This brief from the Stepping Up partners presents counties with steps for examining how people who have serious mental illnesses move through a county’s criminal justice and behavioral health systems, it is one of a series of companion products designed to provide counties with further guidance on how to apply the Stepping Up framework “Reducing the Number of People with Mental Illnesses in Jail: Six Questions County Leaders Need to Ask.”
Stepping Up Resources
This webinar will provide an overview of the crisis of mental illness in jail systems and discuss how the Stepping Up initiative can help counties reduce the number of people with mental illnesses in their jails. In addition, the webinar will provide estimates of the number of incarcerated veterans and present an example of how Veterans Justice Outreach specialists can facilitate linkages to services for veterans with mental illnesses in Stepping Up counties.
The Washington County Board of Supervisors showed its support of the Stepping Up Initiative, which is aimed at reducing the number of people who have mental illnesses in county jails. The board approved a resolution during its meeting.
About 34% of the more than 1,200 inmates in the correctional center have mental issues. In April 2015, Douglas County got involved in Stepping Up, a national initiative to reduce the number of people in jail with mental illness.
The Strategy Lab is a new interactive tool that features over a hundred examples from jurisdictions across the country of people working to reduce the number of people with serious mental illnesses in their jails.
County commissioners proclaimed May the Stepping Up Month of Action to commemorate the county’s 2015 entry into the Stepping Up Initiative.
A large number of people in the jail system struggle with mental health, Potter County commissioner Paul Heimel said. Some addicts or those with mental illnesses have received help, but once they become confined they don’t continue to get the help they need.
The Region is among the 475 counties participating in the Stepping Up Initiative and is comprised of Ringgold, Decatur, Wayne, Clarke, Lucas, Monroe, and Marion counties in Iowa.
The resolution commits the county, led by the County Administrative Office, Sheriff’s Office, and the Probation and Health Departments, to a “call to action” that includes “sharing lessons” learned from other counties in the state and nationally.
In February, Lubbock County was named the first “Stepping Up Innovator County” in Texas, because of their initiatives to address mental health in the jail. They were also awarded the Justice in Mental Health Collaboration Program Grant.
Anderson County has launched a pilot program to address the mental health of detainees in the criminal justice system. It includes a mental health screening and so far, about 30 percent of individuals booked into the county’s detention center have self-reported mental health issues.
Since joining Stepping Up in 2016, Dakota County has made multiple key changes, said Angela Lockhart, the county’s integrated service delivery coordinator. About 15 other Minnesota counties are also part of the program, including Ramsey, Carver, Scott, and Hennepin.
On Monday, Cleveland County became one of a handful of Oklahoma counties to pass a Stepping Up resolution to commit to reducing the number of people with mental illness in jail. According to the Stepping Up website, Cleveland County may be only the third in the state to adopt this resolution, with the other two being Grant and Tulsa counties.
The three-day class at Consolidated Tribal Health in Redwood Valley was part of a push by local law enforcement and the county to give first responders more training and help in understanding mental health.
Ashley Adams, the nursing director for Pennsylvania’s Butler County jail, hopes that ultimately people with serious mental health problems have some place other to go other than jails, noting that she is part of a countywide committee involved in “Stepping Up,” a national organization devoted to reducing the number of mentally ill people being put in jail.
The grant continues established partnerships among the Lafayette Parish Sheriff’s Office, Lafayette Police Department, Acadiana Area Human Services District, Beacon Community Connections Inc., and 232-HELP.
This brief focuses on how counties can collect and analyze baseline data on the prevalence of people in their jails who have serious mental illnesses.
Beginning this month, each person who comes into the county jail will take part in an immediate mental health screening. The screening focuses on what advocates call “self-reporting.” Each inmate is asked eight questions designed to help determine his or her mental health needs.
Former Ohio Supreme Court Justice Evelyn Stratton is the project director for the Ohio Stepping Up initiative. Instead of addressing mental illness in jails on a county-by-county basis, Stratton said, Ohio is tackling the problem on a statewide basis. Including Champaign County, there are currently 45 counties in Ohio participating in the initiative.
Since joining Stepping Up, both Douglas and Champaign counties in Kansas have implemented mental health screenings in jail to get beyond guesswork and make more informed decisions about the strategies needed to have a measurable impact on the number of people with mental illnesses in their jails. Both counties were also named Stepping Up Innovator Counties for their recent efforts to accurately identify people with serious mental illnesses and collect related data.
One goal for the coming year is to get housing involved in the Stepping Up initiative, said Melissa Klass, Assertive Community Treatment team leader for Berryhill Center mental health clinic in Webster County, Iowa. “I think stable housing is a big concern in this community,” Klass said. “More and more people are living in unsafe conditions.”
At least 20 percent of the department completed the more intensive Crisis Intervention Training, a 40-hour curriculum designed by local agencies to train a team of specialized officers to respond to calls that involve individuals with mental health disorders such as depression and intellectual disability.
State and local policymakers are turning their attention from the back end of the criminal justice system—who goes to prison and for how long—to the front end. They are focusing on helping people avoid involvement in the system altogether, rerouting those who get caught up in it but don’t belong, and helping those already involved from getting in even deeper.
Secretaries of Pennsylvania’s Department of Health, Department of Corrections, and others launched a first-of-its-kind resource center on Oct. 15 in Philadelphia focused on helping counties reduce the number of people with mental illnesses in jail through research-driven approaches.
Commander Kevin Huddle, the Sheriff’s Office point person for Stepping Up, closed the meeting with this statistic: In 1960, when the United States population was 150 million, there were 600,000 mental-health beds; today, he said, the population is 330 million, and there are 60,000 beds.
“We have good science,” Fred Osher, M.D., a retired health systems and services policy director for the Council of State Governments Justice Center, told us. “We have policies that are associated with a reduction of people with mental illnesses in the justice system. But we haven’t put it together and sustained it over time.”
The center is a step toward solving a problem that has long plagued the criminal justice system, said John Wetzel, secretary of Pennsylvania’s Department of Corrections. “The notion that we’re delivering behavioral health services and mental health services in the criminal justice system more than any other system is a national embarrassment,” he said.
Key agency administrators, staff, and consumer advocates from the mental health, substance abuse, and criminal justice system in Scotts Bluff County participated in Sequential Intercept Mapping which focused strategic planning efforts on cross-systems collaboration and the reduction of system and service barriers with an integrated, local action plan.
Rhonda Benson, executive director of the Butler County chapter of the National Alliance on Mental Illness, said each honoree epitomizes the purpose of the Stepping Up Initiative, which is to provide services and help for the mentally ill rather than having them repeatedly jailed.
Miami County is already trying to do a lot of things recommended by the Stepping Up program, pointing to the partnership between the Sheriff’s Office, the Tri-County Board of Recovery and Mental Health Services, and the Miami County Recovery Council.
Six of the 24 Stepping Up counties were invited to the BPIA as “Best Practices” teams representing the Data-Driven Justice initiative and the Stepping Up initiative. Best Practices teams showcased their approaches and programs to “Implementation” teams.
Stepping Up has led to better coordination between providers including Community and Family Resources, the UnityPoint Health—Berryhill Center and Fort Dodge Community Health, says Jen Sheehan, justice coordinator.
“Every time that a law enforcement officer brings someone in and helps get them connected to services instead of taking them to jail, we’ve done one good thing,” said Sara Huffman, clinical director for the county’s crisis service contractor, RHA Health Services.
The Potter County Criminal Justice Advisory Board has developed a DUI Treatment Court, Drug Treatment Court and a pilot Pre-Trial Diversion Program to help people stay out of jail by offering substance addiction treatment and related services.
Governor Asa Hutchinson of Arkansas became the latest governor to participate in Face to Face (#MeetFacetoFace), an initiative that encourages policymakers to connect with people closest to the correctional system. He joins 13 other governors—7 Republicans and 6 Democrats—that have participated in the initiative.
This brief is designed to help counties identify the number of people booked into jails who have serious mental illnesses (SMI) and to better connect these individuals to treatment. Determining the number of people who have SMI in jails allows counties to develop or refine strategic plans that will have the greatest impact on addressing this population’s needs.
Cabarrus County Stepping Up coordinator Tasha McLean, who is employed by Daymark Recovery Services and contracted through the county, works directly with inmates as a connector to treatment if needed. When people are arrested and taken into custody, detention officers perform medical screenings, which she reviews. Certain questions are designed to determine if an individual has a mental health or substance abuse issue.
A study indicates that 23 percent of Floyd County’s inmates have mental health issues, “but we know it’s probably well over 50 percent,” said Bonnie Moore, president of NAMI Rome.
The Stepping Up County Self-Assessment is designed to assist counties interested in evaluating the status of their current efforts to reduce the prevalence of people who have mental illnesses in jails.
Too many county jails either have no standard screenings for mental illness or screenings that are subpar—turning institutions of incarceration into de facto psychiatric units.
County commissioner George Murdock said mental illness is a major concern nationwide and Umatilla County is no different. “We have way too many people in jail suffering from mental illness,” he said.
Bill Giguere, development director with the Mental Health Center of North Central Alabama, told commissioners that the Stepping Up Initiative would allow the center to hire a case manager to coordinate between the Morgan County Jail, Decatur Morgan Hospital, and other county hospitals to help identify and communicate about those who have a mental illness.
Stepping Up recently premiered an animated video describing how counties can collect accurate, accessible data on the number of people entering their jails who have mental illnesses, a critical first step for making measurable reductions to the prevalence of mental illness in jails.
The Champaign County Jail signed onto the Stepping Up Initiative after Deputy Chief Allen Jones realized the majority of the jail’s “frequent flyers,” who landed in jail five or more times a year, had mental health or substance use issues.
One of the first grants that our Stepping Up team secured financed an intake survey that identifies people for whom jail time is not the best solution. Once an individual is identified with a mental health or other problem, one of our county’s network of service providers can be brought in to help.
About 1 in 3 people in the Tulsa County jail have a mental illness, according to Sheriff’s Office spokeswoman Casey Roebuck. The county has mental health pods, which are specially designed for such people and have trained staff, but Roebuck said they often are at capacity.
During this Day of Action, county officials are hosting events or participating in local activities to share with constituents the progress made in addressing the prevalence of people who have mental illnesses in jails; raise public awareness and understanding of this important issue; and emphasize their commitment to creating data-driven, systems-level changes to policy and practice to achieve Stepping Up goals.
The jail houses 4,498 total inmates. Last year, it conducted more than 11,000 mental health assessments, providing almost 40,000 mental health visits and drafting 5,042 discharge plans. With about 70 percent of its population spending eight days or less behind bars, finding those services can be a challenge.
Nonviolent offenders with mental illness could be diverted away from New Jersey’s mainstream criminal justice system and into a rehabilitation program designed to provide treatment for their psychiatric disorder, under an initiative envisioned by a longtime Democratic Senator that also reflects the goals of a growing national movement.
Over the past three years, more than 425 counties across the country have committed to reducing the number of people in jails who have mental illness by signing on to the Stepping Up initiative. Fundamental to that goal is each county’s ability to accurately identify and collect data on people in its jail who have mental illnesses. To ensure counties have the tools to do so, Stepping Up has launched a national effort to help them collect accurate and accessible data on this population.
The Menomonie Police Department and Dunn County Sheriff’s Office have committed to training their officers to complete a course on crisis intervention, said Kristin Korpela Dunn County Department of Human Services director. In February, the county received an $80,000 grant to be used for community reentry. The grant is meant to improve support for people exiting the jail by offering resources for stable housing and employment.
Consistently collecting and analyzing this data will not only help counties create a system-wide impact, but also ensure more efficient use of taxpayer dollars.
The Stepping Up initiative recently launched a national effort to help counties collect accurate, accessible data on the number of people entering their jails who have mental illnesses. As part of the effort, seven rural and urban “Innovator Counties” have been selected as models for their expertise in accurately identifying these individuals and consistently collecting data on them.
The Dauphin County Board of Commissioners recently endorsed a comprehensive plan that provides concrete steps for the county to take to help reduce the number of people who have serious mental illnesses (SMI) in the local criminal justice system while making more efficient use of resources and increasing public safety.
Based on a quantitative and qualitative analysis, and with the guidance of members of the county’s Criminal Justice Advisory Board and other senior county and state leaders, five key findings were identified that prompted the development of a set of strategic policy recommendations to improve outcomes for people in Dauphin County’s criminal justice system who have SMI. This report includes the key findings and policy recommendations.
The Lycoming and Clinton Mental Health and Intellectual Disabilities Department has two mental health professionals who provide mental health first aid training to community members as well as a type of suicide prevention training called QPR, or Question Persuade Refer.
One option, California Senate Bill 215, would empower judges to place defendants who commit low-level offenses as a result of their mental illness in diversion programs for up to two years in lieu of prosecution.
Since 2013, Lorain County, Ohio has sponsored nearly 80 officers in Trauma Informed Policing. Over the course of the last 14 years, more than 200 first responders spanning 15 police departments have also received the 40-hour crisis intervention training.
Iowa leads the nation in the number of counties who have signed the Stepping Up agreement, pledging to reduce the number of arrests and incarcerations of people with serious mental illness.
The county’s criminal justice system, mental health services and other organizations have collaborated to initiate programs to help stem this issue already, such as with crisis intervention training.
In Mahoning County, the plan involves the sheriff’s office, the county’s Mental Health and Recovery Board plus outside agencies including Meridian Healthcare, COMPASS Family and Community Services and others.
Aided by a national initiative aimed at reducing the number of people with mental illnesses in jails, the Mahoning County Sheriff’s Office, Mahoning County Mental Health and Recovery Board and local providers have partnered to provide additional services to inmates with mental illnesses.
This report from The Pew Charitable Trusts explores how jails administer their health care programs and whether these programs further county public health and safety goals.
In Douglas County, the goals under “Stepping Up” include: tracking how many people with mental illness are passing through the Douglas County jail; implementing mental health screening and assessments; expanding Crisis Intervention Training for law enforcement officers and others; assisting with efforts to open a crisis respite center for those experiencing a mental health crisis; and improving mental health services and communication between the criminal justice system, mental health providers and the community.
In a presentation last week to the Marion County Commission, Boone County Commissioner Janet Thompson pointed out that people with mental illness often end up being incarcerated because many states, including Missouri, have closed mental health facilities for budgetary reasons.
The program, dubbed “Stepping Up,” is already being used in three Missouri counties–Boone, Pettis and Audrain. Marion County officials are trying to decide if they should give it a try. “It really sounds like a great thing,” said Marion County Assessor Mark Novak, who invited two representatives from Pettis and Boone counties to Marion County to discuss the program.
Jasper County officials have signed up to be part of the Stepping Up Initiative, a nationwide effort to make sure resources for mental health are being used properly.
Joan Elder, president of the National Alliance on Mental Health’s Alabama Chapter, addressed the Commission regarding an upcoming summit and the new “Stepping Up” initiative from NAMI, a national mental health organization that aims to provide resources to families and individuals affected by mental illness.
The commissioners’ agreement to adopt a charter for the Behavioral Health and Justice Working Group (BHJWG) received a 5-0 vote. Commissioner Lee Gabel, who has been a leader in both the Juvenile Detention Alternatives Initiative and BHJWG, explained the latter as a follow-up to the 2015 Stepping Up resolution that deals with the same issue.
In a little more than two years, more than 400 counties—representing 43 states and 40 percent of the U.S. population—have joined Stepping Up: A National Initiative to Reduce the Number of People with Mental Illnesses in Jails.
Sheriff Ian Parkinson addressed the San Luis Obispo County Board of Supervisors, presenting them with a detailed list of recommendations developed by two ad-hoc committees created as part of the county’s participation in the Stepping Up Initiative.
According to the Stepping Up Initiative, about 2 million people with serious mental illnesses are booked into local jails each year. And now representatives from across the state are working together to lower that number.
A nationwide initiative to reduce imprisonment of people with mental illness hosted a two-day summit in State College. The Pennsylvania Stepping Up Summit calls for better practices in evaluating and treating mental illness.
“We’ve got people that are hurting that need help. And they don’t belong in jail. We have got folks in our county doing a life sentence, thirty days at a time, because they are sick,” said Alamance County Deputy Chief Tim Britt.
As presiding judge of Broward’s Misdemeanor Mental Health Court, which recently celebrated its 20th anniversary, I strongly urge all interested local public officials and community behavioral health professionals, mental health consumers, family members and disability rights advocates to coalesce around the goals of the Stepping Up Initiative.
“I’d like to see Alabama as a ‘Stepping Up’ state,” Lynn Beshear, Alabama’s mental health commissioner, said. “I’ve been in touch with Ohio on how they did that.” Ohio Department of Mental Health and Addiction Services director Tracy Plouck serves on the board of directors for the Council of State Governments Justice Center, and was an early champion of the nationwide initiative.
Stepping Up Ohio is working with counties to assess those with serious mental illness and treat them or refer them to the appropriate facility.
“What we want to do is establish the work here in Montgomery to be a model the to the state, to realize the goal of the Stepping Up initiative,” Alabama Department of Mental Health Commissioner Lynn Beshear said.
“You just get to have that kind of chit chat really and to learn and to make friends with people from other states, and that’s when the real learning begins because you start talking about what are your problems and how are you solving them,” said Yadkin County Commissioner Kevin Austin.
“There has been a greater appreciation for the need for officers to be well versed in how to deal with people in crisis,” said Frank Straub, Director of Strategic Studies for the Police Foundation.
A group of nine first responders and human services personnel will attend the event to present their work with Division First, a program that provides treatment to people with mental health or substance abuse issues instead of putting them in jail.
The County Board of Supervisors all motioned to direct staff to research leads on private companies that could provide medical services to inmates, as well as ways to continue improvements within the county’s psychiatric facilities and behavioral health.
This workshop is part of a national push to reduce the number of people in jail with mental illness through the Stepping Up Initiative. Tulsa joined this initiative in 2015.
“Alamance County is one of the best in the state of North Carolina,” said Art Springer, president of the local chapter of the National Alliance on Mental Illness. “There are a lot of services available, but people don’t know how to access the system.”
“It’s money well spent,” said Commissioner Paul W. Conklin. Something like 60 percent of prisoners in Pennsylvania have mental issues, he said, and around two-thirds of released inmates return to jails.
Having lived in Columbus for the last two-and-a-half years, Kerman said she’s seen the ways Franklin County has embraced criminal-justice reform.
Some of the methods Rowley said she intended to highlight are crisis intervention training for law enforcement, which helps officers learn best practices and strategies when responding to a situation involving someone who has a mental illness.
The initiative uses state money to increase the Sheriff’s Department budget by $1.15 million to pay for nine full-time positions. It’s based on the Stepping Up Initiative, a program developed by the National Association of Counties, the Council of State Governments Justice Center, and the American Psychiatric Association Foundation.
Programming for Reentry, Support and Stability, or PROGRESS, will address the mental health of sentenced offenders in an alternative custody setting.
The task force will consist of key community leaders with the goal of creating conditions that allow for optimal success for those living with mental illness who are, or are at risk, of being involved in the criminal justice system.
Executive Director of the Lake Region Law Enforcement Center Rob Johnson explained that what is intended for the region may end up being a pilot project for the entire state. The initiative would provide an assessment tool they can use when individuals come into and through the system.
The Assisted Outpatient Treatment program, funded by a $2.8 million federal grant, has five clients so far, officials said Thursday during a behavioral health summit hosted by the county, and the caseload is expected to grow quickly.
The architects will make changes to the remaining housing units to provide for the special populations, which include inmates with mental health issues or with addictions. The resulting 158 additional beds will bring the facility’s total to 370 beds.
Carson City is building mental health resources but there still is a lot of work to ensure patients don’t fall through the cracks.
Monday’s decision makes La Paz County the 15th Arizona County to commit to the Stepping Up Initiative, which, in turn, makes Arizona the first state in the United States to have all its counties on board, stated Steven Harvey, a board member of David’s Hope, an mental health advocacy organization that leads the Arizona Mental Health Criminal Justice Coalition.
Since Stepping Up’s launch, more than 365 counties—representing 36 percent of the U.S. population—have passed resolutions to join the initiative and work to reduce the number of people with mental illnesses in their jails
To fight back, Lane County has signed on to the Stepping Up initiative.
The Tulsa County Sheriff’s Office helped create the software as part of the “Tulsa Stepping Up Initiative” and the Inside-Outside Collaboration of Justice.
The county will begin looking at programs other counties have initiated to decide what sort of program Brunswick County wants to use to treat prisoners with mental illness and co-occurring substance abuse disorders.