Transcript Medicaid Capitation: Cost Shifting & Multisystem Use

Specialty Mental Health Probation: A CrossAgency Pilot Project
Gary S. Cuddeback, Tonya VanDeinse, Stacey Burgin – UNC-CH
Anne Precythe, Karen Buck, David Edwards – DPS
Sonya Brown, Dale Willetts – DHHS
Lee Coble, Mary Ringley, Ed Mazcyk – Sampson County Probation
North Carolina’s 2015 CIT Conference: Our Time is Now: Building the
Bridge Together
February 10, 2015
McKimmon Center – Raleigh, NC
This project is supported by funding from the North Carolina Governor’s Crime Commission and the North
Carolina Department of Public Safety. We would like to acknowledge the efforts of our many project
partners in Wake and Sampson Counties, including: Judicial District Managers, Chief Probation Officers, and
probation officers; TASC; Alliance and Eastpointe MCOs; and local behavioral health providers.
Today’s Agenda
1. Scope of mental health/criminal justice interface
2. Brief overview of statewide training initiatives
and specialty mental health probation
3. Panel Discussion – perspectives of DPS, DHHS,
UNC-CH about collaboration and
implementation of training efforts and pilot
project
4. Q & A
Criminal Justice and Mental Health
 Mental health system has shrunk over last 50 yrs.
 Jails, prisons and community corrections have a
larger and ever-increasing role in the care and
management of persons with mental illness.
 Exodus from our prisons and jails mirrors the
deinstitutionalization of state hospitals that
started over 30 years ago.
 Probation officers now routinely have offenders
with a spectrum of mental health, substance
abuse and personality disorders on their
caseloads.


Daily Number of Persons with Mental
Illness in the Criminal Justice System
31% of female jail inmates and 15% of male inmates have
mental illness (Steadman et al., 2009)
 June 2009 ~ 130,140 jail inmates with mental illness ready for release
24% of female and 16% of male prisoners have mental
illness (Ditton, 1999)
 June 2009 ~ 267,994 prisoners with mental illness potentially ready for


community reentry
About 27% of 5 million probationers have mental illness
(Crilly et al., 2009)
 ~ 1.35 million probationers!
Approximately 54,000 in state hospitals
# MI
Prisons
Jails
Probation/Parole
276,994
130,140
1,350,000
Justice-involved Persons living with
Mental Illness
 Justice-involved persons living with severe mental
illness ….
 High rates of substance use, which is associated with
violence, treatment noncompliance, homelessness, and
frequent criminal justice contacts (Clark et al., 1999;
Drake & Mueser, 2001; Horsfall et al., 2009; Steadman,
2000; Theriot & Segal, 2005).
 Difficulty accessing housing and services and have
high recidivism rates (Cloyes et al., 2010; Fisher et al.,
2007; Gagliardi et al., 2004; Lovell et al., 2002; MallikKane & Visher, 2008; Skeem & Louden, 2006).
Criminal Justice and Mental Health


Offenders living with mental illness present
unique challenges across the criminal justice
system – courts, jails, prisons, and community
supervision – and criminal justice agents need
ongoing training and support to meet the needs
of this large and growing population.
Justice-based interventions such as mental health
courts, jail and prison-based cognitive behavioral
treatments, Crisis Intervention Training, and
specialty mental health probation exemplify the
changing landscape of corrections at the interface
of criminal justice and mental health.
GCC Grant

Here in North Carolina, with a generous grant
from the Governor’s Crime Commission and
funding from DPS, principals from DPS, DHHS
and UNC-CH have led efforts to …
Train and provide more information about mental
health to all probation officers and other stakeholders
across the state and
 Launch two specialty mental health probation pilots
in Wake and Sampson Counties.

Statewide Training
 To date, statewide mental health training modules have
been disseminated to all probation officers, chiefs, district
managers and other DPS stakeholders across the state
(n=~2100), as well as to TASC employees and other
stakeholders.
 The six training modules cover the following topics:
 (1) using and interpreting the risk and needs assessment;
 (2) severe mental illness;
 (3) psychiatric medications;
 (4) PTSD, personality disorders and other disorders;
 (5) crisis response and local services for persons with
mental illness; and
 (6) self-care for probation officers.
Specialty Mental Health Probation

Specialty mental health caseloads have been
widely disseminated and typically include ..
(1) exclusive mental health caseloads;
 (2) reduced caseloads;
 (3) ongoing officer training; and
 (4) a problem-solving supervision orientation
(Skeem & Louden, 2006; Skeem et al., 2006).


Here, we have added …

On-going training in MI + on-going mental health
supervision by LCSW + community capacity
building
SMHPs (cont’d)

SMHPs have been fully implemented in
Sampson and Wake Counties


Probationers with mental illness are being randomly
assigned to specialty mental health probation or
regular probation as a part of a rigorous outcomes
evaluation
Currently, over 40 offenders are voluntarily
participating in the project
Implementation of SMHPs

Partnership between DPS, DHHS and UNCCH
Committee meetings
 Training
 Education
 Community capacity building
 Stakeholder meetings

Today’s Panel

Department of Public Safety
Anne Precythe, Karen Buck, David Edwards
 Chief Probation Officers and Probation Officers
Coble, Ringley, Mazyck, Gould, Harris


DHHS


Sonya Brown, Dale Willets
UNC-CH

Gary Cuddeback, Stacey Burgin, Tonya VanDeinse
Panelist Perspectives

Department of Public Safety


DHHS


Need for SMHP, role of DPS, experiences with
implementation, officers’ experiences with
implementation and training, day-to-day experiences –
Sampson County
Need for SMHP, role of TASC, experiences with
implementation
UNC-CH

Need for SMHP, experiences with implementation,
community capacity building, stakeholder meetings
THANKS!

Gary Cuddeback
[email protected]
 919-962-4363
