Ensure access to quality treatment and services for behavioral health needs

Ensure access to quality treatment and services for behavioral health needs

Behavioral health care is a critical need among the reentry population. The proportion of people in the criminal justice system who have behavioral health needs—including mental illnesses, substance use disorders, and co-occurring mental illnesses and substance use disorders—is much higher than it is in the general public. This part of the toolkit will provide strategies for quantifying the scope of the problem in your community so you have the information you need to promote access to the quality behavioral health care. You’ll use the information you learned from mental health and substance use screenings and assessments discussed in Section 2 to better understand the behavioral health needs in your community, develop responses, maximize resources, and address risk of recidivism.

Questions to consider
Example from the field
Quick references

These Questions to Consider will help you understand the scope of behavioral health issues in your community and resources that may be available:

Questions to Consider
	Is your community working to reduce avoidable contact with the criminal justice system among people with behavioral health needs? Measures to prevent criminal justice system involvement, as appropriate, among people with behavioral health needs ultimately can help shrink your reentry population and improve individual and community well-being. Your local reentry coalition might seek to expand opportunities to respond to people in behavioral health crisis both before and upon law enforcement contact; such responses can include crisis intervention teams, mobile crisis teams, and co-responder teams. You also might choose to develop a coordinated local approach to diversion, whereby people with behavioral health needs who do not pose a public safety risk may be diverted from the criminal justice system at all decision points and connected to appropriate services and supports in the community.
	Is there a process to connect the reentry population to health care coverage? Continuity of care is uniquely crucial for people leaving prison and jail who have behavioral health needs. Yet lack of access to health care coverage is often a serious barrier to recovery for the reentry population with mental illnesses and substance use disorders. Correctional facilities can offer navigation services upon release, whereby people are connected to health care coverage and services. Medicaid is a primary source of coverage for people leaving prison and jail. A large proportion of Medicaid policy is determined at the state level, so it will be helpful for your local reentry coalition to understand what health care coverage and services are available in your community and whether and how correctional facilities enable enrollment in and continuity of Medicaid coverage.
	Are you aware of the “high utilizers” in your community? The definition of “high utilizer” may vary across systems; the term often refers to people who have frequent contact with police, jails, emergency services, and shelters, straining already limited resources. Local behavioral health, law enforcement, and other criminal justice agencies should know who their high utilizers are and work collaboratively to develop creative solutions that address their unique needs. In many instances, these individuals have serious mental illnesses, substance use disorders, or other significant health and social services needs, which can leave them stuck in a revolving door between the criminal justice system and other systems like health and housing.
	Is your jurisdiction working to prevent relapse and overdose? For people with substance use disorders leaving prison and jail, relapse—a normal but preventable aspect of substance use disorder—can jeopardize recovery, increase the risk of recidivism, and lead to overdose and overdose death. As the number of people overdosing on opioids reaches record levels, and reentry professionals learn more about the dangers of alcohol and benzodiazepine withdrawals, first responders and local reentry coalition leaders are seeking options to connect people to life-saving treatment and supports in lieu of incarceration, when appropriate, including during reentry. For many, the period of transition from incarceration back to the community is a time of great risk for overdose and death. If your jurisdiction does not have an overdose prevention plan in place already, your local reentry coalition is in a good position to help spearhead one; such plans are usually developed by the local health department in conjunction with hospitals, emergency medical services, and local law enforcement, and they offer a comprehensive approach to reducing substance overdoses through prevention, crisis response, treatment, and recovery support. On an individual level, people with substance use disorders leaving facilities in your jurisdiction should receive relapse prevention plans from correctional staff. These plans should account for a person’s triggers for relapse, how to avoid these triggers, and how to manage impulses.

This Example from the Field discusses how the sheriff’s office in Champaign County, Illinois is providing mental health screening and treatment services to people in jail:

Example from the Field
Facilitating Access to Treatment In Champaign County, Illinois, the sheriff’s office works with the service provider Rosecrance to provide mental health treatment services in the jail. To help ensure that more people have access to necessary treatment after they are released, the local mental health board requested that Rosecrance begin facilitating Medicaid enrollment for people while they are incarcerated. Rosecrance recognized that another provider, the nonprofit organization Champaign County Health Care Consumers (CCHCC), has more expertise in Medicaid enrollment, and the board permitted them to partner with CCHCC as a subcontractor. Learn more about (PDF) how this partnership resulted in mental health screening during jail intake, connecting people in need to critical mental health and substance abuse services.

Example from the Field

Facilitating Access to Treatment

In Champaign County, Illinois, the sheriff’s office works with the service provider Rosecrance to provide mental health treatment services in the jail. To help ensure that more people have access to necessary treatment after they are released, the local mental health board requested that Rosecrance begin facilitating Medicaid enrollment for people while they are incarcerated. Rosecrance recognized that another provider, the nonprofit organization Champaign County Health Care Consumers (CCHCC), has more expertise in Medicaid enrollment, and the board permitted them to partner with CCHCC as a subcontractor.

Learn more about (PDF) how this partnership resulted in mental health screening during jail intake, connecting people in need to critical mental health and substance abuse services.

The Quick References in this section provide detailed examples of and strategies for connecting people to mental health services, with a focus on incarcerated and reentry populations:

Quick References
Behavioral Health Diversion Interventions: Moving from Individual Programs to a Systems-Wide Strategy (2019) This brief provides a conceptual framework for creating a continuum of diversion opportunities that span a community’s criminal justice system. Best Practices for Successful Reentry for People Who Have Opioid Addictions (2018) This fact sheet describes the best practices that correctional, community-based behavioral health, and probation and parole agencies can implement to ensure safe and successful reentry for people who have opioid addictions. Critical Connections: Getting People Leaving Prison and Jail the Mental Health Care and Substance Use Treatment They Need—What Policymakers Need to Know about Health Care Coverage (2017) Regardless of the scope of Medicaid coverage in your state, you can use this discussion paper to ensure that prisons and jails are positioned as effective hubs for helping eligible people get public health care coverage and social security and veterans’ benefits. This assistance can facilitate access to treatment and help reduce recidivism as part of a comprehensive reentry effort. How to Reduce Repeat Encounters: A Brief for Law Enforcement Executives (2020) This brief provides four practical steps for addressing the needs of the people whom law enforcement officers frequently encounter while reducing their contact with the criminal justice system over time. Police-Mental Health Collaborations: A Framework for Implementing Effective Law Enforcement Responses for People Who Have Mental Health Needs (2019) This publication is designed to help jurisdictions advance comprehensive, agency-wide responses to people who have mental health needs through criminal justice and behavioral health system collaborations. Preparing People for Reentry: Checklist for Correctional Facilities (2020) Created in response to the COVID-19 pandemic, this checklist guides reentry planning to ensure the health and well-being of people who live and work within a facility, particularly people with behavioral health or chronic health conditions. Relapse Prevention Plans (2020) This web page explains why relapse prevention plans are a critical part of Collaborative Comprehensive Case Plans and provides information on how to create and implement these plans to promote recovery and ensure successful reentry for people who have a substance use disorder. Stepping Up Strategy Lab This is an interactive library of programs, policies, and practices that jurisdictions across the country have implemented to help reduce the prevalence of people with mental illnesses in their jails. Users are able to filter examples of local strategies by various categories, including recidivism reduction and reentry.

Quick References

Behavioral Health Diversion Interventions: Moving from Individual Programs to a Systems-Wide Strategy (2019)
This brief provides a conceptual framework for creating a continuum of diversion opportunities that span a community’s criminal justice system.

Best Practices for Successful Reentry for People Who Have Opioid Addictions (2018)
This fact sheet describes the best practices that correctional, community-based behavioral health, and probation and parole agencies can implement to ensure safe and successful reentry for people who have opioid addictions.

Critical Connections: Getting People Leaving Prison and Jail the Mental Health Care and Substance Use Treatment They Need—What Policymakers Need to Know about Health Care Coverage (2017)
Regardless of the scope of Medicaid coverage in your state, you can use this discussion paper to ensure that prisons and jails are positioned as effective hubs for helping eligible people get public health care coverage and social security and veterans’ benefits. This assistance can facilitate access to treatment and help reduce recidivism as part of a comprehensive reentry effort.

How to Reduce Repeat Encounters: A Brief for Law Enforcement Executives (2020)
This brief provides four practical steps for addressing the needs of the people whom law enforcement officers frequently encounter while reducing their contact with the criminal justice system over time.

Police-Mental Health Collaborations: A Framework for Implementing Effective Law Enforcement Responses for People Who Have Mental Health Needs (2019)
This publication is designed to help jurisdictions advance comprehensive, agency-wide responses to people who have mental health needs through criminal justice and behavioral health system collaborations.

Preparing People for Reentry: Checklist for Correctional Facilities (2020)
Created in response to the COVID-19 pandemic, this checklist guides reentry planning to ensure the health and well-being of people who live and work within a facility, particularly people with behavioral health or chronic health conditions.

Relapse Prevention Plans (2020)
This web page explains why relapse prevention plans are a critical part of Collaborative Comprehensive Case Plans and provides information on how to create and implement these plans to promote recovery and ensure successful reentry for people who have a substance use disorder.

Stepping Up Strategy Lab
This is an interactive library of programs, policies, and practices that jurisdictions across the country have implemented to help reduce the prevalence of people with mental illnesses in their jails. Users are able to filter examples of local strategies by various categories, including recidivism reduction and reentry.

Building Second Chances: Tools for Local Reentry Coalitions