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> This program will begin in approximately 10 minutes, thank you for your patience. Please continue to stand by. Good morning and welcome to the webinar titled Peer Specialists and Police as Partners preventing pre-behavioral health crisis, presented by SAMHSA, my name is Kelle Masten, from the state health program directors and I would like to welcome you to the webinar today, before we introduced her -- Directors for today, the recording is being recorded and will be posted at health America, one where,.net. And the NASMHPD website. Www. NASMHPD.com -- If you're having any technical difficulties during this webinar. Please type your comment in the Q&A part, on the right side of your screen, someone will be able to assist you. Please also type your questions for the presenters that the Q&A part, at the end of the questions Tatian, we can -- At the end of the presentation we can ask as many questions as we can. The PowerPoint presentation is at the top of your screen, please click on the file and download to the slides. Please take a few moment to complete the feedback. Please note we do not offer CEU credits, for the webinar, we will send you a letter of attendance by request, my email address will be available on the top of the screen during the evaluation of the webinar. Thank you for joining us. I will now turn it over to Michelle, who will introduce today's presenters.
Thank you Kelly. Today our presenters are Kasey Moyer, and she proactively assistance in the development within traditional services, and the criminal justice system. Through this work, she has enhance the quality of life for individuals living with mental health, or substance use challenges, many who have been incarcerated, or at risk for higher levels of care. She currently employs 30 peer specialists, and Kasey overseas
respite care programs, partnering with the Lincoln please department, peer benefits program, and appear reentry program within the department of corrections, and the county jail. Luke Bonkiewicz, a police officer for the Lincoln Police Department with approximately 10 years law enforcement experience, he is currently the resource coordinator responsible for coordinating the intern and volunteer program assisting with the police applicant hiring process, and a variety of training and education programs, he has assisted the Lincoln Police Department in analyzing various data related traffic stops, license suspensions, gang intervention programs, use of control by police officers, assault on police officers and victim assistance, and publish peer-reviewed research on patrol officer productivity and role of police in disasters and evaluation, and the police response to mental health calls for service, now I will turn it over to Kelle. --
Hello good morning my name is Kasey Moyer. The mental health Association of Nebraska is peer run and operated, all of our operators are peers, driven by the people that we serve. The real program, which stands for respond, advocate and listen, named by the participant of a program, with law enforcement that we will talk about today, that number of referrals has now reached 2300 referrals, over 300 different officers making those referrals. We also
get referrals from other providers, such as bus drivers, public schools, self referrals. Family. They are completely voluntary. What happens here. The officer will get called out to a situation. The individual may be dealing with mental health, substance use, or dealing with loneliness, loss of job, it could be anything. They turn around to email the peers. Within 24 hours, a Peer Specialists will go out,
we'll talk to that individual just to see if we can get them connected with services before law enforcement goes back again. Luke will talk more about that here. I will go through some of the other programs.
This is our peer run respite house, and we have a warm line run out of that house, and we do have 500 calls a month on that warm line, staffed with peers, no clinical staff that house I call it a bed-and-breakfast, people who cannot afford to come I think it is a place -- People maybe would be at home in their house or apartment, we get in our head. Having somebody that you can be around with this peer support, to talk about what is going on, this can be really helpful.
This is our Honu Home , the average stay is 66 days, which gives them time to create their own wellness plan, to look at employment to find safe affordable housing, to receive 24 seven peer support. This is are supported employment program, we have served 140, that number has quickly risen, we have 75% employment rate. I like to point out, the people that work for MHA, actually we just hired eight more peers, we expanded our Honu Program , 10 of those peers did come out of corrections, and spent time in our prison facilities. 10 of them came out of a drug court
program, we had three peers mental health board commitment and for veterans on staff -- 4 veterans on staff.
At one time we were in the system, now we were giving back and are a part of the solution rather than the part of the problem. This is our peer outreach, we did this without here being able to meet people whether at, we most likely are not scheduling appointments, we are going where people need us at the time they need us, this might mean we are going out to a facility where people are being released, going to jails, even going under bridges, downtown on the street wherever people are. Wherever we can connect with them and help them with services. We help people to look for housing and basic needs. Also to help them get connected. We also go with them to their appointments. We are big on wellness recovery program, we do groups out of our houses, and we do these inside the prisons, we all have 10 state facilities in Nebraska, and we are in current format of them which is a medium maximum security, and we are in the William -- The women's facility. We are not currently there. But we have done it there. This is our new Honu Home , a lot of people coming out into our transition home, in April we moved to this building. This will serve up to 20 individuals, coming out with mental health and substance abuse issues, receiving that 24 seven peer support. The thing about all of our programs law enforcement is very involved in what we do. They will come to the house and we get to know them. Not because we are calling 911, but because they are coming and having coffee with us, they are getting to know the people in the houses. This will build the relationship . Oh they get to see is not only on our worst day, but will also when people are doing well too. Once we have those relationships and we do need them for the price -- The crisis part of it, we know what is helpful, they know who we are, and they also nor support systems and who they can contact.
We are very involved in law enforcement training, and we participate with new recruits we do training with their dispatch, every year we do what is called BHTA training, behavioral health assessment training, we did our ninth annual , this coming year we will do our 10th annual one, we average 65 officers per training. We get to talk to them about what it's like for us dilling with mental health issues, coming in contact with law enforcement. Again we can and do we cover. We get to talk about -- We do recover. We did talk about our support system and how we can best get connected with services rather than ending up in the crisis center or the jail, we have trained all law enforcement here. We do have WRAP plans, and they know when they come in contact, they are to look at the refrigerator in the crisis plan get a list of the people that support them. Our relationship goes beyond the program, Luke will talk about this. They have been great support in all of the programs that we run.
Okay my name is Luke Bonkiewicz, I am a police officer at the police department, I will talk about a little bit more about the R.E.A.L. program, and some of the discussion points, one thing I want to point out talking about R.E.A.L. program, and the analysis so much of what Kasey has talk about, and I will talk about, it seems seamless overnight the way Police Department and the interface resources, in reality this has been taken decades of work, what we are seeing today here, on June 5, 2018, has been 20 years in the making probably longer, that is the way of shifting over a couple of decades, changing in the ways of the attitudes of officers, and the cheese -- Chief of police.
The mental health providers, and providers. Everybody has come far in partnering together.
What we will talk about in terms of the real program, we are standing on the shoulders of giants the people coming before us even 20 years ago.
The R.E.A.L. program, respond and advocate program, to after a call for service, previously, in many jurisdictions today, when someone conducts for mental health services, typically they leave at the end of the call, they can either take them into crisis center or into custody, or determine they are not a danger to themselves this is looking up the model for many years, in conjunction with MHA, there is something simple that can happen after that call for service. When I am going out for service, I take them into custody, maybe I don't. Maybe I take them to Keya House or another respite house, we are making a referral, once they get the referral from the officer, they go out to make contact of the mental health consumer it's important to note three things. The three things that I really want to stress. This referral. This contact from the Peer Specialists, it is free and voluntarily nonclinical, I think those prongs are important. Many times as we know, some cannot afford the things being offered, it is important to go out free of charge to contact them. This is voluntary. This is not the cops, going out there to say you were in contact with police officers you need to do this. You need to take medication. Or do this plan. It is not voluntary. We will present options. But we will not make anybody do anything it unless of course they are a danger to themselves or others, and then in case we would take them into mental health custody. It will be nonclinical, from my experience in the field talking to consumers, this is pretty powerful. I have viewed and observed the way consumers talk to Doctor Ayers and nurses and mental health professionals and psychologists, it is very different, because in their eyes you can see when they come in contact with them they see this person has a peer, someone who has lived experience, there is credibility . It is so important it is nonclinical.
How do I as an officer make this referral? > After I completed my mental health investigation, I will send an email, there are three components of the referral, first I will describe the incident, when I went out this individual, was there an attempted suicide? Did I simply do a mental health investigation where a determined they were not a danger to themselves or anyone else? Did I take them to one of our facilities? Because there was substance dependent? Did I take them to a crisis center? In other words what was the incident and what happened? We will provide contact information. So that the Peer Specialists can make contact. And then a very brief description of the incident, this is not a police report, I'm not given them a police report of what happened, generally just a paragraph of what that contact look like. As simple as I went out John Smith, such and such date and time, he says he lives with depression, and has not been taking his medication he has been doing really well, unfortunately John's wife left him and he is feeling real distraught, I did not EPC or take him into custody, he did not fit the criteria, I left him in the care of so-and-so. They can do that simple, sometimes more complicated come sometimes more two or three paragraphs sent rare cases for those who are using mental health severe services, they are not getting the resources they need from the police department or other mental health providers. We conducted the evaluation of REAL program, and in the papers. And the research articles we're publishing, we're trying to do a good job of framing the issue in terms of what is the real program, how does this benefit mental health consumers. And we are seeing benefits, what type are we experiencing? > We have talked a little bit about what the program is and how officers use the program. We will take not necessarily a deep dive into the data. But we will dive somewhat deep. It is important , to help understand why this program works and why it is positively impacting mental health consumers. We gathered some data. Information on 775 individuals. A portion of those 410 had been referred, 365 were not referred. To the REAL program, it's important to note it is not a randomized control experiment, this is not the goal standard, this is not a drug trial, a situation where someone is referred to us, we can randomly assigned to them, we are not contacted by Peer Specialists, and we need to use other diagnostics. Other diagnostics to analyze data. To get around this. We try to account for numerous control values and individuals of some who which were referred and not referred, age, race, gender, the prior times they have been arrested, for felonies? Prior mental health for this generated, try to get background information to do our best for control for all extraneous variables. We looked at three outcomes following a police abated health call services all of these individuals are contacted by law enforcement because they were experiencing mental health experience, they were not calling us to report , because they were a suspect or anything else. These were incidences where we came into contact, because they experience mental health crisis. After that call for service. We started looking at different outcomes. Three different types of outcomes. Whether this individual was arrested. After this police abated health call service, and the number of health call services they generated for this particular incident, and whether these individuals were taken into protective custody, EPC, and look at three different outcomes at different points in time, 12 and three years after the health calls for service. In other words we looked at end the individual, where they arrested 12 months, 24 months or 36 months after that crisis, whether that individual was EPC,
methods of analysis I won't spend a lot of time. I do know there are people in the audience that are interested. In what type of analysis we use. Very briefly we look at logistic regression, we have binomial distribution, and because the number of calls for the service, instead of using regular regression we have used Negative Binomial Regression. I can answer more questions about that. So what is the program impact? Disappointing news , sorry to lead with this, it is important. We are trying to figure out the impact of the program, if something is not working, we need to know it's not working perhaps we can fix it. On one of the things we found out first. No impact whatsoever on the odds let me back up. No impact on any outcome in a 12 month period. Regardless of whether the person was referred or not referred, there is no difference in odds of being arrested number of health calls or odds being in protected custody one year after, this other part we did not see any effect of the real program, in being arrested, those individuals will were referred to the REAL program, 12 months, 36, these are no different to other individuals referred to the REAL program. We did have this negative effect two years and three years after the crisis, if individuals were referred to this program we found they had a lower number of mental health calls for service two years and three years later. Compared to individuals who are not referred to the program. The other point I want to make, this means it may grow stronger over time there was of the real program on future mental health services, this was not significant at 12 months, it got bigger at 24 months and was significant and then got bigger at 36 months, the effect of REAL program is affected over time, I do not know whether this will get stronger. If I had four or five years or to gas, probably it will stabilize. It will level off, at about three or four, five years, that is just me looking at the data to project beyond the 36 time month period. The other positive impact we saw, this program