Transcript Cornachione-Presentation

Ohio Justice Alliance for
Community Corrections
October 13, 2011
MHAC’s Mission
Foster education and awareness of mental
health issues while advocating for
public policies and strategies that
provide an effective, well-funded mental
health system that serves those in
need, resulting in a stronger
community.
What the MHAC Does
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The MHAC provides a unique forum for interested
organizations to share experiences, needs and
expectations of the mental health system; to set
priorities and an agenda for change; and to speak with
one voice on the public policies and funding issues
that impact mental health.
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Work to create change leading to an effective, efficient,
and integrated mental health system
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Promote diversifying resources to support
maintenance and improvements to the current system
of mental health service delivery
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Increase awareness, knowledge, and understanding of
mental health and the impact of untreated mental
illness on the community
By The Numbers:
Developing a Common
Understanding for the Future of
Behavioral Health Care
Completed in partnership with The Center
for Community Solutions
 Purpose was to:
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 Consolidate
and highlight existing statewide
data on behavioral health to better inform
policy decisions
Content
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Introduction
Community Behavioral Health System
Medicaid Spending for Individuals Previously
Treated in the Community System
Hospitals and Emergency Departments
Long-term Care
Adult and Juvenile Justice
Primary and Secondary Education
Premature Death
Recommendations
Landscape
Over 2.8 million Ohioans have a
diagnosable mental illness
 Over 550,000 adult Ohioans have a
severe mental illness
 Over 851,000 Ohioans have a substance
dependence or abuse disorder
 Roughly 50% of individuals with a severe
mental illness are also affected by
substance abuse
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Landscape
Many individuals who need behavioral
health treatment receive it; too many
others do not
 Treatment and supportive services ideally
should be available early enough to
prevent the need for more costly
interventions
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Adult Criminal Justice
ODRC provided the data for this section of
the report
 ODRC provides outpatient care,
prescription drugs, residential care and
acute care psychiatric treatment
 Every new inmate receives a mental
health evaluation at reception and further
evaluations if necessary
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Mental Health Caseload
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Inmates are assigned to the “mental health
caseload” if:
 They
are on psychotropic medications prior to entry
into the prison system and their evaluation indicates
the need to continue medication and/or other
treatments
 They are referred based on the initial and detailed
screenings at reception
 Referrals from self or staff
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Inmates not on the “mental health caseload” can
receive crisis services and/or up to 3 clinical
contacts.
Mental Health Caseload Numbers
20.4% of the inmate population is on the
mental health caseload
 44.3% of the mental health caseload (9%
of the entire inmate population) has a
severe mental illness
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 This
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is higher than in the general population
The number of inmates on the mental
health caseload grows proportionately to
the growth of the total inmate population
Recovery Services for
Substance Disorders
35% of inmates receive recovery services
 Less than 1% of inmates utilize both
substance abuse treatments and mental
health services
 Unlike mental health services, substance
abuse treatments are voluntary
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Intake Study – Mental Health
67% of inmates did not have a history of a
mental illness
 29% received treatment for a mental
illness prior to incarceration
 4% either self-disclosed a mental illness or
showed evidence of a mental illness
 Less than 1% had a diagnosis of a mental
illness but had not received treatment prior
to incarceration
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Intake Study – Substance
Disorders
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Over 78% of inmates showed evidence of recent
drug abuse
 Including
1.7% who reported receiving treatment in
the last 6 months
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About 90% of inmates had a history of drug
abuse
 Including
33% that had received treatment more than
6 months prior to their arrest
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49% of inmates have recent alcohol abuse
70% of inmates have a history of alcohol abuse
Average Length of Stay
Less than 12% of inmates on the mental
health caseload are serving sentences
less than 1 year
 The average length of stay is 3 times as
long for individuals on the mental health
caseload
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6
years and 2.5 months vs. 2 years
Recidivism
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36% of individuals admitted to prison
because of a probation violation have
mental health needs
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Recidivism rates for individuals with and
without severe mental illnesses are similar
Forensic Hospital Population
Forensic patients use half of the state
psychiatric bed days during the year
 Forensic hospital bed days are used for:
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 Restoring
competency to stand trail
 Individuals deemed Not Guilty by Reason of
Insanity
 Individuals deemed Incompetent to Stand
Trail - Unrestorable
Juvenile Justice
DYS provided the data for this section of
the report
 DYS is responsible to confine and provide
services to youth that have been
adjudicated for a felony and committed to
a facility.
 Not all youth adjudicated for a felony are
committed to DYS
 Rate of commitment is 17%
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Mental Health Caseload Growth
From 2006 to 2010, the percent of youth
on the mental health caseload grew by
14.5%
 49.5% of youth in DYS facilities are on the
mental health caseload
 6% were on a mental health unit
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Average Length of Stay
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Youth on the mental health caseload stay
twice as long as the total DYS population
 22
months for youth on the mental health
caseload
 11.9 months for the total DYS population
Juvenile Diversion
Behavioral Health/Juvenile Justice
Initiative diverts youth to community
treatment
 Youth display improved functioning levels,
decreased drug utilization and less risk for
out of home placement after the program
 Youth also have decreased juvenile court
involvement after the program
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Recommendations - Funding
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If state policies change to require
treatment instead of incarceration, then
appropriate and adequate funding for
behavioral health services must be
allocated to build capacity to ensure
services are available to all those in need.
Recommendations - Policy
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Federal and State rules and regulations
around “aging out of foster care” need to
be examined to allow for youth who turn
18 in the ODYS system to utilize the
expansion of Medicaid for foster children.
Recommendations - Policy
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Improve connections and access to
services for individuals leaving the custody
of the adult and juvenile criminal justice
system. Individuals with behavioral health
disorders leaving state institutions must be
connected with and have access to a
continuum of adequate and appropriate
community based services, including
behavioral health services.
Recommendations - Policy
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ODRC should revisit policies around
recovery services to refocus on
appropriate and adequate treatment and
education for alcohol and other drug
abuse.
Recommendations – Additional Data
Centralized data on the mental health
caseload and spending for individuals
incarcerated in jails.
 Further research on why prisoners on the
ODRC mental health caseload are
incarcerated 3 times longer than those not
on the caseload and juveniles on the
ODYS mental health caseload are
incarcerated 2 times longer than those
who are not.
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Questions & Answers
Elizabeth Cornachione
Program and Policy Director
Mental Health Advocacy Coalition (MHAC)
216-432-7262
[email protected]
mentalhealthadvocacy.org
facebook.com/MHAC.Ohio