Criminal Justice/Mental Health Consensus Project

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The author(s) shown below used Federal funds provided by the U.S.Department of Justice and prepared the following final report:Document Title:Criminal Justice/Mental Health ConsensusProjectAuthor(s):Council of State GovernmentsDocument No.:197103Date Received:10/29/2002Award Number:2002-DD-BX-0002This report has not been published by the U.S. Department of Justice.To provide better customer service, NCJRS has made this Federallyfunded grant final report available electronically in addition totraditional paper copies.Opinions or points of view expressed are thoseof the author(s) and do not necessarily reflectthe official position or policies of the U.S.Department of Justice.

police chiefs consumers pretrial serviceadministrators probation officials state legislators substance abuse providers state corrections directors judges district attorneys families parole boardmembers county executives public defenders crimevictims state corrections directors prosecutors mental healthadvocates court administrators mental health providers researchers jail administrators sheriffs correctional mental health providers state mental health directors victim advocates parole officialsCriminal Justice / Mental HealthConsensus Project

Criminal Justice / Mental HealthConsensus ProjectCoordinated byCouncil of State GovernmentsProject PartnersAssociation of State Correctional Administrators (ASCA)Bazelon Center for Mental Health LawCenter for Behavioral Health, Justice & Public PolicyNational Association of State Mental Health Program Directors (NASMHPD)Police Executive Research Forum (PERF)Pretrial Services Resource Center (PSRC)June 2002

Copyright 2002Council of State GovernmentsEASTERN OFFICEBefore October 1, 2002After October 1, 2002Council of State Governments / Eastern Regional Conference233 Broadway, 22nd FloorNew York, NY 10279Phone: (212) 912-0128Fax: (212) 912-0549Web site: www.csgeast.orgCouncil of State Governments / Eastern Regional Conference170 Broadway18th FloorNew York, NY 10038Phone: (212) 912-0128Fax: (212) 912-0549Web site: www.csgeast.orgNATIONAL HEADQUARTERSCouncil of State Governments2760 Research Park DriveP.O. Box 11910Lexington, Kentucky 40578Phone: (859) 244-8000Fax: (859) 244-8001Web site: www.csg.orgISBN#: 0-87292-896-9Designed by David WilliamsThis report was prepared by the Council of State Governments incollaboration with the Association of State Correctional Administrators, theBazelon Center for Mental Health Law, the Center for Behavioral Health,Justice & Public Policy, the National Association of State Mental HealthProgram Directors, the Police Executive Research Forum, and the PretrialServices Resource Center.The Criminal Justice / Mental Health Consensus Project was supported bygrant number 2002-DD-BX-0002, awarded by the Office of JusticePrograms, U.S. Department of Justice and grant number 01 M008529-01D, awarded by the Center for Mental Health Services, Substance Abuseand Mental Health Services Administration, U.S. Department of Health andHuman Services. The Consensus Project also received support from thevan Ameringen Foundation, the Melville Charitable Trust, the Robert WoodJohnson Foundation, the MacArthur Foundation, and the Open SocietyInstitute, and Pfizer, Inc. and Eli Lilly, Inc.Points of view, recommendations, or findings stated in this document arethose of the authors and do not necessarily represent the official positionor policies of the U.S. Department of Justice, the U.S. Department ofHealth and Human Services, the other project supporters, or the advisoryboard members who provided input into this document.iiCriminal Justice/Mental Health Consensus Project

PrefaceThe Criminal Justice / Mental Health ConsensusFollowing two meetings of a focus group compris-Project is an unprecedented national, two-year effort toing various criminal justice and mental health stake-prepare specific recommendations that local, state, andholders in 1999, project partners established four advi-federal policymakers, and criminal justice and mentalsory boards. Collectively, these advisory groups includedhealth professionals can use to improve the criminal jus-more than 100 leading state lawmakers, police chiefs,tice system’s response to people with mental illness.officers, sheriffs, district attorneys, public defenders,The goal of this project has been to elicit ideas fromjudges, court administrators, state corrections directors,some of the most respected criminal justice and mentalcommunity corrections officials, victim advocates, con-health practitioners in the United States, to develop rec-sumers, family members and other mental health advo-ommendations that reflect a consensus among seeminglycates, county commissioners, state mental health direc-opposing viewpoints, and to disseminate these findingstors, behavioral health care providers, substance abusewidely so they can make the greatest possible impact onexperts, and clinicians. A complete list of advisory boarda national problem that affects every community.members appears on the following pages. In addition toThroughout the project, every effort has been made tothe insights of these experts, the project benefited fromprovide concrete, practical approaches that can be tai-surveys and document reviews that project partners con-lored to the unique needs of each community.ducted to identify relevant efforts from the field.The Council of State Governments (CSG)—in part-The policy statements, recommendations for imple-nership with the Police Executive Research Forum, thementation, and program examples described in this re-Pretrial Services Resource Center, the Association ofport are important products of the Consensus Project.State Correctional Administrators, and the NationalThe true value of this initiative, however, will be theAssociation of State Mental Health Program Directors—extent to which policymakers replicate in their jurisdic-coordinated this project. The Bazelon Center for Mentaltions the substantive bipartisan, cross-system dialogueHealth Law and the Center for Behavioral Health, Jus-that this project has fostered, and the extent to whichtice & Public Policy provided CSG with extensive andagents of change—whether elected officials, criminal jus-valuable assistance. Together, representatives of thesetice and mental health professionals, or community lead-seven organizations made up the Steering Committeeers—implement the practical, specific suggestions con-for this project.tained in this document.Criminal Justice/Mental Health Consensus Projectiii

ContentsAcknowledgements . viPART ONELaw EnforcementAdvisory Board . xiiiSelect Events on theCriminal Justice Continuum22Courts Advisory Board . ixCorrections Advisory Board . xMental Health Advisory Board . xiExecutive Summary . xiiIntroduction . 2The Problem . 4Reasons for Hope . 9How to Use this Report . 10Getting Started . 13Next Steps . 21CHAPTER IInvolvement with the Mental Health System. 26Policy Statement1.Involvement with the Mental Health System . 28CHAPTER IIContact with Law Enforcement . 34Policy Statements2.Request for Police Service . 363.On-Scene Assessment . 404.On-Scene Response . 505.Incident Documentation . 646.Police Response Evaluation . 68CHAPTER IIIPretrial Issues, Adjudication, and Sentencing72Policy Statements7.Appointment of Counsel . 748.Consultation with Victim . 789.Prosecutorial Review of Charges10.Modification of Pretrial Diversion Conditions . 8611.Pretrial Release/Detention Hearing . 9012.Modification of Pretrial Release Conditions . 9813.Intake at County/Municipal Detention Facility . 10214.Adjudication . 11215.Sentencing . 11616.Modification of Conditions of Probation/Supervised Release . 120. 82CHAPTER IVIncarceration and Reentry . 126Policy StatementsivCriminal Justice/Mental Health Consensus Project17.Receiving and Intake of Sentenced Inmates . 12818.Development of Treatment Plans, Assignment to Programs,and Classification/Housing Decisions . 13619.Subsequent Referral forScreening and Mental Health Evaluations . 15220.Release Decision . 15421.Development of Transition Plan . 16222.Modification of Conditions of Supervised Release . 17223.Maintaining Contact Between Individual andMental Health System . 180

PART TWOOverarching Themes184Appendices . 304CHAPTER VA.Glossary . 306Improving Collaboration . 188B.Program ExamplesCited in Report . 316C.An Explanation ofFederal Medicaid andDisability Program Rules . 400D.Project History/Methodology . 406E.Steering Committee . 410F.Bibliography . 414Policy Statements24.Obtaining and Sharing Resources . 19025.Sharing Information . 19426.Institutionalizing the Partnership . 200CHAPTER VITraining Practitioners and Policymakersand Educating the Community . 204Policy Statements27.Determining Training Goals and Objectives . 20828.Training for Law Enforcement Personnel . 21229.Training for Court Personnel . 22030.Training for Corrections Personnel . 22631.Training for Mental Health Professionals . 23232.Educating the Community and Building Community Awareness33.Identifying Trainers . 24034.Evaluating TrainingIndex. 422236. 244CHAPTER VIIElements of an EffectiveMental Health System . 246Policy Statements35.Evidence-Based Practices. 25036.Integration of Services . 25637.Co-Occurring Disorders . 26038.Housing . 26439.Consumer and Family Member Involvement . 27240.Cultural Competency . 27641.Workforce . 28042.Accountability . 28443.Advocacy . 288CHAPTER VIIIMeasuring and Evaluating Outcomes . 290Policy Statements44.Identifying Outcome Measures . 29245.Collecting Data . 29846.Disseminating Findings . 302Criminal Justice/Mental Health Consensus Projectv

AcknowledgmentsSo many people and organizations made the Crimi-mental illness. And George Vose and John Blackmore ofnal Justice / Mental Health Consensus Project possible.ASCA made sure the Steering Committee never lost sightAlthough it is not feasible to recognize each of these con-of the realities that confront corrections and communitytributions individually, the Council of State Governmentscorrections practitioners—a primary target audience for(CSG) staff would like to highlight the special roles ofthe report.several people involved in this two-year initiative.CSG and the project partners are enormously in-First, CSG staff would like to thank the co-chairsdebted to the members of the law enforcement, courts,of the project, Senator Robert Thompson of Pennsylva-corrections, and mental health advisory boards, who arenia and Representative Michael Lawlor of Connecticut.listed earlier in this report. They each volunteered, overThey initiated this effort, and they provided the leader-the course of just 18 months, hundreds of hours from theirship to realize a vision of bipartisan consensus aroundextremely busy schedules. Review