Planning & Implementation Guide Justice and Mental Health Collaboration Program Law Enforcement
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”). JMHCP grantees will complete this guide in partnership with the technical assistance provider from The Council of State Governments Justice Center over the course of their grant.
The Council of State Governments Justice Center prepared this guide with support from the Bureau of Justice Assistance (BJA), U.S. Department of Justice. The contents of this document do not necessarily reflect the official position or policies of the U.S. Department of Justice.
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About the Planning & Implementation Guide The Council of State Governments (CSG) Justice Center has prepared this Planning & Implementation (P&I) Guide to support grantees in developing and refining justice and mental health initiatives to improve outcomes for people with mental disorders who are involved with the criminal justice system. The 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 strategies. 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. You and your TA Provider will use your responses to the self-assessment to collaboratively develop priorities for technical assistance. Any questions about this guide should be directed to your TA provider.
Contents of the Guide The guide is divided into six sections, each with assessment questions, exercises, and discussion prompts. The self-assessment questions and exercises are grounded on evidencebased principles. You will be prompted to write short responses, attach relevant documents, and/or complete exercises for each section. 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 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:
Nicola Smith-Kea
Phone: (301) 915-9718 (o) / (646) 592-2472 (c) Email:
nsmith-kea@csg.org
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Contents Section 1: Getting Started and Identifying Goals Exercise 1: Preparing for Your First TA Call A. Grantee Information B. Partner Inventory C. Focus Area D. Recent Developments Section 2: Developing Your Collaborative Planning Committee and Project Team Exercise 2: Developing Your Collaborative Planning Committee and Project Team A. Planning Committee B. Subcommittees/Working Groups C. Project Team D. Identifying Members Section 3: Defining the Law Enforcement and Mental Health Population Exercise 3: Defining the Population Section 4: Identifying and Applying the Essential Elements of Specialized Police Response Programs Exercise 4: Creating a Successful Law Enforcement Training Program Exercise 5: Training Call Takers and Dispatchers on SPR Protocols Exercise 6: Stabilization, Observation, and Disposition Exercise 7: Transportation and Custodial Transfer Exercise 8: Information Sharing and Confidentiality Section 5: Data Collection, Performance Measurement, and Program Evaluation Exercise 9: Developing a Data Collection Strategy A. Use of Data B. Defining Performance Measures C. Analysis and Evaluation Section 6: Sustainability Exercise 10: Assessing Program Sustainability Exercise 11: Creating a Sustainability Action Plan A. Reviewing Potential Resources B. Engaging Additional Partners C. Next Steps for Sustainability Appendix A: Overview of SPR Programs Appendix B: Resources
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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 a number of 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.
EXERCISE 1: BASIC INFORMATION A. Grantee Information Grantee Name and Award Number Lead Agency (who applied for the grant?)
Primary Agency (who is managing the day-to-day operations of the grant program)
Geographic Location (City/County/State)
Type (Rural/Suburban/Urban/Mix)
Project Name: Name: Title/Role: Agency: Email: Primary Point(s) of Contact
Phone: Name: Title/Role: Agency: Email: Phone:
Target Population (Description and Number of People Targeted)
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B. Partner Inventory. Project partners or subcontractors and their intended roles. Organization
Role in Program/Support Offered
Strategy for continued engagement:
Strategy for continued engagement:
Strategy for continued engagement:
Strategy for continued engagement:
C. Focus Area. From the list provided below, please select all that apply:
Specialized Police Response
Training Initiative:
Other
Crisis Intervention Team (CIT) Program Co-responder Program Mobile Crisis Program Law Enforcement Generalist Case Management Law Enforcement Assisted Diversion Jail Diversion
Crisis Intervention Training Mental Health Intervention Training Other. Please describe __________________________________________________ Please describe:
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D. Recent Developments. We would like to know about any major developments that have occurred between the time that you wrote your grant application and our next call. When completing the exercise below, be sure to reference any major goals changes, stakeholders changes, etc., that may have occurred.
1. Are there any changes to your goals as they were outlined in your grant proposal? This might include changes in program partners, staffing, budget, etc. Answer:
2. Are you aware of any pre-existing initiatives or programs focusing on individuals with mental disorders involved with the criminal justice system, either locally or at the state level? Please indicate if any of these initiatives or programs are funded through either the Bureau of Justice Assistance’s JMHCP or Second Chance Act grant programs. Answer:
3. In what areas do you anticipate spending the majority of grant funds? (For example, funding positions, overtime, training, treatment services, etc.) Answer:
4. What other funding is being used or leveraged to support your program activities? Answer:
5. Has your jurisdiction ever conducted a strategic mapping session, gap analysis, or other needs assessment about the services available in your community? Answer:
6. What are your short-term goals for this grant initiative? Answer:
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7. What are your long-term goals for this grant initiative? Answer:
Additional Comments
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ESSENTIAL ELEMENTS OF A SPECIALIZED LAW ENFORCEMENT-BASED PROGRAM As a growing number of law enforcement jurisdictions grapple at the local level with implementing Specialized Police Responses (SPRs), there has been demand for more information on the key elements of promising programs. In response to this demand, the CSG Justice Center, in partnership with the Police Executive Reform Forum (PERF), produced The Essential Elements of A Specialized Law Enforcement-Based Program, which outlines the following 10 essential elements to implementing effective SPRs:
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• Collaborative Planning and Implementation
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• Program Design
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• Specialized Training
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• Call- Taker and Dispatcher Protocols
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• Stabilization, Observation, and Disposition
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• Transportation and Custodial Transfer
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• Information Exchange and Confidentiality
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• Treatment, Support and Services
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• Organizational Support
10 • Program Evaluation and Sustainability
This P&I Guide is largely based on these 10 essential elements. We encourage you to consult this publication as you create or enhance your particular SPR.
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SECTION 2: DEVELOPING YOUR COLLABORATIVE PLANNING COMMITTEE AND PROJECT TEAM Since a focus of your JMHCP grant is to create innovative cross-systems collaboration between law enforcement and behavioral health agencies, the questions and activities in this section are intended to provide guidance toward achieving this objective in addition to helping you explore various aspects of collaborative decision making essential to the success of your initiative.
EXERCISE 2: DEVELOPING YOUR COLLABORATIVE PLANNING COMMITTEE AND PROJECT TEAM A. Planning Committee 1. Is there a planning committee already in place for this project? Answer:
Yes
No
IF YES: Are there other criminal justice/mental health entities across the county or in the state that your committee can engage with for the duration of this grant initiative? IF NO, please skip to question 5. Answer:
2. Who currently chairs the planning committee? Is it co-chaired by representatives from the law enforcement and mental health systems? Answer:
3. Do you currently have any of the following documents to define responsibilities among committee members? Interagency Agreements
Memoranda of Understanding
Policies & Procedures
Other. If “other,� please explain.
4. Does your planning committee have a mission statement and/or guiding principles? If so, please record them below.
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Answer:
5. If you answered “no,� to question 1, please briefly describe your strategy for establishing a planning committee. This information should include how often you anticipate meeting and who might lead the group.
Answer:
6. What agreements do you anticipate needing (MOUs, etc.) to help make this initiative a success? Answer:
7. How often will your planning committee meet? Answer:
8. Are there additional stakeholders that you would like to reach out to join the planning committee?
Answer:
B. Subcommittees/Working Groups (If Applicable) 1. Does/Will your committee have working groups or subcommittees? If so, briefly describe them. Please attach an organizational chart for the planning committee if available. Answer:
2. Please outline the procedure for your subcommittees or working groups to collaborate and share information with the planning committee. Answer:
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C. Project Team 1. Do you have a project team (separate from your planning committee) to execute the day-today activities necessary to plan and/or implement your program or initiative? Answer: 2. Are there local “champions” for law enforcement that are part of this project team? If not, do you plan to include such individuals in the day-to-day oversight of the law enforcement program? Answer: 3. On a scale of 1 to 5, please indicate the level of support (buy-in) for the program from the law enforcement agency’s leadership. (1=No support; 5=Very high level of support) Select one answer:
1
2
3
4
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4. Are there local “champions” for mental health that are part of this project team? If not, do you plan to include such individuals in the day-to-day oversight of the mental health program? Answer:
5. On a scale of 1 to 5, please indicate the level of support (buy-in) for the program from the mental health facility’s leadership. (1=No support, 5=Very high level of support) Select one answer:
1
2
3
4
5
Additional Comments:
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D. Identifying Members
Name
Title
Organization
Specific role on planning team
Member of Planning Comm.
Member of Project Team
Yes Yes Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
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SECTION 3: DEFINING THE LAW ENFORCEMENT AND BEHAVIORAL HEALTH POPULATION It is important to have defined criteria to describe your target population as your grant award is a limited resource. Since your community will likely have more people who could benefit from service than you are able to effectively serve, you want to ensure that your grant project serves those who are most likely to benefit from it. It will be important for the planning committee to assess calls for service involving people with behavioral health needs. This will help identify the resources necessary for responding to your target population, and will help you identify the law enforcement staffing necessary to build a successful program.
EXERCISE 3: DEFINING THE LAW ENFORCEMENT/BEHAVIORAL HEALTH POPULATION Please respond to the questions below.
Defining The Law Enforcement/ Behavioral Health Population 1. Has your team, with assistance from law enforcement, analyzed mental health emergencies and calls for service in the community? Answer:
2. Have you been able to identify any patterns in mental health calls for service by time of day, day of week or address/location? Answer:
3. Have you been able to identify high utilizers/chronic consumers? Answer:
4. Has your team come to understand the scope of the mental disorder problem in the community by reviewing data and talking with law enforcement and behavioral health practitioners? Answer:
5. Is there agreement between law enforcement and behavioral health care providers on the populations being served? Answer:
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SECTION 4: IDENTIFYING THE ESSENTIAL ELEMENTS OF SPECIALIZED POLICE RESPONSE PROGRAMS People with behavioral health needs who are involved with the criminal justice system often have multiple and complex needs and, as such, responses to address these needs will not be effective unless the necessary services and supports are available. An important goal of the JMHCP program is to facilitate collaboration among the criminal justice and behavioral health care systems to increase access to treatment services to address behavioral health and criminogenic needs. This section will discuss the essential elements of an SPR program; how to implement those elements in a way that is tailored to the needs of your community; and how to create a collaborative program. The topics covered in this section will form the backbone of your SPR program. While you may not have the resources or capacity to implement all of the suggestions here, they should help serve as a helpful guide. Training For law enforcement, one of the most crucial pieces of designing an effective SPR program is to make sure officers are trained to deescalate difficult situations. While there are several SPR models that can be used to design a program for your jurisdiction (see Appendix B), it is important to note that there is no “one-size fits all” approach and the program you create must reflect the resources and needs of your community. Your first step is carefully planning your initiative. This will involve discussions with the project team, law enforcement officials, and mental health representatives. You should design a program that can be implemented with existing resources, being sure to consider the information you developed or recorded in previous sections of this P&I Guide. Next, it will be important to determine the number and types of officers to train. Some programs utilize a mental health responder model, many involve officers in CIT training, and others include hybrid approaches. Agencies will differ regarding the number of officers they train, but at a minimum training should be sufficient to make sure law enforcement officers are able to cover all geographic districts and working shifts. Finally, you must determine the training content, including the curriculum and topics. Although your planning committee can determine what types of training would be the most effective to utilize, your TA provider can provide additional guidance. Training should provide law enforcement officers with an improved understanding of individuals with mental disorders, signs and symptoms of mental disorders, stabilization and de-escalation techniques, disposition options, and legal resources. Mental health professionals, call dispatchers, and other criminal justice professionals should participate in the law enforcement component of the training program to ensure that all involved can understand law enforcement’s role and responsibilities. 14
EXERCISE 4: CREATING A SUCCESSFUL LAW ENFORCEMENT TRAINING PROGRAM Please respond to the questions below.
The Training Program 1. Has the planning committee, with guidance from law enforcement, determined the number of officers to be trained? Answer: 2. Has the law enforcement agency developed selection criteria for identifying officers to participate in the program? Answer: 3. Has a training program been selected for officers? If so, please provide the name of the program/trainer. Answer: 4. Have first-line supervisors and other critical agency personnel, such as field training officers, received information regarding the specialized training, and their role in its implementation? Answer: 5. Will mental health practitioners be involved in the training process to help improve crosssystem understanding of agencies’ roles? Answer: 6. Will mental health advocates, family members, or consumers be involved and included in the training program? Answer: 7. Has a schedule been developed for all training classes? If so, please provide a copy of the schedule to your TA provider. Answer: Additional Comments:
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The Curriculum 1. What type of SPR training are you providing? Are you providing CIT training, another type of LE-MH training, or both? (If so, please provide a copy of your curriculum to your TA provider.) Answer:
2. If you are doing CIT training, have you made modifications to the curriculum to suit your specific needs? Answer:
3. How long is the SPR training course that you provide to officers? 40 Hours
24 Hours
8 Hours
4 Hours
Other: ___________
4. Who is receiving the training? Please check all that apply Officers and Detectives Supervisors Call Takers and Dispatchers Mental Health Workers Paramedics EMTs Firefighters Correctional Officers Probation/Parole Officers Other: ______________________________ Other: ______________________________
5. Please indicate the topics your SPR training program will cover (check all that apply): Active Listening/De-escalation Techniques
Alzheimer’s Disease and Dementia
Anxiety Disorders
Auditory Hallucinations/Hearing Voices
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Autism
Bipolar Disorders
Clinical Issues Related to Mental Disorders
Community Resources
Consumer Perspective
Co-Occurring Disorders
Crisis De-escalation
Depression
Developmental Disabilities
Excited Delirium
Family Member Perspective
Medications and Side Effects
Memphis Model of CIT
Mood Disorders
Officer Legal Liability
Post-Traumatic Stress Disorder
Record Keeping/Data Collection
Schizophrenia
Suicide Prevention
Use of Force
Other:______________________________________________________________________
6. Please indicate what instructional methods you are using during your SPR Training: Guest Speakers (Consumer)
Guest Speakers (Non-Consumer)
Lectures
Role Play
Site Visits to Facilities
Videos
Other: _______________________________________________________________________
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EXERCISE 5: TRAINING CALL TAKERS AND DISPATCHERS ON SPR PROTOCOLS A successful SPR program will inform call takers, dispatchers, and other front-line employees about the SPR program, its purpose, and function. This will help ensure that mental health calls for services are properly identified and routed, and that data is tagged for review. Please respond to the questions below.
Call Taker and Dispatcher Protocols 1. Will call takers and dispatchers receive training that addresses their role in the SPR program? Answer:
2. Will call takers and dispatchers be trained in recognizing and assessing a mental health crisis? Answer:
3. Will procedures be put in place for receiving and dispatching calls involving people with mental disorders? Answer:
4. Will call takers and dispatchers be informed of law enforcement and behavioral health agency staffing patterns to properly route calls for service? Answer:
5. Will protocols be developed to inform call takers at the 911 center about how to record information in the database about calls where mental disorders may be a factor? Answer:
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EXERCISE 6: STABILIZATION, OBSERVATION, AND DISPOSITION Training alone does not make an effective SPR program. An effective program will require continued buy-in and support from on-the-ground personnel who are helping to implement the program, including the law enforcement officers and mental health professionals who are responsible for appropriately identifying and routing individuals who need mental health services. Please respond to the questions below.
Stabilization, Observation, and Disposition 1. Are responding officers trained to safely de-escalate situations involving people who are experiencing mental health crises? Answer:
2. Are agency protocols in place that allow officers to divert people to mental health services when no serious crime has been committed? Answer:
3. Do officers understand the criteria for involuntary emergency evaluation/detention? Answer:
4. Are officers familiar with available community resources, particularly 24-hour centers that act as receiving centers for individuals experiencing mental health crises? Answer:
5. Do officers currently use screening questions when they respond to a call to determine an individual’s mental health status? (If yes, please provide a copy of these questions to your TA provider.) Answer:
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EXERCISE 7: TRANSPORTATION AND CUSTODIAL TRANSFER One of the main benefits of an SPR program is that it can reduce law enforcement officers’ time spent on mental health calls for service. However, this is only possible with the help of mental health professionals and a facility that has procedures in place to facilitate the transfer of people from law enforcement custody into a facility. The following section can help you determine if appropriate procedures are in place and whether there is buy-in from all partners necessary to make an SPR program succeed. Please respond to the questions below.
Transportation and Custodial Transfer 1. Are officers aware of facilities capable of assuming custodial responsibility for people in need of mental health services ? Answer: 2. Are law enforcement officers trained to work with mental health professionals, including individuals’ current behavioral health care providers, to determine appropriate disposition? Answer: 3. Is staff in the receiving facility ready and willing to receive people for care? Answer: 4. Is mental health staff available at correctional facilities or lockup? Answer: 5. Is mental health staff at correctional facilities or lockup screening people for mental health disorders and risk? Answer: 6. Are you familiar with which screening tool is used? If yes, please name the tool(s). Answer: 7. Are noncustodial procedures in place to direct people to mental health support services, family members, peers, or others when necessary? Answer: 8. Is there a line of communication open between law enforcement and behavioral health professionals at all times? Answer:
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EXERCISE 8: INFORMATION SHARING AND CONFIDENTIALITY As you are aware, law enforcement activities are highly regulated and laws exist to govern the exchange of law enforcement information. Adding health care to this equation can add another layer to an already complicated legal structure. Yet information sharing is crucial to a successful SPR program. It will be important for the planning committee and the project team to consult with the appropriate legal authorities to develop an information-sharing agreement that is both fully in compliance with applicable federal, state, and local laws and protects confidentiality. The following questions will help the committee begin to develop an information-sharing program. Please respond to the questions below.
Information Sharing and Confidentiality 1. Have your law enforcement and behavioral health agencies determined the type of information that is needed and that can be shared between the two agencies? Answer: 2. Are law enforcement officers aware of federal and state laws that dictate what and how information can be shared regarding individuals involved with the justice system who are experiencing a mental health crisis? Answer: 3. Have your law enforcement and behavioral health agencies determined what barriers to information might exist? If so, please describe them. Answer: 4. Have policies, or MOUs, been developed to facilitate and formalize information sharing between law enforcement and behavioral health agencies? Answer: 5. Have the law enforcement and mental health agencies reviewed applicable federal, state, and local legal standards and worked with appropriate legal counsel to determine a manner for sharing information that is legal and protected confidentiality? Answer: 6. Have the project team determined which personnel will have authority to request and provide information about an individual’s mental health and criminal history? Answer:
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SECTION 5: DATA COLLECTION, PERFORMANCE MEASUREMENT, AND PROGRAM EVALUATION Throughout this project, you will need to collect data to:
Keep track of participants or other grant project-related activities (program operations); Measure the grant project’s performance on an ongoing basis (performance measurement); and Determine whether the grant project is operating as intended and is having the intended results (process and outcome evaluations, respectively).
It is important to understand the different uses of data early on during your planning phase to help you determine the best way to collect, manage, and analyze the data. For law enforcement, accurately measuring the number of mental health calls for service is difficult if it is not an agency priority. Collecting this and other data is essential to encourage buy-in and support; adjust policies and protocols; and demonstrate program value. The data that law enforcement collects should focus on the information that is most critical to the program’s goals. This section will help you determine what data to collect and develop policies for collecting, storing, analyzing, and querying it.
EXERCISE 9: DEVELOPING A DATA COLLECTION STRATEGY The exercises below are intended to gather information on:
Your initiative’s use of data; Defining performance measures; and Analysis and evaluation.
A. Use of Data
1. Are you currently collecting the data you need for relevant grant requirements (e.g., the Performance Measurement Tool (PMT) from BJA and CSR)? If not, how can you improve your data collection effort to get the data you need? Answer:
2. What are the outcomes that your planning committee is interested in tracking? (For example, reduction in calls for service, etc.) Answer:
3. Do you currently collect the data you need to track the outcomes of interest to your planning committee or other stakeholders? If not, how can you improve your data collection effort to get you the data you need? Answer:
4. What agency or agencies are responsible for collecting data? Answer:
5. Is data currently being shared between law enforcement and mental health when responding to target population? Answer:
6. How is the data that is being collected shared among the relevant agencies? Answer:
7. How is the data being stored? (For example, in paper files, shared drives, or network databases, etc.) Answer:
Additional Comments:
B. Defining Performance Measures
1. How will you define “successful completion?� (For example, a reduction in calls for services, the number of officers trained, etc.) Answer: 2. Has the program determined a method for tracking mental health calls for service? Answer: 3. Has the program determined a method for tracking dispositions for mental health calls for service?
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Answer: 4. Has the program determined a method for tracking dispositions by subcategory? (For example, arrest, emergency evaluation, referral to mental health services, referral to social services, etc.) Answer: Additional Comments:
C. Analysis and Evaluation
1. Will you be conducting an evaluation of your grant initiative? Answer: 2. If so, who is conducting the evaluation? Is this an internal or external entity? Answer: 3. Has the program determined who will be responsible for analyzing the data? Answer: 4. Has the program determined a method for analyzing calls for service and disposition data and using that data to improve the SPR program? Answer: 5. What are you planning to measure in the evaluation, beyond the required PMT measures? Answer: 6. Are you using a comparison group to assess the success of the program? If so, what is the comparison group? Answer: 7. Who will you share evaluation data with? Answer: Additional Comments:
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SECTION 6: SUSTAINABILITY This section focuses on strategies for achieving long-term sustainability for your initiative through focused efforts that are initiated at the beginning of the grant. Sustainability can be especially difficult to achieve if left for “the last minute” when grant dollars are coming to an end; developing a sustainability plan at the onset of a project is essential to build a strong program that can continue after your JMHCP funding concludes. While JMHCP grants are intended to create programs that improve results in a particular jurisdiction, these programs can pave the way for more systemic change by modeling success or innovation. While this may seem like a lot for a program to take on, it will be more sustainable if it is part of a broader effort to improve outcomes. To accomplish this goal, your project team should work to:
Gauge the response to the program from community leaders, elected officials, and other individuals. Solicit feedback from officers and mental health professionals in order to determine how to promote the program within the community and spread the word about its effectiveness to community leaders. Determine long-term funding sources.
Internally, agency leaders on the committee should work to maintain internal support for the program and use data gathered from the feedback process to sell the program’s effectiveness. These strategies will help ensure a long-term sustainable program.
EXERCISE 10: ASSESSING PROGRAM SUSTAINABILITY Please respond to the questions below
1. Are stakeholders meaningfully engaged in the project on a regular basis? Answer:
2. Have stakeholders expressed long-term commitment to and involvement in the program? Answer:
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3. Is there a program “champion� who publicly advocates for the continuation of the program? Answer:
4. Can program leaders clearly articulate the value of the program? Answer:
5. Are program leaders able to tailor their message about the initiative to different audiences? (For example, community supervision, mental health treatment, jail administrators, etc.) Answer:
6. Is there a working group of diverse stakeholders focused on developing a sustainability plan? Answer:
7. Are there additional funding streams from federal, state and local governments, foundations, and private organizations that can sustain the project after current federal funding expires? Answer:
Using Data to Drive Sustainability 1. How often will the performance measures be reported to or discussed by the planning committee? Answer:
2. How will data be reported? (For example, through informal presentations, formal reports, press releases, newsletters, etc..) Answer:
3. How often and to whom will your planning committee report on outcomes? Answer:
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4. How will you communicate the data to other stakeholders; elected officials; the public; and your critics and champions? Answer:
5. How will this data be used, if at all, to make changes in the function, policies, or procedures of your initiative? Answer:
6. How will this data be used, if at all, to frame policies and practices at the administrative and legislative levels? Answer:
7.
Will collected data or evaluation results be shared with each stakeholder and tailored to their specific interests? Answer:
Additional Comments:
EXERCISE 11: CREATING A SUSTAINABILITY ACTION PLAN Please complete the following exercise that identifies the degree to which your jurisdiction is working towards sustainability. It is likely that your TA provider will revisit your responses and use it as a basis for periodically discussing your progress. A. Reviewing Potential Resources
Sustainability Components
Responses
1. Has the group identified components of the program (such as staffing, policy, or practice changes) that could continue in the absence of dedicated funding? 2. List the two most important program components and the partners that can potentially provide resources to sustain these components.
Sustainable Components
Stakeholder Resources
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3. List the policy changes, training programs, and so on that do not need refunding each year.
1. 2. 3.
4. List potential federal, state, and local government, foundation, and private funding opportunities.
1. 2. 3.
5. List program support items that can be donated, such as clothing, goods and services, and the organizations to approach for relevant donations.
Needed Items
Donation Organizations
Additional Comments
B. Engaging Additional Partners
Questions/ Statements 1. Which 2–3 organizations not currently involved in your initiative would you like to invite to participate?
Responses 1. 2. 3.
2. Who is responsible for reaching out to potential stakeholders who are not currently involved in your program? 3. What are the outcomes that are of interest for current and potential stakeholders?
4. What are your current stakeholder engagement strategies?
Stakeholder e.g., Local halfway house
Outcome of Interest e.g., Increase housing options
1. 2.
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3. 5. Please list your ideas for additional stakeholder engagement strategies. (For example, invitations to visit the program, meeting with a program participant, speaking opportunities at local events, etc.) 6. What are your opportunities for sharing program success? (For example, planning committee meetings, judicial meetings, community meetings, school board meetings, with faith-based organizations, newsletters, etc.)
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C. Next Steps for Sustainability Please use the information above to identify action items geared towards long-term sustainability after program funding has ended.
Sustainability Action Item
Person/ Organization Responsible
APPENDIX A. OVERVIEW OF SPR PROGRAMS Overview of Law Enforcement-Mental Health Specialized Police Response (SPR) Programs Law enforcement officers throughout the country regularly respond to calls for service that involve people with mental disorders—often with minimal support, resources or specialized training. Among the most complex and time-consuming calls, these encounters can have significant consequences for the officers, people with mental disorders and their loved ones, the community, and the criminal justice system. At these scenes, officers must stabilize a potentially volatile situation, determine whether the person poses a danger to him- or herself or others, and determine an appropriate disposition that may require a wide range of community support. Because community mental health resources are overtaxed, officers may resolve incidents informally, often only to provide a short-term solution to a person’s long-term needs. As a consequence, many law enforcement personnel respond to the same group of people at the same locations repeatedly, straining already limited resources and fostering a collective sense of frustration at the inability to prevent future encounters. In response, communities across the country are exploring strategies to improve the outcomes of these encounters and to provide a compassionate response that prioritizes treatment over incarceration when appropriate. Specialized police responses (SPRs) provide a new set of response options for frontline personnel that are tailored to the needs of people with mental disorders; they establish a link for these individuals to services in the community; and include strong collaborative ties to mental health partners, other criminal justice agencies, and community members. Various SPR programs, including Crisis Intervention Teams (CIT), coresponder models, mobile crisis teams, and case management models are used by many agencies and produce positive results, including:
Increased access to mental health services Reduced arrest rates Reduced injuries to officers and others Reduced repeat calls for service Reduced SWAT calls
Training and Collaboration Effective SPR programs are built on two key essential elements: First, officers need a basic knowledge of mental disorders and the behaviors associated with mental health crises, as well as the skills to de-escalate those crises. CIT programs rely on a 40-hour curriculum, and many agencies use that curriculum but modify portions to meet community needs and resources. Other agencies have developed their own curriculum to ensure that mental health and de-escalation training is consistent with overall training goals and philosophy. Second, each program depends on meaningful collaboration among professionals in the criminal justice and 31
mental health systems, as well as advocates for those with mental disorders including clients or their family members. Although achieving the requisite level of collaboration is often difficult— particularly when faced with long-standing system barriers—successful partnerships are needed to carry out the full range of program elements.
Responding to Mental Health Calls for Service At the street-level, SPR programs provide officers with the knowledge and skills to deescalate encounters, promote the safety of all involved, and when appropriate, divert the person from further involvement with the criminal justice system and provide a timely connection to accessible and effective community-based behavioral health services. There are four basic models, all of which assume that officers are trained and collaborative partnerships exist:
Crisis Intervention Team: Known as CIT, this popular approach relies upon an agency designating a group of self-selected officers (representing 25 percent of the patrol force) who respond to as many mental health calls for service as possible, working with or relieving officers who do not have the CIT designation. The CIT model originated in the Memphis, TN police department and is therefore often called the “Memphis Model.”
Co-Responder Team: A specially trained officer and a mental health professional ride together in the same vehicle to respond to mental health calls for service. By drawing upon the combined expertise of the officer and mental health professional, this team is able to link people with mental disorders to appropriate services or provide other effective and efficient responses.
Mobile Crisis Team: Mental health professionals respond, at the request of officers, to the scene of calls for services to help stabilize encounters and assume responsibility for securing mental health services for persons in mental health crisis.
Law Enforcement Generalist: Law enforcement agencies provide all officers with extensive training in mental health knowledge and de-escalation skills with the expectation that all officers, rather than specialists, are capable of responding effectively to people experiencing mental health crisis or experiencing other mental health problems.
The models are not necessarily mutually exclusive or distinct. That is, some agencies incorporate elements of different models into their programs, including relying upon CIT officers or generalists as well as co-responder or mobile crisis teams.
Proactive Strategies Law Enforcement-Mental Health SPR programs have been used by agencies for roughly 30 years, and over that time, the programs have evolved and expanded. The number of mental 32
health calls for service, recurring interactions with the same consumers, reductions in mental health resources, and the complexity of navigating behavioral health systems have led agency leaders to designate officers to focus on managing and coordinating the responsibilities and tasks beyond just the initial call for service, and to provide the administrative infrastructure to enhance the program’s effectiveness and sustain program elements. Several agencies, in collaboration with mental health partners, have developed a tiered approach in which patrol officers still respond to mental health calls for service but are augmented by officers who either assume responsibility for reaching a disposition or provide follow-up services for individuals who present complex challenges or utilize significant law enforcement and mental health services. In most of these agencies, officers take on these responsibilities as their full-time assignments, although in smaller agencies these responsibilities may exist in addition to other duties. Some agencies rely on multiple officers to perform these tasks, while other agencies have created entire organizational units to focus on behavioral health responsibilities. Acting as hybrid investigators, case managers, problem solvers, and trainers, these individuals—with titles such as mental health coordinator, CIT investigator, or mental health officer—assume a variety of responsibilities, with the most common being the following:
Case Management: Officers carry a caseload of people who have repeated interactions with law enforcement and work with them to develop specific solutions to reduce repeat interactions; ensure that they remain connected to mental health services and community resources; abide by treatment plans; and meet other responsibilities such as work, school, and training. This follow-up is done collaboratively with mental health professionals, although the level of collaboration varies by agency.
Coordination of Officer Responses: Officers serve as subject-matter experts for colleagues who have questions or concerns about calls/individuals. This can include providing real-time assistance for responding to calls for service and appropriate dispositions, as well as debriefing with responding officers and reviewing reports of mental health calls for service to identify individuals for case management or mental health referral.
Data Collection and Analysis: Coordinate with those entities or individuals—911 dispatch, police records, crime analysis, jails, and mental health providers—that maintain information about mental health calls for service and dispositions to ensure that the community has a robust system for collecting and analyzing this data for the purposes of documenting the extent of the challenge; directing operational decisions about response capabilities; and informing budget and other planning decisions.
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Training and Guidance: Assist in developing and delivering training and educational opportunities for officers and mental health professionals, and provide one-on-one coaching to officers who need guidance to improve responses to mental health crises. In addition, these specialists review—and ensure, when appropriate— whether agency policies and procedures are accurate and consistent.
Community Outreach: Represent the agency at relevant community and stakeholder meetings and serve as the agency’s point-of-contact for consumers and/or their families, mental health and behavioral health providers, and criminal justice partners.
Conclusion More and more agency leaders have reached the conclusion that responding to behavioral health crises and interacting with behavioral health systems is a reality of policing in the twenty-first century. While law enforcement agencies have historically interacted primarily with other components of the criminal justice system, today’s agencies find that they now have significant interactions with behavioral health systems. Addressing problems raised by the large numbers of people with mental disorders in the criminal justice system requires a comprehensive community- and system-wide strategy in which the SPR program plays only one part. The SPR program is a critical first step for any community, but, ultimately, reducing the number of people with mental disorders in the criminal justice system must include complementary programs in jails, courts, the community-based mental health system, and the larger community.
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APPENDIX B. RESOURCES LAW ENFORCEMENT/ MENTAL HEALTH STRATEGIES Draper, Laura and Blake Norton. Lessons Learned: Planning and Assessing a Law Enforcement Reentry Strategy. New York: Council of State Governments Justice Center, 2013. https://csgjusticecenter.org/law-enforcement/publications/lessons-learned-planning-andassessing-a-law-enforcement-reentry-strategy/ Massaro, Jackie. Working with People with Mental Illness Involved in the Criminal Justice System: What Mental Health Service Providers Need to Know. Delmar, NY: Technical Assistance and Policy Analysis Center for Jail Diversion, 2004. Reuland, Melissa, Laura Draper, and Blake Norton. Statewide Law Enforcement / Mental Health Efforts: Strategies to Support and Sustain Local Initiatives. New York: Council of State Governments Justice Center, 2012. https://www.bja.gov/Publications/CSG_StatewideLEMH.pdf. Reuland, Melissa, Laura Draper, and Blake Norton. Improving Responses to People with Mental Illnesses: Tailoring Law Enforcement Initiatives to Individual Jurisdictions. New York: Council of State Governments Justice Center, 2010. https://csgjusticecenter.org/wpcontent/uploads/2012/12/Tailoring_LE_Initiatives.pdf Reuland, Melissa, Matt Schwarzfeld, Laura Draper. Law Enforcement Responses to People with Mental Illnesses: A Guide to Research-Informed Policy and Practice. New York: Council of State Governments Justice Center, 2009. https://csgjusticecenter.org/wpcontent/uploads/2012/12/le-research.pdf Reuland, Melissa, Matt Schwarzfeld. Improving Responses to People with Mental Illnesses: Strategies for Effective Law Enforcement Training New York: Council of State Governments Justice Center, 2009. https://csgjusticecenter.org/wp-content/uploads/2012/12/le-trgstrategies1.pdf Reuland, Melissa. A Guide to Implementing Police-Based Diversion Programs for People with Mental Illness. Delmar, NY: Technical Assistance and Policy Analysis Center for Jail Diversion. Schwarzfeld, Matt, Deidre Weiss, Martha Plotkin and Laura Draper. Planning and Assessing a Law Enforcement Reentry Strategy. New York: Council of State Governments Justice Center, 2009. https://csgjusticecenter.org/wp-content/uploads/2012/12/LE_Reentry_Strategy-1.pdf Schwarzfeld, Matt, Melissa Reuland and Martha Plotkin. Improving Responses to People with Mental Illnesses: The Essential Elements of a Specialized Law Enforcement-Based Program New York: Council of State Governments Justice Center, 2009. https://csgjusticecenter.org/wpcontent/uploads/2012/12/le-essentialelements.pdf
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DATA COLLECTION AND EVALUATION Aos, Steve, Polly Phipps, Robert Barnoski, and Roxanne Lieb. The Comparative Costs and Benefits of Programs to Reduce Crime. Olympia, WA: Washington State Institute for Public Policy, 2001. http://www.wsipp.wa.gov/ReportFile/756. Bersamira, Cliff, Sarah Wurzburg, and Kelly Zentgraf. State Substance Abuse Agencies, Program Management and Data Utilization: Case Studies of Eleven States. Washington, DC: National Association of State Alcohol and Drug Abuse Directors, 2013. http://nasadad.wpengine.com/2015/03/state-substance-abuse-agencies-program-managementand-data-utilization-case-studies-of-eleven-states/. Carter, Madeline M. The Importance of Data and Information in Achieving Successful Criminal Justice Outcomes. Silver Spring, MD: Center for Effective Public Policy, 2006. http://collaborativejustice.org/docs/Collaboration%20Data%20Monograph.pdf. Elias, Gail. How to Collect and Analyze Data: A Manual for Sheriffs and Jail Administrators. Washington, DC: National Institute of Corrections, 2007. https://s3.amazonaws.com/static.nicic.gov/Library/021826.pdf. Kim, KiDeuk, Miriam Becker-Cohen, Maria Serakos. The Processing and Treatment of Mentally Ill Persons in the Criminal Justice System. Washington, DC: Urban Institute, 2015. http://webarchive.urban.org/UploadedPDF/2000173-The-Processing-and-Treatment-ofMentally-Ill-Persons-in-the-Criminal-Justice-System.pdf. Kimmelman-DeVries, Cynthea and Andrew Barbree. “Working with Data for Mental Health Court Practitioners: Part One: Data Collection and Manipulation.” Webinar held by the Council of State Governments Justice Center, New York, NY, May 6, 2010. http://csgjusticecenter.org/cp/webinars/webinar-archive-working-with-data-for-mental-healthcourt-practitioners-part-one-data-collection-and-manipulation/. Kimmelman-DeVries, Cynthea and Andrew Barbree. “Working with Data for Mental Health Court Practitioners: Part Two: Data Analysis and Communication.” Webinar held by the Council of State Governments Justice Center, New York, NY, June 21, 2010. http://csgjusticecenter.org/cp/webinars/webinar-archive-working-with-data-for-mental-healthcourt-practitioners-part-two-data-analysis-and-communication/. Lampkin, Linda M. and Harry P. Hatry. Key Steps in Outcome Management. Washington, DC: The Urban Institute, 2003. http://www.urban.org/sites/default/files/alfresco/publicationpdfs/310776-Key-Steps-in-Outcome-Management.PDF. Morley, Elain and Linda M. Lampkin. Using Outcome Information: Making Data Pay Off. Washington, DC: The Urban Institute, 2004. http://www.urban.org/sites/default/files/alfresco/publication-pdfs/311040-Using-OutcomeInformation.PDF. Parsons, Jim and Talia Sandwick. Closing the Gap: Using Criminal Justice and Public Health Data to Improve the Identification of Mental Illness. New York: Vera Institute of Justice, 2012. http://www.vera.org/sites/default/files/resources/downloads/closing-the-gap-report.pdf. 36
Rossman, Shelli B. and Laura Winterfield. Measuring the Impact of Reentry Efforts. Silver Spring, MD: Center for Effective Public Policy, 2009. http://www.cepp.com/documents/Measuring%20the%20Impact.pdf. Walker, Karen E., Chelsea Farley, and Meredith Polin. Using Data in Multi-Agency Collaborations: Guiding Performance to Ensure Accountability and Improve Programs. New York: Public/Private Ventures, 2012. http://www.issuelab.org/click/download1/using_data_in_multi_agency_collaborations_guiding_p erformance_to_ensure_accountability_and_improve_programs?_ga=1.122235533.762624363. 1428424672.
SUSTAINABILITY Charlier, Jac and Maureen McDonnell. Sustainability for Publicly-Funded Behavioral Health and Justice Grant Programs. Delmar, NY: SAMHSA’s GAINS Center for Behavioral Health and Justice Transformation, 2012. The Council of State Governments Justice Center. Developing a Mental Health Court: An Interdisciplinary Curriculum. Module 2: Your Community, Your Mental Health Court. New York: The Council of State Governments Justice Center, 2012. http://learning.csgjusticecenter.org/?page_id=179. Goss, Stephen and Leonard Bailey. ESTABLISHING AND MANAGING A COMPETENCY DOCKET IN A RURAL OR RESOURCE CHALLENGED JURISDICTION. 2010. http://www.mentalcompetency.org/resources/articles/files/Goss%20-%20Establishing%20and%20Managing%20a%20Competency%20Docket.pdf?collection=journa ls&handle=hein.journals/jusj30&div=24&id=&page. Martin, Alison. Plan for program evaluation from the start. National Institute of Justice. 2015. http://www.nij.gov/journals/275/pages/plan-for-program-evaluation.aspx Office of Rural Health Policy, Health Resources and Services Administration. RURAL BEHAVIORAL HEALTH PROGRAMS AND PROMISING PRACTICES. Washington, DC: US Department of Health and Human Services, 2011. http://www.hrsa.gov/ruralhealth/pdf/ruralbehavioralmanual05312011.pdf. Osher, Fred, David D’Amora, Martha Plotkin, Nicole Jarrett and Alexa Eggleston. Adults with behavioral health needs under correctional supervision: A shared framework for reducing recidivism and promoting recovery. New York: Council of State Governments Justice Center, 2012. http://csgjusticecenter.org/wp-content/uploads/2013/05/9-24-12_Behavioral-HealthFramework-final.pdf.
SYSTEMS COLLABORATION Beeman, Marea and Aimee Wickman. Measuring Performance of CJCCs. Arlington, VA: The Justice Management Institute, 2013. http://69.195.124.207/~jmijust1/wpcontent/uploads/2014/04/CJCCMiniGuide-Performance-Measures.pdf. 37
Carter, Madeline M. Engaging in Collaborative Partnerships to Support Reentry. Silver Spring, MD: Center for Effective Public Policy, 2010. http://www.cepp.com/documents/Engaging%20in%20Collaborative%20Partnerships.pdf. Center for Court Innovation. Engaging Stakeholders in Your Project. New York: Center for Court Innovation. http://www.courtinnovation.org/sites/default/files/Engaging_Stakeholders_in_Your_Project%5B1 %5D.pdf. The Council of State Governments Justice Center. The Criminal Justice Mental Health Consensus Project. New York: Council of State Governments Justice Center, 2002. http://csgjusticecenter.org/mental-health-projects/report-of-the-consensus-project/. The Council of State Governments Justice Center. Franklin County, Ohio: A County Justice and Behavioral Health Systems Improvement Project. New York: Council of State Governments Justice Center, 2015. http://csgjusticecenter.org/wpcontent/uploads/2015/05/FranklinCountyFullReport.pdf. Cushman, Robert C. Guidelines for Developing a Criminal Justice Coordinating Committee. Washington, DC: National Institute of Corrections, 2002. https://s3.amazonaws.com/static.nicic.gov/Library/017232.pdf. Jones, Michel R. Guidelines for Staffing a Local Criminal Justice Coordinating Committee. Washington, DC: National Institute of Corrections, 2012. https://s3.amazonaws.com/static.nicic.gov/Library/026308.pdf. Jones, Michael R. Keeping Your Criminal Justice Coordinating Committee Going Strong. Washington, DC: National Institute of Corrections, 2013. http://www.pretrial.org/download/pjireports/Keeping%20Your%20CJCC%20Going%20Strong%20-%20Jones%202013.pdf. McGarry, Peggy and Becki Ney. Getting it Right: Collaborative Problem Solving for Criminal Justice. Silver Spring, MD: Center for Effective Public Policy, 2006. https://s3.amazonaws.com/static.nicic.gov/Library/019834.pdf. National Alliance on Mental Illness. Engage Your Community. Arlington, VA: National Alliance on Mental Illness, 2015. https://www.nami.org/Get-Involved/Raise-Awareness/Engage-YourCommunity. National Alliance on Mental Illness Massachusetts. 10 Essential Elements for Effective Community Partnerships between Law Enforcement and Mental Health. Boston, MA: National Alliance on Mental Illness Massachusetts, 2014. http://www.namimass.org/wpcontent/uploads/CJDPbuildingbridges_booklet_7-1.pdf. National Association of Mental Health Planning and Advisory Councils. Jail Diversion: Strategies for Persons with Serious Mental Illness. Rockville, MD: Substance Abuse and Mental Health Services Administration, 2006. http://www.namhpac.org/PDFs/01/jaildiversion.pdf.
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Reuland, Melissa, Laura Draper, and Blake Norton. Statewide Law Enforcement / Mental Health Efforts: Strategies to Support and Sustain Local Initiatives. New York: Council of State Governments Justice Center, 2012. https://www.bja.gov/Publications/CSG_StatewideLEMH.pdf. The Stepping Up Initiative and National Alliance on Mental Illness. 10 Ways to Engage People Affected by Mental Illness in Your Community. New York: Council of State Governments Justice Center, 2015. https://stepuptogether.org/wp-content/uploads/2015/07/Ten-Ways-to-EngagePeople-Affected-by-Mental-Illness-in-Your-Community.pdf. Substance Abuse and Mental Health Services Administration. Community Conversations About Mental Health. Rockville, MD: Substance Abuse and Mental Health Services Administration, 2013. http://www.mentalhealth.gov/talk/community-conversation/discussion_guide_07-2213.pdf. Wickman, Aimee. The Criminal Justice Coordinating Council Network Mini-guide Series: Managing a CJCC in a Small Jurisdiction. Arlington, VA: The Justice Management Institute, 2013. http://69.195.124.207/~jmijust1/wp-content/uploads/2014/04/CJCCMiniGuide-SmallJurisdictions.pdf.
INFORMATION SHARING Petrila, John. Dispelling the Myths about Information Sharing between the Mental Health and Criminal Justice Systems. Delmar, NY: CMHS National GAINS Center, 2007. Petrila, John and Hallie Fader-Towe. Information Sharing in Criminal Justice – Mental Health Collaborations: Working with HIPPA and other Privacy Laws. New York: Council of State Governments Justice Center, 2010. http://csgjusticecenter.org/wpcontent/uploads/2012/12/Information_Sharing_in_Criminal_JusticeMental_Health_Collaborations-2.pdf. U.S. Department of Health & Human Services. HIPPA privacy Rules and Sharing Information Related to Mental Health. Washington, DC: U.S. Department of Health & Human Services. http://www.hhs.gov/ocr/privacy/hipaa/understanding/special/mhguidance.html. The White House. National Strategy for Information Sharing and Safeguarding. Washington, DC: The White House, 2012. https://www.whitehouse.gov/sites/default/files/docs/2012sharingstrategy_1.pdf. U.S. Department of Health and Human Services. When does the Privacy Rule allow covered entities to disclose protected health information to law enforcement officials? Washington, DC: U.S. Department of Health & Human Services, 2005. http://www.hhs.gov/ocr/privacy/hipaa/faq/disclosures_for_law_enforcement_purposes/505.html.
OTHER RESOURCES CMHS National GAINS Center. Developing a Comprehensive Plan for Mental Health & Criminal Justice Collaboration: The Sequential Intercept Model. Delmar, NY: CMHS National GAINS Center. 39
“How to Flowchart.” http://www.niatx.net/Content/ContentPage.aspx?NID=149. “How to Perform a Walk-through.” http://www.niatx.net/Content/ContentPage.aspx?NID=146. CMHS National GAINS Center. Practical Advice on Jail Diversion: Ten Years of learnings on jail diversion from the CMHS National GAINS Center. Delmar, NY: CMHS National GAINS Center, 2007. Draper, Laura and Blake Norton. Lessons Learned: Planning and Assessing a Law Enforcement Reentry Strategy. New York: Council of State Governments Justice Center, 2013. https://csgjusticecenter.org/law-enforcement/publications/lessons-learned-planning-andassessing-a-law-enforcement-reentry-strategy/ The National Association of State Alcohol and Drug Abuse Directors. State Regulations on Substance Use Disorder Programs and Counselors: An Overview. Washington, DC: The National Association of State Alcohol and Drug Abuse Directors, 2012. http://nasadad.org/wpcontent/uploads/2010/12/State_Regulation_of_SUD_Programs_and_Counselors-7-26-13.pdf.
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