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Findings and Recommendations 33 findings
F01
Recidivism (also commonly known as the revolving door or recycling) is defined as the tendency to relapse into a former pattern of behavior; specifically, returning to criminal habits.
No recommendations for this finding
F02
The Camarillo State Mental Hospital phased out its services and eventually closed in 1997.
No recommendations for this finding
F03
In a National Public Radio broadcast, Renee Montagne stated, “The largest mental institution in the country is actually a wing of a county jail. Known as Twin Towers, because of the design, the facility houses 1,400 mentally ill patients in one of its two identical hulking structures in downtown Los Angeles.” [Ref-03]
No recommendations for this finding
F04
In the August 14, 2008 edition of the Los Angeles Times, Los Angeles County Sheriff Lee Baca stated: "They're here, and they're going to be cared for, but is this what we want in the way of a policy? Are we saying the legal system is the solution for the mentally ill in L.A. County? I don't think so. I'm saying criminals belong in jail, not the mentally ill." ___________________________________________________________________________ Mentally Ill Housed in Jails 3
No recommendations for this finding
F05
Collaborative justice courts, also known as problem-solving courts, attempt to promote accountability by combining judicial supervision with rehabilitation services that are rigorously monitored and focused on recovery. [Ref-04]
No recommendations for this finding
F06
Collaborative justice courts are distinguished by the following elements: a problem-solving focus, a team approach to decision making, integration of social and treatment services, judicial supervision of the treatment process, community outreach, direct interaction between defendant and judge, and a proactive role for the judge inside and outside the courtroom. [Ref-04]
No recommendations for this finding
F07
MHCs, a type of collaborative justice court, focus on treatment to restore health and reduce criminal activity. They strive to provide mentally ill offenders with better access to treatment, consistent supervision, and support to reconnect with their families. [Ref-04]
No recommendations for this finding
F08
The common elements in MHCs are: [Ref-02] • participation in a mental health court is voluntary • each jurisdiction accepts only persons with demonstrable mental illnesses who have become involved in the criminal justice system • the key objective of a MHC is to either prevent the jailing of mentally ill offenders or to secure their release from jail for appropriate community services • public safety is a high priority, and mentally ill offenders are carefully screened for appropriate inclusion in the program • early intervention is essential, with screening and referral occurring either immediately after arrest or up to a maximum of three weeks after arrest • a multidisciplinary team approach is used, with the involvement of justice system representatives, mental health providers, and other support systems • intensive case management includes supervision of participants, with a focus on accountability and monitoring of each participant's performance • the judge is the center of the treatment and supervision process
No recommendations for this finding
F09
The stated goal of a MHC is to: [Ref-05] • decrease the frequency of clients’ contact with the criminal justice system • provide courts with resources to improve clients social functioning • link clients to employment, housing, treatment, and support services 4 Mentally Ill Housed in Jails
No recommendations for this finding
F10
There are two major concepts underlying the essential elements in any MHC: [Ref-06] • Collaboration among the criminal justice, mental health, substance abuse treatment, and related systems is important • MHCs are not a panacea - reversing the overrepresentation of people with mental illness in the criminal justice system requires a comprehensive strategy of which mental health courts should be just one part
No recommendations for this finding
F11
More than 175 counties in the United States, including 43 of the 58 counties in California, have a MHC.
No recommendations for this finding
F12
Santa Clara and San Bernardino Counties are two of the earliest examples of MHCs in California, having begun in the late 1990s.
No recommendations for this finding
F13
The stated vision of both counties was to bring together the Court, Criminal Justice System, Mental Health System, Drug and Alcohol System, and community treatment to reach mentally ill defendants and to release them from jail into community treatment, consistent with public safety.
No recommendations for this finding
F14
In order to graduate from these programs, each participant must remain sober and drug-free, complete a treatment plan, maintain medication, and continue treatment compliance.
No recommendations for this finding
F15
Officials in both counties stated that a major obstacle has been the availability of sufficient types and numbers of suitable housing facilities.
Related Recommendations (1)
R02
Ventura County should ensure that there is sufficient and suitable housing necessary to support an effective Mental Health Court system. (C-10) Responses (Using the table below is optional. If it is not used, then, as applicable, list each agency that is required to respond and, the recommendation number(s) for each and in a separate list, list each agency that is requested to respond and the recommendation number(s). Responses Required From: Board of Supervisors, County of Ventura (R-01, R-02) District Attorney, County of Ventura (R-01) Sheriff, County of Ventura (R-01) Responses Requested From: Probation Agency, County of Ventura (R-01) Health Care Agency, County of Ventura (R-01, R-02) Public Defender, County of Ventura (R-01) Responses Accepted From: National Alliance on Mental Illness, Ventura County
F16
The average number of participants currently served by these MHCs is: County Participants Santa Clara 150 San Bernardino 125
No recommendations for this finding
F17
The number of graduates from the two programs are: County Period Graduates Santa Clara 1999-2009 1,100 San Bernardino 1999-2009 623
No recommendations for this finding
F18
These graduates have avoided jail bed days with the following cost savings: County Period No. jail bed day $ Savings Santa Clara 1/05–6/06 31,315 $2,175,453 San Bernardino 1/06-12/06 10,316 $ 576,571
No recommendations for this finding
F19
The Council on Mentally Ill Offenders designated The San Bernardino County, Supervised Treatment After Release Program to receive the 2009 Best Practices Award. They stated “. . . the program has been in ___________________________________________________________________________ Mentally Ill Housed in Jails 5 operation for ten years and has effectively reduced recidivism for incarceration, shifted the demand for services to the mental heath system and provided significant benefits for consumers in terms of deinstitutionalization.” [Ref-07]
No recommendations for this finding
F20
San Bernardino County utilizes the following types of housing in support of the individuals in the program: Type of Facility Characteristic Cost /Day Board and Care Licensed to dispense medications $ 32 Room and Board Housing/meals $ 22 Sober Living Housing only $ 18
No recommendations for this finding
F21
In most cases, the cost of housing is paid for by Supplemental Security Income (SSI) and not borne by the County.
No recommendations for this finding
F22
In October 2008 the Ventura County jails housed approximately 1,680 inmates: Facility No. Inmates Main Jail 822 Todd Road 833 East Valley Jail 25
No recommendations for this finding
F23
Approximately 10%-14% of the County inmate population is diagnosed with mental illness.
No recommendations for this finding
F24
The total capacity of the County jails is: Facility Rated1 Overflow2 Total Main Jail 793 108 901 Todd Road 782 98 880 East Valley 35 N/A 35 Total 1,610 206 1,816
No recommendations for this finding
F25
The average daily cost of incarceration per inmate, according to the VCSD is: Facility Cost per Day Main Jail $153.00 Todd Road $115.00 1Rated Capacity means the number of inmate occupants for which a facility’s single and double occupancy cells or dormitories, except those dedicated for health care or disciplinary isolation housing, were planned and designed in conformity to the standards and requirements in Title 15, California Code of Regulations. 2Overflow beds are bunk beds placed in dayrooms of housing sections during overcrowded conditions. The majority of these beds are normally occupied and one cell remains open to give inmates housed in the dayrooms access to a toilet. Mentally Ill Housed in Jails
No recommendations for this finding
F26
The Crisis Intervention Team (CIT) program was implemented in the County in 2001 through the efforts of the BHD and several local police agencies. It was a direct result of a number of shootings involving mentally ill individuals, which occurred in the late 1990s.
No recommendations for this finding
F27
The published goals for the CIT are: [Ref-08] • reduce the necessity for the use-of-force • de-escalate crisis situations • reduce the use of jail • decrease recidivism • increase lawful self-reliance and health enhancing behaviors
No recommendations for this finding
F28
MARRT was federally funded by a Mentally Ill Offender Crime Reduction Program (MIOCOR) Grant which began on April 1, 2007: • the intent was to encourage seriously mentally ill offenders who are not currently involved in mental heath treatment to agree to receive needed treatment • the MARRT Team includes members from the Court, VCSD, DA’s Office, PD’s Office, Probation and BHD • with the exception of BHD, the Judge and other team members are assigned on a rotating basis • average client participation is approximately 20
Related Recommendations (1)
R01
Ventura County should formalize the current MARRT program into a permanent Mental Health Court with the necessary funding and assignment of full-time personnel from each of the collaborative departments. (C-01 through C-10) 8 Mentally Ill Housed in Jails
F29
Although the funding for MARRT ceased in September 2008 after eighteen months, the MARRT Team agencies determined the program to be a success and decided to continue participation utilizing their respective general funds.
Related Recommendations (1)
R01
Ventura County should formalize the current MARRT program into a permanent Mental Health Court with the necessary funding and assignment of full-time personnel from each of the collaborative departments. (C-01 through C-10) 8 Mentally Ill Housed in Jails
F30
The results of the MARRT client screening process are: • 203 were reviewed for eligibility • 136 were found to be eligible and then evaluated for suitability • 76 were found to be suitable • 59 agreed to enter the program • 14 have graduated to voluntary mental health services
No recommendations for this finding
F31
The BHD has identified a shortfall in appropriate housing for very low- income individuals who have serious mental illness. (Att-01)
Related Recommendations (1)
R02
Ventura County should ensure that there is sufficient and suitable housing necessary to support an effective Mental Health Court system. (C-10) Responses (Using the table below is optional. If it is not used, then, as applicable, list each agency that is required to respond and, the recommendation number(s) for each and in a separate list, list each agency that is requested to respond and the recommendation number(s). Responses Required From: Board of Supervisors, County of Ventura (R-01, R-02) District Attorney, County of Ventura (R-01) Sheriff, County of Ventura (R-01) Responses Requested From: Probation Agency, County of Ventura (R-01) Health Care Agency, County of Ventura (R-01, R-02) Public Defender, County of Ventura (R-01) Responses Accepted From: National Alliance on Mental Illness, Ventura County
F32
In a December 2008 article titled, The Mentally Ill in Our Jails, County Supervisor Linda Parks states: (Att-02) • county jails are overcrowded • there are approximately 200 mentally ill people, with females outnumbering the males by more than 2 to 1 ___________________________________________________________________________ Mentally Ill Housed in Jails 7 • common offenses for these people are: public intoxication, trespassing, substance abuse, and theft • those incarcerated lose their Medi-Cal and SSI benefits • keeping people in jail is expensive
No recommendations for this finding
F33
Supervisor Parks closes by stating, “Now is also the time to look at programs to provide treatment for the mentally ill with the same goal of helping them to re-enter society as productive citizens.” (Att-02) Conclusions C-01. MHCs have proven to be successful in the United States, specifically in California over the past ten years. (F-16, through F-19) C-02. To be effective, MHCs require intensive collaboration among judges, prosecutors, defense attorneys, probation, and behavioral health. (F-06, F-07, F-08, F-10, F-13) C-03. The use of MHCs reduces recidivism, thereby lowering the overall cost of multiple incarcerations. (F-19) C-04. The cost to the County of diverting individuals to alternate mental health treatment facilities is lower than the cost of incarceration in County jails. (F-20, F-21, F-25) C-05. The MARRT Program has some of the same features and goals as a MHC. (F-28) C-06. MARRT Team agencies are supportive of the MARRT Program. (F-29, F-30) C-07. The success of the MARRT Program has been demonstrated; it could be expanded with commitment of more resources to accommodate additional clients. (F-29, F-30, F-33) C-08. The funding for MARRT is tenuous, since it is currently based on the generosity of each individual team member agency. (F-29) C-09. Assigning team members on a rotational basis may diminish the effectiveness of the program. (F-28) C-10. The County has a shortage of appropriate housing for those who have serious mental illness, especially those who are of very low income, are homeless, or are at risk of homelessness. (F-31) Recommendations
No recommendations for this finding
Conclusions 1
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CL1 Page 10C-01. MHCs have proven to be successful in the United States, specifically in California over the past ten years. (F-16, through F-19) C-02. To be effective, MHCs require intensive collaboration among judges, prosecutors, defense attorneys, probation, and behavioral health. (F-06, F-07, F-08, F-10, F-13) C-03. The use of MHCs reduces recidivism, thereby lowering the overall cost of multiple incarcerations. (F-19) C-04. The cost to the County of diverting individuals to alternate mental health treatment facilities is lower than the cost of incarceration in County jails. (F-20, F-21, F-25) C-05. The MARRT Program has some of the same features and goals as a MHC. (F-28) C-06. MARRT Team agencies are supportive of the MARRT Program. (F-29, F-30) C-07. The success of the MARRT Program has been demonstrated; it could be expanded with commitment of more resources to accommodate additional clients. (F-29, F-30, F-33) C-08. The funding for MARRT is tenuous, since it is currently based on the generosity of each individual team member agency. (F-29) C-09. Assigning team members on a rotational basis may diminish the effectiveness of the program. (F-28) C-10. The County has a shortage of appropriate housing for those who have serious mental illness, especially those who are of very low income, are homeless, or are at risk of homelessness. (F-31)
Commendations 2
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CM1 Page 11The Grand Jury commends the staff and management of the Behavioral Health Department, part of the County Health Care Agency, for their professional dedication and excellent performance in caring for the mentally ill residents of Ventura County. Their assistance and cooperation throughout this investigation proved invaluable. The Grand Jury thanks and commends the San Bernardino County Mental Health Court collaborative team for providing invaluable and comprehensive insight into their Mental Health Court System. The Grand Jury acknowledges their cooperation and willingness to share their vast experience, success stories, and challenges concerning this very important issue. The Grand Jury thanks the mental health staff at the Sheltered Housing Units for the Mentally Ill at the West Valley Detention Center in Rancho Cucamonga for their briefing and tour of their facility. References Ref-01. Inside the Nation's Largest Mental Institution, by Renee Montagne, dated August 14, 2008 http://www.npr.org/templates/story/story.php?storyId=93581736 Ref-02. Fact Sheet issued by the California Collaborative Justice Courts Advisory Committee, November 2005 http://www.courtinfo.ca.gov/reference/documents/factsheets/collab.p df ___________________________________________________________________________ Mentally Ill Housed in Jails 9
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CM2 Page 12Ref-03. California Courts Programs website http://www.courtinfo.ca.gov/programs/ Ref-04. What is Collaborative Justice?, California Courts Programs website http://www.courtinfo.ca.gov/programs/collab/ Ref-05. California Mental Health Court website http://www.courtinfo.ca.gov/programs/collab/mental.htm
No Responses Found 5
Government entities assigned to respond to this report. No response documents have been linked in our database.
County of Ventura
Agency
Ventura County Board of Supervisors
Elected County Office
Ventura County District Attorney
Elected County Office
Ventura County Public Defender
Elected County Office
Ventura County Sheriff
Elected County Office