Skagit County Community Services

1. Skagit County Community Services Adult Mental Health Program Update March 9, 2011

2. Crisis Intervention Team Training – 0.1%, Millage, Grant funds • Community-based collaborative effort between law enforcement and the mental health community to help law enforcement officers handle incidents involving mentally ill people. • Training is free and focuses on providing practical techniques for de-escalating crises. • Officers learn to integrate their police training with different approaches to a person they believe to have a mental disorder.

3. CIT Topics • Overview of Mental Illness, Personality Disorders, Medications • Suicide Prevention • Threat Assessment, De-escalation & Calming of Individuals with Mental Illness • Co-Occurring Disorders & Substance Abuse Treatment • Involuntary Treatment Process • NAMI In Our Own Voices • PTSD/Veterans • Seniors • Youth & Children • Community Treatment Resources • Site Visits

4. Skagit County Participation

5. Adult Mental Health Court – 0.1% • Skagit County Mental Health Court is a collaborative, problem-solving court designed to promote public safety and reduce recidivism among mentally ill offenders through an intensive program of evaluation, treatment and frequent monitoring of compliance. Its goal is to bring long-term stability, sobriety and safety to mentally ill offenders while ensuring the security and well-being of the community.

6. Mental Health Court Overview • Pilot program began in District Court in November 2004 • Moved to Superior Court in 2006 • Current model began in January 2007 • Felonies and misdemeanors • Treatment Team: MHP, CDP, CM, Psychiatrist

7. Outcome Challenges Mental health courts have existed for only a short period of time, are often very small (frequently having only a few dozen participants), and vary considerably in the services offered and length of supervision. Mental health courts are relatively new so studies have been based on short follow-up periods and do not indicate the long-term impact of these programs. Few studies consider community context, which impacts treatment services offered, public sentiment, and the indirect outcomes of mental health courts. 1

8. Numbers & Results 37 participants since court began in 2004 • 13 graduates 32% • 12 terminations 32% • 3 deceased 08% • 1 moved 03% 2010 • 32 clients served

9. Recidivism Research strongly suggests that mental health court participants have lower rates of new criminal charges while under court supervision than individuals with mental illnesses who go through the traditional criminal court system. There is some empirical evidence to support the belief that this trend may continue after graduation, when individuals are no longer supervised by the court. 2

10. New Post-MHC Criminal Charges • 30% of graduates have new post-MHC criminal charges • 42% of those terminated for non-compliance have new post-MHC criminal charges

11. Effectiveness of Treatment There is some research to suggest that mental health courts are a more effective means of connecting individuals with treatment services than the traditional court system or jails. There is some empirical evidence to support the belief that, when compared with participants’ mental health status before enrollment, mental health courts have a positive effect on participants’ mental health. 3

12. Estimated Local Savings • 770 jail days or $52,360 • 25 ER visits or $12,500 • 91 hospital days or $50,050 Total: $114,910

13. Local Costs 2010 MHC Treatment Cost : $81,800 2010 MHC Legal Cost: Prosecuting Attorney $26,906 Public Defender $13,655 Superior Court $7,441 Public Nurse $1,155 Total 2010 MHC Cost: $130,957 2010 Treatment Cost per client: $1,902 2010 Total Cost per client: $3,045

14. Contact Information • Rebecca Clark • Skagit County Community Services • 419-3363 • www.skagitcounty.net/MHC

15. Community Wellness Program – 0.1% Links eligible Skagit County residents who do not have access to mental health services to counseling services from private mental health professionals in the community.  Case Manager conducts a brief financial screening, verifies Skagit County residency, and links clients to contracted mental health provider.  The case manager will also help the individual apply for public benefits.  Arial

16. Client Stats • 2010 • 363 intakes • 1948 therapy sessions • 5.3 average sessions per client • $358 per client • 2011 • 169 current clients • 28% are homeless

17. Contact Information • Roger Capron • Skagit County Community Services • 419-3379 • www.skagitcounty.net/CWP

18. Jail Transition Program – State funds The Jail Transition Program (JTP) uses a post-booking case management model to facilitate safe transition from confinement to community services for inmates who have mental health disorders. The objectives of transition services are to lessen recidivism and to support individuals in becoming productive members of society.

19. JTP Eligibility Case Manager crosschecks jail bookings with the public mental health system database. Inmates identified as past or current mental health clients are screened for program eligibility. Inmates not previously enrolled in the public mental health system but who may need or want mental health services are also served.

20. Client Stats • 2010 • 94 clients served • 40% homeless • 82% co-occurring • 95% received public benefits

21. Contact Information • Joey Warner • Skagti County Community Services • 419-7684 • www.skagitcounty.net/JTP

22. Skagit Treatment Engagement Program – Federal Block Grant Skagit Treatment Engagement Program (STEP) is aimed at difficult to engage individuals, aged 13 and above, who have a mental illness, and who are homeless and/or resistant to engaging in center-based mental health treatment.

23. Program Objectives STEP locates and reaches out to individuals with mental illness who need intensive efforts to become engaged in ongoing mental health services. The length of service time is open-ended but the objective is to successfully engage an individual within at least twelve months from intake. Mental health and chemical dependency treatment resources, housing, and financial means are among the priorities.

24. Client Stats • 2010 • 64 clients contacted • 36% obtained or maintained housing • 52% have co-occurring disorder • 56% engaged in mental health services • 44% obtained public benefits

25. Contact Information • Faviola Lopez • Skagit County Community Services • 419-3378 • www.skagitcounty.net/CommunityServices

26. Peer Connections Center – Millage funds, NSMHA funds, (previously 0.1%) The Peer Connection Center is a supportive and welcoming recovery oriented community where adults living with mental illness can gain skills and confidence and pursue their own recovery in collaboration with peers, advocates, staff, friends and neighbors. Located at 1115 Riverside Drive, Mount Vernon Hours: 10 am to 4 pm

27. Peer Connections Center 2010 Services • 345 new clients • 60-70 clients per days • 12,000 meals • 585 groups

28. Notes • Almquist, L., and Dodd, E. 2009. Mental Health Courts: A Guide to Research-Informed Policy and Practice. Council of State Governments Justice Center • Ibid. • Ibid.