Post on 01-Feb-2020
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.
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With thanks to our founders
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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
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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
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Where to begin? Priorities?
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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!
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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.
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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.
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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
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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
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Common themes & trends
Childhood
Health Care
Education
Employment
Housing
Public Safety
Justice
Corrections
Reentry
Data
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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
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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.
1 of 9 recommendations
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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.
1 of 7 recommendations
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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.
1 of 3 recommendations
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HOUSING
EXPAND integrated housing programs to support individuals with complex health needs.
1 of 3 recommendations
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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.
1 of 6 recommendations
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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.
1 of 9 recommendations
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CORRECTIONS
EXPAND case management within corrections before parole to ensure continuity of care, successful community integration, and department accountability for improved outcomes.
1 of 5 recommendations
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REENTRY
PARTNER across sectors to ensure continuity of access to services and resources individuals need to stabilize and thrive in the community.
1 of 7 recommendations
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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.
1 of 2 recommendations
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Summary of Legislative Successes in Colorado
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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.
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Legislative Successes in 2018
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.
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Legislative Successes in 2019
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
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Questions?
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Final Remarks
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Read the Full Colorado Course Corrections Document
WWW.EQUITASPROJECT.ORG/COLORADO-COURSE-CORRECTIONS-2019/
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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.
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Visit EquitasProject.org
Follow @EquitasProject
CONTACT:
VINCENT ATCHITY
VATCHITY@EQUITASPROJECT.ORG
GWENDOLYN WEST
GWEST@EQUITASPROJECT.ORG
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