colorado course corrections: steps to health and …...equitas is a nonpartisan, nonprofit...

V I N C E N T AT C H I T Y, P H . D .

E X E C U T I V E D I R E C T O R

T H E E Q U I TA S P R O J E C T

PR ES EN TAT ION TO T H E COLOR A DO COM M I S S ION ON CR I M I N A L A N D J UVEN I L E J UST I CEJ UN E 14 , 2019

Colorado Course Corrections:Steps to Health and Justice

What is The Equitas Project?

The Equitas Project, an initiative of the David and Laura Merage Foundation, envisions an America

rededicated to liberty and justice for all, where there is a commonly held expectation that jails and prisons should not continue to serve as the nation’s warehouses for people with unmet mental health needs.

MISSION

Equitas is a nonpartisan, nonprofit organization that is committed to disentangling mental health and

criminal justice.

CCJJ June 14, 2019 2 of 33Colorado Course Corrections, Equitas Project

With thanks to our founders


1 in 4 people will (experience) a mental illness in their lifetime.1

1 in 17 people will experience a severe mental illness.2

Colorado has only 15 psychiatrists per 100,000 people, compared with 92 primary-care physicians.3

The Colorado ranks 43rd in the country for overall mental health care need versus access.4

57% of people in Colorado who needed mental health treatment did not receive it.5

Mental illness among Colorado inmates is 2-3x more prevalent than among the general population.6

~80% of incarcerated individuals in the United States have suffered Traumatic Brain Injury (TBI). TBI rate among the general public is around 6%.

Nationally, at least 1 in 2 jail or prison inmates has a mental illness.8

Colorado prisons treat more than 4x as many people for mental health as all of the psychiatric hospitals in the state.9

74% of Colorado prison inmates have a substance use disorder.10

7


WHERE ARE WE HEADED? WHAT’S OUR COMMON GROUND?

Where We Are Now…Young & Old

How We’ll Know We’re On the Right Track in 5 yrs Shared Focus, Across all Sectors and SystemsMental Health Measures Understood Universal Assessment, Support, Referrals

Where We Should Want to Be in 15 yrs


Where to begin? Priorities?


Social Determinants11 Criminogenic Risks12

Biology and genetics

Individual behavior

Social environment

Physical environment

Health services

Antisocial personality or temperament Antisocial cognition

Antisocial companions Family and/or marital stressors

Lack of pro-social leisure or recreation

Lack of employment Lack of education

Substance abuse

We share an understanding…

we need to share a

language!


On October 30 and 31 of 2018,2018 Course Corrections participants observed and declared the following:

The State of Colorado is in the midst of a public health crisis. Coloradans with

mental health needs are too often neglected, stigmatized, or inadequately

supported. Failure to address these health needs results in premature death,

injury, substance use and addiction, long-term disability, and many other

preventable threats to public safety and wellbeing.


Over-reliance upon a criminal law enforcement system…

The arrest, punitive detention, and criminalization of Coloradans withunaddressed health needs gravely exacerbates this crisis, is a wastefulmisapplication of resources, and yields poor health and public safety outcomes attremendous cost to individuals, communities, and the economy at large.


FEATURED AUTHORS

Joelle Brouner Executive DirectorColorado Developmental Disabilities Council

Susana Calderon Regional Public Health AdvisorU.S. Department of Health and Human Services, Office of the Assistant Secretary for Health (OASH), Region VIII

Lisa Clements, Ph.D.Vice-President, Population HealthBeacon Health Options

Gary Creager Chief of PoliceCity and County of Broomfield

Doyle Forrestal Chief Executive OfficerColorado Behavioral Healthcare Council

Alison George DirectorColorado Department of Local Affairs Division of Housing

Daric Harvey Chief of PoliceCañon City Police Department

Stan HilkeyExecutive DirectorColorado Department of Public Safety

Steve Holloway Branch Chief, Primary Care OfficeColorado Department of Public Health and Environment

Morgan Honea CEOCORHIO

Hope Hyatt Executive DirectorColorado Mental Wellness Network

Nancy Jackson County CommissionerArapahoe County

Hassan Latif Executive DirectorSecond Chance Center

Dr. Jenn Leiferman Director, Population Mental Health and Wellbeing ProgramColorado School of Public Health

Beth McCann Denver District AttorneyDenver District Attorney’s Office

Lucienne Ohanian Chief DeputyColorado State Public Defender

Carol Plock Executive DirectorHealth District of Northern Larimer County

Rick RaemischExecutive DirectorColorado Department of Corrections

Elsa Ramirez Executive OfficerU.S. Department of Health and Human Services

Carol Plock Executive Director Health District of Northern Larimer County

Charles Smith, Ph.D.Regional Administrator, SAMHSAU.S. Department of Health and Human Services – Region VIII

Joe Thome DirectorDivision of Criminal Justice

Art Way State DirectorDrug Policy Alliance

Dr. Robert WerthweinDirector, Office of Behavioral HealthColorado Department of Human Services


COURSE CORRECTIONS REQUIRED!

Colorado Course Corrections 2016: Summit on Behavioral Health and Criminal Justice

Steps to Health and Justice 2017

Colorado Steps to Health and Justice Summer Tour 2018

Colorado Course Corrections: Steps to Health and Justice Summit 2018


Common themes & trends

Childhood

Health Care

Education

Employment

Housing

Public Safety

Justice

Corrections

Reentry

Data


CHILDHOOD AND YOUTH

EXPAND access to mental health awareness education, support, and care for children and families. Set standards and expectations for the inclusion of wellness support services, education, and curricula in all childcare settings.

1 of 4 recommendations


HEALTH CARE

INVEST in training, deploying, and retaining a world-class health care workforce that provides preventive and supportive care for Coloradans’ minds and bodies, as well as youth engagement, education, access to services and resources, and crisis response. Train all clinicians and first responders on mental health, addiction, and trauma needs assessment, and on pathways to support and care.



EDUCATION

CULTIVATE literacy regarding wellness and make resources available to support wellness among students and families. Everyone should have a mental health plan, and a personal diagnostic and first aid toolkit, as well as an advance directive regarding care preferences in case of health crises.



EMPLOYMENT

ENSURE success by providing training, internships, apprenticeships, and supports for people with mental health needs, as well as for those who have been involved in the justice system.



HOUSING

EXPAND integrated housing programs to support individuals with complex health needs.



PUBLIC SAFETY

SHIFT the response to substance use and addiction, from public safety and law enforcement, to health care. Ensure that people in possession of or using substances are directed to treatment and recovery, with the goals of decriminalizing substance use disorders, reducing harm, and improving outcomes.



JUSTICE

IMPROVE the process of civilly committing individuals to least restrictive outpatient or inpatient care when their health is the primary driver of unlawful behaviors.



CORRECTIONS

EXPAND case management within corrections before parole to ensure continuity of care, successful community integration, and department accountability for improved outcomes.



REENTRY

PARTNER across sectors to ensure continuity of access to services and resources individuals need to stabilize and thrive in the community.



DATA

COLLECT consistent data across health care, public safety, and justice systems. Equity requires accountability regarding access to quality care, arrests, detention in jail, and other restrictions of liberty.



Summary of Legislative Successes in Colorado


Legislative Successes in 2017

SB-207: Strengthen Colorado Behavioral Health Crisis System

HB-1351: Study Inpatient Substance Use Disorder Treatment

SB-021: Assistance to Released Mentally Ill Offenders

SB-074: Create Medication-assisted Treatment Pilot Program

SB-012: Competency Restoration Services and Education

SB-019: Medication Mental Illness in Justice Systems

HB-1326: Justice Reinvestment Crime Prevention Initiative

SB-068: School Counselors Early Support for Students

SB-193: Research Center Prevention Substance Abuse Addiction

HB-1211: Educators Professional Development Discipline Strategies

HB-1308: Individualized Conditions of Parole

More than $44 million in state funds to address Course Corrections recommendations.



HB-1007 Payment Reform

HB-1136 Medicaid Inpatient/Residential Benefit

SB-024 Health Service Corps Loan Repayment for SUD Professionals

SB-249 Redirection Criminal Justice Behavioral Health

SB-250 Expand Jail Based Behavioral Services

SB-251 Statewide Court Liaison Behavioral Health Program

HB-1094 Children and Youth Mental Health Treatment Act

HB-1357 Behavioral Health Care Ombudsperson Parity Reports

More than $14 million in state funds to address Course Corrections recommendations.



HB19-1017: Kindergarten Through Fifth Grade Social & Emotional Health Act

HB-1129: Prohibit Conversion Therapy for a Minor

SB19-010: Professional Behavioral Health Services for Schools

HB19-1044: Advance Behavioral Health Orders Treatment

HB19-1269: Mental Health Parity Insurance Medicaid

HB19-1160: Mental Health Facility Pilot Program

SB19-222: Individuals at Risk of Institutionalization

SB19-223: Actions Related to Competency to Proceed

SB19-036: State Court Administrator Reminder Program

SB19-001: Expand Medication-Assisted Treatment Pilot Program

HB-1009: Substance Use Disorders Recovery

SB19-143: Parole Changes

HB19-1275: Increased Eligibility For Criminal Record Sealing


Questions?


Final Remarks


Read the Full Colorado Course Corrections Document

WWW.EQUITASPROJECT.ORG/COLORADO-COURSE-CORRECTIONS-2019/


https://www.equitasproject.org/colorado-course-corrections-2019/

References1. Breakdown: Mental Health in Colorado (2014). In The Denver Post. Retrieved from http://extras.denverpost.com/mentalillness/index.html.

2. Ibid.

3. Ibid.

4. Mental Health America. (2018). Ranking the States. Available at: http://www.mentalhealthamerica.net/issues/ranking-states

5. Mental Health America. (2018). The State of Mental Health in America 2018 - Access to Care Data. Available at: http://www.mentalhealthamerica.net/issues/mental-health-america-access-care-data

6. Statistical Report 2014, Colorado Department of Corrections.

7. Hayasaki, E., Teaching Prison Inmates About Their Own Brain Trauma Could Help Them Rehabilitate. June 2016. Newsweek. Retrieved from https://www.newsweek.com/2016/07/08/prison-inmate-traumatic-brain-injury-research-475615.html

8. James, D., Glaze, L., Mental Health Problems of Prison and Jail Inmates, Bureau of Justice Statistics Special Report. September 2006, NCJ 213600. Retrieved from https://www.bjs.gov/content/pub/pdf/mhppji.pdf

9. MORE MENTALLY ILL PERSONS ARE IN JAILS AND PRISONS THAN HOSPITALS: A Survey of the States Treatment Advocacy Center, 2010.

10. Colorado Department of Corrections, Department of Reports and Statistics. (2018). Inmate Population Profile: Colorado Inmate Population. December 2018. Retrieved fromhttps://www.colorado.gov/pacific/cdoc/departmental-reports-and-statistics https://www.colorado.gov/pacific/cdoc/departmental-reports-and-statistics

11. U.S. Department of Health and Human Services, Healthy People 2020 Draft. 2009, U.S. Government Printing Office.

12. Andrews, D.A. Bonta, James (2010). Psychology of Criminal Conduct, 5th Ed., 58-65.


https://www.colorado.gov/pacific/cdoc/departmental-reports-and-statistics

Visit EquitasProject.org

Follow @EquitasProject

CONTACT:

VINCENT ATCHITY

[email protected]

GWENDOLYN WEST

[email protected]


colorado course corrections: steps to health and …...equitas is a nonpartisan, nonprofit...

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