HomeMy WebLinkAboutAgenda - 09-01-2015 - 4c 1
ORANGE COUNTY
BOARD OF COMMISSIONERS
ACTION AGENDA ITEM ABSTRACT
Meeting Date: September 1, 2015
Action Agenda
Item No. 4-c
SUBJECT: Resolution Supporting Stepping Up Initiative to Reduce the Number of People
with Mental Illnesses in Jails
DEPARTMENT: County Manager PUBLIC HEARING: (YIN) No
ATTACHMENT(S): INFORMATION CONTACT:
1) Stepping Up Initiative Summary Bonnie Hammersley, 245-2300
2) Draft Resolution
PURPOSE: To approve a resolution expressing support for the Stepping Up Initiative
sponsored by the North Carolina Association of County Commissioners (NCACC), the National
Association of Counties (NACo) and other organizations to help advance counties' efforts to
reduce the number of adults with mental and co-occurring substance use disorders in jails.
BACKGROUND: In May 2015, NACo and partners at the Council of State Governments
Justice Center and American Psychiatric Foundation launched Stepping Up:A National Initiative
to Reduce the Number of People with Mental Illnesses in Jails and announced a Call to Action
demonstrating strong county and state leadership and a shared commitment to a multi-step
planning process that can achieve concrete results for jails in counties of all sizes. As part of
this Call to Action, county elected officials are being asked to adopt resolutions and work with
other leaders (e.g., the sheriff, judges, district attorney, treatment providers, and state and local
policymakers), people with mental illnesses and their advocates, and other stakeholders to
reduce the number of people with mental illnesses in jails.
Additional information on this initiative is provided at Attachment 1 and is also available
at www.StepUpTogether.org.
Commissioners Renee Price and Bernadette Pelissier proposed that the Board consider
adopting a resolution in support of this initiative. A draft resolution, based on a template
provided by NCACC, is provided at Attachment 2 for Board consideration.
FINANCIAL IMPACT: There is no financial impact associated with approval of the resolution.
The Board is asked to express support for the Stepping Up Initiative sponsored by the National
Association of Counties (NACo) and other organizations.
2
SOCIAL JUSTICE IMPACT: The following two Orange County Social Justice Goals are
applicable to this agenda item:
• GOAL: FOSTER A COMMUNITY CULTURE THAT REJECTS OPPRESSION AND
INEQUITY
The fair treatment and meaningful involvement of all people regardless of race or color;
religious or philosophical beliefs; sex, gender or sexual orientation; national origin or
ethnic background; age; military service; disability; and familial, residential or economic
status.
• GOAL: ENSURE ECONOMIC SELF-SUFFICIENCY
The creation and preservation of infrastructure, policies, programs and funding necessary
for residents to provide shelter, food, clothing and medical care for themselves and their
dependents.
RECOMMENDATION(S): The Manager recommends that the Board approve and authorize
the Chair to sign the attached resolution.
THE
1Z U TEPPING . P
Attachment 1 3
I N I T I A T I V E
STEPPING UP: A National Initiative to Reduce
the Number of People with Mental Illnesses in Jails
THERE WAS A TIME WHEN NEWS OF JAILS serving more people with mental illnesses than in-patient treatment
facilities was shocking. Now,it is not surprising to hear that jails across the nation serve an estimated 2
million people with serious mental illnesses each year'—almost three-quarters of whom also have substance
use disorders'—or that the prevalence of people with serious mental illnesses in jails is three to six times
higher than for the general population.' Once incarcerated, they tend to stay longer in jail and upon release
are at a higher risk of returning than individuals without these disorders.
The human toll—and its cost to taxpayers—is staggering.Jails spend two to three times more on adults
with mental illnesses that require intervention than on people without those needs,'yet often do not see
improvements in recidivism or recovery. Despite counties'tremendous efforts to address this problem,
they are often thwarted by significant obstacles, such as coordinating multiple systems and operating with
minimal resources.Without change, large numbers of people with mental illnesses will continue to cycle
through the criminal justice system, often resulting in missed opportunities to link them to treatment,
tragic outcomes, inefficient use of funding, and failure to improve public safety.
The National Initiative
Recognizing the critical role local and state officials play in supporting change, the National Association
of Counties (NACo), the Council of State Governments (CSG) justice Center, and the American
Psychiatric Foundation (APF�have come together to lead a national initiative to help advance counties'
efforts to reduce the number of adults with mental and co-occurring substance use disorders in jails.With
support from the U.S.Justice Department's Bureau of justice Assistance, the initiative will build on the
many innovative and proven practices being implemented across the country. The initiative engages a
diverse group of organizations with expertise on these issues, including those representing sheriffs, jail
administrators, judges, community corrections professionals, treatment providers, people with mental
illnesses and their families, mental health and substance use program directors, and other stakeholders.
The initiative is about creating a long-term, national movement—not a moment in time—to raise awareness
of the factors contributing to the over-representation of people with mental illnesses in jails, and then using
practices and strategies that work to drive those numbers down. The initiative has two key components:
1. A CALL TO ACTION demonstrating strong county and state leadership and a shared commitment to a
multi-step planning process that can achieve concrete results for jails in counties of all sizes.
The Call to Action is more than a vague promise for reform;it focuses on developing an actionable
Plan that can be used to achieve county and state system changes. As part of this Call to Action, county
elected officials are being asked to pass a resolution and work with other leaders (e.g., the sheriff,
district attorney, treatment providers, and state policymakers), people with mental illnesses and their
advocates, and other stakeholders on the following six actions:
• Convene or draw on a diverse team of leaders and decision makers from multiple agencies committed
to safely reducing the number of people with mental illnesses in jails.
P�C American Psychiatric NACO National Association of Counties JUSTICE*CENTER
• 1 Foundation
Research.Edi¢atioa impact THE COUNCIL OF STATE ho-.r.r;.;:.r.,. x STA
40 ® Collaborative Approacbes to Public Safety
Bureau of Justice Assistance
U.S.Department of Justice
4
• Collect and review prevalence numbers and assess individuals' needs to better identify adults entering
jails with mental illnesses and their recidivism risk, and use that baseline information to guide
decision making at the system, program, and case levels.
• Examine treatment and service capacity to determine which programs and services are available in the
county for people with mental illnesses and co-occurring substance use disorders, and identify state
and local policy and funding barriers to minimizing contact with the justice system and providing
treatment and supports in the community.
• Develop a plan with measurable outcomes that draws on the jail assessment and prevalence data and
the examination of available treatment and service capacity,while considering identified barriers.
• Implement research-based approaches that advance the plan.
• Create a process to track progress using data and information systems, and to report on successes.
In addition to county leaders, national and state associations, criminal justice and behavioral health
professionals, state and local policymakers, others with jail authority, and individuals committed to
reducing the number of people with mental illnesses in jails should sign on to the Call to Action.
Stepping Up participants will receive an online toolkit keyed to the six actions,with a series of
exercises and related distance-learning opportunities, peer-to-peer exchanges, and key resources from
initiative partners.' The online toolkit will include self-assessment checklists and information to assist
participants working in counties in identifying how much progress they have already made and a
Planning template to help county teams develop data-driven strategies that are tailored to local needs.
2. A NATIONAL SUMMIT to advance county-led plans to reduce the number of people with mental illnesses
in jails.
Supported by the American Psychiatric Foundation, a summit will be convened in the spring of 2016
in Washington, DC, that includes counties that have signed on to the Call to Action, as well as state
officials and community stakeholders such as criminal justice professionals, treatment providers,
people with mental illnesses and their advocates, and other subject-matter experts. The summit will
help counties advance their plans and measure progress, and identify a core group of counties that
are poised to lead others in their regions. Follow-up assistance will be provided to participants to help
refine strategies that can be used in counties across the nation. After the 2016 summit, participants
will be notified of potential opportunities for sites to be selected for more intensive assistance through
federal and private grant programs.
Although much of the initiative focuses on county efforts, states will be engaged at every step to ensure that their
legislative mandates,policies,and resource-allocation decisions do not create barriers to plan implementation.
To learn more about the initiative or to join the Call to Action,go to Ste UTogether.—
Endnotes
1. Steadman,Henry,et al.,"Prevalence of Serious Mental Illness among Jail Inmates."Psgcbiatric Services 60,no.6(2009):761-765.
These numbers refer to jail admissions.Even greater numbers of individuals have mental illnesses that are not"serious"mental
illnesses,but still require resource-intensive responses.
2. Abram,Karen M.,and Linda A.Teplin,"Co-occurring Disorders Among Mentally 111 Jail Detainees,"American Psgcbologist 46,no.10
(1991):1036-1045.
3. Steadman,Henry,et al.,"Prevalence of Serious Mental Illness among Jail Inmates."
4. Sec,e.g.,Swanson,Jeffery,et al.,Costs of Criminal Justice Involvement in Connecticut:Final Report(Durham:Duke University School of Medicine,2011).
5. Among the key partners are the National Alliance on Mental Illness;Major County Sheriffs'Association;National Association of County
Behavioral Health&Developmental Disability Directors;National Association of State Alcohol and Drug Abuse Directors;National
Association of State Mental Health Program Directors;National Council for Behavioral Health;National Sheriffs'Association;and
Policy Research Associates.
Res-2015-038 ORANGE COUNTY BOARD OF COMMISSIONERS 5
Attachment Resolution Supporting "Stepping Up Initiative to
Reduce the Number of People with Mental Illnesses in Jails"
WHEREAS, counties routinely provide treatment services to the estimated 2 million people with
serious mental illnesses booked into jails each year; and
WHEREAS, prevalence rates of serious mental illnesses in confinement facilities are three to six
times higher than for the general population, with statistics showing that almost 13% of North
Carolina's prison population requires some type of intervention due to mental health issues; and
WHEREAS, almost three-quarters of adults with serious mental illnesses in jails have co-occurring
substance use disorders; and
WHEREAS, adults with mental illnesses tend to stay longer in jail and upon release are at a higher
risk of recidivism than people without these disorders; and
WHEREAS, county jails spend two to three times more on adults with mental illnesses that require
interventions compared to those without these treatment needs; and
WHEREAS, without the appropriate treatment and services, people with mental illnesses can
continue to cycle through the criminal justice system, often resulting in tragic outcomes for these
individuals, their families, and their communities; and
WHEREAS, county jails are generally an unsafe environment for those with mental health
treatment needs; and
WHEREAS, the North Carolina Association of County Commissioners has undertaken a serious
effort to address the local service needs of those with mental illnesses through the appointment of
a special Task Force; and
WHEREAS, Orange County, like all counties, takes pride in our responsibility to protect and
enhance the health, welfare and safety of our residents in efficient, safe, and socially just ways;
and
WHEREAS, through the Stepping Up Initiative, the National Association of Counties, the Council of
State Governments Justice Center and the American Psychiatric Foundation are encouraging
counties to reduce the number of people with mental illnesses in county jails;
NOW THEREFORE, be it resolved by the Orange County Board of Commissioners:
1. That the Board of Commissioners does hereby sign on to the Call to Action to reduce the
number of people with mental illnesses in our county jail and commits to sharing lessons
learned with other counties in North Carolina and across the country to support the Stepping
Up Initiative; and
2. That the Board of Commissioners will utilize resources available through the Stepping Up
Initiative and other resources provided by the Council of State Governments Justice Center to
convene a diverse team of leaders and decision makers from multiple agencies who are
committed to safely reducing the number of people with mental illnesses in jails, and
3. That this team will utilize the comprehensive resources available through the Stepping Up
Initiative to develop a plan to reduce the number of people with mental illness in the county jail
for 2016-2020, consistent with the Council of State Governments Justice Center report and
recommendations, to be presented to the Board of Commissioners at its first meeting in
December 2015.
This the 1St day of September, 2015.
Earl McKee, Chair
Orange County Board of Commissioners