presented by dean aufderheide, phd., mental health service director, on behalf of daniel g. ronay,...
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Mental Health & Substance AbuseRe-Entry Efforts
Presented by Dean Aufderheide, PhD., Mental Health Service Director,
on behalf of Daniel G. Ronay, Chief Deputy Secretary,
Florida Dept. of Corrections
Just the Facts
United States is about 5% of world population, but incarcerates 25% of world’s inmates
40% of individuals with serious mental illnesses have been in jail or prison at some time in their lives
Americans with severe mental illnesses are 3 times more likely to be in jail or prison than in a psychiatric hospital
In less than three decades, the percentage of seriously mentally ill prisoners has almost tripled from about 6% in 1983 to 15-20% today
Defining the Problem
According to the NAMI report, Florida is 49th in the nation in per capita spending on mental health services
In Florida, a person with serious mental illness is 5 times more likely to be in a jail or prison compared to in a hospital.
There are more inpatient beds in the Florida prison system than the number of involuntary civil commitment beds in Florida’s state hospital system
18% of the inmates in the Florida DOC have a diagnosed mental disorder that requires mental health treatment
2010 Survey of states by the Treatment Advocacy Center and the National Sheriffs’ Association
Florida Mirrors the National Trend in Mentally Ill Population
59% Increase, but Has Stabilized Over Past 3 Years at About18%
2002 2003 2004 2005 2006 2007 2008 2009 2010 -
2,000
4,000
6,000
8,000
10,000
12,000
14,000
16,000
18,000
20,000
Mental Illness in by Mental Health Grade
Total Inmates 101,767
82%
4%
13%
1%
S1S2S3S4-S6
Florida Department of Corrections - Bureau of Research and Data Analysis - February 14, 2011
Increase in the Percentage of Inmates with Severe and Persistent
Mental Illness (SPMI) within the Mentally Ill Population
1995 20100%
5%
10%
15%
20%
25%
30%
35%
40%
45%
17%
40.%
(Psychotic Disorders, Bipolar Disorders, Major Depression)
Florida Department of Corrections, Date Bureau of Research & Data Analysis
Mental Health ReEntry ProgramMeeting the Challenge in Florida
Creating an Interagency Agreement between the Department of Corrections and the Department of Children and Families
Coordinating with the Social Security Administration to complete SSDI/SSI applications
Establishing Community Partnerships with Stakeholders
Created a Central Office full-time staff position in mental health to provide oversight and coordinate aftercare services statewide and with stakeholders
Created new institutional Mental Health ReEntry Specialist positions solely dedicated to coordinate aftercare services
Number of Offenders Eligible for Post-Release Aftercare Planning Annually
2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 -
500
1,000
1,500
2,000
2,500
3,000
3,500
4,000
4,500
5,000
2,177 2,367 2,503 2,891 2,740
3,141 3,632
4,526 4,481 4,287
8Florida Department of Corrections; Bureau of Research and Data Analysis; November 30, 2010
DCF Mini-Mainframe
DC/DCF Web-Based Electronic Referral System
Veteran’s Administration
Agency for Health Care Administration
Parole and Probation
Agency for Persons with Disabilities
County Sherriff’s
Department
DC
Mainframe
DCF Web Interface
DC staff enter referral information into DC Mainframe
Encrypted file transfer
DCF staff receives email notice of referral and assigns community provider based on the county of destination
DC, DCF, CMHC providers have access to aftercare database.DC staff obtains aftercare
arrangements from aftercare database / communicates information to inmate.
Updated Weekly
DCF staff calls provider to establish appointment.
DC referral information de-encrypted
Office of Homelessnes
s
Agency WorkforceInnovation
Florida Institute Legal Services
DCF Office of DisabilityDetermination
Potential Stakeholders
“Seamless Delivery System”
CommunityCorrectionsPrograms
In-PrisonPrograms
Residential Short-term (6 months)
Residential Long-term Therapeutic
Community
Aftercare
Upon Admission:IP
Screening
Prevention
Motivational Groups
Intensive Outpatient
Substance Abuse Transition Centers
Residential Therapeutic Community
Support Groups
Upon Release: IP
Post-Release Substance Abuse Transitional Housing
Upon Admission: CC
Assessment (if court ordered)
UA Testing
Outpatient
Type of In-Prison Inmate Treatment2,533 Department Slots
Intensive Outpatient: 1,168 • 14 – Correctional Institutions
Residential Therapeutic Communities: 606 • 5 – Correctional Institutions• 1 –Pre- Release Community-Based
Substance Abuse Transition Centers: 759 Prevention/Outpatient/Aftercare
• 6 – Pre-Release Community-Based
1,048 - Male 120 - Female
561 - Male 45 - Female
503 - Male
256 - Female
In-Prison Substance Abuse Gaps in Services vs. Need FY 2009-10
NEED
65%
35,810 inmates were provided screening assessments at reception.
~65% of the total inmate population have consistently been screened to be in need of substance abuse treatment services.
Approximately 19% of those have a co-occurring SA & MH disorder.
84% of released inmates that needed treatment; did NOT receive it.
Total = 102,232 As of June 30, 2010 -
2,533 available department substance abuse treatment slots.
775 Short – term – 73% 286 Long – term – 27%
Community Corrections Substance Abuse and Mental Health Resources
1,061 – Contracted Residential Substance Abuse Treatment Beds 775 Short – term – 73% 286 Long – term – 27%
37 - Contracts for Outpatient Substance Abuse Programs and 22 Contracts for Outpatient Mental Health and Sex Offenders Treatment available throughout the 20 circuits.
Community Corrections Substance Abuse: Gap vs Need FY2009-10
•On 6/30/10, 152,928 offenders were on active supervision.•Approximately 55.8% (85,341) offenders supervised are potentially in need of
substance abuse treatment.
Statistics compiled by the Bureau of Research & Data Analysis
Need
Total
Special Collaborative Re-Entry Project
• At Century Correctional Institution the Department of Children and Families is funding a Reentry Case Manager position that provides case management and follow up services to inmates with substance abuse problems released from Century CI to the Escambia County area. Services include: – Family connectivity– Housing Referrals– Substance Abuse referrals/follow up– Mental Health referrals/follow up– Case management
Seeking New Funding Opportunities and Partnerships
• Partnering with two community-based treatment providers the Department submitted a 2nd Chance Grant application for Adult Offenders with Co-occurring Disorders in June of 2011 .
• The program, if funded, would target inmates with co-occurring substance abuse and mental health disorders located in the Department’s Therapeutic Community Program at Jefferson Correctional Institution who are returning to the Circuit 2 vicinity.
• Post –release re-entry services include mental health and substance abuse aftercare and case management services, follow-up psychiatric care, and medication management. Based on individual needs, housing, transportation and employment skill training will be provided.
.
Circuit 17 Program Targets Severely and Persistent Mentally Ill
• In 2006, based on legislative appropriation, the Department partnered with Henderson Mental Health Center to develop a pilot program that provides intensive, specialized re-entry rehabilitation and support services to probationers and released inmates who have a severe and persistent mental illness. This program continues today.
• Program Goals include successful re-entry by preventing unnecessary psychiatric hospitalization(s), incarceration(s) or crises.
Prison Diversion
• Currently, Circuit 13 has the only pilot prison diversion program (PDP)
• Offenders are sentenced to the program in lieu of prison. Program provides varying levels of care.
• Individuals in need of mental health services receive services through the provider’s psychiatrist or referred to an outside provider.
• Offenders in need of substance abuse treatment receive services through the program.
Probation Officers work with Mental Health Courts
• Circuit 15- Mental Health Court• Circuit 17-Mental Health Court• Circuit 12-Sarasota County Mental Health Court
was established in the 1990’s. • Circuit 13-Pre Trial Intervention Mental Health
Court• Circuit 20-Lee and Collier counties have Mental
Health Courts• Circuit 8 –Alachua County Mental Health Court• Circuit 2 – Mental Health Court
Veterans Dorm Program
• Over 6,700 self-reported Military Service personnel
• Identified Dorms– 6 dorms sites
Inmate relocation in process Curriculum development in process
• Identify programming– Thinking for a Change, staff trained– Establishment of community partners
and stakeholders
Veteran Inmates Requiring Post-Release Mental Health/Substance Abuse Treatment
4%
96%
Veterans(115)
Non-Veterans(3200)
828
25 114
6
Routine Care
Outpatient w/o Medications
Outpatient with Medications
Inpatient
Level of Service Required for VeteransInmates referred to DCF/VA for Post-ReleaseMental Health/Substance Abuse Treatment in 2007
The Florida Department of Corrections, Bureau of Research and Data Analysis, Inmate Data Section, January 29, 2008; (1) National Survey on Drug Use and Health, “Male Users with Co-Occurring Serious Mental Illness and a Substance Use Disorder," Nov.11, 2004, http://www.oas.samhsa.gov/2k4/vetsDualDX/vetsDualDX.htm ;
In 2002/2003, an estimated 1.2 million male veterans were identified as suffering from serious mental illnesses.
Approximately 340,000 of these individuals had co-occurring substance abuse disorders (1).
Recidivism Reduction Initiatives and Priorities
Increase the number of Pre-Release Substance Abuse Treatment slots.
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Recidivism Reduction Initiatives and Priorities
Increase mental health training opportunities for Probation and Correctional Officers
Increase communication between Institutional Substance Abuse Treatment Staff and Mental Health Treatment Staff
Enhance continuum of care by increasing communication between Institutions and Community Corrections staff
Recidivism Reduction Initiatives and Priorities
Develop one (1) additional Pilot Prison Diversion Program in a rural circuit.
Partner with Florida Certification Board, Florida Alcohol Drug Abuse Association, and Substance Abuse providers to replicate a certification process for a Recovery Specialist Credential.
Recovery Health Network Discount Prescription Drug Cards
The Importance of Collaborative Leadership to the Right Thing, the Right Way for the Right Reasonsin Our Mental Health and Substance Abuse Programs
When They Succeed, We Succeed!
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