12, 2017, Yell County, Arkansas. Mentally ill James Arthur Bowden, 42, gunned down Yell County Sheriff's Lt. Kevin C. Mainhart during a traffic stop. January 16, 2017 Little Elm, Texas. 46-year-old Rudy Garcia, who had a history of schizophrenia and was off his medications, fatally shot Detective Jerry Walker during a confrontation.

• Nov. 4, 2016, Bronx, NY. 35-year-old Manuel Rosales, diagnosed with bipolar disorder, fatally shot 41-

year-old NYPD Sgt. Paul Tuozzolo and shot and wounded Sgt. Emmanuel Kwo during a shootout.

• Oct. 16, 2016 Alabama. 27-year-old Demetrae Griffin, diagnosed with paranoid schizophrenia, injured

two Moulton police officers and two sheriff's deputies during an altercation. (Officer Keith Pepper and Deputy Ashley Browning and Deputy Marcus Solomon)

• Sept. 7. 2016 Detroit Michigan. Marquise Cromer, diagnosed with schizophrenia and bipolar disorder,

fatally shot 46-year-old Detroit police Capt. Kenneth Steil.

• Aug. 25, 2016 Maryville, TN. 44-year-old Brian Keith Stalans, who had a history of mental illness, fatally

shot 32-year-old Maryville Police Officer Kenny Moats. July 17, 2016, East Baton Rouge, LA. 29-year-old Gavin Long who suffered from PTSD ambushed and fatally shot Deputy Brad Garafola, Officer Montrell Jackson, and Officer Matthew Gerald May 13, 2016, Manchester, MA. 32-year-old Ian MacPherson, who was diagnosed with schizophrenia, shot and wounded Manchester police officers Matthew O'Connor and Ryan Hardy April 10, 2016, Columbus OH. 44-year-old Lincoln Rutledge, who had a history of mental illness, shot and critically wounded Columbus, OH S.W.A.T. Officer Steven Smith. March 16, 2016 Prince George’s County, MD. 22-year-old Michael Ford, diagnosed with bipolar disorder, went on a shooting spree killing Police Officer First Class Jacai Colson. February 13, 2016 Baton Rouge, LA. 22-year-old mentally ill Calvin Smith shot officers Theodore Smith III and Sean Garic. November 27, 2015. Colorado Springs, CO. 57-year-old mentally ill Robert Lewis Dear Jr. killed University

• f Colorado Colorado Springs police officer Garrett Swasey, 44, during a shooting spree at a Planned

Parenthood clinic. August 28, 2015/ Harris County, TX. 30-year-old Shannon J. Miles, a homeless man with schizophrenia, fatally shot Harris County Sheriff's Deputy Darren Goforth outside of a gas station. December 20, 2014. Brooklyn, NY. 28-year-old mentally ill Ismaaiyl Brinsley, fatally shot 42-year-old police officer Rafael Ramos and 32-year-old police officer Wenjian Liu. April 2, 2014.Ft. Hood, TX 34-year-old Spc. Ivan Lopez killed 37-year-old Sgt. Timothy Owens, 38- year-old Staff Sgt. Carlos A. Lazaney-Rodriguez, and Sgt. 1st Class Danny Ferguson.

Police Chiefs and CIT Officers Should Insist Programs That Keep Patients and Police Safer be Expanded BEFORE POLICE INVOLVEMENT:

• Include LEO Representation
• n All Mental Health

Committees

• Expand & Protect Hospitals
• Longer Hospital Stays
• Assisted Outpatient

Treatment

• Easier to Meet Civil

Commitment Standards

• HIPAA Reform
• Group Housing
• Clubhouse Programs
• Mandatory Evaluation of

Patients Being Discharged from Involuntary Commitment & Mentally Ill Shelter Residents AFTER POLICE INVOLVEMENT:

• Mandatory Evaluation of

Mentally Ill Prisoners who Are Being Released

• Forensic Parole
• Mental Health Courts

Assisted Outpatient Treatment (AOT) is the only program proven to cut homelessness, arrest, incarceration, hospitalization over 70% each.

Overview: AOT allows judges to order someone who does not comply with treatment and already accumulated multiple episodes of incarceration or needless hospitalization to stay in six months of mandated and monitored treatment while they continue to live free in the

• community. Studies around the country show dramatic reductions in homelessness, arrest, incarceration and hospitalization which is

particularly surprising since Assisted Outpatient Treatment is for the hardest to treat subset of the most seriously ill.

Assisted Outpatient Treatment (AOT) Study Results

New York State Office of Mental Health. Kendra's Law: Final Report

• n the Status of Assisted Outpatient Treatment. Report to

Legislature, Albany: New York State, 2005, 60. http://mentalillnesspolicy.org/kendras-law/research/kendras-law- study-2005.pdf (Accessed 2/8/15). Reduces danger and violence 55% fewer recipients engaged in suicide attempts or physical harm to self 47% fewer physically harmed others 46% fewer damaged or destroyed property 43% fewer threatened physical harm to others Overall, the average decrease in harmful behaviors was 44% Improves consumer outcomes 74% fewer participants experienced homelessness 77% fewer experienced psychiatric hospitalization 56% reduction in length of hospitalization. 83% fewer experienced arrest 87% fewer experienced incarceration 49% fewer abused alcohol 48% fewer abused drugs Consumer perceptions were positive 75% reported that AOT helped them gain control over their lives 81% said AOT helped them get and stay well 90% said AOT made them more likely to keep appointments and take meds Improved collaboration between mental health and court systems. “As AOT processes have matured, professionals from the two systems have improved their working relationships, resulting in greater efficiencies, and ultimately, the conservation of judicial, clinical, and administrative resources.” Allison Gilbert, Lorna Mower, Richard Van Dorn, “Reductions in arrest under assisted outpatient treatment in New York.” Psychiatric Services 61, no. 10 (2010): 996–999. http://dhs.iowa.gov/sites/default/files/GilbertReductionsInArrestUnder AOT_083012.pdf Reduces arrest: “The odds of arrest for participants currently receiving AOT were nearly two-thirds lower (OR=.39, p<.01) than for individuals who had not yet initiated AOT or signed a voluntary service agreement.” Bruce Link, Matthew Epperson, Brian Perron, Dorothy Castille, Lawrence Yang. "Arrest outcomes associated with outpatient commitment in New York State." Psychiatric Services 62, no. 5 (2011): 504–508. http://deepblue.lib.umich.edu/bitstream/handle/2027.42/84915/LinkE pperson_2010.pdf (Accessed 2/8/15). Reduces arrest: “The odds of any arrest were 2.66 times greater (p<.01) and the odds of arrest for a violent offense 8.61 times greater (p<.05) before AOT than they were in the period during and shortly after AOT. The group never receiving AOT had nearly double the odds (1.91, p<.05) of arrest compared with the AOT group.” Jo Phelan, Marilyn Sinkewicz, Dorothy Castille, Steven Huz, Bruce

• Link. "Effectiveness and outcomes of assisted outpatient treatment in

New York State." Psychiatric Services 61, no. 2 (2010): 137–143. http://ps.psychiatryonline.org/doi/pdf/10.1176/ps.2010.61.2.137 Reduces violence: “Patients given mandatory outpatient treatment—who were more violent to begin with—were nevertheless four times less likely than members of the control group to perpetrate serious violence after undergoing

• treatment. Patients who underwent mandatory treatment reported higher social

functioning and slightly less stigma, rebutting claims that mandatory outpatient care is a threat to self-esteem.” Jeffrey Swanson, Richard Van Dorn, Marvin Swartz, Pamela Clark Robbins, Henry Steadman, Thomas McGuire, John Monahan. "The cost of assisted outpatient treatment: can it save states money?" American Journal of Psychiatry 170 (2013): 1423–1432. http://ajp.psychiatryonline.org/doi/pdf/10.1176/appi.ajp.2013.120911 Saves money. Net costs declined 50% in the first year after AOT began and an additional 13% in the second year. This was in spite of the fact that psychotropic drug costs increased. The increased community-based mental health costs were more than offset by the reduction in inpatient and incarceration costs. Cost declines associated with assisted outpatient treatment were about twice as large as those seen for voluntary services.

Fast Facts

The Numbers

MI and SMI not Associated with Violence. Untreated Serious Mental Illness (SMI) is. Stigma NOT a major barrier to care We need more hospitals

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