JEO AJ asked Paul to provide a brief overview of JEO work. She then asked individuals to identify solutions that would improve outcomes for persons with mental health conditions whose lives intersect with the criminal justice system. Paul - The JEO initiative allows the Lt. Governor to convene any state agency related to criminal justice to identify problems and come up with solutions. Lt. Governor is particularly focused about trauma- informed solutions. Right now, we're going on a listening tour meeting with community groups who are working on ground level so we can put a plan together.
AJ - I spoke with Paul and shared two specific recommendations from Gift of Voice 1) Utilize recovery support services within IDOC by structuring recovery support services similar to the current DMH structure, specifically by hiring CRSS professionals in the prisons.
2)Utilize the WRAP curriculum in diversion, prison and re-entry programs.
Tracey - I agree that having a CRSS professional prior to being released and throughout the process is the biggest thing. That's what I want for my son. I want my son to be supported in the community. I'm certain that another individual who has been through that process would be helpful to my son.
Keri - #1) I agree that having peer support available for prisoners as they're incarcerated and as they come out. People should be given the option to have peer support available when they come out. It's on a different level than the parole officer. #2) There are a lot of things
presented on paper that IDOC is providing these services, but there's no follow up or consistency about how people who are incarcerated Continue.
physically get to the groups. Keri gave the example of a loved one being identified as someone with serious mental illness (SMI) and twice being directed to the wrong group therapy, but was not allowed to attend the correct therapy without a hall pass. #3) Being treated poorly by medical staff and being unable to advocate for themselves in that environment about their medications and side effects. Even if they're communicating respectfully, they're running the risk of angering the providers who can label them as hostile and put them in segregations. Sometimes people who are incarcerated become more prone to anxiety and stress due to the "hoops" a person has to jump through to stay on medication. I think there's also a problem with inmates who are heavily medicated and may not know what drugs they're actually taking. #4) The blanket practice of denying spousal visits if spouse was involved in the arrest of the person who is incarcerated. It's common for family members of persons with mental health challenges and co-occurring substance abuse to become arrested in that situation. The person who is incarcerated is denied a family visit from their loved one because the loved one is a co- defendant. #5) Treatment of individuals who are incarcerated regarding illness and end of life care for those incarcerated.
Fred - First, the mental health system is complex and the justice system is maybe more complex. There is no "one size fits all" solutions. "I am uniquely unique." There is no one else with my combination of symptoms, experiences and motivation. What works for some, might not work for others. It is impossible to talk about mental health and justice systems without talking about economic and racial justice. I testified before Judge Dow in the Illinois vrs. Chicago consent decree about my interaction with the Chicago Police Department. It was incredibly moving. Judge Dow listened to over 90 people in two days. I'm not afraid of Chicago police officers hurting me because I'm white and old. I have privileges that others don't and I don't want to give up those privileges because I don't want to get shot. The consent decree, filed by a state agency, is "a floor, not a ceiling." The most important issue is that people need to be diverted from the justice system. For many people, once you fall into the system it is very difficult to get out and the results can be catastrophic.
Sue - Making sure that medications and proper treatment is being provided at the county jail. My comments are in the framework of the county jail and forensic unit at DMH. There needs to be more beds in the community. Our state contract is for individuals found NGRI. We have 15-20 referrals for people who are sitting in state operated facilities because there's not a community conditional release option the courts are comfortable with. We need more money, more beds, more homes for people to be able to move into.
Diana - Following the sequential intercept mapping, to reach people who need mental health and substance use treatment at the initial
point of contact verses them ending up in the criminal justice system. It's where I'd like to see the state move. How quickly we get there is another matter. The things that have already been brought up assist people in functioning at a higher level at a quicker point.
Dar - Everything's that's been talked about so far is spot-on. A) The Peer Coaching that Keri talked about is what we want to do. Upon release, an individual would be assigned a Peer/Life Coach who would come alongside them. This person would be a positive influence who would build a repour, encourage them, take them to meetings, etc.
Having a weekly contact with someone like that, not just a weekly check in with their parole office, would go a long way. I think it would be life changing. I was talking to Judge Hylla and he loves this idea so hopefully we can get something rolling. B) Another thing that would be so simple and have a huge impact is to have a program in place to allow people to turn in prison ID for state ID. This way, there is no lag time when applying for a job and it's not like the state doesn't know who they are. This would enable someone to immediately apply for employment without having to obtain a birth certificate, etc. It would be so simple and probably more cost effective. C) Another thing, that goes along with what Fred was saying is empathy training for corrections officers. Correction officers tend to have a narrow view.
Most corrections officers - not all - view inmates as animals and they're treated as such. They need to understand more about what it was like and what the family goes through. There needs to be a collective effort across the board. 98% of people incarcerated are getting out. Empathy training would be good for correction officers, counselors, parole officers and community organizations. D) Lastly, I cannot believe IDOC said no to WRAP in the prison system. WRAP class should be in the prisons. Why wouldn't it be? It increases outcomes and, with no cost to the state, it's a tremendous benefit.
AJ - Paul, we want to give you opportunity to respond. We didn't collectively prepare a statement. This is diverse individual perspectives. Please feel free to ask any questions you may have. Paul - Thank you everyone for sharing your recommendations and input. A lot of things that you've said are things we are already working on so it's good we're in the right direction. The one thing that stood out is the talk about medications and making sure that people aren't facing backlash from those who provide medication. Poor treatment is something I will make sure to make a note of, especially when talking about quality of life. Can you talk a little bit more about being treated poorly by Doctors and staff?
Keri - It's kind of across the board. My loved one was taken off of medication that was helping. He went for years suffering and, when he was out on bond, began taking medication and started to feel like he was recovering. Upon entry, the state took him off of those
medications and put him on medications they wanted him to take. The
state said "we don't give that here" and they weren't expensive medications. They are the same medications covered by Medicaid. Just staying on those medications, the poor treatment is across the board. The words he used was "treated poorly, useless to society." To stay on medication, he has healthcare requirements and those interactions are often adversarial. He's now in the process - with support from the prison Psychiatrist - of going off medication because he doesn't want the extra anxiety. Also, regarding terminally ill treatment, my loved one is a care provider for other inmates and has had four people in his house pass away since he's been in. Two died very grueling deaths without access to pain medication. One gentleman was in and out of consciousness, released and transported to a hospital, was admitted to ICU and died a week later.
Sue - It seems the jail formulary is much narrower than what is available on most Medicaid plans. Unless we take medications that have been prescribed in the community, the jail will have completely change or discontinued in jail which sets people back. If we could get something where the formulary is broader to continue medication.
Also, when someone is not stable it would be helpful if Doctors in jail would not be afraid to make some changes.
AJ - I also want to emphasize that a "lived experience professional" can sometimes be just as important as medication. In Illinois there are lived experience credentials for mental health recovery, addiction recovery and a trauma recovery for Service Members and Veterans.
The role of the Recovery Support Specialist is to listen to people and support their self-determined choices. It's not to direct people toward formal treatment, though this may occur naturally. The goal is to walk
with that person and support them in their process - diversion, incarceration or re-entry.