CRISIS NOW: National Campaign To Create A Uniform Mental Health Response And Recovery System Not Dependent On Police Or Emergency Rooms

Three minute plus video explains model crisis care system.

(10-26-20) What are we doing to create a better mental health care system?

CRISIS NOW, a four prong approach, is gaining national attention from SAMHSA and being endorsed by many of the nation’s largest mental health organizations, including The National Association of State Mental Health Program Directors (NASMHPD), the National Alliance on Mental Illness, Mental Health America, CIT International, RI International, the National Council for Behavioral Health, the National Action Alliance for Suicide Prevention and the National Suicide Prevention Lifeline.

That’s a powerful coalition so what is CRISIS NOW?

David Covington, the CEO and President of RI International, described the approach at a recent meeting of ISMICC, a federal panel appointed to advise Congress about the most innovative and best practices in mental health.

The goal behind CRISIS NOW is to create a uniform mental health system that is not so heavily dependent on the police and hospital emergency rooms. The first prong is creating Crisis Call Hubs, which can be contacted by voice, text, or chat through a specific telephone number rather than having those in crisis call 9-1-1. President Donald Trump recently signed into law bipartisan legislation identifying 9-8-8 as a three digit number for a Mental Health Crisis Hotline. Slated to go into effect nationally in July 2022, it will replace the current National Suicide Prevention Hotline, a more complicated 10-digit number — 1-800-273-TALK.

But this new number under the CRISIS NOW approach would offer much more than its predecessor.

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Two News Stories: Police More Likely To Fatally Shoot In Smaller Communities; San Francisco Shifts Crisis Calls Away From Police

Patrick Kenny before he was fatally shot by CIT trained officers in Springfield, Oregon. Disgraceful.

(10-23-20) Two recent news stories about law enforcement and mental illnesses are worth reading.

I’ve always supported Crisis Intervention Team training. Years ago, Patti and I donated $500 each year to our local police department to honor a CIT officer of the year. I know of numerous incidents where CIT officers have prevented suicides and helped individuals in crisis get help rather than hauling them to jail.

Sadly, some officers who have undergone CIT training don’t get it. One of the worst instances involves four Springfield, Oregon police officers who underwent CIT training but killed a young man in crisis. I posted a first person blog written by Kimberly Kenny about her brother’s death in July and The Washington Post used that tragic killing this week to illustrated a story with the headline: Fatal police shootings of mentally ill people are 39 percent more likely to take place in small and midsized areas.

The second news story comes from NPR and is entitled: Removing Cops From Behavioral Crisis Calls: ‘We Need To Change The Model.  San Francisco, California is preparing to deploy teams of professionals from the fire and health departments, rather than the police, to respond to most calls for people in a psychiatric, behavioral or substance abuse crisis. The action “will be among the largest and boldest urban police reform experiment in decades.”

When someone becomes violent, there’s often little choice but to have the police respond. But I would argue that they shouldn’t be the first called and, in a majority of cases, don’t need to be involved. In June, I posted a blog about how Albuquerque, Mexico officials were studying ways to free law enforcement from mental health crisis calls.

What’s happening in San Francisco and Albuquerque is a much needed shift that should be endorsed by law enforcement as well as those of us with a family member who has a serious mental illness. My son, Kevin, was shot twice with a taser when the police were called. That didn’t need to happen.

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What More Can We Do? Parents Ask After Years Of Trying To Help Son With Mental Illness & Alcoholism. Is Jail The Only Answer?

Image by Gordon Johnson from Pixabay

(10-19-20) A mother from Fairfax County, Va., recently sent me an email about her son who was about to be released from probation. In addition to having been diagnosed with a serious mental illness, this young man also is an alcoholic and was born with fetal alcohol spectrum disorder that he inherited from his birth mother. It is difficult for individuals to get treatment for a mental disorder. When you add an addiction, it becomes even harder and if an individual refuses help, there are even fewer options. I asked the mother to share her family’s story and I was stunned when I received a detailed account that dated back to her son’s birth. The mother and her husband have tried every possible program in Fairfax with limited success.  I am posting her account anonymously and with pseudonyms to protect the privacy of those involved.

Dear Pete.

My husband and I have tried everything to get help for our son since he was born. He has fetal alcohol spectrum disorders from his birth mother and has been diagnosed with borderline schizophrenia, OCD, learning disabilities, and a sociopathic personality. He is an alcoholic and dangerous when he drinks. He refuses all help offered.  We can’t live with him or around him.
What more can we do?
We have been through the Community Service Board’s services (mental health services in Virginia,) our local jail diversion programs, have hired life coaches and mentors. We’ve found him housing only to have him be evicted. He is about to get off probation. It seems involuntary commitment is a short term solution but he was in (a local mental hospital) several years ago and they released him after seven days.
We are at a loss.

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Mental Health Judge Is Not A “Social Worker” But Uses Docket To Connect Individuals With Mental Illnesses To Social Workers

Judge Tina Snee of the Fairfax County General District Court speaks at first mental health docket graduation. Photo courtesy of Fairfax County Government.

(10-6-20)  I want to thank Fairfax County General District Judge Tina Snee for answering questions about the county’s mental health docket, which is an important part of the overall Diversion First program that was created to divert individuals with mental illnesses and addiction problems into treatment services rather than having them languish in jail and ultimately being released untreated. 

  1. What made you agree to add a mental health docket to your already full schedule as a Fairfax County General District Judge?

I joined the bench in 2015 from a background of civil litigation.  It was my first immersion into the criminal justice system, and I was surprised at the number of defendants who presented, or charges reflected mental health and/or addiction issues. I was approached by Fairfax Court Services to see if I would be willing to work cross agency on the Fairfax County Diversion First Initiative.  We decided it would be beneficial to add a Behavioral Health Docket so we successfully petitioned the Virginia Supreme Court for approval of a Behavioral Health Docket and after its first year of operation can say it is a success.

All of us who work on Diversion First are doing it in addition to our busy schedules but we all receive a great deal of satisfaction seeing the benefits to individual defendants and the criminal justice system here in Fairfax.  

  1. Some Virginia Judges oppose problem solving dockets – arguing that they require judges to become “social workers” or they argue defendants who come before them shouldn’t get special treatment simply because they have a mental disorder. How do you respond to those arguments?

The simple answer is I am trying to connect those on the docket to a “social worker” not be a social worker. I am still a Judge, and this is still the criminal justice system. The Fairfax County Mental Health Docket was approved by the Virginia Supreme Court and follows the structures implemented by the NADCP (National Association for Drug Court Professionals). NADCP provides a structured outline of the roles of each MH Docket team member (Judge, Prosecutor, Defense, Probation, Treatment). This outline clearly defines each team member’s role and duties – a sort of “stay in your lane” approach. The judge does not enter into a role of a “social worker.” The Judge hears the perspective of the team and requires participants to follow treatment recommendations.

At pre-court meetings, the team discusses each participant’s progress, to include challenges and successes that have occurred over the course of the past two weeks. We discuss possible treatment interventions, supervision adjustments, sanctions, and incentives. This allows us to have a discussion between everyone – treatment, supervision, defense, and prosecution – the judge ultimately decides if there will be a sanction or incentive issued. However, the judge does not determine the treatment intervention – treatment providers make that decision based on each individual’s treatment needs.

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A Third Have Schizophrenia, Most Drug/Alcohol Problems, Half Homeless: Offered Hope In Mental Health Court


Gary Ambrose, retired brigadier general, who lost his son to mental illness, speaks at Fairfax County Mental Health Docket graduation. Photo Courtesy of Fairfax County Government.

(10-15-20) This is the second in a three part series about Fairfax County’s mental health docket. Yesterday, I posted Washington Post Columnist Petula Dvorak’s profile of one of the first graduates from the docket program. Today, I look at the history behind the docket and statistics about those it helps.

More than a third of individuals with mental illnesses who participate in the Fairfax County’s mental health docket have been diagnosed with schizophrenia. More than half have drug and substance addictions and nearly half are homeless. The court helps link them with services so they can address those problems – as well as their criminal conduct.

I’ve been advocating for a mental health docket in my local county since 2008. Fairfax County finally submitted an application to the Virginia Supreme Court in January 2019 and launched its docket in July 2019, It held its first graduation ceremony earlier this month.  Fairfax General Court Judge Tina Snee issued completion certificates to three graduates with diagnosed mental illnesses who volunteered to participate in a rigorous treatment program instead of being punished through the traditional criminal justice system.

More than 350 mental health courts/dockets operate nationally. About two-thirds have been supervising cases since 2000. Studies have found that those who complete a court’s requirements tend to have lower rates of criminal activity and increased linkages to treatment services than defendants with mental illnesses who do not.

Judge Snee currently has eighteen participants under her supervision on her docket. Fairfax is one of eleven Virginia jurisdictions with a mental health docket, including one in Fairfax’s neighbor, Loudon County. The state also has approved a behavioral docket in Arlington. There are 95 counties in Virginia, so these dockets remain in a minority in our state.

Fairfax County also operates a Veteran’s Treatment Docket and a drug court. It was Judge Penney S. Azcarate who got support and approval in 2014 for a Veteran’s Treatment Docket. (Judge Azcarate served four years in the U.S. Marine Corps.) Judge Azcarate also oversees the Fairfax County Drug Court.  Judge Azcarate’s actions are what opened the door in the county’s judiciary for a mental health docket.

Sadly, the death of Natasha McKenna, an African American woman with a serious mental illness, who died in 2015 after being repeatedly stunned with a Taser at the Fairfax County’s Adult Detention Center, is what caused the county’s elected officials to get serious about diverting individuals with mental illnesses from jail into treatment. Sheriff Stacey A. Kincaid championed the effort to create a Diversion First program. Former Board of Supervisors Chairwoman Sharon Bulova and former Supervisor John Cook immediately jumped on board. Retired Air Force General Gary Ambrose, who lost his son to mental illness, was put in charge of bringing stakeholders together to develop the country’s Diversion First program. It was launched with great excitement the same year as McKenna’s death with tremendous support from a slew of groups, including fire fighters, local police departments, the Fairfax Falls Church Community Service Board (CSB), The Office of the Public Defender, The Office of the Commonwealth’s Attorney, Court Services/Probation, General District Court (GDC) Judges, GDC Clerk’s Office, Victims’ Services Section – Fairfax County Police Department, and the Fairfax County Sheriff’s Office. The county’s Diversion First program has been operating for five years and is the umbrella over which the mental health docket rests.

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Tried To Kill Himself Twice Before Fairfax Mental Health Docket Helped Him Get His Life Together


(10-14-20) This is the first of three posts about the Fairfax County Mental Health docket, which recently held its first graduation ceremony. One of my favorite columnists, Petula Dvorak, attended the graduation and wrote about it for The Washington Post.

In one Virginia courtroom, a judge tries to stop a revolving door

By Petula Dvorak, The Washington Post

On good days, he’s charming, genteel and hard-working. The polite guy who always holds the door for people.

But the problems piling up on the bad days — speeding tickets, failures to show in court, fix-it tickets, unpaid fines, anger and depression — baffled everyone around the smart 23-year-old business owner from Virginia. For years, his mom tried therapists and counseling to help her smart and troubled son find his balance. Imprisonment, rather than treatment, was where he kept ending up.

And in July 2019, the thing she feared most happened.

After landing in jail again — this time for a 10-day jag for speeding — the young man broke free from his section of a Northern Virginia detention facility, ran up the stairs to a higher level overlooking an atrium and jumped. It was the second time he tried to kill himself.

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