ROUGHLY EDITED FILE
BURTON BLATT INSTITUTE AT SYRACUSE UNIVERSITY
12/14/2011
BBI‑TACE WEBINAR
FORENSIC EMPLOYMENT PROGRAMS FOR OFFENDERS WITH MENTAL HEALTH
2 P.M. TO 4.P.M.
REMOTE CART PROVIDED BY ALTERNATIVE COMMUNICATION SERVICES
800‑335‑0911
* * * * *
This is being provided in a rough‑draft format. Communication Access Realtime Translation (CART) is provided in order to facilitate communication accessibility and may not be a totally verbatim record of the proceedings
* * * *
>> Natashia has received her master's degree in behavioral health. She has also certification for drugs and alcohol. She is also an ethnic minority specialist and educational specialist. I think you will all enjoy their presentation and at this point I'm turn it over to Declan and Natashia.
>> INSTRUCTOR: Good afternoon, everyone. And I am Declan.
>> I'm Natashia.
>> And today's presentation is coming from Seattle where our sound mental health is the largest behavioral agency. We have many sites throughout King County. First of all, I will just give you an orientation to the process we are using. We will discuss our forensic programs and identify our approach to services within these programs. We will then give you an understanding of the consumers that we work with. We will show you how we have incorporated employment into our program. We will be stopping intermittently within the presentation so that you can ask questions rather than hold them all till the end, but we will notify you when you have ‑‑ when we will take questions. A rough estimate is between at the end of every second slide. Some mental health is the largest metropolitan health agency in Washington. We are also an enhanced provider for chemical treatment.
>> We are a Parkland Rehabilitation provider and also a contract supported provider. We have housing throughout the county for both our and other people's consumers, and we are also a specialty provider for certain populations, like developmental disabilities, older adults, death services, and forensic services. Today we're going to concentrate on our forensic programs which means we're those involved with the criminal justice system and how we have developed our employment services within those programs. Slide number 3. Specialized programs for those involved in the criminal justice system. Like in a lot of agencies, we love acronyms. I will explain a few. Forensic FACT is Forensic Assertive Community Treatment which is an act approach for those who have seven or more incarcerations within the last year. FISH is for those who are ‑‑ FISH means for adults who are incompetent to stand trial but not not attainable within civil commitment. They generally have had 7‑10 incarcerations within the last year. ORCSP is Offender Reentry Community Support Program normally known as the dangerous offenders. First is for metal mental health court. Court works primarily with outpatient treatment for those involved in the public mental health system. This is the program that we will concentrate on primarily for today. Slide number 4. Forensic team. Some mental health decided they did not want to develop a program where the individual is responsible. We wanted to develop a program where we have all of the offenders on the one mode, we wanted to develop a program that we would educate our staff on how to work with the criminal justice systems and the different court entities. We also wanted to develop a program where our staff are experienced in working with the dynamics of criminologies where they can develop boundaries with the consumers and where they can develop how they can address the housing employment and treatment needs of this population which are very often more difficult in general populations. We have decided on the trans‑multi disciplinary approach. That means that though a consumer is assigned to an individual caseload, it is chief as a whole who is responsible for the treatment of the consumer. And lastly, we have placed a very strong emphasis on a multi system wraparound team which contains external system as team members. Slide number 5. Multi personalized home. There are 75 case workers. They are a variety of specialties which doctors of psychology, mental health professionals, chemical dependency professionals, those who work solely within the domestic violence program. We have sex offender treatment providers, peer supports and housing support staff. These are the individuals that make up the core team as we started these programs. I would just mention peer support. Peer supports are those in these programs who have been successful in their own recovery. They're those who have initially been incarcerated either within the prison system or the jail system. And who understand the experience of being within these programs. We have employed a number of peers to be involved on all of the teams. Within forensic science. They can walk the walk and talk the talk. Most members of our team are core credentials. Rather than sending an individual either to different parts of the agency for mental health treatment or for chemical dependency treatment or vocational services, we have both encouraged, cross trained, and provided financial incentives to our clinicians to be multi disciplinary. We have 140 clinicians who are trained in chemical depend sent ‑‑ dependency. We have 40 training for vocational specialists who are mental health specialists who are chemical dependency specialists. We find it easier to address the issues of the consumers as it arises rather than not have the scales or the staff available to address that particular issue at that particular time. The teams are cross‑trained, so if you do not wish to be specialized in a particular and specialty you are a newly trained to have the basic skills to address an emerging issue until ‑‑ until the specialist then appears. At this stage, plot slide 7, are there any questions?
>> It doesn't appear so.
>> Okay. Thank you, Abby. So slide number 7, multi system wraparound care. How we initially began our forensic programs, it was the first pilot project in Washington State. And that was back in 1998. The ‑‑ back in 1998 we had 2.5 staff and 25 clients. Today we are a lot bigger. We made a commitment with the Department of Corrections that they would be a member of our team. That there would be more frequent tuneups, the client would be informed of this communication and we would meet the client as co‑peers. We have continued to development throughout all our programs. Today our multi system wraparound care includes also all of the team members previously mentioned, but it also includes the various Department of Corrections, probation, which is county or city, but we also have members of the police team part of our weekly meetings and we have residential housing staff and managers as part of our team meetings. We have an approach that we believe is a wraparound care that are the team that can provide more comprehensive services, more‑out reach to the community, more eyes‑on, hands‑on interventions. And this will be one event later in the presentation around our forensic ‑‑ our employment services. The next slide starting with slide 8, forensic consumers gives us the opportunity to explain to you a little bit about the consumers we are working with. Our consumers are the chronically mentally ill. They are not those who generally suffer from affective disorder, they are more psychotic, schizophrenia, bipolar, delusional mental illness. Some of our clients have brain disorders. 85 ‑‑ or 86% of our clients have disorders, substance abusers. This figure comes from a number of evaluations we have done over the years by the University of Washington, our Washington public policy institute. The consumers are primarily homeless upon referral, I said around 75% with the majority unemployed. They are not generally your white collar consumer. They have little education, little interpretive work history due to the number of incarcerations. Some have been incarcerated for up to 20 years, others have been incarcerated maybe three months at a time or a week at a time. Most of them, when they are released, try to get on to some entitlement program, public benefits. And most of them while they are in jail or in prison end up on the mental health units, therefore they're not selected for any kind of employment task, education and courses and become accustomed to remaining in their treatment environment. They are released to the community where they committed the crime, not necessarily where they come from, which means for our consumers they have been removed from their community supports within their home areas, they have little or no contact with their families, and they often have no access to some of the necessary certifications they need for employment, like certifications, ID's, they have little or no work history or employment history. Slide number 8. Complicated by criminal history. In general, national statistics would show that although involved in mental health agency, about 4 to 5% had one contact with the criminal justice ‑‑ 45% had contact with the criminal justice system. Some mental health would not refuse clients with criminal history. We really will accept nearly everybody that will come to us, and we have to our own evaluations discovered that most of our consumers within the forensic programs have anywhere between 2 to 18 convictions, five or more felons. Some of the crimes are murder, rape, assaultive behaviors, numerous drug related offenses and a lot of assaultive behaviors.
We also have a program for sex offenders. Slide number 7. Sorry. Thank you. Sex offenders are probably the hardest challenge for housing, treatment, and employment. We have found that because they have to register, there are many places of both employment and housing that they cannot live at. Because probation officers go to an employer prior to employment then we have to acknowledge up front all of their crimes, and not only have they the stigma of mental health and chemical dependency, they now have the stigma of mentally ill, chemical dependent sex offenders in the community. Slide number 11. The role of employment in reentry programs. Back in 1998, when we were developing our first employment program, we decided that we would like our consumers to be productive within 30 days of release from a prison. Productivity meant being part of a day program, being a volunteer, returning to educational pursuits or having a job. What we didn't realize at that time is that we would constantly have to come back to talk to our case managers about keeping this as a priority and because there were so many reentry issues that had emerged that employment would be moved down the scale of priorities. I think we can say really we understand that employment is important for the resocialization of this population. However, we have discovered that there are many barriers, not just from employers, but sometimes within our own organizations and within our own agency. Slide number 12. Entry vocational services. So prior to 2010, we have set up a rather complicated, conpre‑hence ‑‑ comprehensive employment services department that we were hoping would serve all of our consumers. We have many sites around the current, so we have a vocational specialist to ‑‑ vocational specialist to work adult community programs. Within each community support program, our campus, there are numerous programs so we identified staff person from every program to get with the vocational specialist to heighten the awareness of employment within the individual program. And then within our specialty programs we employed specialists to work with developmentally disabled, and also we have stand employment for employment program which is open to all of our consumers, but we only have nine volunteer ‑‑ vocation staff. The very growth that we have experienced with our offender population became the very challenge we have within our employment programs. Slide number 13. Growth brought additional challenge. As I mentioned earlier, we actually have within the program 2,500 consumers. But what we decided to do ‑‑ for our vocational consumers is have programs. Within our program, within the campus where the program exists, the feedback we got from our vocational specialist was that it takes too much to try and get our offenders back to work. Too much energy, too much focus, too many barriers, and with all of the other consumers did not have that time. We then worked with our forensic staff who then told us there are so many reentry priorities that to focus on employment for them was again too difficult, too much of a challenge that they could not do either. So we have to go back and redesign and revisit what we are doing for this population. Before I move to that section, are there any questions?
>> Declan, there was one question, on slide 3 you used a lot of acronyms, and people were wondering what some of those acronyms stood for, if you could go over that again, or if there was a place where they could see that list. So maybe you could just go over the acronyms again.
>> Sure. Sure. And I don't know if there's an e‑mail distribution list I can follow with it afterwards too. Let me start with that. Fact is forensic assertive community treatment. It is a high intensity community outreach model, usually caseload is 1‑10. It is particularly for just those coming out of jail that have 7‑10 incarcerations within the last year, so they have to have a major mental illness and 7‑10 incarcerations. FISH is forensic intensive support of housing. It's a housing first model, it is for how utilizers of the community jail. It is for those who are found incompetent to stand trial so therefore they stand before a judge, they're assessed for competency, and they have decided you don't meet competency criteria, they're evaluated for civil commitment. And they find them, they don't meet that criteria, what happens is the population are released back out of jail to the streets primarily, and then cycle back into the jail, the courts, the streets and it's just a continuous cycle. They're actually probably the highest spenders of the jail money within our system. ORCSP is ‑‑ ORCSP is a program for the dangerous mental illness offenders. Dangerous mental illness offenders have two ‑‑ they're made up of nine defendant co‑entities. One, the person has to be dangerous, the second is they have to be mentally ill. The two have to have correlation to each other. It's an inside transit support model. Mental health and crime have to have a correlation, unlike the one prior to that. It began as a prison program and in both of these programs we do three months prerelease, so we go to the prisons, work with them prior to then coming out into the community. The CCAP and court are a diversion program as an alternative to going back to the jail or the prison. We do intensive outpatient treatment for chemical dependency primarily within those programs. Sound reentry is the program that we are focusing on employment outcome today. It is a program of approximately 700 consumers who are all on public benefits, outpatient treatment, not as intensive as the other programs, also refers homeless from the jail. And IDDT is an intensive disorder treatment for jail clients who is an evident approach for mental illness and chemical dependency. These programs have more money in them.