Does Your Loved One have A Mental Illness?
Are They Faced With A Prison Sentence?
Get A Fort Lauderdale Criminal Lawyer For A Diversion Program
According to a recent articel America's jails and prisons have replaced psychiatric hospitals as warehouses for people with mental illness. Substance abuse disorders also abound, but innovative healthcare models and other advances are helping to confront the crisis in our nation's correctional facilities.
About 15% of men and 31% of women in jails are affected by serious mental illness, according to the Council of State Governments' Justice Center.
The crisis of mentally ill individuals flooding prisons is a "common-sense problem," according to Roy Austin, JD, deputy assistant to the President for the Office of Urban Affairs, Justice and Opportunity. Austin spoke last week in Washington at a conference on criminal justice reform hosted by the Washington-based National Council for Behavioral Health, and by Community Oriented Correctional Health Services (COCHS) of Oakland, Calif.
"We know for a fact that we are incarcerating people who are having mental health issues. And we know for a fact that we are not providing them with the treatment that they need so that they can be successful when they come out," Austin said, adding that the "common-sense solution" is the Excellence in Mental Health Act.
Its purpose is to establish criteria and funding for the development of federally qualified behavioral health centers, also known as certified community behavioral health centers or CCBHCs.
Co-sponsored by senators Debbie Stabenow (D-Mich.) and Roy Blunt (R-Mo.) and signed into law April 2014, the legislation allocates $1 billion in Medicaid dollars to CCBHCs. Twenty-four states have received grants to aid in planning the development of such CCBHCs. Late next year, eight of the 24 states will be chosen to participate in the demonstration project.
Steven Rosenberg, president of COCHS, told MedPage Today that CCBHCs use a "trauma-informed recovery model" which seeks to understand the underlying events in patients' lives — such as physical abuse or other types of victimization — that may have contributed to their current situation.
These care teams are unique in that they operate outside of traditional settings. They can visit jails, arraignment courts, foster homes, and halfway houses, helping to divert people who should be receiving treatment instead of being incarcerated into the proper setting. They will also coordinate care services for those leaving the prison system.
"It opens up an entirely new vista in how we've thought about the connectivity between behavioral health and justice involved individuals," he added.
The Excellence in Mental Health Act builds on the Affordable Care Act, which encourages states to expand Medicaid to include individuals with incomes up to 138% of the federal poverty level, or about $16,242 for an individual in 2015.
So far, 30 states and the District of Columbia have chosen to go ahead and do so, according to the Kaiser Family Foundation, a nonprofit health policy group here. While inmates cannot use Medicaid benefits while they are in prison or jail — except during hospital and nursing home visits longer than 24 hours — 12 states, as of 2014, have implemented a policy of suspending inmates' coverage rather than ending it, according to the foundation.
In 2006, Massachusetts began enrolling Medicaid eligible inmates, after the state overhauled its healthcare system. Other states followed suit when the ACA went into effect. Ohio enacted a program to help enroll inmates in Medicaid prior to their release, as has one large New Mexico county.
Wisconsin, which did not expand Medicaid under the ACA, nonetheless extended coverage to nondisabled, childless adults if their incomes don't exceed the federal poverty level. The state has also engaged its corrections staff in helping inmates to enroll in Medicaid by phone 3 months prior to their release.
A 2007 report published in the journal Psychiatric Services found that the number of detentions among inmates who were already enrolled in Medicaid on release from jail was "slightly lower" than those without the benefits. However, an as-yet-unpublished study by Joseph Morrissey, PhD, a professor of health policy at the University of North Carolina Gillings School of Public Health, in Chapel Hill, did not duplicate these findings, he said — expedited Medicaid benefits did not have any impact on recidivism.
"Something more than health insurance is needed to help people make a successful adjustment to the community and to keep them from behaviors that might lead to rearrest and re-incarceration," Morrissey told MedPage Today.
Morrissey noted that coupling social welfare — such as secure housing — with more targeted psychiatric and behavioral health interventions could have a greater impact, and stressed the need for further research into such programs.
In addition to early enrollment some states have focused on enhancing care continuity through stronger information exchange. Interoperable electronic health records are, in fact, a requirement of certified community behavioral health clinics.
In Kentucky, Karen Krisman, JD, MA, a staff attorney for the Governor's Office of Electronic Health Information in Frankfort, who also spoke at the conference, explained how her state had expanded its health information exchange.
Currently, five behavioral health locations and one of the state's detention centers can actively send and retrieve health data. Real-time data, not claims data, is available to treating providers, and complete operability for the state remains the ultimate goal, she said.
Do you have a loved one who has been arrested but, has a mental illness that was causing their actions?
Contact one of our Fort Lauderdale criminal lawyers for help today.