A recent report on the need to reduce the number of people with mental illness incarcerated in county jails confirms that Douglas County is on the right track, county officials say.
The report was released Jan. 18 by the Stepping Up Initiative to Reduce the Number of People with Mental Illnesses in Jails. The organization of 320 counties, of which Douglas County is a member, is supported by the National Association of Counties and the Council of State Governments Justice Center, in partnership with the U.S. Department of Justice.
The report lists six questions that county leaders should ask to address the incarceration of individuals with mental illness:
• Is county leadership committed?
• Does the county conduct timely screening and assessments?
• Does the county have baseline data?
• Has the county conducted a comprehensive process analysis and inventory of services?
• Have we prioritized policy, practice and funding improvements?
• Do we track progress?
In the report’s analysis of those questions, its authors present examples of best practices that counties have implemented to address them.
Douglas County Commission Chair Mike Gaughan said the county could put a check by the first question on commitment and is demonstrating that resolve by its support for initiatives to implement the best practices cited in the report.
Gaughan acknowledged the county did need to improve in those areas involving data collection, particularly in regard to sharing information among the county’s different agencies. To address that, the county created a data analyst position this year within the Douglas County Sheriff’s Office, he said.
Mike Brouwer, Douglas County Jail re-entry program director, and David Johnson, executive director of Bert Nash Community Mental Health Center, said it was very rare in Douglas County for individuals with mental illness to be incarcerated solely for their condition. What wasn't rare, however, was the incarceration of mentally ill individuals from actions they took while in crisis or from lack of sufficient active treatment.
Brouwer said the county used the “sequential intercepts model” to help craft its response to the mental-health incarceration rate issue. The model envisions a funnel-like representation of the county’s criminal justice system from suspects’ first contacts with law enforcement officers at the top of the funnel to the release of inmates to community corrections with community support.
The county made strides early in the bottom part of the funnel with the re-entry program, Brouwer said. Mental-health initiatives of the past two years have focused on wider top of the funnel when those with mental illness first make contact with the criminal justice system.
Gaughan and Brouwer said those initiatives start with the Crisis Intervention Team training given to Lawrence and county law enforcement officers, which instructs officers on how to recognize mental-health issues and defuse situations arising from them.
Sgt. David Hogue of the Lawrence Police Department said 65 percent of the department’s force has received CIT training. The department made a commitment to the faith-based activist group Justice Matters to train 100 percent of the officers by the end of 2017, he said.
In January 2016, the county took a step to directly address the second question on the list with the hiring of two Bert Nash Community Mental Health employees for the jail’s Assess-Identify-Divert program. The two employees were hired with a U.S. Department of Justice grant that provided $100,000 to pay for two case manager positions in the jail through the end of 2018, at which time the county will have to pick up their salaries. It is a groundbreaking program with Douglas County one of three in the country to have jail AID case managers in place, Brouwer said.
The two case managers screen newly admitted inmates to the jail for mental health and substance abuse concerns and point candidates to appropriate alternative programs.
One of those programs is the behavioral health court, which the County Commission funded this year, Gaughan said. The court places defendants with case managers who develop treatment programs and monitor progress.
Another program that addresses early contact with the criminal justice system is the co-responder program the Lawrence City Commission agreed to fund with the start of the year. It will have a two-person team of a law enforcement officer and Bert Nash behavioral specialist respond to calls involving those in mental health crisis. Johnson said the city will provide $50,000 this year for the Bert Nash employee.
Hogue said the Lawrence Police Department was currently looking to hire four new patrol officers and was training an additional 14. The department would fill the co-responder position when officers are hired and trained for those patrol positions. There was no schedule for when the co-responder officer would be hired and trained, he said.
“We’re developing (co-responder) policies and procedures,” Hogue said. “We’re very much in the implementation process right now.”
The potential of the co-responder program is illustrated in the Stepping Up Initiative report, which cites its use in neighboring Johnson County.
That county’s data showed that after it was implemented in Olathe during a 12-month period ending in 2012, only 10 of 808 co-responder team’s contacts ended in arrests, while hospitalizations from such contacts decreased from 54 percent to 17 percent. Referrals to treatment services increased from 1 percent to 39 percent.
Those statistics are not news to Brouwer, who worked at the Johnson County Jail at the time the program was introduced. The program has since been expanded to other Johnson County cities, he said.
Brouwer and Johnson expect that the co-responder program would have similar success in Lawrence and anticipate future expansion in Lawrence and Douglas County.
A final piece of the county’s approach to the issue of mental health and the criminal justice was the proposed mental health crisis intervention center, Brouwer said. It would address a current gap in services for the uninsured, although further programs did need to be developed for uninsured patients, particularly those with the dual diagnosis of substance abuse, he said.
The opening of a crisis intervention center would make the county’s comprehensive approach to the issue of mental illness in the criminal justice system “second to none,” Brouwer said.
The report “encompassed” the concerns Justice Matters has in regard to the incarceration of county residents with mental illness, said Randy Krehbiel, the group’s statistician. Justice Matters turned its attention to the incarceration issue and its relationship with the proposed expansion of the Douglas County Jail from its initial advocacy for better mental health services, he said.
“I thought it was an excellent report,” he said. “My only concern is there are other ways to divert people from incarceration, as well, I hope the county considers.”
Krehbiel said in addition to better data sharing between county departments, those efforts include expansion of the county’s pilot electronic monitoring and measures to decrease bottlenecks in Douglas County District Court.
Overall, Gaughan said the report was confirmation that the county was taking the right approach to reducing the number of inmates with mental health issues.
“For a number of years we have been putting the right pieces in place, but any time you ask these questions of criminal justice and mental health, you always want to be better,” he said. “For me, the next question would be data collection to make sure we are taking the right steps and improve on what we see.”