The Bishop Alfred A. Owens, Jr. Family Life Community Center
605 Rhode Island Ave., NE, Washington, DC 20001
April 29, 2015, 6:30 pm – 8:30 pm
Promoting Healthy Minds to Support Safe Communities: A Community Conversation about Behavioral Health
The 2015 CJCC Spring Public Meeting addressed the critically important issue of mental health policy in the District of Columbia’s criminal justice system. National and local mental health policy experts, panelists, and community advocates discussed the pressing need to improve and enhance mental health policy and services, and provided information about mental health-focused programs and resources available to District residents. Additionally, members of the public in attendance had the opportunity to share their experiences with criminal justice system responses to persons who are mentally ill, in recovery, or receiving treatment.
The audience consisted of a cross-section of individuals, including vendors, community resource providers, public officials, community advocates, and concerned citizens.
CJCC Executive Director Mannone Butler welcomed attendees to the public meeting and introduced CJCC Co-Chairs, Kevin Donahue, Deputy City Administrator and Deputy Mayor for Public Safety and Justice, and Nancy Ware, Director, Court Services and Offender Supervision Agency (CSOSA), each of whom provided opening remarks.
A Father’s Illness: A Daughter’s Task
Lyn Twyman, a community advocate and social activist, shared a powerful testimonial detailing the struggles and hardships she faced as a child growing up with a father diagnosed with schizophrenia. Her father’s illness led to transience, dysfunctional behavior, and eventual involvement with the criminal justice system. With a lack of any reentry or wraparound services for her father, it fell to Lyn to act as caregiver.
Addressing the public officials and service providers in attendance who work with clients with behavioral or mental health issues, Lyn asked them to always remember the children of persons with these issues, who are also victims and are deeply affected by the mental health issues of family members. Lyn shared the following takeaways from her experiences:
- Families dealing with mental illness can never have too much support, especially when children are involved;
- The criminal justice system must improve its responses for the mentally ill, especially for those who have demonstrated a commitment to being non-violent;
- Treatment is vastly superior to detention or incarceration; and
- The criminal justice system needs a new progressive approach for the mentally ill, which includes more wraparound services for families.
Discussion Panel #1: Mental Health Perspectives
Councilmember David Grosso (At Large)
Bob Bernstein, President and CEO, Bazelon Center, Mental Health Policy Advocate
Peter Earley, Author, Journalist, Parent
Councilmember David Grosso moderated the panel, and stated that over the course of the last year he has taken tours of District mental health facilities, as well as the DC Jail. During these visits, he learned about the impact that the criminal justice system has on mental health services. He added that the solution to the District’s mental health challenges will involve early diagnosis, particularly in schools to identify mental health issues in children, as well as the availability of more robust mental health services.
Bob Bernstein provided historical perspective on the national mental health civil rights movement, as well as the trend towards marriage between mental health and criminal justice. Concern over the poor treatment of persons in state hospitals for the mentally ill, as well as the civil rights advocacy agenda, led to the deinstitutionalization of mental illness. However, the community services that were intended to address mental illness in the wake of deinstitutionalization proved to be inadequate. This has led to large numbers of homeless persons suffering from mental illness, who have routine contact with law enforcement, and suffer negative outcomes when incarcerated. The modern approach to mental health policy incorporates:
- Meaningful community integration
- Greater access to community-based services and supports
- Assertive community treatment
- Mobile Crisis Services and walk-in centers
- Supported employment and housing
- Intensive case management
- Greater understanding of the effects of neglect, and abandoning the idea that those persons with mental illness who are incarcerated need to be locked up somewhere.
Author and Journalist Peter Earley shared his son’s story and struggle with bipolar disorder, and the criminal justice and mental health systems’ inadequate responses to his son’s needs. Many jails across the country have become de facto mental health facilities. According to Mr. Early, progressive cities such as the District of Columbia are implementing innovative programs, such as the mental health court, MPD’s Crisis Intervention Team training, and identification of persons in jail who need mental health services. However, without community services and supports, and access to medication, the effectiveness of these programs is undercut.
The panel discussion yielded the following proposals for improving mental health services and outcomes for persons with mental health needs:
- Increase funding to community-based mental health programs, which are currently underfunded
- Increase awareness of the federal requirements for service provision to persons with mental health needs under the Americans with Disabilities Act (ADA)
- Increase awareness that community treatment is a less expensive option than incarceration
- Improve early identification of, and services support for, children with mental health needs in schools
Discussion Panel #2: Federal/Local Strategies and Initiatives
Councilmember Yvette Alexander (Ward 7)
Beth Mynett, MD, Medical Director, DC Department of Corrections (DOC)
Kimberly Missouri, Assistant Chief, Metropolitan Police Department (MPD)
Honorable Melvin Wright, Presiding Judge, Mental Health Community Court, DC Superior Court (DCSC)
Barbara Bazron, Ph.D., Interim Director, Department of Behavioral Health (DBH)
Linda McGrew, Assistant Director, Federal Bureau of Prisons (BOP)
Malcolm Woodland, Court Social Services Division of the Superior Court (CSSD)
This panel provided information on the mental health strategies and program availabilities of local and federal criminal justice agencies. Councilmember Yvette Alexander, who is chair of the Committee on Health and Human Services, moderated the panel, and informed attendees of the Council’s efforts to ratify the Behavioral Health Coordination Act of 2015. This act will enhance the coordination of care and the sharing of medical information to improve the treatment of mental illness.
Beth Mynett stated that 25% of the DOC jail population is diagnosed with a serious mental health condition. Approximately 35% of these persons have a co-occurring drug disorder. The DOC has a crisis intervention and mental health unit, which receives training on identifying behavioral and mental health disorders. DOC plans on the development of a self-injurious behavior management team as well. DOC partners with DBH in conducting screenings of inmates for substance abuse and mental health issues.
Kimberly Missouri stated that MPD offers training for its officers through the Crisis Intervention Officer (CIO) Program. Participating officers receive training that incorporate best practices from jurisdictions across the country in order to respond to crisis calls involving individuals with mental illness, de-escalating situations, making appropriate dispositions, and utilizing community-based resources for individuals experiencing mental health crises. Training for officers is voluntary, and officers who receive the training receive no additional compensation. Demand for these training sessions is high, and all available training sessions are at capacity.
Judge Melvin Wright provided information on the DCSC Mental Health Community Court (MHCC). The MHCC works with prosecutors, defense lawyers, court personnel, and pretrial services, all working in conjunction to act in the best interest of defendants, and public safety. Judge Wright noted that the cost of treatment per year for persons with mental health needs is somewhere between $5,000 and $10,000, whereas the cost of one year of incarceration is between $35,000 and $40,000. The cost savings in providing mental health treatment is further evidence of the need for increased funding to mental health services. Judge Wright noted that housing, transportation and employment are the primary barriers for those who come before the MHCC.
Dr. Barbara Bazron informed attendees that DBH offers an array of services and supports to those with mental health needs or substance abuse disorders, including prevention treatment and recovery. DBH has implemented a process for incorporating mental health screenings for children that are now part of routine health checks. Through the Behavioral Juvenile Diversion Program, DBH offers youth with status offenses the option of avoiding detention by going into mental health treatment, with the consent of the youth’s parents/guardians. DBH also staffs an urgent care clinic located within the DC Superior Court, and has a 24-hour ACCESS Help Line telephone line staffed by behavioral health professions who can refer callers to immediate help or ongoing care. The phone number is 1(888)-793-4357 or 1-888-7WE-HELP.
Linda McGrew stated that the Federal Bureau of Prisons (BOP) uses evidence-based programs and individualized treatment for persons with mental health needs, offering mental health services, drug programs, and residential reentry management. BOP has updated its contract with its halfway houses to ensure continuity of care from services received within BOP facilities to those received outside upon release.
Malcolm Woodland (CSSD) works in the Child Guidance Clinic at the Superior Court, which conducts court-ordered psychiatric evaluations for young people in the District. CSSD screens all youth that are referred to the agency. The Child Guidance Clinic conducts about 1000 evaluations per year. 50% of young men and 60% of young women evaluated meet the criteria for at least one mental illness. Dr. Woodland also stated that CSSD has partnered with other agencies to create a juvenile mental health court, which boasts a 7% recidivism rate for its young participants. The recidivism rate for youth outside of the mental health court is 40%.
The panel discussion and subsequent public question and answer session yielded the following proposals for improving mental health services and outcomes for persons with mental health needs:
- Increasing availability of community housing options for those with mental health needs
- Increasing wraparound services and crisis intervention supports
- Improve interagency collaboration and coordination of resources
- Appeal to council members and government officials to increase funding for much needed mental health resources
- Increasing family support services for the family members of persons with mental health needs
Establishment of an online database resource for mental health services.
- The CJCC has an online database called the CJCC Resource Locator, which was developed under the auspices of its Substance Abuse Treatment and Mental Health Services Integration Taskforce and in collaboration with the Public Defender Service and the Pretrial Services Agency. This database lists many behavioral health resources available in the District. The website for the Resource Locator is: www.cjccresourcelocator.net. Community organizations and government agencies are encouraged to use the resource and provide additional information on available resources to the CJCC.