jmhcp_county_pi_guide by CSG Justice Center

Planning & Implementation Guide

Justice and Mental Health Collaboration Program: Collaborative County Approaches to Reducing the Prevalence of Individuals with Mental Illnesses in Jail

DESCRIPTION This Planning & Implementation Guide is intended for recipients of Justice and Mental Health Collaboration Program (JMHCP) grants administered by the U.S. Department of Justice’s Bureau of Justice Assistance. JMHCP grantees will complete this guide in partnership with the technical assistance provider from The Council of State Governments Justice Center.

The Council of State Governments Justice Center prepared this guide with support from the U.S. Department of Justice’s Bureau of Justice Assistance (BJA). The contents of this document do not necessarily reflect the official position or policies of the U.S. Department of Justice.

Planning and Implementation Guide Collaborative County Approaches to Reducing the Prevalence of Individuals with Mental Illnesses in Jail

About the Planning & Implementation Guide The Council of State Governments (CSG) Justice Center has prepared this Planning & Implementation Guide (P&I Guide) to support grantees in developing and refining their initiative. The guide is intended for the state, local, or tribal government agencies that have received JMHCP grants to plan initiatives and programs serving adult populations. This guide is not intended to serve as a step-by-step blueprint, but rather to cultivate discussion on best practices, identify considerations for your collaborative effort, and help you work through key decisions and implementation considerations. While the guide was developed as a tool for grantees, it also serves as an important tool for your CSG Justice Center technical assistance provider (“TA provider”) to understand the status and progress of your project, the types of challenges you are encountering, and the ways your TA provider might be helpful to you in making your project successful. Your TA Provider will use your responses to the self-assessment to work with you to develop priorities for technical assistance. Any questions about this guide should be directed to your TA provider. Contents of the Guide This guide is divided into eight sections that include a variety of exercises aimed at helping guide your county’s system planning process. You will be prompted to write short responses, attach relevant documents, and/or answer yes or no questions. Your answers will provide insight into your initiative’s strengths and identify areas for improvement. As you work through the sections, take note of the corresponding supporting resources in the final section as they contain suggestions for further reading and provide access to important resources and tools. Your TA provider may also send you additional information on specific relevant topics to complement certain sections. If you need additional information or resources on a topic, please reach out to your TA provider.

TA Provider Contact Information Name:

Will Engelhardt

Phone: 646-383-5764 Email:

wengelhardt@csg.org

Planning and Implementation Guide Collaborative County Approaches to Reducing the Prevalence of Individuals with Mental Illnesses in Jail

Contents Section 1: Getting Started and Identifying Goals Exercise 1: Initiative Snapshot A. Grantee Information B. Grant Initiative Updates and Information Section 2: Developing Your Collaborative Planning Team Exercise 2: Developing Your Collaborative Planning Team Section 3: Jail Identification Process and Data Collection Exercise 3:Jail Identification Process and the Determination of Prevalence Rates and Risk Levels A. Local Definition of Mental Illness B. Jail Identification Process for Mental Illness C. Local Definition of Substance Use Disorder D. Jail Identification Process for Co-occurring Substance Use Disorder Information E. Local Definition of Recidivism F. Risk and Need Identification Process G. Connection to Community Supervision H. Connection to Community-Based Services Section 4: Data Driven Findings Exercise 4: Measuring Outcomes Exercise 5: Key Findings Section 5: County System Analysis Exercise 6: System Mapping and Gaps Analysis A. System Mapping by Intercept Points B. System Mapping by Key Outcomes C. Addressing Gaps in the System Section 6: Planning to Address Gaps in the System Exercise 7: Expanding Screening and Assessment Exercise 8: Expanding Evidence-Based Practices Section 7: Strategic Plan Exercise 9: Planning and Prioritizing Section 8: Ongoing Evaluation and Sustainability Exercise 10: Following Your Plan Exercise 11: Assessing Sustainability

Appendix A & B Overview and Schedule: By the time you complete exercise 9 of this guide, you should have a full plan in place to implement systematic changes aimed at reducing the number of people with mental illnesses and co-occurring substance use disorders in your county’s jail. Exercises 1 through 8 will help you identify the information you need to develop your plan, while exercises 10 and 11 will help you ensure that your plan is implemented properly and is sustainable following the completion of your grant. The following is a timeline for when sections of the guide are due to your TA provider. Exercises are due prior to the scheduled monthly calls. These are suggested timeframes and your TA provider will work with you to complete this P&I Guide at a pace that works for your grant team.

Planning and Implementation Guide Collaborative County Approaches to Reducing the Prevalence of Individuals with Mental Illnesses in Jail

Planning & Implementation Guide Schedule Activity Due Date

Review P&I Guide at JMHCP Orientation • Exercise 1: Initiative Snapshot P&I Guide Exercises Due to Your TA Provider • Exercise 2: Developing Your Collaborative Planning Team P&I Guide Exercises Due to Your TA Provider • Exercise 3: Jail Identification Process and the Determination of Prevalence Rates and Risk Levels • Exercise 4: Measuring Outcomes • Exercise 5: Key Findings P&I Guide Exercises Due to Your TA Provider • Exercise 6: System Mapping and Gaps Analysis P&I Guide Exercises Due to Your TA Provider • Exercise 7: Expanding Screening and Assessment • Exercise 8: Expanding Evidence-Based Practices P&I Guide Exercises Due to Your TA Provider • Exercise 9: Planning and Prioritizing P&I Guide Exercises Due to CSG Justice Center TA Provider • Exercise 10: Following Your Plan • Exercise 11: Assessing Sustainability Final review of exercises and submission of P&I Guide to BJA for review

Completed (for grantee to mark and keep track)

December 2015 January 2015 April 2016

June 2016 July 2016

August 2016 September 2016 October 2016

Planning and Implementation Guide Collaborative County Approaches to Reducing the Prevalence of Individuals with Mental Illnesses in Jail

SECTION 1: GETTING STARTED AND IDENTIFYING GOALS While your TA provider has read the project narrative that you submitted in response to the JMHCP solicitation, there may have been updates or developments since your original application was submitted. This exercise is intended to give your TA provider a sense of your current project goals and your initial technical assistance needs. Please provide the following documents, if available, to your TA provider at your earliest convenience: ☐ MOUs and information sharing agreements ☐ Current strategic plan ☐ County organizational and hierarchical charts

☐ Letters of support ☐ Staffing and Budgeting Information ☐ Additional planning materials

Exercise 1: Initiative Snapshot A. Grantee Information Please complete the chart below. A. Grantee Information Grantee Name and Award Number: Geographic Location (City/County/State) Type (Rural/Suburban/Urban or mix) Project Name: Mental Health Partner(s): Point(s) of Contact:

Collaborators:

Criminal Justice Partner(s): Name:

Email:

Agency:

Name:

Email:

Agency:

Name:

Email:

Agency:

Project partners, sub-contractors, and their intended roles:

Planning and Implementation Guide Collaborative County Approaches to Reducing the Prevalence of Individuals with Mental Illnesses in Jail

B. Grant Initiative Updates and Information Your TA provider would find it helpful to know about any major developments that have occurred between the time you wrote your grant application / narrative and our next TA call. When completing the exercise below, be sure to reference any major goals changes, stakeholder changes, etc. that may have occurred. B. Grant Initiative Updates and Information 1. What do you want to accomplish with this grant initiative?

2. What is the relationship between this initiative and any pre-existing initiatives or programs focusing on people with mental illnesses involved with the criminal justice system, either locally or at the state level?

3. Has your state participated in a Justice Reinvestment Initiative and are there any programs funded through this initiative in your county?

4. What intercepts in the criminal justice system do you anticipate primarily focusing on? (Intercept 1: law enforcement; Intercept 2: initial detention; Intercept 3: jails/courts; Intercept 4: reentry; Intercept 5: community supervision and treatment)

5. Has your jurisdiction ever conducted a system mapping exercise, gap analysis, or other needs assessment about the services available in your community? If so, attach copies of these materials.

Planning and Implementation Guide Collaborative County Approaches to Reducing the Prevalence of Individuals with Mental Illnesses in Jail

SECTION 2: DEVELOPING YOUR COLLABORATIVE PLANNING TEAM In order to conduct a comprehensive, data-driven plan to safely reduce the prevalence of people with mental illnesses in your county’s jail, it is essential that you establish a team (or utilize a pre-existing team) of county leaders and decision makers from multiple agencies to engage in the planning process.

Exercise 2: Developing Your Collaborative Planning Team 1. Will an existing decision-making entity guide the direction of this project? If not, is a new collaborative planning team being developed as part of this initiative? Yes

Answer:

2. How will this planning team communicate/coordinate with other entities that are currently engaged in criminal justice/mental health planning for your county/? Answer:

Planning and Implementation Guide Collaborative County Approaches to Reducing the Prevalence of Individuals with Mental Illnesses in Jail

3. List the members of your planning team Name

Title

Organization

Specific role on planning team

Planning and Implementation Guide Collaborative County Approaches to Reducing the Prevalence of Individuals with Mental Illnesses in Jail

Signed a letter of agreement committing to involvement in project? Yes

Yes

4. Are there additional stakeholders you would like to join the planning team to ensure that there is system-wide representation? Answer:

5. Who are the local “champions” for mental health- and criminal justice-related issues? Are they participating in your collaborative planning team? If not, do you plan to include them in the collaborative planning team? Answer:

6. Does the planning team include sub-committees or working groups? If so, what are they? Answer:

7. Have you developed MOUs or LOAs for the planning team members’ respective agencies? If so, please attach the documents. Do you anticipate needing additional agreements to be developed? Yes Answer:

8. How often will the planning team meet? Answer:

Planning and Implementation Guide Collaborative County Approaches to Reducing the Prevalence of Individuals with Mental Illnesses in Jail

9. Who coordinates the planning team’s meeting schedule, agenda, and logistics? How is the agenda developed and shared with collaborative planning team members? What will the process be for reporting on the team’s progress (internally and externally)? Answer:

10. Has your planning team developed vision, mission, and guiding principles statements? If not, do you plan to do so? Yes Answer:

Planning and Implementation Guide Collaborative County Approaches to Reducing the Prevalence of Individuals with Mental Illnesses in Jail

SECTION 3: JAIL IDENTIFICATION PROCESS AND DATA COLLECTION In order to safely and effectively reduce the number of adults with mental illnesses in jails, counties need to know how many people with mental illnesses are entering and leaving their jails, and the extent of their needs. While it may seem simple to count the number of people with mental illnesses who have treatment needs, it is not uncommon to see different ways of defining and measuring the presence of mental illnesses and co-occurring substance use disorders. The following exercises will help ensure that you and your TA provider are on the same page when discussing your county’s data.

Exercise 3: Jail Identification Process and the Determination of Prevalence Rates and Risk Levels Jails and behavioral health care providers will need to agree on a consistent screening and assessment process that accurately identifies people’s mental illnesses, substance use disorders, and criminogenic risk. This activity will help you consider whether your existing screening and assessment process is operating effectively and is gathering the information necessary to improve outcomes in your criminal justice system. A. Local Definition of Mental Illness 1. Is there a state or county definition of mental illness that governs access to services in your community? (yes/no) ________ If so, what is it?

2. Is this or another definition currently used within your jail? (yes/no)_________ If so, what is it?

B. Jail Identification Process for Mental Illness 1. How does the jail staff determine when a possible mental illness and/or substance use disorder/treatment need is present?

Planning and Implementation Guide Collaborative County Approaches to Reducing the Prevalence of Individuals with Mental Illnesses in Jail

Please answer the questions below: B. Jail Identification Process for Mental Illness

Question

Yes /No

Explanation

Is there an objective, standardized screening tool in place to screen for these mental illnesses/disorders/needs (e.g., Brief Jail Mental Health Screen)?1 Who do you screen and at what times (e.g., everyone at booking, everyone in jail for 48 hours)? Is there a process in place to conduct a full assessment of anyone who screens positive for a possible mental illness? Is there a process in place to conduct a substance use disorder screen for those that screen positive for a possible mental illness? Do you keep data on how many people are screened and assessed?

2. Is there a process that determines whether a person meets state/county criteria for serious or persistent mental illnesses? (yes/no)________ i. If yes, must a social worker, counselor, psychiatrist, or qualified mental health professional make the determination? (yes/no)________ 3. Does your jail collect data on people who meet your definition of having a mental illness regarding the following? If reports are available for any of the following information, please provide it to your TA provider. i. Their length of stay (yes/no)________ ii. Their status as pretrial or sentenced (yes/no) ________ iii. Their history of prior incarceration at the jail (yes/no)_________ iv. Their history of prior community supervision (yes/no)_________ v. Prior contact with mental health care providers in the community (yes/no)_________ vi. Do you have a specific process to track how many people with mental illnesses in the jail are being held pretrial and how many are sentenced to jail? (yes/no) ______________

The tools referenced in the planning guide are meant to merely serve as examples; their inclusion does not in any way reflect the endorsement of it. In response to requests from the field for examples, when appropriate an example of a commonly used proprietary and nonproprietary tool is provided. Planning and Implementation Guide Collaborative County Approaches to Reducing the Prevalence of Individuals with Mental Illnesses in Jail

4. How will you develop your baseline and future prevalence rates for people with mental illnesses in your jail (e.g., using booking/admissions data and average daily population)

Which database(s) will you use to access, create, or update to help determine your prevalence numbers for people with mental illnesses in your overall jail population?

C. Local Definition of Substance Use Disorder Is there a state or county definition of mental illness that governs access to services in your community? (yes/no) ________ If so, what is it?

D. Jail Identification Process for Co-occurring Substance Use Disorder Information For people with mental illnesses, do you have a process to identify how many of them are found to have a co-occurring substance use disorder? (yes/no)__________ i.

If yes, what is that process?

Is there a validated tool used to screen people for substance use disorders? (yes/no)__________ a. If so, what tool do you use? _______________________ b. Who administers the tool?

ii.

Is there a follow-up assessment process for people who screen positive for a substance use disorder? (yes/no)__________ a. If so, by who?

E. Local Definition of Recidivism What is your state or county definition of recidivism (e.g., reincarceration within a year of release for reoffending or violating conditions of supervision)?

Planning and Implementation Guide Collaborative County Approaches to Reducing the Prevalence of Individuals with Mental Illnesses in Jail

F. Risk and Need Identification Process 1. Is there an objective, validated screening tool in place for assessing risk at: i.

Pretrial detention (assessing for likelihood of failing to appear in court or commit a new crime during the pretrial period)? (yes/no) _________ ii. Post conviction (assessing for risk of recidivism)? (yes/no) _________________ 2. For people with mental illnesses in your jail, can you determine how many are high, medium, or low risk for recidivism? (yes/no)__________ G. Connection to Community Supervision 1. Do you have a process for tracking people on community supervision to identify recidivism rates for those with mental illnesses and co-occurring disorders? (yes/no)___________ i.

If yes, what is that process?

2. Is there a process for alerting the appropriate community supervision officer that a person on supervision has been booked into jail? (yes/no)___________ i.

If yes, do they connect with the person prior to leaving jail to ensure successful transition to supervision? (yes/no)___________

H. Connection to Community-Based Services 1. Do you have a process for tracking how many people with mental illnesses and co-occurring disorders received services from community-based treatment providers after release from jail? (yes/no)___________ i.

If yes, what is that process?

2. Is there a process to notify a community-based treatment provider when a person who has screened positive for mental illness and co-occurring disorders or has previously used their services has been booked into jail? (yes/no)___________ i.

If yes, what is that process?

Planning and Implementation Guide Collaborative County Approaches to Reducing the Prevalence of Individuals with Mental Illnesses in Jail

SECTION 4: DATA-DRIVEN FINDINGS For your county to develop a plan to safely reduce the prevalence of people with mental illnesses in your jail, your collaborative planning team should use available data to drive its decision-making. Key data findings should focus on improving outcomes for people with mental illnesses involved in the criminal justice system and increasing public safety. Specifically, counties should focus on achieving the following four key outcomes: 1. Reduce the number of people with mental illnesses and co-occurring disorders who are booked into jail 2. Reduce the length of time people with mental illnesses and co-occurring disorders stay in jail 3. Increase the number of people released from jail who are connected to community-based services and supports 4. Reduce the number of people with mental illnesses and co-occurring disorders returning to jail The following exercises will help you to understand whether your county is currently able to measure these key outcomes, and advise you on the types of data findings that will help your collaborative planning team understand whether your county is effectively reducing the prevalence of mental illnesses and co-occurring substance use disorders in its jail.

Exercise 4: Measuring Outcomes Please answer whether your county is collecting the appropriate data to measure your county’s progress towards achieving key outcomes. Outcomes Measurements Reduce the number of people with MI/COD who are booked into jail

Is there a flag for mental illness and co-occurring disorders from screening and assessments entered into an electronic database? Yes No

Reduce the length of time people with MI/COD stay in jail

Does your county have the ability to track length of stay for pretrial and sentenced populations? Yes No

Increase the number of people released from jail who are connected to community-based services

Does your county have the ability to track every person booked into jail to the local behavioral health authority’s database to establish connection to care? Yes No

Reduce the number of people with MI/CO returning to jail

Does your county track recidivism rates, including technical violations and new offenses for people at both the pretrial and post-conviction stage? Yes No Does your county track pretrial and criminogenic risk levels for people booked into jail and on community supervision? Yes No

Planning and Implementation Guide Collaborative County Approaches to Reducing the Prevalence of Individuals with Mental Illnesses in Jail

Exercise 5: Key Findings Below is a list of questions that every county should be able to answer.. Please use these questions to guide the types of findings that you can list in the chart below, using any data that you have available. These findings should help guide your county’s planning process. • • • • • • •

How many people with mental illnesses and co-occurring disorders are in your criminal justice system? At what intercept points? Do people with mental illnesses and co-occurring disorders stay longer in jail those without these disorders? Are people with mental illnesses and co-occurring disorders returning to jail more often than those without these disorders? How many people identified with mental illnesses and co-occurring disorders in jail are connected to the treatment and services they need in the community? What percentage of people are at medium to high risk of committing a new crime in the criminal justice system? Are most people who receive pretrial and post-conviction community supervision fulfilling their supervision requirements? How many systems share information and resources with each other?

Key Findings

Data that supports this finding

Comments

i. Example: Average length of stay in jail for people with mental illnesses is twice as long as people without mental illnesses.

People with mental illnesses stay in jail an average of 50 days, while the rest of the population stay an average of 25 days.

Need to examine length of stay based on pretrial risk score.

ii. iii. iv. v. vi. vii. viii.

Planning and Implementation Guide Collaborative County Approaches to Reducing the Prevalence of Individuals with Mental Illnesses in Jail

SECTION 5: COUNTY SYSTEM ANALYSIS For any county plan to be effective, a person’s mental health, substance use, and criminogenic needs (the factors that make people more likely to reoffend) should be identified and addressed at the earliest points possible using law enforcement diversion, screening and identification, connections to services, and community supervision. Meaningful reductions in the prevalence of mental illnesses in jails cannot be realized without examining which programs and strategies are in place and effective. Each program that is identified in the planning process should achieve at least one of the following four key outcomes that had been previously discussed in Section 4: 1. Reduce the number of people with mental illnesses and co-occurring disorders who are booked into jail 2. Reduce the length of time people with mental illnesses and co-occurring disorders stay in jail 3. Increase the number of people released from jail who are connected to community-based services and supports 4. Reduce the number of people with mental illnesses and co-occurring disorders returning to jail The following exercises will help you identify gaps in your county’s policies, practices, and programs.

Exercise 6: System Mapping and Gaps Analysis A. System Mapping by Intercept Points The following table includes the Sequential Intercept Model2 for your reference. Using this model, identify existing policies, practices, programs and treatments that are currently underway in your system.

The Sequential Intercept Model was developed by Mark Munetz, MD, and Patricia Griffin, PhD, and is described in this article and was subsequently adapted into a user-friendly handout in partnership with SAMHSA’s GAINS Center for Behavioral Health and Justice Transformation. Planning and Implementation Guide Collaborative County Approaches to Reducing the Prevalence of Individuals with Mental Illnesses in Jail

Ini0al$Deten0on/Ini0al$ Court$Hearings$

Intercept(4(

Jails/Courts$

Reentry$

Intercept 5:

Intercept(5( Community$ Correc0ons$

Parole$ Proba0on$

Prison/ Reentry$ Jail/ Reentry$

Disposi0onal$ Court$

First$Appearance$ Court$

Ini0al$Deten0on$

COMMUNITY(

Local$Law$ Enforcement$

Intercept 4:

Intercept(3(

Intercept 1:

Intercept 2:

Intercept 3:

Intercept 4:

Intercept 5:

Policies and Practices:

Evidence Based Programs and Treatments:

Planning and Implementation Guide Collaborative County Approaches to Reducing the Prevalence of Individuals with Mental Illnesses in Jail

COMMUNITY(

Intercept 3:

Intercept(2(

911$

Law$Enforcement$

Intercept 2:

Specialty$ Court$

Intercept(1(

Jail$

Intercept 1:

B. System Mapping by Key Outcomes Use the following four tables to identify current policies, practices, programs, and treatment options in your county that address each of the four key outcomes described at the beginning of this section. Your TA provider will provide you with a chart that gives examples of policies and programs for each key outcome, and will work with you to identify additional information about each of the policies, practices, programs and treatments that you identify.

Key Outcome 1: Reduce the number of people with mental illnesses & co-occurring disorders who are booked into jail Instructions

Identification of MI/COD pre-arrest

List the relevant policies, practices, evidence-based programs, and treatment options currently being implemented and include a brief description.

1. EXAMPLE: Mental health crisis identified on 911 call • Process for identifying whether a 911 call requires a

Law Enforcement Responses 1. EXAMPLE: Crisis Intervention Training •

response by the mobile crisis outreach team

All law enforcement in the county are required to be trained in CIT

Screening for MI, COD, and Risk at Booking

Jail Diversion Opportunities

1. EXAMPLE: The Brief Jail Mental Health Screen is administered to people at booking into jail • Everyone booked into jail receives the screen, with the results recorded electronically.

1. EXAMPLE: Crisis Center • Provides short-term mental health crisis stabilization

in a secure unit.

Planning and Implementation Guide Collaborative County Approaches to Reducing the Prevalence of Individuals with Mental Illnesses in Jail

Key Outcome 2: Reduce the length of time people with mental illnesses and co-occurring disorders stay in jail Instructions

Screening for MI, COD, and Risk in Jail

List the relevant policies, practices, evidence-based programs, and treatment options currently being implemented and include a brief description.

Pretrial Release Decision Making

1. EXAMPLE: A pretrial risk assessment tool is administered • Everyone booked into jail receives the screen, with the results recorded electronically.

1. EXAMPLE: Pretrial risk information is made available to inform the court regarding release at the first appearance • The information is electronically submitted to judge, prosecutor and defense lawyer.

5. Pretrial Treatment Programs

Pretrial Community Supervision

1. EXAMPLE: Referral to treatment included in pretrial release order • All who are screened and/or assessed as needing treatment receive an appointment for follow-up care upon release.

1. EXAMPLE: Pretrial supervision ordered for people identified as moderate to high risk • People assigned to pretrial supervision and identified as needing mental health services are connected to care.

Planning and Implementation Guide Collaborative County Approaches to Reducing the Prevalence of Individuals with Mental Illnesses in Jail

Key Outcome 3: Increase the number of people released from jail who are connected to community-based services Instructions

Assessments for MI and COD in Jail/Community

List the relevant policies, practices, evidence-based programs, and treatment options currently being implemented and include a brief description.

Mental Health and Substance Use Policies

1. EXAMPLE: People who screen positive for mental illness receive a full assessment • There is process in place for both in-jail and community based assessments.

1. EXAMPLE: Release of information policies are in place to allow for information sharing. • The sheriff’s office shares relevant information with the local behavioral health authority

5. Case Management/Supervision

Mental Health and Substance Use Treatment

1. EXAMPLE: A community supervision officer and behavioral health clinician provide collaborative case management • Roles and responsibilities are clear, to increase consistency in care and supervision expectations

•

1. EXAMPLE: The local behavioral health agency

•

administers an in-reach program in the jail The local behavioral health agency provides jail-based services and ensure connection to care upon release.

Planning and Implementation Guide Collaborative County Approaches to Reducing the Prevalence of Individuals with Mental Illnesses in Jail

Key Outcome 4: Reduce the number of people with mental illnesses and co-occurring disorders returning to jail Instructions List the relevant policies, practices, evidence-based programs, and treatment options currently being implemented and include a brief description.

Assessments for Risk in Jail/Community

Risk Reduction Policies

1. EXAMPLE: A post-conviction risk tool is administered • Everyone assigned to supervision receives a risk assessment

1. EXAMPLE: The community supervision provider implements evidence-based practices that are proven effective at reducing recidivism • Interventions such as Cognitive Behavioral Therapy (CBT) are in place to address criminal thinking.

and a case management plan, which is developed based on risk and needs.

Community Supervision Focused on Risk Reduction

Risk Reduction Treatment

1. EXAMPLE: Community supervision follows the principles of Risk, Needs and Responsivity • More intense supervision is provided to moderate to higher risk individuals.

1. EXAMPLE: Treatment plans follow the principles of Risk, Needs and Responsivity • For people who are moderate to high risk and have mental health needs, treatment includes interventions based on CBT

Planning and Implementation Guide Collaborative County Approaches to Reducing the Prevalence of Individuals with Mental Illnesses in Jail

C. Addressing Gaps In the System Use the following four tables to identify the policies, practices, programs, and treatment options across all four of the key outcomes that do not currently exist in your system. Later in this guide, you will be asked to prioritize these responses, so this exercise can be used as a “wish list.” Refer to the previous charts in this exercise to identify gaps in services and practices.

Key Outcome 1: Reduce the number of people with mental illnesses & co-occurring disorders who are booked into jail Instructions

Identification of MI/COD pre-arrest

List the relevant policies, practices, evidence-based programs, and treatment options that are not currently in place but would improve your system’s outcomes and include a brief description.

Law Enforcement Responses

5. Screening for MI, COD, and Risk at Booking

Jail Diversion Opportunities

Planning and Implementation Guide Collaborative County Approaches to Reducing the Prevalence of Individuals with Mental Illnesses in Jail

Key Outcome 2: Reduce the length of time people with mental illnesses and co-occurring disorders stay in jail Instructions

Screening for MI, COD, and Risk in Jail

List the relevant policies, practices, evidence-based programs, and treatment options that are not currently in place but would improve your system’s outcomes and include a brief description.

Pretrial Release Decision Making

Pretrial Treatment Programs

Pretrial Community Supervision

Planning and Implementation Guide Collaborative County Approaches to Reducing the Prevalence of Individuals with Mental Illnesses in Jail

Key Outcome 3: Increase the number of people released from jail who are connected to community-based services Instructions

Assessments for MI and COD in Jail/Community

List the relevant policies, practices, evidence-based programs, and treatment options that are not currently in place but would improve your system’s outcomes and include a brief description.

Mental Health and Substance Use Policies

Case Management/Supervision

Mental Health and Substance Use Treatment

Planning and Implementation Guide Collaborative County Approaches to Reducing the Prevalence of Individuals with Mental Illnesses in Jail

Key Outcome 4: Reduce the number of people with mental illnesses and co-occurring disorders returning to jail Instructions

Assessments for Risk in Jail/Community

List the relevant policies, practices, evidence-based programs, and treatment options that are not currently in place but would improve your system’s outcomes and include a brief description.

Risk Reduction Policies

Community Supervision Focused on Risk Reduction

Risk Reduction Treatment

Planning and Implementation Guide Collaborative County Approaches to Reducing the Prevalence of Individuals with Mental Illnesses in Jail

SECTION 6: PLANNING TO ADDRESS GAPS IN THE SYSTEM To achieve the four key outcomes described in previous sections of reducing the prevalence of people with mental illnesses and cooccurring disorders in your county jail, reducing length of stay, increasing connection to care, and reducing recidivism, it is necessary to develop appropriate pre-arrest diversion opportunities, pretrial release mechanisms, match people to the appropriate intensity of community supervision, and to connect them to treatment services based on risk and need. To do so, a county needs to have effective screening and assessment in place. Most counties have significant gaps in their screening and assessment processes. This section helps your county develop a plan for improving screening and assessment for mental illnesses, substance use disorders, and risk. Once screening and assessment is in place, it is essential to match the intensity of community supervision and treatment services to an individual’s level of risk and needs.3 Identifying the population who are moderate to high risk of reoffending and have high needs (e.g. serious and persistent mental illnesses and co-occurring disorders), will provide clear direction on where to concentrate supervision and treatment resources, including cognitive based interventions. The Shared Framework for Reducing Recidivism and Promoting Recovery (p.33) can be used to prioritize groups of people for treatment and supervision to maximize the impact of available resources.

Andrews, Donald A., 2012. “The Risk-‐Need-‐Responsivity (RNR) Model of Correctional Assessment and Treatment,” Using Social Science to Reduce Offending, ed. Joel A. Dvoskin, Jennifer L. Skeem, Raymond W. Novaco, and Kevin S. Douglas. New York, NY: Oxford University Press. Planning and Implementation Guide Collaborative County Approaches to Reducing the Prevalence of Individuals with Mental Illnesses in Jail

Exercise 7: Expanding Screening and Assessment To prioritize county resources based on risk and need, screening and assessment for mental illness, substance use disorders, and risk should be in place. Based on the gaps identified in Exercise 6, this chart will help you develop a plan for implementing screening and assessment What tool or process would you like to implement? Who would administer it and when would it take place?

How will the information be recorded (e.g. entered into a database)?

Pretrial Risk Assessment Mental Illness Screen Substance Use Disorder Screen Post-Conviction Risk Assessment Mental Illness Assessment Substance Use Disorder Assessment

Planning and Implementation Guide Collaborative County Approaches to Reducing the Prevalence of Individuals with Mental Illnesses in Jail

What agencies would share this information?

Exercise 8: Expanding Evidence-Based Practices This exercise identifies some programming and treatment opportunities that could provide services based on risk and need. If they do not currently exist, in your county, please answer the questions in the chart that are intended to help your county plan for implementing these programs and practices. What agency would administer this program or training?

How would you decide on eligibility for this program?

Would recidivism data be gathered for people who received services?

Co-responder model/ CIT Mobile Crisis Response Team Crisis Center Cognitive Behavioral Therapy Motivational Interviewing Other (e.g.. Assertive Community Treatment and Forensic ACT teams) Planning and Implementation Guide Collaborative County Approaches to Reducing the Prevalence of Individuals with Mental Illnesses in Jail

Is it possible to implement this training or program in the next 18 months?

SECTION 7: STRATEGIC PLAN All of your collaborative work is now coming together in one master planning chart that includes the data you have gathered, policies practices and programs you currently have in place as well as those that are on your wish list to fill identified gaps. The next step involves analysis and prioritization of interventions that will result in achieving the four key outcomes. 1. 2. 3. 4.

Reduce the number of people with mental illnesses and co-occurring disorders who are booked into jail Reduce the length of time people with mental illnesses and co-occurring disorders stay in jail Increase the number of people released from jail who are connected to community-based services and supports Reduce the number of people with mental illnesses and co-occurring disorders returning to jail

Exercise 9: Planning and Prioritizing You are encouraged to complete the following chart with your collaborative planning team and should anticipate for this to take multiple meetings or be scheduled as a “planning retreat.” Each of the four sections of the chart addresses one of the four key outcomes; repeating the same process for each outcome. Once all four sections are completed, the collaborative planning team should review the prioritized responses for each section and develop consensus around an action plan that is data based, cost effective and provides the most potential for reducing the prevalence of the mentally ill in your jail.

Planning and Implementation Guide Collaborative County Approaches to Reducing the Prevalence of Individuals with Mental Illnesses in Jail

Key Outcome 1. Reduce the number of people with MI/CO who are booked into jail

Current Policies, Practices, and Programs in Place Key data (e.g. mental illness prevalence, recidivism)

Current policies, practices, and programs (include numbers served)

Identified gaps in policies, practices, and programs

Planning for Implementation of Policies, Practices, and Programs Planned policies and evidencedbased responses to be implemented

Projected number to be served

Projected cost/ funding source

Prioritized evidence-based responses for implementation

2. Reduce the length of time people with MI/CO stay in jail

Current Policies, Practices, and Programs in Place Key data (e.g. mental illness prevalence, recidivism)

Current policies, practices, and programs (include numbers served)

Identified gaps in policies, practices, and programs

Planning for Implementation of Policies, Practices, and Programs Planned policies and evidencedbased responses to be implemented

Projected number to be served

Planning and Implementation Guide Collaborative County Approaches to Reducing the Prevalence of Individuals with Mental Illnesses in Jail

Projected cost/ funding source

Prioritized evidence-based responses for implementation

3. Increase the number of people released from jail who are connected to community-based services

Current Policies, Practices, and Programs in Place Key data (e.g. mental illness prevalence, recidivism)

Current policies, practices, and programs (include numbers served)

Identified gaps in policies, practices, and programs

Planning for Implementation of Policies, Practices, and Programs Planned policies and evidencedbased responses to be implemented

Projected number to be served

Projected cost/ funding source

Prioritized evidence-based responses for implementation

4.Reduce the number of people with MI/CO returning to jail

Current Policies, Practices, and Programs in Place Key data (e.g. mental illness prevalence, recidivism)

Current policies, practices, and programs (include numbers served)

Identified gaps in policies, practices, and programs

Planning for Implementation of Policies, Practices, and Programs Planned policies and evidencedbased responses to be implemented

Projected number to be served

Planning and Implementation Guide Collaborative County Approaches to Reducing the Prevalence of Individuals with Mental Illnesses in Jail

Projected cost/ funding source

Prioritized evidence-based responses for implementation

SECTION 8: ONGOING EVALUATION AND SUSTAINABILITY Once your planning is completed, the work of tracking progress and on-going evaluation starts! Identifying the essential data and outcomes to track will provide your collaborative planning team with clear indicators of progress. As your planning segues to implementation, sustainability will become a focus. This section will help you ensure that your plan is implemented appropriately and can continue beyond the completion of this grant.

Exercise 10: Following Your Plan It is essential to implement your selected evidenced-based programs with fidelity to ensure the highest likelihood that an intervention will achieve the anticipated outcomes. In addition, it is an opportunity to complete a quality check on existing practices, such as risk assessment tool implementation. The chart below will guide your collaborative planning team in this assessment process.

Program

Re-certification/Training Plan

Quality Assurance Plan (e.g. inter-rater reliability, pre/post testing, integrated treatment fidelity scale)

Planning and Implementation Guide Collaborative County Approaches to Reducing the Prevalence of Individuals with Mental Illnesses in Jail

Exercise 11: Assessing Sustainability Read the following statements and consider the degree to which your jurisdiction has implemented the given policy or practice. The options are as follows: N = not implemented or planned, PL = not implemented but planned, P = partially implemented, and F = fully implemented. N

P F

Sustainability Expectations Stakeholders are meaningfully engaged in the project on an ongoing basis. Stakeholders express long-term commitment to and regular involvement in the program. A champion publicly advocates for the continuation of the program. Initiative leaders can articulately discuss the value of the program. Initiative leaders are able to tailor their message about the initiative to different audiences in consideration of the goals of the audience (e.g., community supervision officers, behavioral health treatment providers, jail administrators). There is a working group of diverse stakeholders focused on sustaining the initiative developed through this grant. Funding streams from federal, state and local governments, foundations, and private organizations that can sustain the project after current federal funding expires are identified. Relevant data is shared with each stakeholder, tailored to their specific interests.

Planning and Implementation Guide Collaborative County Approaches to Reducing the Prevalence of Individuals with Mental Illnesses in Jail

Appendix A About the Justice & Mental Health Collaboration Program The Justice and Mental Health Collaboration Program (JMHCP) is a grant program designed 1) to increase public safety by facilitating collaboration among the criminal justice, juvenile justice, mental health, and substance use systems, and 2) to improve access to effective treatment for people with mental illnesses involved with the criminal justice system. The JMHCP was authorized by the Mentally Ill Offender Treatment and Crime Reduction Act (MIOTCRA) and is administered by the U.S. Department of Justice’s Bureau of Justice Assistance (BJA). Grants may be used to support a range of activities and approaches to accomplish the aforementioned goals, including planning, implementing, or expanding: • • • • • • •

Mental health courts for adults and juveniles; Mental health and substance use treatment for those incarcerated with mental illnesses; Community-based reentry services; Diversion and alternative prosecution programs; Cross-training of criminal justice and mental health; Training for local law enforcement officials on how to identify and safely resolve encounters with people with mental illnesses; and Collaborative county approaches to reducing the prevalence of people with mental illnesses in jail.

Each grantee is given the opportunity to tailor its responses to best fit their particular location and the unique needs of their community. Since 2006, MIOTCRA has provided 321 grants to fund critical initiatives across 49 states and territories. All grants require a joint application from a mental health agency and unit of government responsible for criminal and/or juvenile justice activities. Grant awards fall into three categories: Collaborative County Approaches to Reducing the Prevalence of people with Mental illnesses in Jail (category 1; 24 months; maximum $150,000), Planning & Implementation grants (category 2; 36 months; maximum $250,000); and Expansion grants (category 3; 24 months; maximum $200,000). Grantees must apply for each level of funding; awards in one category do not guarantee future awards. For example, Planning & Implementation grantees should not assume that they will receive Implementation or Expansion grants in future years.

Support for Your Grant As a JMHCP Category 1 grantee, you have support from multiple organizations to ensure the success of your grant activities:

Planning and Implementation Guide Collaborative County Approaches to Reducing the Prevalence of Individuals with Mental Illnesses in Jail

The U.S. Department of Justice’s Bureau of Justice Assistance Each JMHCP grantee is assigned a BJA State Policy Advisor. The State Policy Advisors provide information to grantees regarding grant management and budget questions. The Office of Justice Programs (OJP) has resources available for grantees to help answer questions regarding grant management. Please visit Grants 101 and the OJP Financial Guide for additional information. Your BJA State Policy Advisor will be in touch throughout your grant. If at any time you need contact information for your BJA State Policy Advisor, you can ask your TA Provider. The Council of State Governments Justice Center The Bureau of Justice Assistance provides training and technical assistance to support JMHCP grantees in achieving their projects’ objectives. The CSG Justice Center has been the technical assistance provider to the JMHCP program since its inception in 2006.

Note on Using JMHCP Funds to Plan a Jurisdiction-wide Response The goal of JMHCP is not limited to focusing on just a small subset (or target population) of people, but for the broader population of those with mental illnesses and co-occurring substance use and mental disorders who come into contact with the criminal justice system. As a tool meant to facilitate a jurisdiction-wide strategy, the guide is not limited only to planning an initiative. Rather, it is intended to help you think about how to design and implement a collaborative jurisdiction-wide strategy that is neither timelimited nor funding-dependent.

Each JMHCP grantee is assigned a Technical Assistance (TA) provider who provides support for completion and review of the Planning and Implementation Guide (P&I Guide) and works with the grantee to identify and execute technical assistance support for successful grant planning and implementation. You should feel comfortable contacting your TA provider with any questions or concerns and s/he will connect you to the right entity to address your need. All of the organizations listed here work together to ensure you have the right support you need. Please visit the CSG Justice Center’s website to access resources and sign up for the newsletter, which features new resources, available funding options, and highlights of grantee work. CSR, Inc.

CSR, Inc. is contracted by BJA to administer the BJA Performance Measurement Tool (PMT). The PMT is the portal for reporting performance metrics on a quarterly basis. Grantees can access the PMT here and a full list of quarterly performance measures is located here, for categories 1 and 2, and here for category 3. CSR, Inc. provides support to the grantees regarding interpreting reporting questions and other reporting needs. Planning and Implementation Guide Collaborative County Approaches to Reducing the Prevalence of Individuals with Mental Illnesses in Jail

Appendix B Supporting Resources Developing an Effective Collaborative Planning Team • • • • • •

• • • • • •

Substance Abuse and Mental Health Services Administration (SAMHSA): Community Conversations about Mental Health: Discussion Guide http://www.mentalhealth.gov/talk/community-conversation/discussion_guide_07-22-13.pdf The Justice Management Institute: The Criminal Justice Coordination Council Network Mini-Guide Series: Managing a CJCC in a Small Jurisdiction http://69.195.124.207/~jmijust1/wp-content/uploads/2014/04/CJCCMiniGuide-Small-Jurisdictions.pdf Council of State Governments Justice Center: Criminal Justice/Mental Health Consensus Project (chapter four) https://csgjusticecenter.org/mental-health-projects/report-of-the-consensus-project/ Center for Court Innovation: Engaging Stakeholders in Your Project http://www.courtinnovation.org/sites/default/files/Engaging_Stakeholders_in_Your_Project%5B1%5D.pdf National Institute of Corrections: Getting It Right: Collaborative Problem Solving for Criminal Justice https://s3.amazonaws.com/static.nicic.gov/Library/019834.pdf Council of State Governments Justice Center and Bureau of Justice Assistance: Information Sharing in Criminal Justice-Mental Health Collaborations: Working with HIPAA and Other Privacy Laws https://www.bja.gov/Publications/CSG_CJMH_Info_Sharing.pdf National Alliance on Mental Illness (NAMI): Engage Your Community https://www.nami.org/Get-Involved/Raise-Awareness/Engage-Your-Community National Institute of Corrections: Guidelines for Developing a Criminal Justice Coordinating Committee https://s3.amazonaws.com/static.nicic.gov/Library/017232.pdf National Institute of Corrections: Guidelines for Staffing a Local Criminal Justice Coordinating Committee https://s3.amazonaws.com/static.nicic.gov/Library/026308.pdf The Justice Management Institute: National Network of Criminal Justice Coordinating Councils http://www.jmijustice.org/network-coordination/national-network-criminal-justice-coordinating-councils/ NAMI: Ten Ways to Engage People Affected by mental Illness in Your Community https://stepuptogether.org/wp-content/uploads/2015/07/Ten-Ways-to-Engage-People-Affected-by-Mental-Illness-in-Your-Community.pdf The Justice Management Institute: Measuring Performance of CJCCs http://69.195.124.207/~jmijust1/wp-content/uploads/2014/04/CJCCMiniGuide-Performance-Measures.pdf

Planning and Implementation Guide Collaborative County Approaches to Reducing the Prevalence of Individuals with Mental Illnesses in Jail

Screening, Assessment, and Risk-Needs-Responsivity Screening and Assessment for Criminogenic Risk • Council of State Governments Justice Center: Risk Assessment Instruments Validated and Implemented in Correctional Settings in the United States http://csgjusticecenter.org/reentry/publications/risk-assessment-instruments-validated-and-implemented-in-correctional-settings-in-the-united-states/ Screening and Assessment for Substance Use, Mental illnesses and Co-occurring Disorders • National Institute of Justice: Mental Health Screens for Corrections https://www.ncjrs.gov/pdffiles1/nij/216152.pdf • University of South Florida and SAMHSA’s National GAINS Center: Screening and Assessment of Co-Occurring Disorders in the Justice System http://csgjusticecenter.org/wp-content/uploads/2014/12/ScreeningAndAssessment.pdf • SAMHSA’s GAINS Center: Working with People with Mental Illness Involved in the Criminal Justice System: What Mental health Service Providers Need to Know http://www.ce-credit.com/articles/100933/Massaro.pdf Risk-Needs-Responsivity • Bonta, James and Don A. Andrews: Risk-Need-Responsivity Model for Offender Assessment and Rehabilitation http://www.publicsafety.gc.ca/cnt/rsrcs/pblctns/rsk-nd-rspnsvty/rsk-nd-rspnsvty-eng.pdf. • The Council of State Governments Justice Center: Risk Assessment: What You Need to Know http://csgjusticecenter.org/reentry/posts/risk-assessment-what-you-need-to-know/. • Council of State Governments Justice Center: Risk Need Responsivity 101: A Primer for SCA and JMHCP Grant Recipients http://csgjusticecenter.org/reentry/webinars/risk-need-responsivity-101-a-primer-for-sca-and-jmhcp-grant-recipients/ • The Pew Center on the States: Risk Needs Assessment 101: Science Reveals New Tools to Manage Offenders http://www.pewtrusts.org/~/media/legacy/uploadedfiles/pcs_assets/2011/PewRiskAssessmentbriefpdf.pdf • Council of State Governments Justice Center: Risk Assessment Instruments Validated and Implemented in Correctional Settings in the United States: An Empirical Guide https://csgjusticecenter.org/wp-content/uploads/2014/07/Risk-Instruments-Guide.pdf • SAMHSA’s Gains Center: Reducing Criminal Recidivism for Justice-Involved Persons with Mental Illness: Risk/Needs/Responsivity and Cognitive-Behavioral Interventions http://www.nationalafc.com/images/file/ReduceCrimRecidMIRiskNeedsResponCogBehavInter.pdf

Planning and Implementation Guide 38 Collaborative County Approaches to Reducing the Prevalence of Individuals with Mental Illnesses in Jail

Data Collection and Analysis • • • • •

National Institute of Corrections: How to Collect and Analyze Data: a Manual for Sheriffs and Jail Administrators https://s3.amazonaws.com/static.nicic.gov/Library/021826.pdf Closing the Gap: Using Criminal Justice and Public Health Data to Improve the Identification of Mental Illness http://www.vera.org/pubs/closing-gap-using-criminal-justice-and-public-health-data-improve-identification-mental-illness Council of State Governments Justice Center: Working with Data for Mental Health Court Practitioners, Part One: Data Collection and Manipulation https://csgjusticecenter.org/cp/webinars/webinar-archive-working-with-data-for-mental-health-court-practitioners-part-one-data-collection-and-manipulation/ Council of State Governments Justice Center: Working with Data for Mental Health Court Practitioners, Part One: Data Analysis and Communication https://csgjusticecenter.org/cp/webinars/webinar-archive-working-with-data-for-mental-health-court-practitioners-part-two-data-analysis-and-communication/ Council of State Governments Justice Center: Performance Measure Resources https://csgjusticecenter.org/reentry/issue-areas/performance-measurement/

System Assessment • • • • •

•

SAMHSA’s GAINS Center: Developing a Comprehensive plan for Mental health and Criminal Justice Collaboration: The Sequential Intercept Model http://www.criminaljustice.ny.gov/opca/pdfs/5-GAINS_Sequential_Intercept.pdf Adults with Behavioral Health Needs Under Correctional Supervision: A Shared Framework for Reducing Recidivism and Promoting Recovery https://csgjusticecenter.org/mental-health/publications/behavioral-health-framework/ Council of State Governments Justice Center: Salt Lake County, Utah: A County Justice and Behavioral Health Systems Improvement Project https://csgjusticecenter.org/wp-content/uploads/2015/09/SaltLakeCountyReport.pdf Council of State Governments Justice Center: Franklin County, Ohio: A County Justice and Behavioral Health Systems Improvement Project https://csgjusticecenter.org/mental-health/publications/franklin-county-ohio-a-county-justice-and-behavioral-health-systems-improvement-project/ National Institute of Corrections: Mapping the Criminal Justice System to Connect Justice-Involved Individuals with Treatment and Health Care under the Affordable Care Act https://s3.amazonaws.com/static.nicic.gov/Library/028222.pdf SAMHSA’s GAINS Center and the Council of State Governments Justice Center: Checklist for Implementing Evidence-Based Practices and Programs for Justice Involved Adults with Behavioral Health Disorders https://csgjusticecenter.org/mental-health/publications/a-checklist-for-implementing-evidence-based-practices-and-programs-for-justice-involved-adults-withbehavioral-health-disorders-2/ Urban Institute: The Processing and Treatment of Mentally Ill Persons in the Criminal Justice System: Practice and Background Analysis http://webarchive.urban.org/UploadedPDF/2000173-The-Processing-and-Treatment-of-Mentally-Ill-Persons-in-the-Criminal-Justice-System.pdf

Planning and Implementation Guide 39 Collaborative County Approaches to Reducing the Prevalence of Individuals with Mental Illnesses in Jail

Planning and Implementation Responses •

• •

• • • • • •

• •

Council of State Governments Justice Center: Adults with Behavioral Health needs Under Correctional Supervision: A Shared Framework for Reducing Recidivism and Promoting Recovery https://csgjusticecenter.org/mental-health/publications/behavioral-health-framework/ SAMHSA’s GAINS Center: A Guide to Implementing Police-Based Diversion Programs for People with Mental Illness http://www.pacenterofexcellence.pitt.edu/documents/A%20Guide%20to%20Implementing%20Police-Based%20Diversion%20Programs.pdf Council of State Governments Justice Center: Improving Responses to People with Mental Illnesses: The Essential Elements of a Specialized Law EnforcementBased Program https://csgjusticecenter.org/law-enforcement/publications/improving-responses-to-people-with-mental-illnesses-the-essential-elements-of-a-specialized-lawenforcement-based-program/ The National Association of Mental Health Planning and Advisory Councils: Jail Diversion: Strategies for Persons with Serious Mental Illness http://www.namhpac.org/PDFs/01/jaildiversion.pdf SAMHSA GAINS Center: Practical Advice on Jail Diversion: Ten Years Learnings on Jail Diversion from the CMHS National GAINS Center http://www.prainc.com/wp-content/uploads/2015/10/practical-advice-jail-diversion-ten-years-learnings-cmhs-national-gains-center.pdf Bexar County Jail Diversion Program: Blueprint for Success: The Bexar County Model http://www.naco.org/sites/default/files/documents/Jail%20Diversion%20Toolkit.pdf Council of State Governments Justice Center: Improving Responses to People with Mental Illnesses at the pretrial stage: Essential Elements https://csgjusticecenter.org/courts/publications/improving-responses-to-people-with-mental-illnesses-at-the-pretrial-stage-essential-elements/ Council of State Governments Justice Center: Improving Responses to People with Mental Illnesses: The Essential Elements of a Mental Health Court https://csgjusticecenter.org/courts/publications/improving-responses-to-people-with-mental-illnesses-the-essential-elements-of-a-mental-health-court/ SAMHSA’s GAINS Center and Council of State Governments Justice Center: Guidelines for the Successful Transition of People with Behavioral Health Disorders from Jail and Prison https://csgjusticecenter.org/wp-content/uploads/2013/12/Guidelines-for-Successful-Transition.pdf Council of State Governments Justice Center: Improving Responses to People with Mental Illnesses: The Essential Elements of Specialized Probation Initiatives https://csgjusticecenter.org/cp/publications/improving-responses-to-people-with-mental-illnesses-the-essential-elements-of-specialized-probation-initiatives/ City of New York Mayor’s Task Force: Mayor’s Task Force on behavioral Health and the Criminal Justice System: Action Plan 2014 http://www1.nyc.gov/assets/criminaljustice/downloads/pdf/annual-report-complete.pdf

Planning and Implementation Guide 40 Collaborative County Approaches to Reducing the Prevalence of Individuals with Mental Illnesses in Jail