The Center for Behavioral Health and Justice is a center of excellence for the Commonwealth of Virginia designed to address the evolving challenges that exist in coordinating and collaborating across the behavioral health and criminal justice systems. The Center brings together stakeholders at the local, regional, and state level to identify, discuss, and study the needs of justice-involved, behavioral health consumers. The work of the Center is to develop and help implement strategies to effectively meet the needs of this vulnerable population. Research has shown that individuals living with a serious mental illness (or a co-occurring disorder) are at high risk for being incarcerated, and often remain incarcerated for longer periods of time than their counterparts in the general population. These frequent and extended periods of incarceration often result in further psychological decompensation, and can serve to increase an individual’s risk of re-offending. Intervening early on in a consumer’s interaction with the criminal justice system and linking them to appropriate behavioral health treatment services an change the trajectory of an individual’s future mental health recovery and involvement in the criminal justice system.
The Center for Behavioral Health and Justice (CBHJ) plays a unique role not currently being filled in the Commonwealth by serving in the following capacities:
The CBHJ provides high level coordination across agencies serving individuals involved in the criminal justice and behavioral health systems; and facilitates connections between state and local partners.
The CBHJ has developed a multi-agency, cross-secretariat vision for serving Virginians involved in both the criminal justice and behavioral health systems, to include the prevention of additional individuals from becoming entwined in the criminal justice system unnecessarily.
The CBHJ serves as a central hub for the collection and dissemination of best practices; and the identification of new resources and coordinated grant applications.
The Center for Behavioral Health and Justice operates through an Executive Committee, a Center Advisory Group (CAG), ad-hoc committees, and standing workgroups called 'Action Committees'. The three standing committees are focused on the following priority areas:
- Criminal Justice & Behavioral Health Facilities
- Data, Technology, and Information Sharing
- Diversion and Re-Entry
The 'work' of the center occurs through the Action Committees. Center Advisory Group members serve on the various committees and members of the Executive Committee serve as committee co-chairs. Subject matter experts are also invited to attend committee meetings to provide additional information, expertise, and guidance upon request. Each Action Committee has a 'working' action plan based on the priorities identified by the Center.
The Executive Committee
The Executive Committee provides the final approval of operations, priorities and projects of the Center. The Executive Committee includes the Secretary of Health and Human Resources, the Secretary of Public Safety and Homeland Security, the Lieutenant Governor, the Commissioner of Department of Behavioral Health and Developmental Services, and the Director of Department of Criminal Justice Services or their designee.
The Center Advisory Group
The Center Advisory Group or CAG provides input on the needs within the Commonwealth, and provides counsel on the priorities and projects of the Center. The Center Advisory Group is a diverse group of behavioral health, criminal justice, and other stakeholders from across the Commonwealth. Membership includes: Virginia Department of Corrections, Virginia Department of Health, Virginia Department of Medical Assistance Services, Virginia Department of Juvenile Justice, Virginia State Police, Virginia Department of Veterans Services, Virginia Sheriff’s Association, Virginia Association of Chiefs of Police, National Alliance on Mental Illness – Virginia, Virginia Association of Community Service Boards, Virginia CIT Coalition, Office of the Executive Secretary- Virginia Supreme Court, Mental Health America-Virginia, Virginia Organization of Consumers Asserting Leadership, Virginia Association of Regional Jails, Virginia Indigent Defense Commission, Institute of Law, Psychiatry and Public Policy at the University of Virginia, Virginia Municipal League, Virginia Office of the Attorney General, Veteran’s Administration, Virginia Association of Commonwealth’s Attorneys, Virginia Association of Counties, Virginia State Compensation Board, Virginia Department of Housing and Community Development, General District Courts, private behavioral health providers, and private medical providers.
The Center Advisory Group meets on a quarterly basis and Action Committee Meetings occur prior to Advisory Group Meetings. Center Advisory Group meetings are posted on the Commonwealth Calendar and meeting materials can be found below:
Regular Quarterly CAG Meeting: January 10, 2017 (1pm-3pm)
- 1/10/17 Minutes: Click HERE
- 1/10/17 Materials: Click HERE
Questions about meetings or materials can be directed to the Center Coordinator by clicking HERE
The contextual framework for the center is based on the Sequential Intercept Model, developed by Dr. Patricia Griffin, Ph.D. and Dr. Mark Munetz, M.D. The Sequential Intercept Model identifies five points in the criminal justice system where it is most effective to identify whether an individual has a behavioral health disorder, provide an evidence based intervention appropriate to the needs and situation of that individual and produce an impact that improves the individuals clinical and/or criminal justice outcomes.
The Sequential Intercept Model
The following are diversion and treatment options that exist across the 5 Intercepts:
-Crisis Intervention Teams training and assessment sites (Virginia CIT Coalition and CIT International)
-Mental Health First Aid
-Connection to community treatment services and resources
-Early mental health screening in jails
-Post-Booking Magistrate Diversion Program
-MH screening at initial hearing
-Pre-trial Diversion Program
-Treatment with evidence-based practices in jails/prisons
-Mental health units in jails/prisons
-Forensic peer support specialists in jails/prisons
-Forensic discharge planning
-Mental health probation case loads
-Specialized post-release community mental health services
At each intercept, data driven decisions can be made utilizing evidence based tools, training, programs and practices. Localities across the Commonwealth experience wide variations in their ability to access the information provide the programs, training and resources that are shown to be most effective in addressing the needs of this population. The Center can assist localities in the following ways:
Coordinate Research and Data Collection
-The Center will compile or link to national and statewide data, identify and encourage the use of standardized metrics, and assess the efficacy of programs in the field.
House a Repository of Best Practices
-The Center will be a single point of contact for collection and dissemination of the most current research and evidence based practices in the field.
-As a convener, the Center will work with appropriate state and local partners to bring together stakeholders across the criminal justice and behavioral health systems to identify common challenges, develop recommendations for solutions, disseminate best practices and assist in providing evidence based training and education.
Provide Technical Assistance
-The Center will support provision of technical assistance either directly or by linking entities in need of assistance to other experts, both within the Commonwealth and nationally.
The following are Evidence-Based Practices and Interventions that are available for use with justice-involved behavioral health consumers. Please click on the individual links to get detailed information about each EBP and it's appropriate implementation procedure.
Acceptance and Commitment Therapy (ACT): Acceptance and Commitment Therapy (ACT) is a contextually focused form of cognitive behavioral psychotherapy that uses mindfulness and behavioral activation to increase clients’ psychological flexibility—their ability to engage in values-based, positive behaviors while experiencing difficult thoughts, emotions, or sensations.
Dialectical Behavior Therapy: Dialectical Behavior Therapy (DBT) is a cognitive-behavioral treatment approach with two key characteristics: a behavioral, problem-solving focus blended with acceptance-based strategies, and an emphasis on dialectical processes.
Integrated Dual Disorder Treatment (IDDT): Integrated Dual Disorder Treatment (IDDT) services are tailored to the client and are intended to treat persons with severe mental illness and a co-occurring substance abuse disorder. IDDT has proven especially effective when delivered through the Assertive Community Treatment (ACT) model. IDDT is a stage-recovery, rather than expecting immediate conformity to rigid guidelines. Motivational interviewing techniques are used to engage clients into treatment, and the IDDT model takes cues from each person in establishing pace and goals.
Living in Balance: Living in Balance (LIB): Moving From a Life of Addiction to a Life of Recovery is a manual-based, comprehensive addiction treatment program that emphasizes relapse prevention. LIB consists of a series of 1.5- to 2-hour psychoeducational and experiential training sessions.
Moral Reconation Therapy: Moral Reconation Therapy (MRT) is a systematic treatment strategy that seeks to decrease recidivism among juvenile and adult criminal offenders by increasing moral reasoning. Its cognitive-behavioral approach combines elements from a variety of psychological traditions to progressively address ego, social, moral, and positive behavioral growth.
Motivational Interviewing: Motivational Interviewing (MI) is a goal-directed, client-centered counseling style for eliciting behavioral change by helping clients to explore and resolve ambivalence. The operational assumption in MI is that ambivalent attitudes or lack of resolve is the primary obstacle to behavioral change, so that the examination and resolution of ambivalence becomes its key goal.
Relapse Prevention Therapy (RPT): Relapse Prevention Therapy (RPT) is a behavioral self-control program that teaches individuals with substance addiction how to anticipate and cope with the potential for relapse. RPT can be used as a stand-alone substance use treatment program or as an aftercare program to sustain gains achieved during initial substance use treatment.
Seeking Safety: Seeking Safety is a present-focused treatment for clients with a history of trauma and substance abuse. The treatment was designed for flexible use: group or individual format, male and female clients, and a variety of settings, including outpatient, inpatient, and residential environments.
Wellness Recovery Action Plan (WRAP): Wellness Recovery Action Plan (WRAP) is a manualized group intervention for persons with mental illness. WRAP guides participants through the process of identifying and understanding their personal wellness resources (“wellness tools”) and then helps them develop an individualized plan to use these resources on a daily basis to manage their mental illness.
CROSS SYSTEMS MAPPING
SAMHSA Cross Systems Mapping workshops are available FREE to interested communities!! The deadline to apply for a workshop is February 24th, 2017 (accepted applications will have workshops scheduled between May and August). To download the application, click HERE.
"SAMHSA’s GAINS Center is currently soliciting applications from communities interested in developing integrated strategies to better identify and respond to the needs of adults with co-occurring mental health and substance use disorders in contact with the criminal justice system. Sequential Intercept Mapping (SIM) is a 1.5-day workshop designed to allow local, multidisciplinary teams of people from jurisdictions to facilitate collaboration and to identify and discuss ways in which barriers between the criminal justice, mental health, and substance use systems can be reduced and to begin development of integrated local plans".
Helpful Links for Funding Opportunities
Substance Abuse and Mental Health Services Administration (SAMHSA)
Virginia Department of Criminal Justice Services (DCJS)
Bureau of Justice Assistance
National Institute of Justice
Office of Justice
National Institute of Corrections
First Episode Incarceration Creating a Recovery-Informed Framework for Integrated Mental Health and Criminal Justice Responses
Information Sharing in Criminal Justice-Mental Health Collaborations
Screening and Assessment of Co-Occurring Disorders in the Justice System
Adults with Behavioral Health Needs Under Correctional Supervision
Law Enforcement Responses to People with Mental Illnesses
Improving Responses to People with Mental Illnesses at the Pretrial Stage
Council of State Governments Justice Center: Reducing the Number of People With Mental Illnesses In Jails
Voices of Jericho: Stories of Jail Diversion
Other Centers of Excellence for Behavioral Health and Justice
Veterans Re-Entry Search Services (VRSS): This secure Web site enables correctional and other criminal justice system entities to identify inmates or defendants who have served in the United States (U.S.) military. The U.S. Department of Veterans Affairs (VA) makes this service available to facilitate its own direct outreach to these Veterans, and to inform the development of Veteran-specific programs in the criminal justice system.