Credit Claims For Kansas Legal And Criminal Justice Professionals: Legal Considerations For Career Advancement – Recruiting clinicians to work with criminal justice agencies through different intercepts in the justice system is one way jurisdictions are working to improve their response to people with mental health needs. Using the sequential intercept model as a starting point to identify where clinicians can be employed, this brief article highlights ways in which embedded clinicians can support mental health and criminal justice partnerships. It also provides specific examples of Justice and Mental Health Collaborative Program beneficiaries who have successfully implemented integrated treatment programs throughout the criminal justice system. Photo Credit: cottonbro from Pexels
Across the country, jurisdictions are working to improve their response to people with mental health needs who end up in the criminal justice system. One important way to achieve this goal is to recruit doctors to work with criminal organizations through different intercepts in the legal system. By doing this, embedded physicians can help these organizations develop new strategies and provide direct intervention when needed.
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This brief highlights ways that embedded clinicians can support mental health and criminal justice partnerships at various points within the criminal justice system. Using the Sequential Intercept Model1 as a starting point to identify where clinicians can be recruited to help identify, refer and provide direct care for people with mental health needs, the brief also includes specific examples of Justice and Mental Health Collaborative program beneficiaries who have successfully implemented treatment-embedded programs throughout the criminal justice system.
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The Sequential Intercept Model (SIM) identifies six intercepts of the criminal justice system.2 It can be used as a strategic tool to examine how a person moves through the justice system. The SIM can also help stakeholders make decisions about where to recruit clinicians to support people with mental health needs entering or ending up in the criminal justice system.
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As communities seek to improve their crisis services through initiatives such as emergency response programs, mobile trauma teams, and crisis stabilization units, embedded clinicians can be hired to help identify and direct calls for services. One option is to hire a physician as a member of a 911 or other non-emergency dispatcher to help look for mental health-related problems and determine the appropriate response. These doctors are also sometimes available to resolve emergency calls over the phone without having to send someone to the scene. Law enforcement will typically determine the level of public safety risk before coordinating a medical response. However, when necessary, on-site responding physicians may also provide screening to determine immediate level of care or need for further evaluation based on screening results. After a crisis, embedded clinicians can provide ongoing case management and treatment to address mental health needs and help reduce future ED contacts.
Monroe County created a Forensic Intervention Team (FIT), which includes embedded medical professionals within law enforcement. FIT clinicians serve as the primary point of contact for triage calls and connecting people with mental health resources. They also provide on-site crisis intervention, mental health screenings and post-crisis care, including case management and referrals for services. In addition, the Monroe County Office of Mental Health has partnerships with community mental health agencies, including a commitment to accepting referrals from FIT and offering rapid access to care.
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Doctors embedded in county jails play a key role in initial bookings by screening and evaluating people to help determine if they have any mental health needs. This early identification can help better connect people to care while incarcerated and/or determine potential options for diversion from prison. For example, doctors can provide important behavioral health information to the court to help inform legal and treatment decisions. They can also provide evidence-based interventions through individual or group therapy while the person is in the facility to help them prepare for re-entry.
When integrated into the court system, clinicians can be employed to provide the court with updates on an individual’s progress and challenges; they can also assist the court in developing a plan to help the individual meet the legal and treatment requirements to resolve their case. In treatment courts, clinicians serve as liaisons between the court and the treatment team, as well as advocates for people under court supervision.
In Colorado, the statewide Bridges Program places behavioral health professionals in each state judicial district to act as court liaisons and facilitate assessments and connections to needed care. The court liaisons also work to ensure that judges, prosecutors and defense attorneys are informed about mental health services available in their communities. These services may include resources and support for defendants who have been ordered to undergo competency evaluations and people who need competency restoration services.
During a reentry program, resident physicians may serve in different roles, including as a discharge planner, primary case manager, or direct caregiver. In any role, clinicians help connect people with community-based treatment options, family, religious and community support, as well as other resources that can aid their transition into society. During a pre-release program, clinicians often have the opportunity to help develop a collaborative comprehensive case plan to identify the types of support the person will need when re-entering the community. In addition, most jurisdictions have the ability for clinicians to identify and connect the person to appropriate community support while they are still in custody.
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In Franklin County, the Sheriff’s Office has on-board doctors who provide re-entry services to all individuals leaving the jail. Reentry Case Workers (RCWs) interact with people during and after release to help navigate re-entry and address barriers such as transportation and housing. RCWs connect people to wrap services in partnership with therapists.
The State Council’s Justice Center offers free in-depth subject matter expertise and can answer questions about incorporating clinicians into mental health and criminal justice systems. Visit the Center for Justice and Mental Health Partnerships to learn more.
Strategy Lab includes more than a hundred examples of jurisdictions working to reduce the number of people with serious mental illness in their prisons.
The Taking the Call website offers video recordings from the October 2021 National Conference on Community Response Models, as well as additional resources designed to help communities build effective and comprehensive emergency systems.
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The Expanding First Response Toolkit serves as a central hub for local communities and states seeking to establish or strengthen community response initiatives.
2 These intercepts indicate how a person with mental health or substance abuse enters the justice system from the community, moves through the system, and eventually returns to the community. The six intercepts are: Intercept 0-Community Services; Intercept 1-Law Enforcement; Interception 2-First Detention/First Court Hearings; Intercept 3-Prison/Courts; Intercept 4-Reentry; Hlera 5-Community Control. See Policy Research Associates, The Sequential Intercept Model.
This project was supported by grant no. 2019-MO-BX-K001 awarded by the Bureau of Justice Assistance. The Justice Department’s Office of Justice is part of the Department of Justice’s Department of Justice programs, which also include the Justice Department’s Bureau of Statistics, the National Institute of Justice, the Office of Juvenile Justice and Delinquency Prevention, the Office for Victims of Crimes, and the SMART Office. The views or opinions expressed in this document are those of the authors and do not necessarily represent the official position or policy of the US Department of Justice.
Ethan Kelly provides technical assistance to grantees who work with people who have co-occurring substance abuse and mental illness and who are involved in the criminal justice system. Prior to joining the CSG Justice Center, Ethan was a Clinical Instructor and Trainer … for Behavioral Health/Criminal Programs, managed a pretrial mental health program, and provided training on mental health, critical incident stress management, and crime risk. He earned a BSW from Southern Connecticut State University and an MSW from Fordham University. Read more
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Andrea Chambers provides administrative, operational and programmatic support to the Behavioral Health Unit at the Council of State’s Judicial Center (CSG). Prior to joining the CSG Justice Center, Andrea served as the Master Research Fellow for the Health Communication … Research Laboratory (HCRL) at the Brown School at Washington University in St. Louis. At HCRL, Andrea assisted the lab with innovative and community-based research through health policy analysis and data management. Andrea earned a BA in International and Regional Studies from Washington University in St. Louis and is currently completing an MPH in Health Policy Analysis at the Brown School at Washington University in St. Louis. Louis. Read more
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