States Supporting Familiar Faces in New Mexico

The Problem

Like many states around the country, New Mexico is facing a crisis in substance use disorder (SUD) and overdose deaths:

• Over 200,000 New Mexicans—almost 10 percent of the state’s population—are living with SUD.
• In 2021, the state had the country’s highest rate of alcohol-related overdose deaths and the sixth highest rate of drug overdose deaths.
• Despite the high rates of SUD and overdose deaths, only an estimated one-third of people with SUD in New Mexico are receiving treatment.

Lack of availability and access to treatment, services, and supports drives poor outcomes for people with complex behavioral health needs. Through their frequent contacts with multiple systems, these people become “familiar faces” in those systems. Because no single provider or system can support these individuals’ unique needs, people who are familiar faces, especially those with serious mental illness, often end up in jail where they are overrepresented compared to the general population.

Local data from across the state support the urgent need for policy and program changes to support people who are familiar faces:

• Bernalillo County (Albuquerque) conducted an 18-month study that identified 900 individuals who frequently visited the county’s behavioral health services and jail.
• From April 2019 through October 2022, 100 individuals with the highest utilization of services and the highest number of jail bookings accounted for 871 jail bookings, 35,891 days in jail, 313 admissions to detox services, and $5.5 million in costs to the county.

Some New Mexico communities have developed interventions to better identify and support people who are familiar faces. Others lack the resources and capacity to do so but are enthusiastic to partner with the state and neighboring counties to build local responses. Despite the challenges, state and local leaders are united in seeking better, trauma-informed, human-centered, evidence-based approaches to improve outcomes for familiar faces.

How the States Supporting Familiar Faces Initiative Helped

From 2022 to 2023, the States Supporting Familiar Faces (SSFF) initiative supported two states, New Mexico and Georgia, in reorienting funding and policies to strengthen local data-driven efforts to improve outcomes for familiar faces. As part of the SSFF initiative, state and local policymakers and practitioners in New Mexico have received 18 months of intensive support from The Council of State Governments (CSG) Justice Center.

The initiative was guided by the States Supporting Familiar Faces Ad Hoc Subcommittee under the New Mexico Supreme Court Commission on Mental Health and Competency. The subcommittee had representation from state and local behavioral health, housing, criminal justice, court, and law enforcement systems, all three branches of government, and people with direct experience in behavioral health and justice systems in New Mexico. Representatives from 10 urban and rural counties across New Mexico joined the subcommittee to provide insight on local needs, current practices, and opportunities to shape the subcommittee’s focus and work.

Implementation and Impact

The subcommittee developed and approved policy recommendations based on analysis of local data and promising practices in New Mexico and nationally. The recommendations were presented to the New Mexico Supreme Court Commission on Mental Health and Competency in December 2022. Policy recommendations moved to implementation through legislative, administrative, and regulatory action in 2023 and through multiyear approaches, including pilot projects, continued legislative action, and future administrative changes.

As of November 2023, and extending into 2024, implementation included the following:

• Adopting a statewide definition of serious mental illness
• Supporting expanded access to medication-assisted treatment (MAT) for substance use disorders through local Public Health Offices
• Simplifying state grantmaking processes to alleviate burdensome grant requirements that may prevent local agencies and under-resourced communities from applying or securing state grant funding
• Developing training for judges and court staff on MAT through the Court Education Institute within the New Mexico Administrative Office of the Courts that is planned to be offered in summer 2024

Several policy recommendations are being implemented as part of a Competency Diversion Pilot Project led by the New Mexico Supreme Court’s Commission on Mental Health and Competency:

• Introducing legislation to reform the state’s competency to stand trial process to improve outcomes for people who are familiar faces
• Expanding access to housing for people who are familiar faces by leveraging collaboration of state agency leaders and local teams of practitioners in four pilot judicial districts charged with developing local forensic behavioral health systems
• Implementing metrics to measure the impact of policy and service changes