Video   Slides   Program

Summit Components:

^{Click to expand each section of the agenda to find video, speaker biographies, and supplemental documents.}

• Welcome and Opening Remarks

  Speakers:

  Steven Mays
  Diversion Administrator and Liason to the Michigan Mental Health Diversion Council - Michigan Department of Health and Human Services

  Steven Mays is the Diversion Administrator for the Behavioral Health and Developmental Disabilities Administration through the Michigan Department of Health and Human Services.  Steven was hired by Genesee Health System (formally Genesee County Community Mental Health) in 1992 and for almost 22 years worked in a number of clinical positions, most recently as clinical liaison working specifically with law enforcement, hospitals and the court system that designed and implemented Michigan's first adult Mental Health Court.  As Diversion Administrator with the Michigan Department of Health and Human Services, Steven works as the Liaison to  the Michigan Mental Health Diversion Council and consults in devising and implementing strategic goals to help divert persons with mental illness from jails and in to treatment on a statewide basis and acts as a boundary spanner connecting agencies across the state to assist with common goals and directives. 

   

  Dr. Debra Pinals, M.D.
  Medical Director of Behavioral Health and Forensic Programs, DHHS Designee to the Michigan Mental Health Diversion Council - Michigan Department of Health and Human Services

  DEBRA A. PINALS, M.D. is the Medical Director of Behavioral Health and Forensic Programs for the Michigan Department of Health and Human Services (MDHHS) and Director of the Program in Psychiatry, Law, & Ethics and Clinical Professor of Psychiatry at the University of Michigan Medical School and Clinical Adjunct Professor at the University of Michigan Law School. Dr. Pinals serves as the MDHHS designee on the Michigan Mental Health Diversion Council. Her prior roles have included serving on the Statewide Prescription Drug and Opioid Abuse Commission from 2016 to 2018.  Prior to coming to Michigan in 2016, she served Assistant Commissioner of Forensic Services as well as the Interim State Medical Director for the Massachusetts Department of Mental Health where she oversaw law enforcement CIT grant development, co-responder programs and other training and diversion initiatives as well as court clinic forensic services, and reentry initiatives in partnership with jails and the Department of Correction related to the needs of persons with mental illness. She has worked in outpatient, inpatient settings, forensic and correctional facilities, emergency rooms and court clinics, has received public service awards and has been an expert witness in many cases. She is Board Certified in Psychiatry, Forensic Psychiatry, and Addiction Medicine. During her career she has consulted on complex systems cases for people with mental illness, substance use disorder, and Intellectual and Developmental Disabilities who are receiving treatment or support in various places- such as in state hospitals, community and justice and forensic settings. She teaches and publishes extensively and has led and consulted on numerous federal grants including those related to opioids, juvenile justice, and behavioral health and justice partnerships. Recently she has been a lead subject matter expert on issues pertaining to competence to stand trial for the SAMHSA GAINS Center. She is a past President of the American Academy of Psychiatry and the Law, current Chair of the American Psychiatric Association Council on Psychiatry and the Law, and current Chair of the Medical Directors Division and past Chair of the Forensic Division for the National Association of State Mental Health Program Directors (NASMHPD). 

• Data and Evaluation Presentation
  Comparing Outcomes of Stepping Up Counties to Jail Diversion Pilots

  Stepping Up is a national initiative to reduce the number of people with mental illnesses in jails and is the result of a collaboration between the National Association of Counties, The Council of State Governments Justice Center and the American Psychiatric Association Foundation. 
  
  Through support of the Michigan Mental Health Diversion Council (MMHDC) and the Michigan Department of Health and Human Services, the Wayne State University School of Social Work Center for Behavioral Health and Justice (CBHJ) provided technical assistance to five Michigan counties navigating the Stepping Up framework during the 2018-2019 fiscal year: Charlevoix, Genesee, Jackson, Muskegon, and Washtenaw. This presentation describes CBHJ Stepping Up Technical Assistance and provide a brief summary of the CBHJ's recent report comparing aggregated data from the five Stepping Up Counties to aggregate data from the ten Jail Diversion counties. 

  Presentation by:

  Erin Comartin, Ph.D.
  Data Director - Center for Behavioral Health and Justice
  Associate Professor - Wayne State University School of Social Work

  Erin Comartin is an Associate Professor of Social Work at Wayne State University and the Data Director for the Center for Behavioral Health and Justice. Since 2005, her social work practice experience and research expertise has focused on policy, systems, and program interventions for vulnerable populations in the criminal/legal system. As part of the evaluation team funded by the Michigan Mental Health Diversion Council and the Michigan Department of Health and Human Services to assess jail diversion pilot sites, she helped local mental health and criminal/legal partners collect data to uncover best practices in jail diversion. The knowledge discovered through these pilot sites has led to the provision of technical assistance to new Michigan communities through the Stepping Up Initiative. Comartin's most recent research findings on these projects have been published in Criminal Justice and Behavior, Journal of Correctional Health Care, and The Prison Journal.

  Send us an email if you would like to get connected to the CBHJ Data Dashboard project.

  Supplemental Documents:

  •  Stepping Up Technical Assistance: Data Outcomes and Technical Assistance Processes Across Five Stepping Up Counties
• Panel #1: Enhancing Deflection and Diversion for Individuals with Serious Mental Illness
  (Intercept 0)

  Deflection (pre-arrest) directs an individual to behavioral health intervention without arresting or processing the individual into the criminal/legal system. Diversion (post-arrest) offers an individual who has entered the criminal/legal system an opportunity to avoid prosecution or sentencing or reduce jail days by taking part in treatment. Speakers for this panel touch upon methods for enhancing deflection and diversion for individuals with Serious Mental Illness, such as implementing a referral system, addressing high utilizers, developing co-responder models, and identifying alternative drop-off locations.

  Moderated by:

  Liz Tillander, LMSW
  Deputy Director - Center for Behavioral Health and Justice

  Liz has served as project director for Dean Sheryl Kubiak on several local, state, and national evaluation projects since 2008. After nearly 19 years in the business field, Liz was motivated by an interest in social justice and the desire to stem the cycle of incarceration for marginalized women and men to pursue a degree in social work. Building upon her business career, she brings a wealth of experience in networking and collaboration, outcome measurement and evaluation, program and staff development, finance and administrative management, and data-driven solutions to the field of social work.

  Panelists:

  Major Troy Goodnough
  Major of Jail Operations - Monroe County Sheriff's Office

  Major Troy Goodnough is a 30 year veteran of the Monroe County Sheriff's Office. In 2013, he was promoted to Major of Jail Operations after working nearly 23 years in the Patrol Division. Shortly after assuming responsibility of the Jail Division, Major Goodnough discovered the lack of Mental Health resources available to the inmate population. He developed a partnership with various community partners including Monroe Community Mental Health. It didn't take long for the partnership to develop into a thriving, cohesive team of five employees including clinicians and peer support staff who work daily in the jail to ensure mental health treatment for inmates while incarcerated and prepare a discharge plan to ensure the continuity of care upon discharge. Major Goodnough also developed a partnership with the local Department of Health and Human Services to facilitate speedy reactivation of services when an inmate is released from custody.

  
  Sojourner Jones, LBSW, M.P.A.
  Community Liaison for Law Enforcement - Detroit Wayne Integrated Health Network

  Sojourner Jones has been working in the field of mental health for over 25 years. Affectionately known as the "Fixer". The majority of her tenure has been serving those persons who have been clinically diagnosed as severe and persistent mentally ill; many who have substance addictions and/or interaction with criminal justice involvement.  She has worked for the Detroit Police Department (twice), Michigan Department of Corrections (twice) most known for coordinating all after care plans for returning citizens in Wayne County who received mental health services while incarcerated.  The U.S. Attorney of Eastern District of Michigan and several non-profits.  Her current position was created just for her. The Community Liaison for Law Enforcement with Detroit Wayne Integrated Health Network (formerly Detroit Wayne Mental Health Authority). Her role is to assist law enforcement and the courts in addressing the behavioral health issues of those who come to the attention of the justice system.  Work to resolve structural issues, communication glitches, and consistent patterns between law enforcement, courts and community mental health treatment providers.  Serving as the conduit between the courts, hospitals and treatment provider ensuring compliance of civil commitment procedures (Kevin's Law). Explore other avenues to engage the most complex/difficult consumer with treatment/medication adherence abuse from jail and /or to reengage them with community mental health services.  In addition, she trains the Detroit Police Department and surrounding first responders on de-escalation techniques for engaging those persons who may be experiencing a mental illness. She has served on several panels, numerous committees and task forces on crisis interventions, suicide prevention, law enforcement, jail diversion, including SAMHSA.  She is a college graduate from Central Michigan University (MPA) and Michigan State University (BS).  She is the mother of two children. One son (Ishmael) and a daughter (Mikalaha).  She is an avid golfer, loves to sing, travel and indulge in retail therapy.  She is a member of the Alpha Kappa Alpha sorority incorporated ®, a Lifelong Member of the NAACP, and The Historic Little Rock Baptist Church.  

   

  Brian Swiecicki
  Executive Director - Genesee Community Health Center (GCHC)
  VP of Business Operations - Genesee Health System

  Brian Swiecicki has been working within the health care system for over 30 years. During his career, his vast experience has included clinical as well as administrative positions. He is currently Genesee Community Health Center's (GCHC) Executive Director. GCHC is a Federally Qualified Health Center offering physical healthcare, mental healthcare, substance use disorder treatments, and dental care. As Director, he oversees all functions of the Health Center including grants and budget, services, community involvement and certifications. Mr. Swiecicki also holds the title of Vice President of Business Operations for Genesee Health System, GCHC's parent organization. There, he oversees finance, contracts and access to services, as well as being a liaison with the state and regional oversight entities. He has lead the development of crisis residential facilities, a sobriety facility and the merger of the Coordinating Agency for Substance Abuse Services into Genesee County Community Mental Health (now Genesee Health System.). He led the redesign of multiple programs and services which have assisted individuals to live more independently and have a higher standard of quality in their lives. He also worked on developing the Genesee County Mental Health Court, Jail Diversion, and Prison Re-entry programs. Mr. Swiecicki is a graduate of Central Michigan University. He sits on many community boards and planning committees that focus on community projects that provide assistance to those GCHC and GHS serves.

  Supplemental Documents:

  • Recommended Best Practices for Jail Diversion for Individuals with Mental Health Disorders
  • Alternative Drop-off Locations for Individuals with Serious Mental Illness
  • Michigan Joint Task Force on Jail and Pretrial Incarceration Final Report and Recommendations 
• Panel #1: Q&A

  Do you have people sign ROI for the mental health referrals prior to making them?
  Not at the time of law enforcement contact. (Major Goodnough)

  Is the "urgent care" center limited to <24 hour stays opposed to a crisis stabilization unit?
  The facility we have identified has wings to it. One of the wings will be a 23-hour setting where people can obtain medication while being observed by peers and clinicians. They can work through their issues through solution focus or brief therapy at that time. However, it also has wings we are developing so you'll be able to move into the crisis residential unit or sobriety facility. Our sobriety facility is a place where individuals who are intoxicated can spend 23-hours to sober up from whatever substance they may be on. We also hope to have a subacute detox center within that facility as well. (Brian Swiecicki)

  Who staffs the sobriety facility?
  Mostly peers. They work with the individual to help them and encourage them in the morning to seek and be screened for services.   We are located near the Hospital and can transport to the ED if any emergencies do happen. (Brian Swiecicki)

  Do you have psychiatry in the 23 hour facility?
  We will have Psychiatry prescribers (Psychiatrist or PsyNP) on site during certain hours. They will cover the walk-in individuals and our crisis residential unit. They will also work with our Crisis Stabilization Team for follow up during time between crisis service and linking to Access and first service. (Brian Swiecicki)

  Can you explain a little more about how you work with local convenience stores and businesses in regards to jail diversion and deflection?
  The beauty of downtown is most of the officers have been there for a while and visit/purchase from the stores frequently. So, in our downtime, we go talk to them and let them know what we are doing here and what we are trying to do. (Sojourner Jones)

  How did you educate all collaborators - law enforcement, central dispatch, etc. - as to these new diversion approaches?
  We provide all law enforcement with mental health first aid training, psychological first aid training, as well as other trainings. (Brian Swiecicki)

  We provide all correctional staff with mental health first aid training. We had a representative from each department attend one crisis intervention training. We plan on holding additional classes next year with the goal to have a significant number of our uniformed law enforcement trained in CIT, and our central dispatch also participates in that training. We also hand out a 3-page document that outlines the encounter and how to handle those situations. (Major Goodnough)

  Our new recruits in the academy receive mental health first aid training and also we have a scavenger hunt in terms of resources at your backdoor. It is very important developing those relationships and knowing who your contact person is at any given time. (Sojourner Jones)

  Are local fire or EMS involved in deflection conversations?
  We actually met with our local fire chiefs and explained to them what our goals and objectives were, so when they arrived on scene, they knew what to expect, as it is a continuous training module. In 2021, we are really hoping to bolster that and meet with each fire department individually and cover a number of training topics from substance abuse disorder, behavioral health, and Narcan. (Major Goodnough)

  We trained our fire and EMS in mental health first aid and suicide prevention. Our officers also have Narcan on-site. (Sojourner Jones)

  We have trained them and provided Narcan kits to all law enforcement as well as first responders. Our hope with the virtual crisis response team will be to expand that to all first responders. (Brian Swiecicki)

  When will the 988 number be in place for mental health emergencies?
  The 988 number was just passed by the FCC. It will become the number for the national suicide prevention lifeline. It is estimated that communities will be using it within 2 years as the main number for all behavioral health emergencies. In Michigan, we are building the Mi-CAL line as a first step to a single number.

  Have you seen a difference or change in involuntary holds of homicidal/suicidal persons?
  Genesee Health System is just starting the Virtual Crisis Law Enforcement ride along.  So at this time we do not have the data to provide an answer to that questions.  But that is our hope and we believe it will offer early intervention to Mental Health Services.   This new program along with others we have implemented is the goal to address Behavioral Health Urgent Care within the community and divert the need for inpatient hospitalization. (Brian Swiecicki)

  With the implementation of the referral form, Mental Health First Aid training and CIT for our officers assigned to the Road Patrol, we saw a significant decrease in individuals with mental health disorder being lodged. (Major Goodnough)

  We have seen a 65% increase with our "familiar faces" engaged with CMH treatment. This population would have normally been petitioned for involuntary treatment if the crisis mobile unit was not in place. In addition, with the implementation of the Crisis Residential Unit decreased petitioning and diverted from inpatient hospitalization as well. (Sojourner Jones)

• Panel #2: Behavioral Health and Crisis Response Training for Law Enforcement
  (Intercepts 0-1)

  Behavioral health and crisis response training for law enforcement and corrections officers is critical to helping officers respond to mental health calls efficiently and identify mental health crises that may or may not be identified at dispatch. This panel begins with MCOLES Director Tim Bourgeois introducing MDHC efforts, followed by a review of training models being used across the state and how different training models can be used in tandem by departments and jurisdictions.

  Moderated by:

  Liz Tillander, LMSW
  Deputy Director - Center for Behavioral Health and Justice

  Panel Introduction by:

  Tim Bourgeois
  Executive Director - Michigan Commission on Law Enforcement Standards (MCOLES)

  In January 2018, Tim Bourgeois began serving as the executive director of the Michigan Commission on Law Enforcement Standards.  He retired from the Township of Kalamazoo (Michigan) police department on December 31, 2017 after 41 years of service.  Director Bourgeois served the department as a cadet, dispatcher, police officer, undercover narcotics detective, patrol sergeant, detective sergeant, detective lieutenant, captain of operations and since 2003 as its chief of police. Tim is a past president of the Michigan Association of Chiefs of Police and served on several boards and commissions in the criminal justice arena.  While chief, he also held four gubernatorial appointments: to the Council on Law Enforcement and Reinvention; the Michigan Intelligence Operations Center for Homeland Security; the Mental Health Diversion Council and the Michigan Commission on Law Enforcement Standards. Tim has taught at both the graduate and undergraduate levels as well as at professional development and leadership seminars. Tim has an Associate's of Applied Science degree in Law Enforcement from Kalamazoo Valley Community College; a Bachelor of Arts in Public Service Administration degree from Siena Heights College and a Masters of Public Administration degree from Western Michigan University.  He is a graduate of the Kalamazoo Regional Training Academy and the 187th session of the FBI National Academy.

   

  Panelists:

  Dr. William Fales, M.D.
  Professor and Chief, Division of EMS and Disaster Medicine - Western Michigan University Medical School, Medical Director - Kalamazoo County Medical Control Authority, State Medical Director - Michigan Bureau of EMS, Trauma and Preparedness

  William Fales, MD is Professor of Emergency Medicine and Chief of the Division of EMS and Disaster Medicine at Western Michigan University Homer Stryker MD School of Medicine (WMed). Since 1993, Dr. Fales has also served as EMS Medical Director for Kalamazoo County. In 2015, Dr. Fales was appointed to serve in a newly created position of State Medical Director for the Michigan Department of Health and Human Services Division of EMS and Trauma. Dr. Fales has been very involved in training emergency responders in behavioral health emergencies. He has instructed hundreds of law enforcement officers in Crisis Intervention Training. Dr. Fales was a major contributor to the development of the Michigan Crisis Intervention System (MI-CIS), a novel approach to multi-disciplinary behavioral health crisis training including both distance learning as well as in-person enhanced reality-based simulation training. A former paramedic, Dr. Fales, in his role as EMS Medical Director, routinely responds to EMS incidents in Kalamazoo County, including complex behavioral health incidents.   

   

  Meghan Taft, LLP, CAADC
  CIT Coordinator & Community Engagement Manager - Summit Pointe Community Mental Health

  Meghan Taft is the Crisis Intervention Team (CIT) Coordinator and Community Engagement Lead at Summit Pointe Community Mental Health. She also serves as co-chair of the Michigan CIT Committee. Meghan is a Limited Licensed Psychologist and Certified Advanced Alcohol and Drug Abuse Counselor and provided Outpatient therapy services for over 5 years. For the past 3 years, Meghan assisted Calhoun County in developing a robust CIT program and conducts CIT trainings. She has also presented at CIT-International and at numerous other conferences on Calhoun County's CIT program and successes. In 2019, she planned and hosted the second annual Michigan CIT Conference. Meghan currently works with seven different law enforcement agencies in Calhoun County and is currently implementing programs to improve responses to behavioral health crises including the Co-Responder model. Meghan also provides Mental Health First Aid Public Safety training and regular CIT Program Reviews for Officers. As Calhoun County's CIT program continues to grow, Meghan will also provide CIT training for dispatchers and Corrections officers. She is a firm believer in the community benefits of CIT and all it can do to strengthen partnerships and help individuals with behavioral health needs.  

   

  J. Eric Waddell
  Chief Learning Officer, The Cardinal Group II

  J. Eric Waddell is a 20-year public safety professional specializing in public safety communications, training curricula design and instructor development. Eric has designed adult learning-based courses for police service professionals, public safety dispatchers, corrections officers and other government agencies. In addition to curricula development, Eric is a frequent presenter at local and national conferences covering topics ranging from interpersonal communications, effective leadership and mental health response. For the last two years, Eric Waddell and The Cardinal Group II have facilitated Managing Mental Health Crisis training to law enforcement agencies throughout the state of Michigan.
   

  Supplemental Documents:

  • Recommended Best Practices for Jail Diversion for Individuals with Mental Health Disorders
  • Behavioral Health and Crisis Response Trainings for Law Enforcement Officers
• Panel #2: Q&A

  How does or will a department access the new training dollars?
  If the legislature appropriates the funding, MCOLES will reach out directly to all law enforcement agencies to make them aware of the opportunity. (Director Bourgeois)

  Where did the funding come from to train the 61 officers in CIT?
  We had zero funding in Calhoun County for the first three times that we hosted a CIT training. The cost was quite minimal when you include your community in the process. We pulled our local presenters and experts to do that. We were able to get locations donated and food in-kind. The biggest cost is the time of the officers. I think getting officers and departments to begin to realize the impact or maybe other areas they are saving costs, you get more buy-in with your future trainings. (Meghan Taft)

  Who is the main contact for the MICIS training?
  Robert T. Christensen, Program Manager, Department of Emergency Medicine, Western Michigan University School of Medicine, robert.christensen@med.wmich.edumi-cis.org. (Dr. Fales) Learn more

  During this COVID pandemic, are trainings being offered virtually, in-person?
  We have not been able to have any in-person training. (Dr. Fales)

  We have, with Managing Mental Health Crisis, suspended classroom training until we can do so confidently and safely. We are exploring virtual classroom opportunities to mirror the classroom experience as best we can; however, that is a work in process. (Eric Waddell)

  We are moving forward with in-person training and our classroom trainings are a lot smaller. We have taken a lot of precautions and adjusted some of the ways we trained historically. (Meghan Taft)

  To what extent are jail staff included in these trainings?
  We highly encourage their involvement in every class. In our model, we bring in partners and partners throughout the sequential intercept model to train alongside law enforcement and corrections. (Eric Waddell)

  In our program, our jail staff often will present on some topic. In addition, many CIT programs have trained within their corrections. We haven't yet locally in Calhoun County, but with this new DOJ grant and initiative, we are able to expand to our corrections officers, so staff will be highly involved with that training as well. (Meghan Taft)

  We have two operations: one online course specific for correctional officers and we've had a number of correctional officers participate in the online operation and second course where they're integrated with law enforcement and EMS. (Dr. Fales)

• Panel #3: Standardized Screening for Mental Health and Substance Misuse in Michigan Jails
  (Intercept 2)

  The use of standardized screens during jail intake allows facilitates to identify individuals who present immediate risk for harming themselves or others, including high-risk individuals whose symptoms may not be evident to corrections staff. Identification is the first crucial step to preventing potential violence and withdrawal, mitigating risk, and providing treatment. This panel discussion reviews validated screens for mental health issues and substance misuse currently being utilized in facilities across the state, why and how those screens are used, and challenges facilities have faced in implementing standardized screens. 

  Moderated by:

  Liz Tillander, LMSW
  Deputy Director - Center for Behavioral Health and Justice

  Panelists:

  Adam Anastasoff
  Diversion Services Supervisor - Monroe County Mental Health Authority

  As the Monroe County Diversion Services Program Supervisor, Anastasoff has lead with creativity and passion to ensure those who become entangled with the justice system are afforded the tools needed to become successful members of society. Anastasoff has 12 years of diversified experience in the mental health field enabling him to lead a team that can meet the diversified needs of those his team serves. Over the 7 years Monroe has been working on diversion efforts, it has grown from one peer support in the jail to two clinicians and a peer support located within the county jail, a community case manager, a developed and successful mental health court and now the recent addition of Youth Diversion Services. Recidivism has dropped over 10% in Monroe and the percentage of SMI population booked into the Monroe County Jail has dropped from 32% to 12%. The relationship with Monroe Community Mental Health Authority and the Monroe Sheriff's office has been priceless in helping to achieve all these goals. Anastasoff intends to continue leading the diversion efforts in order to continue to create a better, safer and more fulfilled community for the Monroe Community.

   

  Lt. Derek Gaylord
  Jail Administrator - Charlevoix County Sheriff's Office

   

  Renee Wilson
  Director of Community Corrections and Director of Correctional and Reentry Services - Washtenaw County Sheriff's Office

  Renee Wilson has spent the last 22 years working within the corrections field both inside correctional facilities and through community corrections. Renee has been the Director of Community Corrections in Washtenaw County since 2009 and in 2015 also assumed the position of Director of Correctional and Reentry Services for the Washtenaw County Sheriff's Office. Through these roles, she is responsible for overseeing all alternatives to incarceration programs, pretrial services, jail programming and services, population management, and has worked to design, develop, and implement a Reentry program for the Washtenaw County Jail.

  Supplemental documents:

  • Screening for Mental Health and Substance Misuse in Michigan Jails
• Panel #3: Q&A

  Can you explain the role of the peer support? Is that a mental health professional?
  Yes, it is a mental health professional in the capacity of a peer support role. The peer support duties include pulling the K6 reports, finding positive K6/RODS, cross referencing the K6 with our electronic health record, and answering all kites. The peer support is also important in helping individuals housed in the jail who might be having higher emotional responses, as well as helping with court liaison duties. (Adam Anastasoff)

  What is the K6 screening?
  The K6 is a 6-item screen that takes approximately 2-3 minutes to administer. It was designed to detect any past-year diagnosis of a mental disorder, and has been validated in criminal justice settings for men and women to measure psychological distress. When used with a modified cut score of 9, it has been shown to be superior to other instruments for justice-involved females, who are at greater risk for a mental health disorder. When accompanied by self-reported psychiatric medication history, the K6 has been demonstrated to be more effective than alternate screening tools. Learn more

  Is the K6 available in languages besides English?
  Yes! The K6 is available in over a dozen languages. Learn more           

  How are the teams responding to positive K6 and what is the turnaround time on receiving a positive screen until being seen by someone from your agency?
  We found that to be something we did struggle through, we would get a lot of referrals and have a lot of follow-up. For a long time, we had one clinician in the jail and it was pretty overwhelming, so we would have to triage and prioritize the higher scores first and those that were exhibiting symptoms and behaviors currently. We now have a peer support in the jail, and that's been very helpful. For some of the individuals that are determined by the screen with less intense needs, we would have the peer support go and talk and see if there was need for clinical follow-up or if it can be resolved with given resources. (Adam Anastasoff)

  Similarly, we have an amazing partnership with our CMH. We have 5 mental health clinicians on staff that work in the jail fulltime. We do a triage system, so when we do get all those screens we have someone who immediately takes a look at them, triaging based off need. If we have certain emergent situations, we do a full view of an individual and move through the assessments in that manner. But the triage system has proved to be fairly effective in getting those folks engaged as quickly as possible. (Renee Wilson)

  We have not run into a problem of services being overwhelmed due to us being a smaller county. The individuals that are referred, CMH follows through and everybody is seen in a timely fashion. (Lt. Gaylord)

  Have experienced any "down side" to using these standardized assessments?

  I can't say I've seen any down side. I think the challenge upfront was the influx of referrals that we mentioned before. But we figured out a way to navigate that, and also, I would say Major Goodnough and his staff are excellent with the continued training of their staff and their ability to recognize mental health needs, which helps with that triage process as well. (Adam Anastasoff)

  I agree. I think once you get through getting into your jail management system and making screenings part of the booking process, you're able to identify how you're going to use those screens and triage them and move forward with them. I wouldn't see any drawbacks or downside to using these screens. (Renee Wilson)

  In your experience, do jail chaplains play a supportive role in this process at any time?
  While jail chaplains are not involved in the jail intake and screening process, they can provide invaluable support to jail inmates and, in some cases, can supplement the work of behavioral health professionals.

• Panel #4: "Warm Handoff": Using Boundary Spanners for Cross-System Collaboration
  (Intercepts 3-5)

  For individuals with serious mental illness, the hours and days directly following release from jail present a critical juncture for intervention. Boundary spanners facilitate system-wide coordination between the criminal/legal system and the treatment sector and play a crucial role in connecting individuals with serious mental illness to services. Boundary spanners foster communication between community mental health agencies and county jails through strategies such as warm hand-offs.

  Panelists will discuss what a boundary spanner's role looks like in their agency and how cross-system collaboration has helped to bridge individuals from jail to community. 

  Moderated by:

  Liz Tillander, LMSW
  Deputy Director - Center for Behavioral Health and Justice

  Panelists:

  Dane Beckford, M.S.W., M.C.J.
  Jail Diversion Therapist and Boundary Spanner - Riverwood Center

  Before embarking on a career in the mental health profession, Dane Beckford was an accountant at the Office of the Prime Minister in Jamaica for 5 years. During his tenure, he was able to develop skills in communication and learnt how to adapt/function in challenging situations at the highest level of government.  Dane received a performance award for the fiscal year 2006/2007 before leaving the Prime Minister's Office to pursue a career in the field of social work.  He attended graduate school at Loma Linda University in California, where he obtained degrees in Social Work and Criminal Justice.  Dane is passionate about working with the correctional population and subsequently began working with San Bernardino County Department of Behavioral Health. Dane was assigned to West Valley Detention Center where he worked in "Unit 15"-housing for the severely mentally ill inmates and participated in training jail staff on issues surrounding the criminal mind and malingering.  Eventually, Dane moved to Guam as a missionary, and provided mental health services in the prison for two years. While in Guam, he was on the reintegration committee to help inmates' transition into society with the goal of reducing recidivism.  He was also involved in providing professional advise to various government officials (Lt. Gov., Attorney General, Director of Behavioral Health, Director of Corrections) to avoid receivership by the Federal Government.  Dane and his family felt distant from friends and family, which resulted in him returning to the mainland in 2017. Dane now works for Riverwood Center as the Jail Diversion Therapist/Boundary Spanner. He continues to enjoy working with the correctional population and hopes to eventually work with troubled youth as a preventative measure to avoid the path leading to incarceration. 

   

  Nichole Brunn, M.A., LPC, LLP, CAADC
  Jail Diversion Clinician - Livingston County CMH

  As the Jail Diversion Clinician for Livingston County CMH, Nichole evaluates individuals incarcerated in the Livingston County Jail to determine eligibility for diversion from the jail.  Nichole has over 18 years of experience working in the mental health field, including 12+ years working directly with justice involved individuals in prison, jail and community settings.  She earned a BS in Psychology from Grand Valley State University, and received her MA in Counseling Psychology from Western Michigan University in 2007.   Nichole is CIT certified and has co-facilitated the Managing Mental Health Crisis training with Livingston County Sheriff's deputies over the past 3 years; training road deputies and jail staff from the Sheriff's Office, as well as, officers from other local police departments.  In addition to diversion, Nichole provides crisis intervention services in the jail, to individuals that have had some level of contact with CMH at any point in the past, and screens and authorizes individuals seeking SUD or MH services.  Within the community, Nichole provides outreach and screening to individuals referred by local police departments and facilitates MRT for participants in the Livingston County mental health court.  

   

  Lindsey O'Neil
  Criminal Justice Dept. Supervisor - Integrated Services of Kalamazoo

  As a dedicated member of the Kalamazoo community, Lindsey has spent the last 13 years focused on providing mental health care for underserved individuals and their families. After six years as an advocate with Assertive Community Treatment and completing her Masters in Social Work at Grand Valley State University, Lindsey traveled to Botswana for two years with the United States Peace Corps. While in Botswana she focused on providing education and prevention strategies to local human service providers working with individuals with disabilities at risk of contracting HIV and other communicable diseases. Upon returning to Kalamazoo, Lindsey began working with Integrated Services of Kalamazoo (then Kalamazoo Community Mental Health and Substance Abuse Services) as an Emergency Mental Health Clinician in the Kalamazoo County Jail, bringing her passion for mental health to the criminal justice system. As the current supervisor of the Criminal Justice Unit within ISK, Lindsey is focused on continuing the expansion of Jail Diversion Services and Re-entry Planning, both within the Kalamazoo County Jail and throughout the community through local police departments and community corrections departments. Lindsey also leads the 8th District Mental Health Recovery Court program and is an FBI-trained member of the Kalamazoo County SWAT Crisis Negotiation team. 

  Supplemental documents:

  • Using Boundary Spanners For Cross-System Collaboration
• Panel #4: Q&A

  The CMH SUD screenings that you do for people in the jail, do you do any for higher level of care or strictly for outpatient services? If for higher level of care, how closely do you do these screenings to their discharge?
  I do complete SUD screenings for higher levels of care.  I have never actually done one for detox, but there could be a potential situation where that would be appropriate.  The timing of the screens can vary.  Sometimes we have people that can have their jail stay shortened if they are able to get into a residential setting.  Other times, if someone is determined to be eligible before sentencing, the judge will sometimes include release directly to residential treatment in their final sentence.  In those situations, we have to get the consumer to a phone (outside line) so they can complete the screening process with the treatment center and determine the date of intake.  If the individual has a specific release date (i.e. has already been sentenced), then we try to use that date to gauge when we see them.  Sometimes it's not until a couple of days before their release, but if we know they want residential we will try to screen them 1-2 weeks before, to allow time for coordinating everything and for bed space to become available. (Nichole Brunn)

  What happens if the person does not live in an AFC? How do you navigate housing?
  If the person qualifies for or is receiving disability, I would generally place them using money in our budget to pay their first month's rent. Riverwood has a list of all updated housing information in the community, which makes it a lot easier to locate appropriate housing. They may also go to the shelter or stay with a family member. In this case, we try to assign a case manager for regular monitoring if classified as severely mentally ill. (Dane Beckford)

  Our county does not have AFC homes or shelters, so we have to get pretty creative.  We have a few nonprofit organizations that can pay for short stays at a motel (usually a few days) as well as some funding through local churches.  They are only able to receive that assistance once per year. (Nichole Brunn)

  How do you handle transportation if people are released at midnight or during the night?
  For us, we do have the opportunity to coordinate with the sergeants and with the person's agreement they can stay until the morning. If they are leaving in the middle of the night or we're not aware of the release when it happens, then we're relying on the ability of someone to stay later. Our jail is really good at identifying those needs and not sending someone out the door that they may have those concerns about and utilizing our emergency on-call service if needed to address that before the person leaves. (Lindsey O'Neil)

  We only release in the morning for liability issues, just to be sure the person is safe and has access to transportation. (Dane Beckford)

  As a part of discharge planning, we ask them if they have someone coming to pick them up and offer them that ability to have their release held off until the morning. If they don't have a ride, we try to help them get connected with another community resource that may provide transportation like our Stepping Stone Engagement Center if they are someone who struggles with a substance disorder. There are some situation where the judge orders that they're released after a certain time to allow for them to get more appropriate transportation. (Nichole Brunn)

  How do you handle coordinating services for out-of-county residents?
  We have them sign a release of information saying that it is ok for us to contact those agencies in the other counties. For individuals involved in treatment, especially CMH in other counties, we will start working with their treatment teams relatively early in their incarceration, including just informing them of their incarceration. As long as we have the ROI, there are no barriers to that. (Nichole Brunn)

  In Berrien County, if a person is not from this county, we obtain permission from the prior county to provide services at Berrien County. Of, course we have to contact those county officials there to make sure they're wiling to provide payment for those services. Unfortunately, there are times where those individuals don't qualify, so at Riverwood, we try to work with that individual to make sure they receive some type of service such as connecting them to other resources that are not available at Riverwood or in the jail. (Dane Beckford)

  For us, we coordinate with other counties if we're aware they're working with other counties or from other counties. Unfortunately, our matching system doesn't pull that information, so we rely on the individual getting flagged for us in different ways. But with a release of information, we're frequently working with other counties to ensure they're getting the treatment they were previously while in jail, or making their way back to their county and still ensuring their following through with their criminal justice needs here. (Lindsey O'Neil)

  Is anyone collection data from prosecutor's office? E.g. personal recognizances bond, which charges are most often being diverted?
  We personally track that data and submit to Southwest Michigan Behavioral Health. It's not in conjunction with the prosecutor's office at all. It is simply us handling that data on our end when we participate in a diversion. (Lindsey O'Neil)

  My supervisor keeps a spreadsheet of the people we make contact with at the jail and of course she provides that information to Wayne State when needed. We collect that information by me completing a form for each person I see. (Dane Beckford)

  We track our information, but in terms of all charges through the prosecutor's office, I'm not aware of that. I think part of their computer system collects some of it, but I don't know how they necessarily correlate that data and how closely they monitor or track it. (Nichole Brunn)

  Does anyone work with a Jail Diversion Coordinator that is actually part of the Sheriff's office in the court?  If so, is that relationship helpful for you?
  We are not currently aware of any counties with this arrangement.

  Is there a current list of divertible charges?
  Charges eligible for diversion will vary based on county, courts, and prosecutor's offices. In general, cases that are considered divertible are lower level offenses including misdemeanors, civil infractions, and violations.

• Conclusion and Closing Remarks 

  Speaker:

  Hon. Milt Mack
  State Court Administrator Emeritus
  Chair, Michigan Mental Health Diversion Council

  Currently serving as State Court Administrator Emeritus, Judge Mack served as State Court Administrator from 2015 to 2020. He previously served as a judge for the Wayne County Probate Court from 1990 to 2015 and as Chief Judge from 1998 to 2015.  He served as Co-Chair of the National Initiative Advisory Committee to improve the justice system response to those with mental illness and currently serves on the National Task Force to Examine State Courts' Response to Mental Illness. Judge Mack currently serves as Chair of Governor Whitmer's Mental Health Diversion Council. He also served on Governor Granholm's Michigan Mental Health Commission in 2004, the Michigan Partners in Crisis Public Policy Committee and the Michigan Supreme Court Guardianship Task Force. Judge Mack is the principle author of COSCA's 2016-2017 Policy Paper: Decriminalization of Mental Illness: Fixing a Broken System. He also wrote "Involuntary Treatment for the 21st Century" published in the Quinnipiac Probate Law Journal in 2008. In 2017, he received the Snyder-Kok Award from the Mental Health Association in Michigan, was named Judge of the Year by the Michigan Guardianship Association and Advocate of the Year by NAMI Michigan.

   

Additional Resources:

• Michigan Joint Task Force on Jail and Pretrial Incarceration

• Recommended Best Practices for Jail Diversion for Individuals with Mental Health Disorders

• Screening for Mental Health and Substance Misuse in Michigan Jails

• Using Boundary Spanners For Cross-System Collaboration

• Behavioral Health and Crisis Response Trainings for Law Enforcement Officers

• Alternate Drop-Off Locations for Individuals with Serious Mental Illness

• Stepping Up Technical Assistance: Data Outcomes and Technical Assistance Processes Across Five Stepping Up Counties

• The Sequential Intercept Model