Texas Health and Human Services, TX

Action Areas Diversion Mental Health Substance Abuse

Last Updated

Background & Approach

The Texas Health and Human Services Commission (HHSC) is collaborating with 13 local mental health authorities (LMHAs) to support community-based solutions for expanding or strengthening mental health crisis response and jail diversion. These 13 LMHAs serve North and West Texas and participate in All Texas Access as the North Texas State Hospital Regional Group and Big Spring State Hospital Regional Group, respectively. These regional groups of LMHAs work together to strengthen mental health care access and services in rural areas, providing access when and where it is needed, with the goal of reducing mental health crises that result in emergency room use, incarceration, transportation to mental health facilities, and other costs to local government. Texas is particularly interested in further strengthening partnerships between the behavioral health and the criminal justice systems in rural communities, since 70 percent of Texas is rural.

HHSC will support each LMHA in identifying at least one crisis response or jail diversion strategy that would work most effectively in their community. HHSC is particularly interested in law enforcement drop off or diversion centers, integration of behavioral health crisis staff in 911 dispatch centers, and the use of technology to support crisis services in Texas’ most remote areas. These strategies would complement services already offered by each LMHA, including 24/7 crisis hotlines and mobile crisis outreach teams. Participation in IMPACT also contributes towards HHSC’s implementation of Texas’s new strategic plan, Well and Safe: the Texas Strategic Plan for Diversion, Community Integration, and Forensic Services.

Lead Agency

Texas Health and Human Services Commission

Contact Information

Robert Dole, LCSW-S
Deputy Associate Commissioner

Dr. Jennie M. Simpson
State Forensic Director

Orange County, CA

Action Areas Diversion Mental Health

Last Updated

Background & Approach

With over 3 million people and 34 cities, Orange County California is the sixth most-populated county in the United States and is more populous than 21 U.S. states. Our jurisdiction’s interagency planning group, the Orange County Criminal Justice Coordinating Council (OCCJCC), has focused much of its work to date at Intercepts 3-5, including enhanced in-custody mental health and substance use treatment services, a coordinated reentry process, and a screening and referral system to connect probationers to the newly opened (March 2021) Behavioral Health Services Campus, BeWell OC.

We are hoping to initiate further reform at Intercepts 1-2 through a joint effort led by the District Attorney’s Office as the connection point to each of Orange County’s police departments. Our plan is to start a pilot program with the selected jurisdictions and police departments, building outcome and evaluation data that then can be used as justification to request further resources for countywide expansion.

Lead Agency

Orange County District Attorney’s Office

Contact Information

Jess Rodriguez
Supervisor, Mental Health Unit, Orange County District Attorney’s Office
jess.rodriguez@da.ocgov.com

Partners

Orange County Health Care Agency; Social Services Agency; Irvine Police Department; Orange County Sheriff’s Department; Seal Beach Police Department; University of California, Irvine

Eau Claire County, WI

Action Areas Diversion Mental Health

Last Updated

Background & Approach

Eau Claire County’s primary challenges, among many, will be aligning mental health services upfront in real time to include government and community support to this approach.

We will focus on key community and system partners who need to be engaged in sequential intercept mapping to identify gaps, set goals, and determine strategies to reach those goals. Once this is done, we need to build diversion options such as specialty crisis facilities with the focus on diverting away from jail or the criminal justice system and refocus towards community solutions.

Lead Agency

Eau Claire County Criminal Justice Collaborating Council

Contact Information

Tiana Glenna,
Tiana.glenna@co.eau-claire.wi.us

Partners

Criminal Justice Collaborating Council, County Administrator, District Attorney, Wisconsin State Public Defender, County Board Supervisor, Police Department, Sheriff’s Department, Jail, Department of Human Services, Jail Health Nurse, Department of Corrections, Community treatment provider, County mental health clinic

San Juan County, NM

Action Areas Diversion Mental Health

Last Updated

Background & Approach

As part of the Impact Network, San Juan County is committed to addressing the lack of resources available to Law Enforcement when officers are called to handle individuals in a mental health crisis. Currently, the hospital is the only place where the immediate need can be addressed. Unfortunately, far too often these individuals are released and later arrested with criminal charges, resulting in detention stays.

San Juan County plans to work closely with community stakeholders to create a Sequential Intercept Model that will identify the gaps in services available to individuals with mental health issues. In addition to the gaps, the county is interested in identifying the services that are available to treat mental health issues and how these services can best be utilized to provide care and treatment to those individuals needing assistance. As part of development of the SIM, the county plans to identify a system for data collection that will assist stakeholders in tracking the needs in the county as well as the ability to use that information to apply for funding for a Mental Health Drop In Center.

Lead Agency

San Juan County Behavioral Health Services Department

Contact Information

Su Hodgman
San Juan County Behavioral Health Services Dept

Partners

San Juan County Sheriff Dept. District Attorney’s Office, Public Defenders Office, 11th Judicial Court and Problem-Solving Court Programs, Adult Detention Center, Farmington Police Dept.

Middlesex County Working to Solve the Question of “Divert-to-What?” Through Stakeholder Collaboration

By: Peter J. Koutoujian, Danna Mauch, PhD

Diversion Frequent Jail Users Homelessness Interagency Collaboration Mental Health Substance Abuse December 2, 2021

For years we have witnessed an increase in the number law enforcement interactions with individuals in the community with unaddressed behavioral health challenges. Conversely, there remain far too few alternatives to unnecessary arrest or transport to the emergency department.

Middlesex County, in Eastern Massachusetts, is New England’s most populous county. Our criminal justice and behavioral health leaders recognized the need improve capacity and access to behavioral healthcare in the community. In 2018, the Massachusetts legislature created the Middlesex County Restoration Center Commission to develop a pilot that would help solve the “divert-to-what?” question. In Middlesex County, the sheriff’s office offers evidence-based programing and treatment for incarcerated individuals, but individuals should not have to go to jail to receive the services they need.

We are grateful to have recently been invited to join the Safety and Justice Challenge’s new IMPACT behavioral health cohort, to share some of the lessons we have learned, and learn from our partner jurisdictions in this impressive network. The Commission has just entered its fourth year of work, and our path forward will be made easier through this tremendous peer exchange opportunity.

One of the biggest lessons we have learned, and hope to pass along to our partner jurisdictions, is the importance of improving collaboration and communication across siloed fields like public safety and behavioral health. All too often, addressing behavioral health needs of the community remains in traditional agency siloes. From the sheriff’s office to mental health service providers and police departments to peer and advocacy organizations, it is only this kind of collaboration that is able to stop people from falling through the cracks.

Middlesex County has 1.6 million people with 54 different police departments spread across urban, suburban, and rural areas. We are fortunate to have the progressive leadership of our police chiefs focused on diverting individuals away from the criminal justice system and into treatment. Similarly, we are fortunate to have a health and human services community poised to step up to increase outreach and engagement, to partner with public safety, and to provide appropriate assessment, treatment, stabilization, and support services to affected individuals.

In an effort to shift the responsibility back to the behavioral health community, we knew it was necessary to develop a model that knit together services in a way that made them easily accessible to both the public and local law enforcement. We wanted to move away from the traditional model of stabilization and release from the emergency department. The Restoration Center will offer both stabilization as well as a comprehensive assessment to inform referral to treatment so the needs of individuals can be appropriately met. Our goal is not only to stop the cycle of unnecessary incarceration but also to help individuals stay healthy enough that they do not have to return to the center.

After years of planning and implementation our goal is to launch a pilot Restoration Center in 2022. We believe we are well positioned to launch the model we have developed in large part due to our commitment to the cross-sector planning process which started with identifying gaps in the delivery of behavioral healthcare, a cost-benefit analysis, and interviews with individuals with lived experience. Through our state legislature, we were successful in securing initial funding as well as a trust fund that will allow the Commission to accept third-party funding.

Now that the Commission’s 2022 budget includes $1 million in funding for the pilot – endorsed by a recent editorial in the Boston Globe, we can begin our work of identifying a provider. We continue to pursue additional funding to ensure that we can implement a full range of services identified as critical to the success of individuals who might otherwise be arrested or hospitalized.

The center will provide behavioral health services to individuals in mental health or substance use crisis. These services will help support ongoing law enforcement efforts across the county to divert individuals with behavioral health conditions from arrest or unnecessary hospitalization.

Local law enforcement and corrections have shouldered this burden for far too long, with over 70 percent of people in our Middlesex Jail & House of Correction having an open mental health case and 80 percent have a history of substance use.  Each and every one of these individuals receives treatment while incarcerated, but these are services that people should be able to access in the community. Our hope is that the Restoration Center will help stop the cycle of unnecessary incarceration.

We attribute a lot of the success of the Middlesex County Restoration Center Commission to the commitment of our diverse stakeholder group. It is not common to have a sheriff co-chair a legislative commission with the president of a mental health advocacy group. It is also unusual to get representatives of the 80 largest behavioral health providers at the county, police chiefs, the chief administrative justice of the trial court, and key state legislators at that table. And sustaining the focus on a challenging goal for over three years is the rarest thing of all. But that is what it takes.

Unfortunately, political will is often the hardest thing to secure. But we owe it to the people falling through the cracks to get it right.