State looks at how courts deal with mentally ill, substance abuse

The state of Oregon began work Wednesday on a data-driven approach to address challenges in how the state responds to people in the criminal justice system who have mental illnesses and substance addictions.

Oregon’s Behavioral Health Justice Reinvestment Steering Committee met to officially launch the state’s participation in the federally funded Justice Reinvestment Initiative. The committee will focus on developing a statewide policy framework to support local governments in improving recidivism and health outcomes for people who repeatedly cycle through both the public safety and health systems.

The Council of State Governments Justice Center, a national nonprofit organization, will assist Oregon in this effort with funding from the U.S. Department of Justice’s Bureau of Justice Assistance and The Pew Charitable Trusts.

“We know that when we make meaningful change in behavioral health treatment and addiction recovery, we lift a burden off of our prisons, our hospitals, and our law enforcement,” said Governor Kate Brown, who served as CSG’s national president in 2017. “Oregon successfully used justice reinvestment to slow prison growth and expand programs that help people succeed outside of prison. By focusing on the intersection of the behavioral health and criminal justice systems in this new model of reinvestment, we can continue to improve both health and public safety.”

During the meeting, CSG Justice Center staff presented analyses highlighting how a small number of people can account for a large percentage of annual jail admissions.

For example, Clackamas County has a population of just over 400,000 residents. In 2017, 6 percent of people booked into the county jail accounted for almost 20 percent of all booking events. The analysis showed that this group of 569 people, who cycled in and out of the jail throughout the year as many as four to 15 times, accounted for 2,848 separate admissions.

“The criminal justice system was designed to prevent, protect against and prosecute criminal offenses. It was not designed to treat mental illness or substance addiction,” said Oregon Health Authority Director Patrick Allen, who serves as co-chair of the Behavioral Health Justice Reinvestment Steering Committee.

“The best way to support people with behavioral health needs is to connect them to treatment in their local communities. The Justice Reinvestment process will allow us to develop solutions that better promote individual recovery while preserving community safety.”

The criminal justice information presented by the CSG Justice Center staff will be matched with Medicaid and Oregon State Hospital data by the Oregon Health Authority and Oregon’s Integrated Client Services.

The goal is to quantify the population of people who have frequent contact with Oregon’s criminal justice system and determine this population’s complex health care needs, what types of services they are currently receiving, and the related impacts and costs on the criminal justice and health systems.

“Law enforcement officers often face tense interaction with people with behavioral health problems. Too often, these people end up in our jails and emergency rooms,” said Senate President Peter Courtney. “Adjusting how we use our resources can get them the help they need. We can end the cycle and change lives.”

“Studies have shown that a small percentage of people make up a disproportionate share of the costs to these systems,” said Senate Republican Leader Jackie Winters, who is a member of the Behavioral Health Justice Reinvestment Steering Committee. “By identifying this population of people, we can develop proactive strategies to improve results and their quality of life at a lower cost.”

In July Governor Brown, former Supreme Court Chief Justice Thomas Balmer, Senate President Courtney, Senate Republican Leader Winters, House Speaker Tina Kotek, House Minority Whip Duane Stark, Oregon Health Authority director Allen, Oregon Department of Corrections director Colette Peters and Oregon Association of Counties president, Polk County Commissioner Craig Pope, formally requested support from the U.S. Department of Justice’s Bureau of Justice Assistance and The Pew Charitable Trusts to use a behavioral health Justice Reinvestment approach to address challenges in the state’s criminal justice and behavioral health systems.

“Nearly every day members of law enforcement come into contact with people who are struggling with mental illnesses or substance addiction,” said Marion County Sheriff Jason Myers, co-chair of the Behavioral Health Justice Reinvestment Steering Committee. “Our officers have received training to help them recognize who needs treatment, but we also need to have appropriate community-based services available to help when someone is in crisis. A statewide behavioral health strategy for people in the criminal justice system will help officers better respond to the needs of their communities and keep Oregon’s citizens safe.”

More than 30 states have successfully used the Justice Reinvestment approach to date, with each state tailoring the process to help address particularly challenging issues within their criminal justice systems.

Policy packages that states pass have often had significant impacts on controlling criminal justice spending, averting growth in prison populations and increasing public safety. While improving access to and the quality of community-based behavioral health treatment are often critical pieces of these Justice Reinvestment approaches,

Oregon is the first state to focus its Justice Reinvestment efforts entirely on the intersection of the criminal justice and behavioral health systems.

“People battling mental illnesses and substance addiction need resources and opportunities to succeed,” said Rep. Mitch Greenlick, chair of the House Committee on Health Care and a member of the Behavioral Health Justice Reinvestment Steering Committee. “This project will also help identify barriers to housing, transportation and employment for people at the intersection of the criminal justice and behavioral health systems.”

Local perspectives will be critical to properly defining the challenges that Oregon’s project will address. Committee members will work to ensure that the statewide strategies ultimately identified are designed to improve client outcomes and reduce costs at the local level.

A strength of this project is its level of engagement with county and tribal government officials. The CSG Justice Center team has already traveled to 27 counties and three tribal nations to meet directly with local officials, including sheriffs, district attorneys, community corrections officers and behavioral health treatment providers.

The CSG Justice Center will assist throughout this process by collecting and analyzing data and supporting the steering committee in developing appropriate policy options to improve health outcomes and reduce recidivism. CSG Justice Center staff will collect input from stakeholders in the behavioral health and criminal justice systems throughout the state to inform the process and identify solutions.

“Oregon’s behavioral health treatment practitioners have strong capacity, but services are not equally accessible to all, especially in rural and remote areas,” said House Minority Whip Stark, who will serve on the Behavioral Health Justice Reinvestment Steering Committee. “The behavioral health Justice Reinvestment approach will help us identify and understand the gaps in access to treatment and programming services.”

The Behavioral Health Justice Reinvestment Steering Committee will present a series of policy proposals to the Oregon Legislature during its 2019 session. In addition to Allen, Myers, Greenlick, Stark and Winters, members of the steering committee include: Kevin Barton, Washington County District Attorney; Suzanne Chanti, Lane County Circuit Court Judge; Julia Delgado, director of programs, Urban League of Portland; Jim Doherty, Morrow County Commissioner; Andi Easton, vice president of government affairs, Oregon Association of Hospitals and Health Systems; Lee Eby, Clackamas County Jail Captain; Janie Gullickson, executive director, Mental Health Association of Oregon; Eric Guyer, director, Jackson County Community Justice; Claire Hall, Lincoln County Commissioner; Silas Halloran-Steiner, director, Yamhill County Health and Human Services; Sandra Hernández Lomelí, Youth Programs director, Latinos Unidos Siempre (L.U.S.) youth organization; Bob Joondeph, executive director, Disability Rights Oregon; Cheryle Kennedy, chairwoman, The Confederated Tribes of Grand Ronde; Allison Knight, Lane County public defender; Belinda “Linda” Maddy, Department of Public Safety Standards and Training crisis intervention training coordinator, Crisis Intervention Teams Center for Excellence; Angel Prater, executive director, FolkTime; Steve Sanden, executive director, Bay Area First Step; Paul Solomon, executive director, Sponsors, Inc.; Abbey Stamp, executive director, Multnomah County Local Public Safety Coordinating Council; Elizabeth Steiner Hayward, State Senator, District 17; Heidi Steward, assistant director, offender management and rehabilitation, Oregon Department of Corrections; Nan Waller, Multnomah County Mental Health Court Judge; and Shannon Wight, deputy director, Partnership for Safety and Justice.

“The justice system is on the frontl ines of the problems we face as a society, and every day too many people end up before us as a result of mental illnesses or substance addiction,” said Supreme Court Chief Justice Martha Walters. “If we’re going to truly make a difference in the lives of people who struggle with these issues, we must develop common priorities and coordinated approaches. This new committee will help facilitate discussion between complex systems that aren’t used to engaging with each other on a regular basis.”

Conversations about enhanced coordination between Oregon’s behavioral health and criminal justice systems initially began in May, when the Oregon Criminal Justice Commission and Oregon Alcohol and Drug Policy Commission hosted a statewide public safety forum facilitated by the CSG Justice Center.

Participants discussed how to increase access to and the effectiveness of behavioral health treatment in localities across the state and how to improve information and data sharing across behavioral health and criminal justice agencies.

The CSG Justice Center serves policymakers at the local, state and federal levels from all branches of government. It provides practical, nonpartisan advice and evidence-based, consensus-driven strategies to increase public safety and strengthen communities. For more information, visit the CSG Justice Center website at http://www.csgjusticecenter.org/.