Crisis Intervention Teams (CIT) and Jail Diversion

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Crisis Intervention Teams (CIT) and Jail Diversion

The Department of Behavioral Health and Developmental Services supports a variety of Jail Diversion initiatives, all of which reside in the Office of Forensic Services. Jail Diversion initiatives come in a variety of forms, but all essentially strive to identify individuals diagnosed with serious mental illnesses (SMI) and co-occurring disorders (early identification), divert individuals away from the criminal justice system (or penetrating more deeply, if identified after arrest/incarceration), and connect individuals to meaningful services and treatment (as early as possible, but often during initial court appearance,  during incarceration, or upon release from jail).   

Click on the following links for information on the initiatives currently supported and managed by the Office of Forensic Services:

 

History of Jail Diversion Initiatives in Virginia:

In Virginia, statewide Jail Diversion efforts began in 2007 when the Virginia General Assembly approved funding to promote the diversion of persons with mental illness from unnecessary involvement with the criminal justice system. The Department was given the responsibility for oversight of those funds, and seven (7) Community Services Boards (CSBs) were awarded funding for the purpose of Jail Diversion and forensic discharge planning.

Jail Diversion gained further momentum with the 2008 signing of Executive Order 62 by Governor Timothy M. Kaine. This order established the Commonwealth Consortium for Mental Health/Criminal Justice Transformation. The Consortium was tasked with the development of a comprehensive approach to address the challenging needs of individuals with mental illness in the Commonwealth’s criminal justice system. Under the leadership of the Secretaries of Health and Human Resources and Public Safety, the Consortium hosted two statewide meetings and saw the development of multiple programs and processes for creating positive systems change.

In May 2008 the Governor's Conference for Mental Health and Criminal Justice Transformation was convened, with a goal of assisting localities with initiating or furthering their community planning for Jail Diversion and improved services. The model soon after adopted by the Commonwealth’s Jail Diversion Initiatives was the Sequential Intercept Model. Developed in 2006 by Dr. Mark Munetz and Dr. Patricia Griffin, this model provided a conceptual framework for communities to organize targeted strategies for justice-involved individuals with serious mental illness. This conference also paved the way for the Cross-Systems Mapping Initiative, in which key players from the CSBs, DBHDS, Community Corrections and the Department of Criminal Justice Services were trained to help communities "map" how the mental health and criminal justice systems coincide.

In 2008 the General Assembly approved funding for the continuation and expansion of Jail Diversion services. The Department is responsible for administering and overseeing these grants, which were awarded to ten (10) CSBs in December 2008. That same year, the General Assembly also awarded funding for the statewide expansion of Crisis Intervention Training (CIT), a 40-hour training that enables law enforcement officers to more effectively communicate with and understand the particular needs of individuals with mental illness. Eight (8) CIT programs were funded as a result, allowing for the growth of CIT throughout the Commonwealth.

Since that time, programs have continued to expand. In 2014, three (3) one-time jail diversion grants were awarded by the Department to CSBs to enhance or initiate new diversion programs. Additionally, CIT has continued to grow with the establishment of additional funding for new CIT training programs and CIT Assessment Sites, which provide a therapeutic location for assessment and evaluation, and aim to decrease the use of arrest and detention of persons with mental health or substance use disorders by providing timely access to treatment.

The need for these services remains clear - in a 2014 survey of Virginia jails, 13.95% of inmates were identified as having a mental illness and 53.76% of those were diagnosed with a serious mental illness, which includes diagnoses such as schizophrenia, bi-polar disorder, or post-traumatic stress disorder. Findings also suggest that persons with mental illness are far too often subject to arrest and incarceration in Virginia for minor “nuisance” offenses related to their symptoms, and that many jail inmates with mental illness do not receive adequate mental health treatment in our jails, or when they return to the community. The Department remains committed to pursuing strategies for the diversion of persons with serious mental illness from jail into treatment whenever appropriate.

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Cross-Systems Mapping Initiative:  

Cross-Systems Mapping is a dynamic exercise developed to bring stakeholders from both mental health and criminal justice systems to the table with the goal of transforming fragmented systems into a system that makes sense to the people who use it. It is essentially a process for identifying gaps in services, reducing duplication of efforts, and creating an action plan with attainable goals and specific steps to improve services in communities across Virginia.

Based upon the Sequential Intercept Model that was developed by Dr. Mark Munetz and Dr. Patricia Griffin, the mapping exercise is used as a tool for identifying gaps and needs in the system, and for prioritized action planning to improve access to services for justice-involved individuals with serious mental illness. Since the mapping initiative began in 2009, 40 two-day mappings have been completed with over 1400 mental health and criminal justice stakeholders present and spanning 98 of 134 Virginia localities. This means that 89% of the entire population of Virginia lives in “mapped” communities.

For a listing of localities that have participated in Cross-Systems Mapping as well as an outline of identified gaps and priorities that came from these mappings, click here for the Cross-Systems Mapping Final Report. The Department continues its efforts to assist communities in this initiative with the hope that communities may continue to enhance mental health/criminal justice collaboration and diversion efforts.

For more information about Cross-Systems Mapping please contact Sarah Shrum or check out our Training and Resources section for helpful publications and articles.

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Jail Diversion Programs: 

In 2007 the Virginia General Assembly approved funding to promote the diversion of persons with mental illness from unnecessary involvement with the criminal justice system. As a result, seven (7) Community Services Boards (CSBs) were awarded funding for the purpose of Jail Diversion and forensic discharge planning. However, it wasn't until 2008 when the Governor's Conference for Mental Health and Criminal Justice Transformation was convened that programs throughout the state began to operate from the framework of the Sequential Intercept Model. In that same year, the Department received additional funding to expand jail diversion initiatives in the Commonwealth. With this new funding, the Department was able to support an additional ten (10) CSBs for an array of programmatic activity along the Sequential Intercept Model. In 2014, three (3) one-time grants were awarded to further expand criminal justice diversion options.

It should be noted that many localities throughout Virginia offer services that target this vulnerable population, without the benefit of additional funding from the Department. In some cases Community Services Boards provide jail-based mental health and re-entry planning services, while other localities have established specialty courts or mental health dockets as a means of better identifying and diverting this population to the appropriate community services. The Department is invested in helping to establish and expand diversion initiatives whenever possible, and is available to provide resources and assistance to all Virginia localities whether or not they are the recipient of Department funding.

A brief description of all of the DBHDS-funded jail diversion programs/initiatives can be found below:

  • Seven (7) Community Services Boards received funding in 2007 for the purpose of establishing a community jail diversion/discharge planning coordinator position, and for other necessary resources to provide post-booking jail diversion services to inmates in the local jails. The CSBs who were awarded these grants were: Arlington CSB, Fairfax-Falls Church CSB, Henrico CSB, Horizon Behavioral Health, Norfolk CSB, Richmond Behavioral Health Authority, and Virginia Beach CSB.
  • Ten (10) Community Services Boards received funding starting in 2008 for the purpose of jail diversion. The CSBs who were awarded these grants and description of their diversion programs are below: 
    • Alexandria Community Services Board: The Jail Diversion Grant supports the CORE Program (COllaboration for Recovery and ReEntry), a partnership between the Alexandria CSB and the Office of Probation and Parole aimed at helping offenders with mental illness live healthy and law abiding lives in the community. Clinicians and probation officers work closely to connect persons with mental illness to appropriate treatment prior to release and collaborate through the duration of the probation to prevent the individual from returning to jail.
    • Arlington Community Services Board: The Jail Diversion Grant supports the work of the Magistrate's Post-Booking Diversion Program. Clinicians provide case management, assessment, diversion, and support services to clients across all levels of the Sequential Intercept Model, particularly at the Magistrate’s intercept. The program responds to requests from the Magistrate to assess and divert persons with mental illness into community treatment, and that treatment becomes a condition of the person's bond. This allows early release from jail and expedited access to treatment when appropriate.
    • Chesterfield Community Services Board: The Jail Diversion Grant supports the Dual Treatment Track (DTT) – a pretrial diversion program for non-violent defendants that suffer from both a serious mental illness and substance abuse addiction. The services are delivered in a day reporting center model, which allows for a “one stop shop” where mental health, case management, substance abuse and criminal justice supervision are combined under one roof with a collaborative multi-agency staff.
    • Fairfax-Falls Church Community Services Board: The Jail Diversion Grant funds the Jail Diversion Program, which provides intensive community-based, wrap around services to mentally ill/co-occurring individuals involved with the criminal justice system. Referrals to the program come from all five Sequential Intercept points. The program provides intensive case management and targeted support services as well as peer specialist partnering. The program also provides vouchers for temporary transitional housing, transportation assistance, and emergency food/clothing needs
    • Hampton-Newport News Community Services Board: The Jail Diversion Grant funds supervisory, clinical, case management, and peer staffing to work with individuals diverted across the Intercepts. Funds also support psychiatry in the detention center and CIT Assessment Site security. The Program makes a distinction between Primary and Secondary Diversions in describing their work. Primary Diversions are persons identified immediately at the time of arrest and secondary diversion is targeted at providing psychiatric care and release linkage for persons in jail.
    • Middle Peninsula-Northern Neck Community Services Board: The Jail Diversion Program provides services for individuals at Intercept one through five. The Jail Diversion Grant funds a Jail Diversion Counselor provides intensive case management services aimed at intervening and establishing/reestablishing services in the community to avoid incarceration. Funding also supports Peer Support Services that are offered in the community and in the correctional facility, transitional housing, and some of the costs associated with the CIT training program.
    • New River Valley Community Services Board: The Jail Diversion Grant supports several diversion efforts. The first is the NRV Crisis Intervention Team (NRVCIT) program. Funds also support the Bridge Program, which includes clinical/supervisory, case management, and peer staffing to individuals with mental illness transitioning from jail to community. The Bridge clinicians also provide individual counseling to incarcerated consumers. Additionally, grant funds support short-term housing assistance, medications, and other emergency needs as they arise
    • Portsmouth Community Services Board: The Jail Diversion Grant supports diversion efforts at multiple Intercepts. Portsmouth Department of Behavioral Healthcare Services (PBHS) partnered with Chesapeake Integrated Behavioral Healthcare Services, law enforcement, and a local medical center to establish the CIT Assessment Center (Safe Harbor). Funding also supports one full-time Forensic Case Management position to provide pre- and post-booking services for individuals currently in jail who exhibit symptoms of mental illness, and are charged with minor, non-violent crimes.
    • Rappahannock Area Community Services Board: Jail Diversion Grant funding supports Jail Diversion Therapist and Case Management positions responsible for completing assessments and developing discharge and diversion plans in partnership with the Office of Programs and Community Corrects (pre-trial services) at the Rappahannock Regional Jail. The funds also support a CIT Coordinator position, responsible for coordinating CIT training for law enforcement
    • Virginia Beach Community Services Board: The Jail Diversion Grant funds The Mental Health Supervision Program, which is an intervention program designed to provide an alternative to incarceration by diverting individuals with serious mental illness and substance use, who come in contact with the Criminal Justice System. Grant funds are also used to pay for transitional housing, peer services, SOAR, discharge planning services, WRAP Facilitation, and a portion of a full-time CIT/Clinical Systems Coordinator position and Assessment Site security costs are funded through the grant as well.
  • Three (3) one-time diversion grants were awarded in 2014 to promote the development or expansion of jail diversion efforts. The CSBs who were awarded these grants and description of their diversion programs are below:
    • Valley Community Services Board: One-time funding was granted to the Valley Community Services Board in 2014 to support a pilot mental health docket in that catchment area. This docket will target misdemeanor defendants with mental health issues who come before the Staunton and Augusta County General District Courts.
    • Norfolk Community Services Board: One-time funding was granted to Norfolk Community Services Board in 2014 to provide for temporary housing assistance and other short-term interventions for individuals that are enrolled in the Norfolk Mental Health Court and Norfolk Mental Health Docket who are homeless or in unstable housing. 
    • Crossroads Community Services Board: One-time funding was granted to Crossroads Community Services Board in 2014 to support several initiatives in that area, including the initiation of CIT training, implementation of Mental Health First Aid training for criminal justice personnel, expansion of discharge planning staff hours, and the development of a stakeholder group designed to identify individuals at risk and increase awareness and collaboration.
  • Two (2) Community Services Boards will receive funding starting in 2015 for the purpose of jail diversion. The CSBs who were awarded these grants and description of their diversion programs are below:
    • Henrico Area Mental Health & Developmental Services: The Jail Diversion Grant will fund the development of an Intercept 2 Post-Booking Diversion Program. The funds will pay for two additional staff who will work with the jail at the booking level to identify individuals with a mental illness who are appropriate for diversion and will subsequently craft diversion/release plans that will be presented to the court for approval. The program hopes to secure pre-trial release for these defendants, allowing them to be more quickly linked with mental health and support services in the community.
    • Prince William Community Services Board: The Jail Diversion Grant will fund the enhancement of the Prince William DIVERT Docket, a specialty therapeutic docket designed to more quickly identify defendants with mental illness, divert from jail when appropriate, and ensure timely linkage to community mental health and support services while under the monitoring of the court. Upon successful completion of the docket program, individuals may have their cases dismissed, charges reduced, or may receive time served. The program will involve close collaboration between the CSB, court, and local Community Corrections.

For more information about Jail Diversion initiatives throughout Virginia, please contact Sarah Shrum or check out our Training and Resources section for helpful publications and articles.

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Crisis Intervention Team (CIT) Programs:  

The Crisis Intervention Team (CIT) Program is the premier police-based, mental health crisis response initiative in the nation. CIT is an interdisciplinary, collaborative, community program that enhances law enforcement capability to respond to situations involving individuals with symptomatic behavioral health issues. CIT creates a coalition of local stakeholders, including law enforcement, emergency dispatchers, mental health treatment providers, consumers of mental health services and others (such as hospitals, emergency medical care facilities, non-law enforcement first responders, and family advocates) to oversee and guide the program. The program provides 40 hours of advanced training for law enforcement first responders and other team members, enhances coordination between the local criminal justice and behavioral health systems and improves access to services for persons with behavioral health concerns who come into contact with law enforcement. 

In the course of their regular duties, law enforcement and other first responders or corrections and jail personnel often interact with individuals who are exhibiting symptoms or behaviors which are inappropriate, or even potentially dangerous or violent.  These actions can be misinterpreted as criminal in nature. Additionally, law enforcement officers routinely interact with individuals with behavioral health disorders as a result of the statutory structure of Virginia’s civil commitment process. CIT programs increase the likelihood that such individuals will be more effectively identified, receive skilled intervention by a trained CIT responder to reduce the risk of danger or injury and be linked to services in lieu of arrest, whenever appropriate.

Virginia’s CIT programs started in the New River Valley in 2001.  From 2001 – 2004, that community worked with the originators of the CIT model in Memphis, Tennessee, to develop the nation’s first rural, multi-jurisdictional CIT program.  From 2004 – 2009, New River Valley CIT worked with the Department of Criminal Justice Services (DCJS) to provide technical assistance and identify funding sources to initiate several additional programs, including those in the Thomas Jefferson Area, Mt. Rogers, Hampton/Newport News, and Virginia Beach. 

In 2009, responding to increasing interest in CIT program development, sections 9.1-102, 9.1-187, 9.1-188, 9.1-189 and 190 of the Code of Virginia were amended.  The legislation provides a more effective, consistent process for CIT development and oversight, directing the Department of Criminal Justice Services in conjunction with the Department of Behavioral Health and Developmental Services (DBHDS) to “…support the establishment of crisis intervention team programs in areas throughout the Commonwealth…”

The goals for CIT programs are included in the Code of Virginia, §9.1-187, and are generally oriented toward reducing injuries to both law enforcement and citizens, reducing arrest of persons in behavioral health crisis, improving access and linkage to appropriate community treatment and supports, and promoting dignity and respect for individuals with behavioral health disorders. In 2011, DBHDS and DCJS, along with the leadership from the Virginia CIT Coalition, developed a guidance document (Essential Elements for the Commonwealth of Virginia’s CIT Programs) to establish consistent minimum requirements for the development and implementation of CIT programs in Virginia.

At its core, CIT provides 1) law enforcement crisis intervention training to enhance response to individuals exhibiting signs of a mental illness; 2) a forum to promote effective systems change and problem solving regarding interaction between the criminal justice and mental health care systems; and, 3) improved community-based solutions to enhance access to services for individuals with mental illness. Successful CIT programs improve officer and consumer safety, reduce inappropriate incarceration and redirect individuals with mental illness from the criminal justice system to the health care system when to do so is consistent with the needs of public safety.

 

For more information about Crisis Intervention Team (CIT) initiatives throughout Virginia, please contact Stephen Craver or check out our Training and Resources section for helpful publications and articles.

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Crisis Intervention Team (CIT) Assessment Sites

A Crisis Intervention Team (CIT) Assessment Site is a non-criminal justice setting where persons with mentally illness can be taken by law enforcement officers in lieu of arrest or incarceration. The Assessment Site is designed to enable police officers or sheriff’s deputies to take a person experiencing a mental health crisis for quick and appropriate mental health assessment and therapeutic treatment. These persons are often in the officer’s care under an involuntary order for their own safety, and must remain in custody until assessed and treated. This process has historically kept law enforcement officers tied up and away from other law enforcement duties for lengthy periods of time. The Assessment Sites allow for the best and fastest outcome for the mental health consumer and quick return of officers to their regular law enforcement duties.

The CIT Assessment Sites serve to support ongoing Jail Diversion Initiatives by:

  • Providing a therapeutic environment for assessment and possible diversion from arrest and further involvement in criminal justice system; and
  • Improving access to services for individuals with behavioral health concerns who come into contact with law enforcement by referring individuals in need of mental health services to crisis stabilization units, inpatient treatment, and community-based treatment.

The following six components represent the ideal elements which are necessary to achieve the most successful type of triage/CIT Assessment Site:

  • Twenty four hour, year round availability of the assessment site for law enforcement to use as an access point for services as an alternative to incarceration
  • Availability of mental health emergency services personnel who can determine clinical status and assess treatment needs for the individual
  • On-site trained security to support the site by accepting transfer of the individual and to provide for the safety of all persons involved
  • Quick access to any necessary medical screening for those individuals in crisis
  • Ready access to dispositional options including psychiatric beds available to accept voluntary patients and those under mental health detention orders, crisis stabilization units, detox, and other community-based services
  • Availability of peer support for individuals awaiting evaluation or transportation to dispositional options during the site’s operational hours

Virginia currently has established Assessment Sites with participating CIT programs in multiple regions throughout the Commonwealth and anticipates continued expansion of the program through the coming fiscal year.


For more information about Crisis Intervention Team (CIT) initiatives throughout Virginia, please contact 
Stephen Craver or check out our Training and Resources section for helpful publications and articles.

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