State-Level Initiatives to Promote and Sustain Local Efforts
The origins of crisis intervention teams, mental health courts, and programs to improve transition planning for people released from local jails can typically be traced to the efforts of leaders at the local level. A judge, a police chief, a sheriff, or a mental health advocate, for example, brings people together and insists that the criminal justice and mental health care systems work together to improve their response to people with mental illness. Refusing to wait for state funding or a federal grant, these “agents of change” develop new programs that improve outcomes for people with mental illness in the criminal justice system, make their communities safer, and improve the use of existing resources.
But sooner or later, coordination and leadership at the state level must be provided in order to sustain these innovative local efforts, replicate them in other counties and municipalities, and ensure quality of service delivery and fidelity to program models across jurisdictions.
This feature profiles statewide criminal justice/mental health initiatives in Texas, Connecticut, Ohio, and California. Each of these initiatives goes beyond typical state-level taskforces or blue-ribbon commissions that are established to assess the problem and submit a plan of action to the legislature or governor. Instead, the initiatives profiled below have the funding, staff, and authority to promote and sustain local efforts.
Texas’ statewide initiative, TCOOMMI, is one approach to formalizing collaboration between the criminal justice and mental health care systems.
In 1987, the Texas state legislature established TCOOMMI to provide a formal structure for state criminal justice, health and human service, and other affected agencies to communicate on policy, legislative, and programmatic issues affecting criminal-justice-involved individuals with special needs. TCOOMMI’s advisory committee is appointed by the governor and is comprised of representatives from 21 agencies and organizations, as well as 10 members at large. These members include representatives from the Departments of Criminal Justice and Mental Health, as well as various commissions and advocacy groups.
The legislation creating TCOOMMI charges it with coordination and agenda-setting, as opposed to service delivery. Its responsibilities include:
- Identifying gaps in local service coverage
- Developing plans to meet these treatment, rehabilitative, and educational needs
- Coordinating procedures to provide these services
- Evaluating these programs and make recommendations for improvement
- Providing technical assistance
- Administering funds to develop, operate, and evaluate programs
- Establishing, coordinating, and evaluating a regionalized continuity of care system
CABLE’s state-funded Crisis Intervention Team (CIT) training reflects one approach to stimulating new efforts in police departments where officials have yet to improve their response to people with mental illness. Law enforcement officers, mental health care providers, and members of the community established this statewide nonprofit organization in 1998.
In September 2004, the governor allocated $2 million to CABLE, over four years, to coordinate CIT training across the state. To date, CABLE has coordinated these trainings in both rural and urban settings, including seven municipalities and one campus police department. The trainings involve psychiatrists, psychologists, advocacy groups, and law enforcement personnel.
Connecticut’s Department of Mental Health and Addiction Services is supporting outcome evaluations of CABLE’s CIT trainings in two large urban police departments in fiscal year 2004-2005.
The Ohio Criminal Justice Coordinating Center of Excellence (CJ/CCoE) was established in 2001 to promote jail diversion for people with mental illness throughout the state. The Ohio Department of Mental Health provides funding to the County of Summit Alcohol, Drug Addiction, and Mental Health Services Board to operate CJ/CCoE. The Board, in turn, contracts with the Northeastern Ohio Universities College of Medicine to operate the Center.
CJ/CCoE encourages communities to approach jail diversion systematically, at multiple levels, in order to protect people with mental illness from unnecessary arrest and incarceration. To think about this goal strategically and monitor growth, the Center coordinates statewide conferences and presents up-to-date maps on its Web site that document the prevalence of CITs, jail diversion programs, and post-release services across the state.
The grant program created under California’s Assembly Bill 34 (AB34) reflects a statewide approach to funding, supporting, and evaluating local programs to improve outcomes for people with mental illness at risk of homelessness and frequent contact with the criminal justice system. In 1999, AB34 granted $10 million to three demonstration programs that were charged with reducing homelessness among people with mental illness–including people released from prison and jail–through housing and intensive support services. In 2000, based on favorable early outcome data from the three demonstration sites, the California legislature provided $55 million to expand these services to 31 additional counties and 40 additional service providers across the state.
To date, these state and local programs serve over 4,500 people out of an estimated 50,000 who are homeless and have a serious mental illness. [For a complete fact sheet on AB34, please click here.] The grant program established under AB34 is flexible: funds enable providers to offer housing subsidies, rental assistance, and the intensive staff support services necessary to sustain people in housing.
The California Department of Mental Health collects monthly data reports from the 34 participating counties, which it then translates into annual reports. The legislation that established AB34 requires that these annual reports be submitted to the state legislature and the governor. Because the initiative’s outcomes are presented in a clear and accessible manner to both legislators and the public, AB34 facilitates its own continued support.
The local programs created and coordinated under AB34 have been identified by the President’s New Freedom Commission on Mental Health as a national model for service delivery.
Developing an inventory of statewide initiatives
To facilitate and encourage the continued growth of criminal justice/mental health collaboration across the country, CSG plans to develop an inventory of statewide initiatives and make the findings available in an online database. If you would like to provide any information about a statewide initiative in your state, please contact Seth Prins at 212-482-2320.