Transcript Document

Heartland:
Colorado, Iowa, Kansas, Missouri, Nebraska and Oklahoma
KS Counties: Butler, Douglas, Geary, Johnson, Leavenworth, Sedgwick, Shawnee and Wyandotte
Prepared by Jim Brann, Advocate Kansas Mental Health Coaltion
[email protected]
10/9/2014
Table of Contents
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Study summary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
Costs of Mental Health Treatment . . . . . . . . . . . . . . . . .6. . . . . . . . . .
Costs of Untreated Mental Illness . . . . . . . . . . . . . . . . . 7. . . . . . . . . . . . . . . .
Recommendations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .11
........
Appendix Supporting Documentation . . . . . . . . . . . . . . . . . . . 13
Background and Objective . . . . . . . . . . . . . . . . . . . . . . . .14
..........
Bar Chart . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
.
Data Chart and NAMI Facts . . . . . . . . . . . . . . . . . . . . . . . 16
.............
Sources . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17
Source synopsis
-
Colorado . . . . . . . . . . . . . 18
. . . . . . . . . . . . . . . . .13
Iowa. . . . . . . . . . . . . . . . . 19
. . . . . . . . . . . . . . . . . . . . . . . . . . .14
Kansas. . . . . . . . . . . . . . . .20
............................
Missouri . . . . . . . . . . . . . .22
..............................
Nebraska . . . . . . . . . . . . . 23
...............................
Oklahoma . . . . . . . . . . . . .24. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
United States . . . . . . . . . .25. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
KS Counties . . . . . . . . . . . 26
.................................
2014 Studies & News . . . 36
...............
2
Percentage of Population with Mental Illness, Incarcerated and Veterans
Study Summary – Heartland States & US (Part 1)
1.
State Population (millions)
Average 4.6; Colorado 5.3, Iowa 3.1, Kansas 2.9, Nebraska 1.9, Missouri 6.1, Oklahoma 3.9
2.
Number of Inmates
Average 16,416; Colorado 17,699, Iowa 8,069, Kansas 9,580, Missouri 31,513, Nebraska 5,097,
Oklahoma 26,539
3.
Average Daily Cost per Inmate
Average $64.28; Colorado $95.77, Iowa $90.81, Kansas $67.14, Missouri $56.81, Nebraska $71.36
Oklahoma $41.68
4.
Percentage of the Population who are Mentally Ill
Average 19; Colorado 18, Iowa 18, Kansas 18, Nebraska 18, Missouri 19, Oklahoma 22
5.
Percentage of Incarcerated Population who are Mentally Ill
Average 33; Colorado 29, Iowa 47, Kansas 38, Missouri 16, Nebraska 37, Oklahoma 33
3
Percentage of Population with Mental Illness, Incarcerated and Veterans
Study Summary – Heartland States & US (Part 2)
6. Percentage of Population Incarcerated who are Veterans
Average 7; Colorado 9, Iowa 6, Kansas 8, Missouri 7, Nebraska 3, Oklahoma 6
7. Percentage of Incarcerated Veterans who are Mentally Ill
Average 44; Colorado 33, Iowa 50, Kansas 66, Missouri 18, Nebraska 60, Oklahoma 35
8. Percentage of Incarcerated Mentally Ill Veterans with Less than an Honorable
Discharge (no data for Nebraska and Oklahoma)
Average 21; Colorado 22, Iowa 4, Kansas 10, Missouri 46
9. Percentage of Incarcerated Mentally Ill Veterans convicted of Violent Crime
Average 68; Colorado 66, Iowa 53, Kansas 84, Missouri 64, Nebraska 95, Oklahoma 45
10. Data for the United States as a whole
2013 Population 316.1M, Number of Inmates 731,208, Average Daily Cost per Inmate >$60, Percentage of
Population Mentally Ill 18; No data on Percentage of Mentally Ill who are incarcerated; No Data on
Mentally Ill or Incarcerated Veterans
4
Percentage of Population with Mental Illness, Incarcerated and Veterans
Study Summary – Kansas Counties
5
Percentage of Population with Mental Illness, Incarcerated and Veterans
The Cost of Mental Illness Treatment
Cost of Mental Health Treatment
On average, per day, it costs:
•
•
•
•
•
$428 at a State Psychiatric Hospital
$292 at a Psychiatric Residential Treatment Facility
$80 at Larned Correctional Mental Health Facility
$9 for Medicaid reimbursed community treatment
Incarceration:
Facility
Cost
KDOC $
67
Butler $
62
Community HealthcareDouglas
Cuts$ by 145
KS
FY07 – FY12 = 65% Cumulative
Geary
Johnson
Levenworth
Sedgwick
Shawnee
Wyandotte
County Average
$
$
$
$
$
$
65
118
55
68
95
92
$
86
Suicide rate climbs 30% as Kansas cuts budgets
Paying for the costs of treating mental illness is unavoidable!
Our only decision is how we as a State pay for it.
6
Sources: Association of Community Mental Health Centers of Kansas 2012 Testimony , 2013 KDOC Annual Report and KS County Sheriffs
Percentage of Population with Mental Illness, Incarcerated and Veterans
The Cost of Untreated Mental Illness
• Health Care Foundation of Greater Kansas City 2012 Study
“The Costs of Untreated Mental Illness in Greater Kansas City”
• Study quotes:
– A high proportion, 87.5%, of these costs is in the form of indirect costs to
employers and individuals. Indirect costs include unrealized earnings due to higher
unemployment rates, the cost of lost productive time at work due to untreated SMI
(presenteeism), time missed from work (absenteeism), and unrealized earnings due to
permanent disability or premature death (suicides)
– Those with severe mental illness are 10 times more likely to become incarcerated
compared to the general population.
– One barrier might be reluctance to consider mental illness on par with physical
illnesses. However, in the Surgeon General’s report on mental health, major depression
was the second-leading source of disease burden worldwide, behind only heart disease.
– Some might argue that state and local governments cannot afford to improve the
treatment rate of the seriously mentally ill. This economic model shows that improving
the treatment rate for the mentally ill is something they cannot afford to ignore.
7
Source: HCFGKC: http://hcfgkc.org/costs-untreated-mental-illness and US Census Bureau 2013 Estimates for KS
Percentage of Population with Mental Illness, Incarcerated and Veterans
The Cost of Untreated Mental Illness
Who Pays - Total Costs
Kansas 2013 Estimated Census
$800,000,000
$700,000,000
$600,000,000
$1.7 Billion
$500,000,000
$400,000,000
$715,105,971
$300,000,000
$594,260,364
$200,000,000
$100,000,000
$154,648,432
$152,390,903
$5,112,210
$State/local
Who Pays - Indirect Costs
Federal
Private sector/
Employers
Who Pays - Direct Costs
Individual & family
Other private
Who Pays - Other Costs
8
0
Percentage of Population with Mental Illness, Incarcerated and Veterans
The Cost of Untreated Mental Illness
Who Pays - Total Costs
Johnson County - 2013 Estimated Census
$312M
$160,000,000
$140,000,000
$120,000,000
$100,000,000
$80,000,000
$312 Million
$138,484,380
$60,000,000
$113,607,373
$40,000,000
$20,000,000
$29,736,131
$29,316,689
$975,503
$State/local
Who Pays - Indirect Costs
Federal
Private sector/
Employers
Who Pays - Direct Costs
Individual & family
Other private
Who Pays - Other Costs
9
Percentage of Population with Mental Illness, Incarcerated and Veterans
The Cost of Untreated Mental Illness
Who Pays - Total Costs
Wyandotte County - 2013 Estimates
$65
$35,000,000
$30,000,000
$25,000,000
$20,000,000
$65 Million
$15,000,000
$28,782,820
$23,822,216
$10,000,000
$5,000,000
$6,205,530
$6,118,229
$204,623
$State/local
Who Pays - Indirect Costs
Federal
Private sector/
Employers
Who Pays - Direct Costs
Individual & family
Other private
Who Pays - Other Costs
10
Recommendations
1.
Annual conference call among interested Heartland state agencies, federal
agencies, state NAMI, and national NAMI
A.
B.
2.
3.
Review common areas of concern
Discuss potential solutions
Request that DOJ collect and report on this data beginning in FY 2016
State of Kansas consider 2015 legislation to provide:
A.
B.
C.
D.
E.
F.
G.
Diversion programs to keep people with Mental Illness out of the criminal justice system
connecting them with mental health treatment;
Therapeutic care (prescribed mediations and counseling) for incarcerated offenders living
with mental illness;
If incarcerated, benefits such as Medicaid (KH&E) and Food Stamps (DCF) will be suspended
in lieu of cancelled;
Discharge planning linking people with mental illness to community based services upon
their release from correctional facilities including reinstatement of any suspended services;
KDOC and KS Counties which operate Detention Facilities collect and report data annually;
KU and / or WSU annual and random, unannounced, KDOC and KS County Detention
Facilities audits; and
Require Court Services to determine veteran status of anyone charged with a crime and if
convicted their status must become part of their incarceration profile instead of relying on
“self-identification”. Requires access to Veteran’s data similar to HB2655
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Recommendations - KS County Sheriffs & Wyandot Inc.
1.
Issue: Continuation of Therapeutic Mental Health Care when Discharged
Statue requiring engagement of Community Mental Health Services prior to discharge and
continuation of Therapeutic Mental Health Care
2.
Issue: Larned Correctional Mental Health Facility is typically full,
understaffed and a long distance for Eastern Counties
Evaluate use of Johnson County Detention Center in lieu of Larned for Eastern Counties
3.
Issue: Crisis Intervention Training needed for all KS jurisdictions
A. Recommend that CIT International evaluate CIT needs for counties that implement or
have implemented CIT; should not be unfunded mandate
B. Recommend that KDADS establish a fund for “seed” money to assist a county or city to
establish or improve CIT. Use a “grant” process to request and select
4. Enact Warrantless Apprehension for Law Enforcement
Allow detention up to 3 days in a mental health facility deemed suitable by the local mental
health authority.
5.
Need for Regional Acute Care Centers similar to Rainbow
KDADS is working on this capability using funds announced in the Governor’s May 27th
initiative
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APPENDIX
Supporting Documentation
7/17/2015
13
Percentage of Population with Mental Illness, Incarcerated and Veterans
Background
I am Jim Brann a member of the Kansas Mental Health Coalition (KMCH) and KS National Alliance for Mental Illness (KS NAMI). I am also a veteran of Vietnam. My father and an uncle
served in WWII, and other uncles served in Korea and during the Vietnam era. I also have multiple cousins who served in Vietnam. My youngest son served two tours in Iraq. In other
words, I come from a pretty typical American family.
I am a firm believer in the Jimmy Valvano philosophy of life: “never, ever, never, ever, never give up”! I hope you have a similar philosophy based on your faith or some other deeply held
belief.
During the KS Mental Health Advocacy Day on March 13 I met with Governor Brownback, Representatives Bollier, Kleeb, Rubin and Senator Denning.
The purpose of these meetings was to urge them to:
1. Protect mental health funding and budgets;
2. Work with Representative John Rubin and Governor Brownback to create legislation that addresses Mental Health and Criminal Justice System issues.
My youngest son deployed to Iraq twice serving with the Marine Corps. During his first tour he was involved in extreme combat at Fallujah and Ramadi. He was awarded Certificates of
Commendation (Individual Awards) for these engagements. He also received the National Defense Service Medal, Global War on Terrorism Service Medal, Global War on Terrorism
Expeditionary Medal (Iraq) Sea Service Deployment Ribbon (2), and Marine Good Conduct Medal and was promoted early. Unfortunately he got in trouble during his second tour in Iraq and
received a Bad Conduct Discharge.
He suffers from Bi-polar Disorder and Post Traumatic Syndrome Disorder. Since leaving the Corps he has self-medicated and had multiple encounters with law enforcement. He is currently
nd
incarcerated in Sedgwick County Jail awaiting sentencing for a probation violation. This is his 2 violation. On November 3, 2013 after serving 60 days for his first violation he was released
from Sedgwick County Jail at midnight; no money, wearing shorts and a tee-shirt, no transportation and no place to go.
Objective
I fully support recently passed KS HB2655 which provides alternatives for veterans who encounter law enforcement as long as they have acceptable discharges from the military, are mentally
ill and served in combat. This bill is a great start but leaves out Kansas men and women who were separated with less than honorable discharges and Kansas non-veterans with mental
illness.
I have offered my assistance to Representative John Rubin, Chairman of the KS House Criminal Justice Committee. The goal is the creation of new legislation in 2015 to enact laws that
support all veterans with mental illness who have encounters with the Criminal Justice System especially key components of 2014 KMHC Mental Health and Criminal Justice Issues which call
for:
a. Diversion programs to keep people with Mental Illness out of the criminal justice system connecting them with mental health treatment;
b. Therapeutic care for incarcerated offenders living with mental illness;
c. Discharge planning linking people with mental illness to community based services upon their release from correctional facilities;
d. Require annual audits and random, unannounced audits of KDOC facilities to be performed by Kansas Psychological Association; and
e. Require law enforcement to determine veteran status of anyone charged with a crime and if convicted their status must become part of their incarceration
profile instead of relying on “self-identification”.
This legislation must apply to both state and local jurisdictions.
The veteran population can’t be adequately served unless we have specific information about them relating to mental illness, incarceration, type of discharge and types of criminal charges
particularly violent crime. As an Advocate for Kansas Mental Health Coalition I have gathered data for Kansas and the five surrounding states – MO, IA, NB, CO, OK and the US. This
data provides a clearer picture of our mentally ill, incarcerated veterans and will assist us to advocate for legislation in 2015 that covers all veterans. The following bar
graph and chart reflects this information.
State Departments of Corrections, state NAMI organizations, Veterans Administration, the Substance Abuse and Mental Health Services Administration (SAMSHA) and DOJ should work
together going forward to provide these statistics. By having better information about the incarcerated population DOCs can be more effective providing mental health services to all
14
Veterans with Mental Illness. The ultimate goal is to provide diversion for people with mental illness if possible, provide therapeutic mental illness care to those we do incarcerate and
provide discharge planning linking people with mental illness to community services upon their release from incarceration.
120
Heartland Data
2013
Number of Inmates Incarcerated in
2013 (Thousands)
100
96
95
Percentage of the Population who
are Mentally Ill
91
84
Percentage of Incarcerated
Population who are Mentally Ill
80
Percentage of Population
Incarcerated who are Veterans
71
66
66
67
64
Percentage of Incarcerated Veterans
who are Mentally Ill
60
60
57
53
50
47
46
45
42
38
40
37
33
33
32
29
27
22
20
35
22
1818
18
9
8
5
19 18
16
18
10
6
8
10
4 3
7
6
3
5
6
3
0
Iowa
Average Daily Cost Per Inmate
18
0
Colorado
Percentage of Incarcerated Mentally
Ill Veterans with Less than
Honorable Discharge
Percentage of Incarcerated Mentally
Ill Veterans convicted of Violent
Crime
2013 Estimated State Population
(Millions)
Kansas
Missouri
2
Nebraska
4
0
Oklahoma
15
Percentage of Population with Mental Illness, Incarcerated and Veterans
Percentage of
Incarcerated
Mentally Ill
Veterans with
Less than
Honorable
Discharge
Number of
Percentage of
Percentage of
Percentage of
Inmates
Percentage of the
Incarcerated
Population
Incarcerated
Incarcerated in Population who
Population who Incarcerated who Veterans who are
2013
are Mentally Ill
are Mentally Ill
are Veterans
Mentally Ill
(Thousands)
Colorado
Iowa
Kansas
Missouri
Nebraska
Oklahoma
Notes:
18
8
10
32
5
27
18
18
18
19
18
22
29
47
38
16
37
33
9
6
8
7
3
6
33
50
66
18
60
35
Percentage of
Incarcerated
2013 Estimated State
Mentally Ill Veterans
Population
convicted of Violent
(Millions)
Crime
22
4
10
46
0
0
Fill Color
Self-reported; believed to be conservative because of reluctance to reveal the information.
Fill Color
Missouri scores mental illness on a scale 1-5 and a score of 3+ is equivalent to a diagnosis of a mental illness.
Fill Color
Data not available or not collected
66
53
84
64
95
45
Average Daily Cost
Per Inmate
5
3
3
6
2
4
96
91
67
57
71
42
The Facts: (published by National Mental Health of America & KDOC)
1. Mental disorders reported in more than 26% of returning soldiers from Iraq and Afghanistan. Government Accountability Office
2. More than one in four U.S. troops have come home from the Iraq war with health problems that require medical or mental health treatment,
according to the Pentagon's first detailed screening of service members leaving a war zone.
3. Almost 1,700 service members returning from the war this year said they harbored thoughts of hurting themselves or that they would be
better off dead. More than 250 said they had such thoughts "a lot." Nearly 20,000 reported nightmares or unwanted war recollections;
more than 3,700 said they had concerns that they might "hurt or lose control" with someone else. Army Center for Health Promotion and
Preventive Medicine
4. The suicide rate among active duty Army soldiers has leveled off in 2010, while the rate has nearly doubled for National Guard and Reserve
soldiers in 2010.
5. Female veterans returning from deployment have experienced sexual trauma at the rate of 23-33%, and the suicide rate for female veterans
is triple that of non-veteran females.
According to the National Alliance on Mental Illness, “increasingly, emergency rooms, homeless shelters and jails are struggling with the effects of
people falling through the cracks due to lack of needed mental health services and supports.” In the last five years, significant budget cuts have
befallen mental health programs and services. From 2009 to 2011, states cut mental health budgets by a combined $4 billion - the largest single combined
reduction to mental health spending since de-institutionalization in the 1970s.
http://www.nami.org/Template.cfm?Section=state_budget_cuts_report
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Sources
1 Colorado - DOC, NAMI, MHSAS, & SAMHSA
5 Nebraska - DOC, NAMI & SAMHSA
http://www.namicolorado.org/
http://naminebraska.org/
mailto: [email protected]
http://www.samhsa.gov/
http://samhsa.gov/
mailto:[email protected]
[email protected]
http://www.corrections.state.ne.us/pdf/annualreports/2013%20NDCS%20Stats.pdf
mailto:[email protected]
mailto:[email protected]
6 Oklahoma - NAMI, DMHSAS & SAMHSA
http://www.namioklahoma.org/
http://www.doc.state.co.us/sites/default/files/opa/0_Stat_Report_Website.pdf
mailto:[email protected] Buck
2 Iowa - DOC, NAMI, & SAMHSA
http://samhsa.gov/
http://namiiowa.com/
http://www.ok.gov/doc/documents/annual%20report%202013%20for%20web.pdf)
http://samhsa.gov/
mailto:[email protected]
http://www.doc.state.ia.us/
http://www.ok.gov/doc/documents/annual%20report%202013%20for%20web.pdf
mailto:[email protected] DOC
US - Census Bureau, DOJ, HHS, NIH, SAMHSA, VA and VFW
David Wright
http://www.doc.state.ia.us/Documents/2013AnnualReport.pdf
Mailto:[email protected]
3 Kansas - DOC, NAMI' & SAMHSA
http://www.nami.org/MSTemplate.cfm?Site=NAMI_Kansas
Mailto:[email protected]
DOJ stopped collecting data in 2004
Mailto:[email protected]
HHS cannot find any data related to these issues
http://www.doc.ks.gov/publications/kdoc-annual-reports/2013 www.nih.gov/
mailto:[email protected]
Jessica Brunton
http://samhsa.gov/
4 Missouri - DOC, NAMI & SAMHSA
Referred to DOJ Bureau of Statistics
http://www.samhsa.gov/
NIH MHS doesn't collect data on the incarcerated
Mailto:[email protected]
Never responded
http://www.samhsa.gov/data/NSDUH/2k12State/Tables/NSDUHsaeTOC2012.htm
[email protected] can't respond because issue isn't related to benefits or services
http://www.nami.org/MSTemplate.cfm?MicrositeID=310
mailto:[email protected]
VRM Sr. Analyst
[email protected]
Mailto:[email protected]
Zach Schwenk, Asst. Director Operation; relys on VA
http://samhsa.gov/
http://www.bjs.gov/index.cfm?ty=pbdetail&iid=4988
mailto:[email protected]
http://quickfacts.census.gov/qfd/index.html
http://doc.mo.gov/Documents/publications/AR2013.pdf
2014 KMHC Mental Health and Criminal Justice Issues
http://kansasmentalhealthcoalition.onefireplace.com/Resources/Documents/2014%20Criminal%20Justice%20Issues.pdf
2014 KMHC Mental Health and Veterans Issues
http://kansasmentalhealthcoalition.onefireplace.com/Resources/Documents/2014%20Veterans%20Issues.pdf
17
Mental Health and Criminal Justice System
Source Synopsis
Colorado DOC Data
Provided by Heather Wells and Alysha Stucker, CO DOC
[email protected]
[email protected]
The data are run from the Colorado Department of Corrections' population on 4/1/2014. Please note that our veteran
population is tracked by offender self-report at time of admittance into DOC. Additionally, our psychological needs level
codes (p-code) range from 1-5, with 3-5 indicating moderate to severe mental health needs. The p-code identifies broad
need levels and may not match the definition of offenders with mental illness provided by other states. Offenders with pcodes of 3-5 have been included in this analysis. Finally, the p-code used for this analysis is the veteran's p-code as of
4/1/2014, and is not an indication of his or her mental health status during the commission of the crime.

As of 4/1/2014 there were 17,699 offenders in the CDOC with 1596 self-reporting as veterans (9%),

Of those identifying as a veteran 33% (530) had a p-code of 3-5,

119 (22%) of that population received a less than honorable discharge, and of the 119, and

78 or 66% were convicted of a violent crime.
Average daily cost per inmate: $95.77
2013 population is estimated to be 5.3 Million.
18
Mental Health and Criminal Justice System
Source Synopsis
Iowa DOC Data
Provided by Lettie Prell, Director of Research IA DOC
[email protected]

What is the percent of Iowans incarcerated with mental illness? 47.1%

What percent of Iowans incarcerated are Veterans? 6.4% and please note some individuals do not
wish to report this to us so may be incomplete; also, this percent includes individuals who received
bad conduct and “other than honorable” discharges.

What percent of the incarcerated veterans are mentally ill? 50.3%

I also looked at serious mental illness for you. Looking at the total prison population, 28.4% have at
least one serious mental illness; for veterans the percent is 32.7%.

For the total prison population – 46.5% are incarcerated for violent offenses as their most serious
offense; for veterans – 53.4%.
http://www.doc.state.ia.us/Documents/2013AnnualReport.pdf
Offenders in Prison 8,069
Prison Population Forecast:
July 2014 8,064 July 2019 8,838 July 2015 8,158 July 2020 8,901 July 2016 8,294 July 2021 8,981 July
2017 8,513 July 2022 9,078 July 2018 8,713 July 2023 9,243
Average Daily Cost (FY 2013) $90.81
2013 population is estimated to be 3.1M
19
Mental Health and Criminal Justice System
Source Synopsis
Kansas DOC Data
Provided by 2013 Annual DOC Report and Jessica Brunton, Research Analyst IV, KS DOC
http://www.doc.ks.gov/publications/kdoc-annual-reports/2013 [email protected]
As of 6/30/2013
There were 9580 offenders incarcerated in a KDOC facility
Of the 9580 offenders, 799 are veterans (this is SELF-REPORTED)
Of the 799 veterans, 526 (65.8%) have been diagnosed with some sort of mental
illness (codes 2 - 6 in chart below)
Mental Disorder Code
Frequency
0 - not yet scored
1 - none
2 - paraphilia/personality
3 - transient mental disorder
4 - serious Axis I or II
5 - mental retardation
6 - severe mental illness
Total
2
271
263
13
227
1
22
799
Percent
.3
33.9
32.9
1.6
28.4
.1
2.8
100.0
50
119
312
36
9
526
Percent
9.5
22.6
59.3
6.8
1.7
100.0
Of the 526, 50 (9.5%) received a dishonorable discharge
MILITARY DISCHARGE CODE
Frequency
D - DISHONORABLE
G - GENERAL
H - HONORABLE
M - MEDICAL
S - STILL IN
Total
By the end of FY 2013, 38 percent of the prison population was diagnosed with a mental illness, making the KDOC the
largest mental health provider in the state.
Health Care Foundation of Greater Kansas City Study: “The Cost of Untreated Mental Illness”
http://hcfgkc.org/sites/default/files/overview-cost-untreated-illness-greater-kansas-city.pdf
http://hcfgkc.org/sites/default/files/documents/1943_HCFGKC_Kansas.pdf
20
Average Daily Cost: $67.14; 2013 population is estimated to be 2.9M
Mental Health and Criminal Justice System
Source Synopsis
21
Mental Health and Criminal Justice System
Source Synopsis
Missouri DOC Data
Provided by David Oldfield, Director of Research and Evaluation MO DOC
[email protected] http://doc.mo.gov/Documents/publications/AR2013.pdf
Prison
Population
31,513
Mentally
Ill
5,025
16%
Veterans
2056
7%
Veterans
Mentally
Ill
361
18%
Honorable
Discharge
194
of which
Other
Discharge
167
46%
Violent
Offenses
226
63%
Missouri scores mental illness on a five point scale at the time of the initial classification and at the periodic
reclassifications.
1.
No mental health problems
2.
Mild impairment
3.
Clinic care and medication
4.
Serious functional impairment
5.
Severe Functional Impairment
Offenders who score 3-5 are considered to be mentally ill and require medication. The mentally ill classification
requires a clinical assessment and placement in an institution that has psychiatric services.
Health Care Foundation of Greater Kansas City Study: “The Cost of Untreated Mental Illness”
http://hcfgkc.org/sites/default/files/overview-cost-untreated-illness-greater-kansas-city.pdf
http://hcfgkc.org/sites/default/files/documents/1943_HCFGKC_Missouri.pdf
Average Daily Cost per Inmate: $56.81
2013 population estimated to be 6.1M
22
Mental Health and Criminal Justice System
Source Synopsis
Nebraska DOC Data
Provided by Dr. Abby Vandenberg, Ph.D. Research Manager and Robert Lyle NE DOC
[email protected]
http://www.corrections.state.ne.us/pdf/annualreports/2013%20NDCS%20Stats.pdf

On 4/8/2014, 5,097 inmates were incarcerated within the Nebraska Department of Correctional Services
(NDCS). Of These inmates, 1889 (37%) presented with an Axis I diagnosis;

141 incarcerated inmates identified as veterans through self‐reported military service (n=6), membership in
inmate Veterans clubs (n=112), or both (n=23). These individuals made up approximately 3% of the active
population on the analysis date;

Of the 141 self‐reported veterans, 84 (60%) presented with at least one Axis I diagnosis;

Due to the limited number of inmates who self‐reported military service, information regarding discharge
status is not available at this time; and

Of the 84 veterans with at least one Axis I diagnosis, 80 (95% of self‐reported veterans with Axis I diagnoses,
57% of all self‐reported veterans) were incarcerated for at least one violent offense.
Average daily cost per inmate: $71.36
2013 population estimated to be 1.9M
23
Mental Health and Criminal Justice System
Source Synopsis
Oklahoma DOC Data
Provided by Dr. David Wright, Ph.D., Evaluation Projects Manager, OK OKMHSAS
[email protected] http://www.ok.gov/doc/documents/annual%20report%202013%20for%20web.pdf






Percent of the Population that are Mentally Ill – 22% (Per 2011-2012 NSDUH Table 24:
http://www.samhsa.gov/data/NSDUH/2k12State/Tables/NSDUHsaeTOC2012.htm)
Percent of Incarcerated Population that are Mentally Ill – 33% (Per Oklahoma Department of Corrections
2013 Annual Report: http://www.ok.gov/doc/documents/annual%20report%202013%20for%20web.pdf)
Percent of Population Incarcerated that are Veterans – 6% (Per Self Report Data from Oklahoma
Department of Corrections)
Percent of Incarcerated Veterans that are Mentally Ill – 35% (Per Mental Illness Rates Applied to
Department of Correction Veteran Population data)
Percent of Incarcerated Mentally Ill Veterans with Less than Honorable Discharge – (Oklahoma Department
of Corrections does not collect this information)
Percent of Incarcerated Mentally Ill Veterans convicted of Violent Crime – 45% (Per Oklahoma Department
of Corrections Mental Health Services Fact Sheet)
DEMOGRAPHICS (from 2013 Annual Report)
Incarcerated Offenders
Of the state’s 26,539 incarcerated offenders (which excludes county jail backup),
 53.9% are white and 46.1% are non-white.

The controlling or major offense of half of Oklahoma’s incarcerated offenders is a non-violent crime.

The average age of incarcerated offenders is 38.1.

Compared to the state’s general population, the U.S. Census Bureau reports Caucasians are 75.5% of the
state’s population; African Americans represents 7.6% of the state’s population.
Average daily cost: $41.68
2013 population estimated to be 3.9M
24
Mental Health and Criminal Justice System
Source Synopsis
US - Census Bureau, DOJ, HHS, NIH, SAMHSA, VA and VFW
[email protected]
[email protected]
[email protected]
www.nih.gov
[email protected]
www.samshsa.gov
http://www.samhsa.gov/data/NSDUH/2k12State/Tables/NSDUHsaeTOC2012.htm
[email protected]
[email protected]
[email protected]
http://quickfacts.census.gov/qfd/index.html
Per SAMSHSA 18% of the Adult US Population is considered mentally ill. There is NO data about
US incarceration of the Mentally Ill from any US Federal Agency.
There is NO current data on Veterans for the US Population as a whole from any US Federal
Agency.
Further, mid-year 2013 report http://www.bjs.gov/index.cfm?ty=pbdetail&iid=4988 reveals most
current numbers of US incarceration:



After a peak in the number of inmates confined in county and city jails at midyear 2008
(785,533), the jail population was significantly lower by midyear 2013 (731,208).
Males represented at least 86% of the jail population since 2000. The female inmate
population increased 10.9% (up 10,000 inmates) between midyear 2010 and 2013, while
the male population declined 4.2% (down 27,500 inmates).
White inmates accounted for 47% of the total jail population, blacks represented 36%,
and Hispanics represented 15%.
Average daily cost per inmate: estimated to be > $60
2013 population estimated to be 316.1M
25
Mental Health and Criminal Justice System
Source Synopsis
KS County Sources
Butler County Data
Sedgwick County KS Data
Provide by Sheriff Kelly Herzet
[email protected]
Provided by Sheriff Jeff Easter
and Captain Jared Schechter
[email protected]
[email protected]
Douglas County Data
Provided by Sheriff Ken McGovern
[email protected]
Shawnee County KS Data
Provided by Sheriff Herman Jones
and Director Brian Cole of County Corrections
Geary County Data
[email protected]
Provide by Sheriff Tony Wolf
[email protected]
[email protected]
Wyandotte County KS Data
Johnson County Data
Provided by Sheriff Frank Denning,
and Marjor Doug Baker
[email protected]
[email protected]
Provided by Sheriff Don Ash
and Warden Jeffrey Fewell
[email protected]
[email protected]
Wyandot, Inc.
Leavenworth County Data
Provided by Sheriff Andrew Dedeke
[email protected]
Povided by Chief Strategic Officer
Julie Solomon, LSCSW, MBA
[email protected]
26
Mental Health and Criminal Justice System
Source Synopsis
Multi-County Issues
1.
Continuation of Mental Health Prescribed Medications
When an inmate being provided mental health prescribed medications while incarcerated is released they are not provided
a short-term supply or the prescription from the facility doctor who prescribed the medication. This causes a gap in
medication for the individual and with some medications can be dangerous and lead to inappropriate behavior, etc.
Per article in June 3, 2014 Wichita Eagle: http://www.kansas.com/2014/06/03/3490825/in-wichita-brownbackoutlines.html “You just try to create a better system to where you’re handling the person while they’re in jail, getting them
some mental health services, and then there’s no drop when they get out they’re handed right off to the next group,”
Brownback said. “And so you (the person with mental illness) stay on medications, you stay in group therapy and you get a
better result – much better result.”
An interview with Sheriff Jeff Easter of Sedgwick County on June 4, 2014 revealed that “Doctors don’t allow us to provide
prescriptions or short term supplies to inmates from the general jail when they leave. If an inmate was in the Mental Illness
Pod then a couple of days supply is provided.”
In discussions with Sheriff Don Ash and Warden Jeffrey Fewell of Wyandotte County and Debbie Schaffer, Senior Social
Worker of Sedgwick County ComCare & County Corrections they indicated that “Getting short term mental health
medications is a huge problem when someone is released from jail. Sometimes it can take 7 – 10 days to get a mental
health evaluation and then get the medications. Just missing a few days of medication can cause someone to relapse back
into inappropriate behavior then we have real problems. These medications are vital to their health.”
Rep Kay Wolfe-Moore suggested that a partial solution to the cost of medications upon release is to suspend Medicaid and
other Social Services when incarcerated in lieu of cancellation. Then reinstate the services prior to release.
2.
Larned Correctional Mental Health Facility – distance from Eastern Counties and Capacity
In discussions with multiple Sheriffs they indicated that: “Larned is always full or even beyond 100% capacity. This means
that inmates that we need to send there wait, sometimes 4-5 months. Then it’s a 500 mile round trip to take someone
there and return. They also have major staffing problems in Larned because of its location. We need a facility in the
Eastern part of the state.”
Potential Solution: Currently the Johnson County Detention Facility has excess capacity. In lieu of sending an inmate from
an Eastern Kansas County to Larned they would be sent to Johnson County.
Issues:
a. The actual cost of the use of Johnson County Detention facilities must be reimbursed at 100%,
b. The same legal statues used to send an inmate to Larned must be created and enacted,
c. Personnel, numbers and types must be identified and recruited,
d. Security issues of adding these types of inmates to the Johnson County Detention must be identified and evaluate.
e. Number of inmates of this type that the facility can reasonably handle.
27
Mental Health and Criminal Justice System
Source Synopsis
Butler County
Provided by Sheriff Kelly Herzet and Tony Wilhite
[email protected]
[email protected]
County
Butler
Percentage of
Percentage of
Percentage of
Average Number
Incarcerated
Population
Incarcerated
of Inmates per
Population who Incarcerated who Veterans who are
Day (Hundreds)
are Mentally Ill
are Veterans
Mentally Ill
21
16
Based on Prescriptions provided
0
0
Percentage of
Incarcerated
Mentally Ill
Veterans with
Less than
Honorable
Discharge
Percentage of
Incarcerated
Mentally Ill
Veterans
convicted of
Violent Crime
2013 Estimated
County
Population (Ten
Thousands)
0
0
6.6
Average Daily
Cost Per Inmate
$
62
Data not Collected
Concerns expressed by Sherriff Herzet and Undersheriff Wilhite:
 Unfunded mandates from the state and federal governments
 Attitudes of “old-timers” when it comes to mental illness. You just need to “buck-up and deal
with it”
 Cost of CIT Training and the time an officer is not available for duty
 Certification Training is 14 weeks. Adding another week for CIT doesn’t seem feasible
 The message of the study needs the support of Kansas Sheriffs Association
28
Mental Health and Criminal Justice System
Source Synopsis
Douglas County KS Data
Provided by Sheriff Ken McGovern
[email protected]
Douglas County 2013 Annual Report:
http://www.dgso.org/web/index.php?option=com_docman&Itemid=191
The DCCF’s cost per day is historically higher than other facilities because this facility does not "double bunk"
except for the female housing unit. By not "double bunking" we eliminate or greatly reduce the possibility of
inmate on inmate assault which ultimately reduces the possibility of inmate medical costs and liability. The lack
of "double bunking" also reduces or eliminates the spread of communicable diseases within the DCCF which
again equates to a reduction in costs of medical expenses. By conducting inmate uniform exchange and inmate
hygiene practices daily we feel we are reducing the possibility of health related issues by keeping our inmates
and their clothing clean. This proactive approach to inmate hygiene reduces medical costs and promotes inmate
accountability within our facility. Both of the above mentioned practices ultimately may increase inmate costs
per day but are a great counter balance to more possible expensive situations that could surface if they were
not implemented and followed strictly.
For the year 2013, the billing price to house an inmate for other local, Douglas County law enforcement
agencies, was $72.41per day. This rate is a 50% discount to our local agencies as the actual cost to house an
inmate per day is approximately $144.82.
As in prior years, providing high quality mental and health care to the inmates in the DCCF is a top priority for
the Sheriff’s Office staff. These quality services are provided by a variety of community partners in conjunction
with DCCF staff. With the continued reduction and closing of mental health facilities and local mental health
treatment options, the need to provide top quality mental health care to inmates continues to be one of the
major priorities for the DCCF, as approximately 37% of all individuals booked into the DCCF in 2013 self-reported
having some type of mental health issue at the time of their booking.
Average Daily Inmate Population (Page 32 of 2013 Annual Report)
County
Douglas
Percentage of
Percentage of
Percentage of
Average Number
Incarcerated
Population
Incarcerated
of Inmates per
Population who Incarcerated who Veterans who are
Day (Hundreds)
are Mentally Ill
are Veterans
Mentally Ill
13.8
37
Data not Collected
0
0
Percentage of
Incarcerated
Mentally Ill
Veterans with
Less than
Honorable
Discharge
Percentage of
Incarcerated
Mentally Ill
Veterans
convicted of
Violent Crime
2013 Estimated
County
Population (Ten
Thousands)
0
0
11.4
Average Daily
Cost Per Inmate
$
145
29
Mental Health and Criminal Justice System
Source Synopsis
Geary County
Provided by Sheriff Tony Wolf
[email protected]
County
Geary
Percentage of
Percentage of
Percentage of
Average Number
Incarcerated
Population
Incarcerated
of Inmates per
Population who Incarcerated who Veterans who are
Day (Hundreds)
are Mentally Ill
are Veterans
Mentally Ill
10
13
Based on Prescriptions provided
0
0
Percentage of
Incarcerated
Mentally Ill
Veterans with
Less than
Honorable
Discharge
Percentage of
Incarcerated
Mentally Ill
Veterans
convicted of
Violent Crime
2013 Estimated
County
Population (Ten
Thousands)
0
0
3.7
Average Daily
Cost Per Inmate
$
65
Data not Collected
Geary County Sheriff’s Office, Junction City Police, Fort Riley Military Police and Fort Riley Command have an
excellent relationship and work together when Active Duty and Veterans are encountered in the community by
law enforcement.
Sheriff Wolf is fully supportive of the study and the recommendations. He indicated he would discuss with
Sheriff Frank Denning.
30
Mental Health and Criminal Justice System
Source Synopsis
Johnson County KS Data
Provided by Sheriff Frank Denning, Executive Administrator Rita Jones and Major Doug Baker
[email protected]
[email protected]
[email protected]
JOCO booked 15,054 people in 2013 and released 14,960. Our average daily population for the year was
650. Some of the specific request(s) made regarding inmates with mental health issues could not be obtained
but the information I received from our Mental Health Director is listed below:

5979 inmates were referred to Mental Health during the intake/booking process during 2013 but 2717
of them were released prior to being seen…………fyi, a referral is no indication that an inmate has had or
currently has mental health issues………they were simply referred to Mental Health for an interview,
which could be for any number of reasons. Of the 3,262 inmates remaining, Mental Health met with
and assessed 3,205. This initial assessment is not always enough to determine if mental health issues
are present………..follow up is sometimes required.

During 2013, mental health staff had an average of 92.9 individuals on the special needs list at a
time. These are individuals that were identified as having chronic mental health issues that required
more intensive monitoring and treatment by mental health staff. An average of 14.42% of our daily
population was on mental health special needs during the year.

During 2013, we also had an average of 157.7 inmates prescribed psychotropic medications, which
would be on average 24.48% of our daily population prescribed mental health medication(s).
When a subject is booked into our facility and interviewed, he/she is asked if they are a veteran. Statistics
concerning their response are not kept though.
An average for all of the different classifications and factors, the average daily cost for 2013 was just over
$118.00.
County
Johnson
Percentage of
Percentage of
Percentage of
Average Number
Incarcerated
Population
Incarcerated
of Inmates per
Population who Incarcerated who Veterans who are
Day (Hundreds)
are Mentally Ill
are Veterans
Mentally Ill
65.0
26
0
0
Percentage of
Incarcerated
Mentally Ill
Veterans with
Less than
Honorable
Discharge
Percentage of
Incarcerated
Mentally Ill
Veterans
convicted of
Violent Crime
2013 Estimated
County
Population (Ten
Thousands)
0
0
56.7
Average Daily
Cost Per Inmate
$
118
Data not Collected
Health Care Foundation of Greater Kansas City Study: “The Cost of Untreated Mental Illness”
http://hcfgkc.org/sites/default/files/documents/1943_CUMI_Johnson.pdf
31
Mental Health and Criminal Justice System
Source Synopsis
Leavenworth County
Provided by Sheriff Andrew Dedeke
[email protected]
County
Leavenworth
Percentage of
Percentage of
Percentage of
Average Number
Incarcerated
Population
Incarcerated
of Inmates per
Population who Incarcerated who Veterans who are
Day (Hundreds)
are Mentally Ill
are Veterans
Mentally Ill
11.7
34
0
0
Percentage of
Incarcerated
Mentally Ill
Veterans with
Less than
Honorable
Discharge
Percentage of
Incarcerated
Mentally Ill
Veterans
convicted of
Violent Crime
2013 Estimated
County
Population (Ten
Thousands)
0
0
7.8
Average Daily
Cost Per Inmate
$
55
Data not Collected
Issues and Concerns:







Short-term stay reporting and Therapeutic Mental Health Care
Barriers in communication with VA; they raise HIPA even though it doesn’t apply to law enforcement
Communications with the Military at the officer level when engaging military personnel
Mental Health First-aid needs to be added to CIT
CIT should be mandatory part of officer certification process
The new Rainbow acute care facility is very limited and Johnson and Wyandotte Counties get priority.
Multiple Regional Centers similar in function to Rainbow are needed as soon as possible.
Distance to and capacity of Larned
32
Mental Health and Criminal Justice System
Source Synopsis
Sedgwick County KS Data
Provided by Sheriff Jeff Easter
[email protected]
Captain Jared Schechter
[email protected]
We do not currently track some of the information you have requested but below is the information that we do
track that I can give you:
For the calendar year of 2013 the Detention Facility had an average daily population of 1,418 inmates and
booked in a total of 26,514 arrestees during 2013.
We do not track how many inmates are mentally ill but below are the number of inmates per month in 2013
that received mental health medication:
Jan
Feb March April
May June July Aug Sept
303
265
291
269
273
276 250
285
Oct Nov
279 273
246
Dec
298
Concerning inmates who are veterans, during the year of 2013 there were 236 inmates booked in who reported
that they were veterans (less than .01%).
County
Sedgwick
Percentage of
Percentage of
Percentage of
Average Number
Incarcerated
Population
Incarcerated
of Inmates per
Population who Incarcerated who Veterans who are
Day (Hundreds)
are Mentally Ill
are Veterans
Mentally Ill
142
19
Based on Prescriptions provided
0
0
Percentage of
Incarcerated
Mentally Ill
Veterans with
Less than
Honorable
Discharge
Percentage of
Incarcerated
Mentally Ill
Veterans
convicted of
Violent Crime
2013 Estimated
County
Population (Ten
Thousands)
0
0
50.5
Average Daily
Cost Per Inmate
$
68
Data not Collected
Issues and Concerns:
Continuity of Therapeutic Mental Health Care is an issue when an inmate has been in the general population.
Currently prescribed medications are not provided upon release to inmates unless they were in the Mental
Health Pod. County Corrections and ComCare has raised this issue and we’re trying to determine a solution.
There will be a significant increase in cost of these types of medications. Currently it is not considered a vital
health care issue.
33
Mental Health and Criminal Justice System
Source Synopsis
Shawnee County KS Data
Provided by Sheriff Herman Jones and Director of County Corrections Brian Cole
[email protected]
[email protected]
County
Shawnee
Percentage of
Percentage of
Percentage of
Average Number
Incarcerated
Population
Incarcerated
of Inmates per
Population who Incarcerated who Veterans who are
Day (Hundreds)
are Mentally Ill
are Veterans
Mentally Ill
50
18
Based on Prescriptions provided
0
0
Percentage of
Incarcerated
Mentally Ill
Veterans with
Less than
Honorable
Discharge
Percentage of
Incarcerated
Mentally Ill
Veterans
convicted of
Violent Crime
2013 Estimated
County
Population (Ten
Thousands)
0
0
17.9
Average Daily
Cost Per Inmate
$
95
Data not Collected
Issues and Concerns:
The distance to and capacity of Larned is a significant issue. It is a 500 mile round-trip and requires two officers
to take and inmate to the facility. Of greater concern is the delay because of capacity. Sometimes it can be 4 -5
months before we can transfer someone.
34
Mental Health and Criminal Justice System
Source Synopsis
35
Mental Health, Incarceration and Veterans
Studies & News
Studies
•
•
•
•
•
•
•
•
Orange County Ground Breaking Event
CIT Training Overview
Apprehension by a Police Officer without a Warrant
Help for Veterans Involved in the Justice System
Mercer Report-State of KS.pdf
West Virginia Survey of Veterans – Final Report 2012
Validation of Self-reported Veteran Status Among Two Homeless Groups
The Costs of Untreated Mental Illness in Greater Kansas City
News
•
•
•
•
•
•
•
•
•
•
•
Suicide Rates Climb by 30% as Kansas Cuts Budgets
Home From War, Our Soldiers Continue to Die
Brownback: Society Needs to Handle Mental Illness as Treatable Disease
Improve Mental Health Care for Our Veterans
Veteran’s Father Fights for More Treatment Less Jail Time for Mentally Ill
Brownback Outlines Plans to Improve Mental Health Services for Mentally Ill Kansans
Veteran Shot Dead by Police after he was Refused Psychiatric Care by Kansas City VA
Kansas City VA also had Secret List
Huge Backlog – VA Audit Show VA Uses Secret Lists
Kansas Citians Push to Remove Stigma of Mental Illness
State Funding for Mental Health Lagging
36