The Winnebago County (Ill.) Therapeutic Intervention Program is a pre- and post-booking program. The pre-booking component consists of Crisis Intervention Team (CIT) law enforcement officers diverting individuals with mental illnesses to the mental health system instead of the criminal justice system. The post-booking program aims to identify persons in the criminal justice system whose criminogenic behavior can be attributed to an Axis I diagnosis of a serious mental illness. The Therapeutic Intervention Program Court (TIP Court) is a voluntary program where all participants agree to adhere to the rules and expectations, including taking prescribed psychotropic medications. The team comprises a judge, a program coordinator, an assistant state attorney, a public defender, a clinical jail assessor, two case managers, a clinical supervisor, two adult probation officers, and a nurse.
The TIP Court received a grant that has allowed them to add a full-time dual-disorder specialist, a full-time trauma specialist, and a part-time family education liaison. Participants receive services in the areas of intensive case management, housing, medication monitoring, dual-disorder treatment, trauma therapy, and family education and support. The goal is to decrease recidivism, reduce the number of days in jail and the hospital, and provide linkage to mental health treatment.
How did your jurisdiction realize that there was a need to respond to the prevalence of individuals with mental illnesses in the
criminal justice system?
There was a federal lawsuit resulting from jail overcrowding, which forced our jurisdiction to look at the make-up of the jail population. By dong a point-in-time study, we determined that 16% of the jail population had a severe mental illness, which was comparable to the national average.
How did your initiative capitalize on preexisting relationships or partnerships in the jurisdiction, or build new ones?
The mental health system had a long-standing presence in the jail with a mental health liaison who worked to identify those inmates with mental illnesses. This liaison, however, was not sufficient to make a difference in the revolving door of individuals with mental illnesses finding themselves in the criminal justice system. The mental health system and the criminal justice system also had a long-standing relationship and further developed a strategy on how they could positively impact the numbers of people with mental illnesses in jail. In June 2003, the chief judge sent out invitations to over 100 key community stakeholders with an interest in forming a task force to develop a mental health court. There was an 85% response rate. This group met for 18 months to develop the parameters of the court and protocols and to deal with current issues. This task force also established the Community Mental Health Coordinating Council, the successor body to the task force, which meets quarterly to facilitate discussion and coordination among member organizations in the community who routinely have an interest in individuals with mental illnesses. The TIP Court opened in February 2005.
How did you identify your program’s target population?
One of the roles of the task force’s court committee was to determine who would be eligible. The main factor was that the defendant had been diagnosed with a severe mental illness (Axis I) and that there was a causal connection between the mental illness and the criminogenic behavior.
What has been your biggest challenge, and how are you addressing it?
Working with the dual-disorder population was our biggest challenge. There were financial and treatment barriers for participants to access services. There were no existing services that integrated this treatment. In May 2006, the chief judge called a summit of the mental health and substance abuse providers to discuss the issue and determine who could provide a service to resolve it. One substance abuse treatment provider and one mental health service provider were assigned by their respective agencies to a new program to provide integrated dual-diagnosis treatment. The separate funding of substance abuse and mental health services still provides a challenge for integrated services and treatment.
Provide an example of a particular success your program has had to date, either in moving from planning to implementation or in showing an impact on an individual, group, or community.
We have seen a dramatic decrease in the number of days the participants have been in jail or in the hospital since entering our program and after they have left the program. In turn, this has saved the county a tremendous amount of money.
What steps have you taken or are you planning to take to sustain your initiative?
Continued evaluation and enhancement of the court and case management structure, continued training, and continued funding sources.
Judge Janet Holmgren
Chief Judge, 17th Judicial Circuit
400 West State Street
Rockford, IL 61101-1221
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