Illinois Department of Human Services

Division of Mental Health Services and Forensic Initiatives

April 23, 2009

2

Presenters

Anderson Freeman, PhD., Director, Forensic Services Jordan Litvak, Executive Director, Region 3&4 Gustavo Espinosa, Executive Director, Region 1 Central James Novelli, Executive Director, Region 5 Robert Granger, Acting Executive Director, Region 1 South Dan Wasmer, Acting Director of Region Services

Hospital-Based Care

• There are 9 State Operated Hospitals h mental illness.

• There are 23 private hospitals providing care funded by DMH under the Community Hospital Inpatient Psychiatric Services (CHIPS) contracts.

Illinois Department of

Human Services

Division of Mental Health

State Operated Facilities

Catchment Area Map by Hospital

DMH Community Providers

• Regions manage contracts with 149 private provider organizations.

• Each provider operates a different array of program and residential sites.

• Some providers operate 1 site, others operate multiple sites.

• DHS/DMH sets standards the providers must conform to maintain certification.

• Individual services must comply with Rules and Regulations set by DHS/DMH.

DMH Vision

It is the vision of the DMH that all persons with mental illness recover, and are able to participate

fully in life in the community.

“The Expectation is Recovery!”

Three Ways to Access DMH Service System

1. Consumer request for services at local Community MH Center.

2. Consumer in crisis presents at a local community hospital emergency room.

3. Family and/or friends can go to the Cook County States Attorney’s Office to get a Writ of Detention.

Local Emergency Room

A common entry point for the public MH system. Result in the patient receiving:

Medical Clearance Psychiatric Evaluation Benefits Clearance Pre-screening by community MH provider

)Relationship building )Offer less restrictive, community based alternative )Begin discharge planning

Emergency Room [Continued]

If hospitalization needed -- three choices:1. Private community hospital admission using

insurance/other coverage;

2. Private community hospital admission using CHIPS funding from DMH; or

3. Transfer to State Operated Hospital.

Emergency Room [Continued]

Sometimes hospital crisis workers, or community agency crisis workers co-located at the emergency room, will help construct a plan by which the individual can leave the ER without hospitalization.

When this happens, the individual may be immediately linked or rapidly linked to community-based services.

Principals of Recovery

Hope Self-Direction Individual and Person-

Centered Empowerment Holistic

Non-Linear Strength – based Peer support Respect Responsibility

Excerpts from the Goal of Services in a Transformed Mental Health SystemPrepared by: Nanette Larson, Director of Consumer Recovery Support Services

DMH Community-Based Services:

Designed for People who have a Serious Mental Illness (SMI) or a Serious Emotional Disorder

Schizophrenia Schizophreniform Disorder Schizo-affective disorder Brief Psychotic Disorder Psychotic Disorder NOS

Bipolar Disorders Major Depression Obsessive-Compulsive

Disorders Anorexia Nervosa Bulimia Nervosa

DMH Funded Services

Assertive Community Treatment (ACT)

Case Management Community Support

(Team, Group, Individual) Crisis Intervention Psychosocial

Rehabilitation

Counseling/Therapy Psychiatric evaluation,

medication administration & monitoring

Supported Residential Supervised Residential Permanent Supportive

Housing (New)

Valued Approaches to People Recovering from a Serious Mental Illness

Wellness Recovery Action Planning (WRAP)

Peer Support Services Mental Health and

Justice Initiatives Diversion activities

Individual Placement and Support

Rapid engagement in job search, job development and retention,

Ongoing supports

How to locate a mental health center?

By computer:

www.illinois.gov/government/agency.cfm

Scroll to: Department of Human Services, then down to Office Locator

Type in: Mental Health; Look up by County. For Cook County type in Zip Code. The nearest MH Center will be listed .

Via phone call: 1 (800) 853-6154 (voice) 1 (800) 447-6404 (TTY)

DMH Regional Offices

Regional Directors represent the Division of Mental Health Monitor state contracts with community mental health agencies Help Coordinate Services with other Divisions. Work towards integrating services.

Region 1 North – (773) 794-4139 Region 1 Central – (708) 338-7200 Region 1 South – (708) 614-4002 Region 2 (collar counties) – (847) 742-1040 #2002 Region 2 (northwest)- (815) 987-7910 Regions 3 and 4 (central) – (217) 786-6866 Region 5 (metro east southern) – (618) 474-3348 Region 5 (southern) – (618) 833-8266

An FYI -- Illinois Mental Health Collaborative for Access and Choice (The Collaborative)

Serves as a third party administrator for the Division of Mental Health

Processes claims and maintains the DMH data base Supports DMH monitoring of services Supports DMH Recovery Services, including “Warm Line” Provides centralized clearing house for complaints:

(866) 359-7953 (voice) (866) 880-4459 (TTY)

Questions

BREAK

Mental Health and Justice System Transformation: Special Projects

Anderson Freeman, Ph.D.,

Deputy Director for Forensic Services

Three Cs of Transformation

Capacity Building Continuum of Care Collaboration

…….For the Justice Involved Individual with SMI and Co-Occurring Disorders

DMH Community Treatment Data (2006)

2,244 consumers of 129,564 consumers were UST or NGRI 2,872 consumers of 129,564 were referred by corrections or under

court supervision (parole or probation) IDOC & Jail Data

Based on IDOC data approximately 3000 or 10% of all inmates paroled in a given year have serious mental health issues that necessitate care in the community.

Cook County Jail which has a daily census ranging from 9,000 to 11,000 treats 10% of the jail population for serious mental illness.

There 22,000+ jail beds in Illinois. Researchers estimate that 10% -16% of detainees have serious mental illness.

Data-Link July 1, 2007 - May 20, 2008

Will Peoria Jefferson Marion Proviso Cook*

JailAdm. 7620 13409 2518 2188 75140

JailAdmU 6450 9016 1913 1684 62398

Positve X 1010 1528 292 368 514 4476

PositiveUX 786 934 202 251 387 3546

#exclus. 663 730 83 172 353 1292

#elig. Link 123 204 119 79 34 2254

Actual Link 118 184 119 79 31 168

30 Day 47 77 26 43 15 25

Top Ten High Impact IDOC Re-Entry Regions in Illinois (2004 data)

County/Community

Ranked / Parole Rate

% of Parole

Population

Population Parole Population

Rate #Parolees per 100,000

Recidivism Rate (%)

Macon

(Decatur)

1.9 114,706 689 6.0 50.1

Cook 59.7 5,376,741 19,561 3.6 57.4

Winnebago

(Rockford)

2.8 284,313 930 3.1 51.6

Peoria 1.8 183,433 571 3.1 60.7

Champaign/

Vermillion

2.3 262,969 764 2.9 54.4

Jefferson 0.3 40,045 105 2.6 54.4

Sangamon

(Springfield)

1.5 114,706 460 2.4 54.6

Rock Island 0.8 147,912 273 1.9 45.4

St. Clair /Madison

(East St. Louis)

3.1 258,606

261,689

416

534

1.8 54.2

Collar Counties (esp. Aurora)

9.8 2,954,577 3,223 1.1 n/a

DMH Justice & Mental Health Transformation Goals

A Recovery Oriented System for Individuals with mental illness who are involved in the criminal justice system.

Improved continuum of mental health care for individuals involved with the criminal justice system.

Paro

le

COM

MUN

ITY

COMM

UNITY

Intercept 1 Law enforcement / Emergency services

Intercept 2 Initial detention / Initial court hearings

Sequential Intercepts for Change: Criminal Justice - Mental Health Partnerships

Intercept 3 Jails / Courts

Intercept 4 Reentry

Intercept 5 Community corrections/ Community support

Prob

atio

n

Pris

on

Law

Enfo

rcem

ent

Arre

st

Initi

al D

eten

tion

Initi

al H

earin

gs

Jail

Courts

Dispatch 911

Jail Re-entry

Violation

Violation

Transformative Activities

Cook County Jail Diversion Community Re-integration Collaborative (SMHSA Grant 2006-2008)

Jail Data Link Expansion 2 (ICJIA) Transformation Transfer Initiative/MHJ Regional and Statewide System

Mapping (NASMHPD) Veterans Re-integration Initiative (SAMHSA Grant 2009) Mental Health Court Association Development Integrated Mental Health Court Database (Partnership with Justice

Kathryn Zenoff and Council of State Governments) Mental Health and Justice Center of Excellence (BJA Grant Application

3/12) Mental Health Juvenile Justice Program Expansions

Examples of Impact of Transformation Activities

Jail Data Link Program County Expansions Additional CIT officers trained (over 800 trained in Cook County) Expanded Cook County Mental Health Court Statewide Mental Health Court Expansions (over 300 participants) Veterans Re-integration Initiative projects in Cook County and

Rock Island Regional Mental Health and Justice stakeholder groups Judiciary Involvement Development of an Integrated MHC Database Development of a Center of Excellence for Mental Health and

Justice (BJA grant application)

Description of Jail Data Link

The Jail Data Link program provides a web based computer cross match between the census in county jails and open DHS cases. The program identifies individuals in our targeted mental health population that should have been involved in services with community mental health providers, but have been detained in jail. The program also provides case managers located with community providers that provide linkage to community services from county jails.

Contact Information

Anderson Freeman, Ph.D.

Anderson.Freeman@Illinois.gov

(312) 814-1646

DMH Justice & Mental Health Transformation Goals (continued)

Increased collaboration between system partners and stakeholders to facilitate federal funds to the state, advocacy for helpful legislation, and expansion of existing initiatives and practices.

Improved integration with Illinois county court systems in responding to Forensic and MH/Criminal Justice issues.

Illinois MentalHealth &

Justice AdultDiversionInitiatives

MHC = Mental HealthCourt

JDL = Jail Data LinkProgram (DMH)

CIT = Police CrisisIntervention Team

PRU = Placement ResoureUnit (IDOC)

Cook ProvisoMHC

CookMHC

Dupage MHC

LakeMHC

McHenryMHC

WinnebagoMHC

Rock IslandMHC

Madison MHC

KaneMHC

JDL

JDL

JDL

JDL

PRU

PRU

PRU

PRU

PRU

PRU

PRU

PRU

Sample Case #1 -- Region 3 & 4

Steven -- Illustrates how people released from DOC informally make their way into DMH funded programs. At the same time, it underscores the risk factors that could be avoided if a coordinated referral and linkage effort was in place between these service sectors.

Sample Case #2 -- Region 5

Alex – Illustrates how collaboration between the Probation Office and the local Community MHC can help to titrate services from each partner to match need of the individual over time.

Sample Case #3 – Region 1

John -- A case that illustrates how some cases take continued hard work by all partners over time. Partners do much to keep each other going under circumstances that would overwhelm a single provider.

Sample Case #4 -- Region 3 & 4

Sally -- A case that illustrates how existing relationships between Probation Office and Community Provider can pave the way for quick response to emergent needs that might otherwise cause a person to loose ground or return to an institution (prison/hospital/or both).

Sample Case #5 -- Region 5

Jeremy -- A case that illustrates how the addition of a court order to existing ACT services helped a homeless person with a history of violence find stable housing, stay off drugs, make friends, and begin to re-connect with family.

Sample Case #6 – Region 3&4

Bobby -- A case that illustrates how “disconnects” from DOC to community public mental health services could create high risk situations for the individual, the community MHC, and the Department of Correction.

Sample Case #7 -- Region 5

John II -- A case that illustrates how the addition of mental health court oversight helped to bring very troublesome symptoms, which were not previously controlled by mental health care alone, under control and lead to positive steps to recovery.

Questions