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Introduction to the Interface Between Serious Ment ...
Presentation Q&A
Presentation Q&A
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So, we've had some questions come in, Debra, and we will hopefully get a few more in the next few minutes. One person wrote in and said, what's the difference between parole and probation? So, that's a great question and often a point of confusion. Generally speaking, probation is going to be assigned at the court level and it will be under the review of a judge. So, complying with the terms of probation means complying with the terms that a judge set out at the determination that probation was necessary. And compliance might mean complying with mental health treatment, avoiding certain people. It can be anything that the court determines as necessary as part of the sentence. The probation officer's job is to ensure and to be able to report back to the court that the individual is complying with those terms. Now, probation officers can have caseloads of hundreds and hundreds of people. Probation does not mean that the individual is going to be seen every week or going to be, I didn't know this when I started working in this business, I thought that probation officers see their probationers regularly. There can be administrative probation and there can be more risk needs probation. Administrative probation can be a phone check-in. It can be kind of a light touch. When somebody is determined to be a higher risk need case, it can be more intensive home visits and more regular contact, toxicology screens and the like. But generally speaking, probation is under the auspices of the original sentencing judge. Parole, on the other hand, is part of the parole board, which again might fall under an entire correctional state agency or might be its own state agency and is done when somebody is allowed to be released when they have a sentence that does not have where it's, you know, your sentence, let's say five to ten years with parole eligibility at five years. At that point, an independent parole board will look at your case and look at whether they feel that you're ready for release on parole and then you will be supervised by the parole agency. That will have nothing to do with the judge. The judge is out of the picture at that point. The supervision terms and the level of supervision might look the same because a parole agent might see somebody regularly or they might have them on more of a light touch parole supervision. That will depend on the case. Terrific. Can you tell us a little bit about peer forensic specialists on teams? Yes, peer forensic specialists are a fantastic addition to the workforce. They're not everywhere. A peer specialist is somebody with lived experience and that can be lived experience if you're working in the VA system. It might be lived experience as a veteran. If you're working in recovery for substance use, it might be somebody with lived experience with substance use. It might be lived experience with somebody with mental illness. A forensic peer or a criminal justice peer is generally thought to be somebody with lived experience in the criminal justice system because the peer support workforce generally also has either mental illness or substance use issues or both, oftentimes a forensic peer is somebody with criminal justice involvement, substance use history, and or mental health history. And these people are doing yeoman's work across the country, working hand in hand with specialized programs to help support individuals either upon reentry or really at any point of the intercept system. For people that are interested, and I neglected to mention this before, I have it on the slide, you can look at the Editor's Choice Mental Health Criminal Justice Diversions and the website is available to see some examples in the literature of jail diversion programs or criminal justice diversion programs, many of which in these articles utilize peer support specialists to exemplify their work. Great. Many people have written in, thank you so much for this seminar, including this person who said, you mentioned, quote, mental illness, unquote, throughout the lecture and provided some evidence for bipolar and schizophrenia. From your experience, what other psychiatric conditions show up often in patients with SMI who have passed through the legal system somehow? So co-occurring, I think they're asking about. So we know that, so first of all, people who are in jail or incarcerated can have any mental health condition just like anybody in the general population can. We do see a large percentage of individuals who have co-occurring substance use disorders. We're also seeing, for example, when we look at who gets incarcerated from the substance use side of things, for example, with the opioid crisis, a lot of the individuals, many if not most of the individuals who are incarcerated with opioid use disorder have co-occurring trauma-related disorders, anxiety disorders, depression, and the like. So it's important to think holistically about what might be going on with the individual. I should also point out that many of the individuals, because once they are in this vicious cycle of criminal justice involvement, they're going to have disrupted care across a variety of dimensions. So we also see many comorbid medical conditions, and those also have to be attended to. Right. This person says, great presentation. How does a mental health court factor into SMI-CJS? Mental health courts, if you see one mental health court, you've only seen one mental health court. They have specific common elements that can be interpreted differently. So, for example, the admitting criteria for a mental health court, in some mental health courts, they will have specific diagnoses being the eligibility criteria requiring specific diagnoses such as schizophrenia, bipolar disorder, post-traumatic stress disorder, major depressive disorder. One court might say that those are the illnesses that they will consider including. Some will say they will only consider including those mental illnesses if the underlying criminal offense was related to that illness, and there has to be a nexus. So rather than just serving anyone generally who has an anxiety disorder, they're going to say this individual finds themselves in the criminal justice system because their illness has, you know, their symptomatology, their hearing voices, and that's what told them to steal that sandwich, like in that example I gave you before. So some will require a nexus. And some will also look at the type of crime. For example, in some states, there are laws that prohibit violent offenders from being included in mental health courts and, therefore, only lower level offenders. Other states will allow violent offenders, but they will exclude certain offenses such as sex offenses or arson or, obviously, murder, and that wouldn't generally be allowable because these are alternatives to incarceration. So there's a combination of factors that would allow diagnoses to be included. Another important thing to say is that in some mental health courts, there might be a requirement for a prior diagnosis rather than a new diagnosis because the staffing might not include a clinician that can actually make a new diagnosis. It might be a nonclinical case manager, for example, and so they will be relying on prior mental health records produced either by the defense attorney or by the defendant or that they can get from the community mental health system to help establish an individual's eligibility. Great. How can, and this is sort of the crux of the presentation today, how can a mental health professional best collaborate with parole and probation to facilitate recovery? So sometimes it's as simple as going and meeting with them and establishing a relationship. We've established many programs. I have partnered with teams that have established many programs at all of the intercept points, and oftentimes it's just the left hand did not know the right hand at all, let alone what they were doing or what they were responsible for. We have set up, you know, cross-systems trainings. For example, in one place we brought in probation to train the mental health staff on what the probation officers actually were doing and how they did it and how they developed their case plan, and then we had our mental health staff go and train the probation officers. We've had ride-along opportunities with police so that people can learn about multiple crisis response and we can learn about law enforcement response. So some of it is really outside of the context of a particular case, just talking to each other and understanding what the goals are, and then building bridges from there. Great. One last question. There are many more questions, but here's the last one that we have time for. So slide 27 they're asking about, which is your slide where you have the OSHA data about, you know, the nice green table about the prevalence and proportion of adults with mental health in the system compared to the general population. This person asks, do you know if these rates of SMI and SUD and co-occurring mirror rates of the same among chronically homeless populations? So I think they're asking about the differential. Yeah. I don't have that specific answer, but I can tell you that there is a big overlap, as you probably know by asking that question, in those populations. And so I don't know if anyone has done that particular study to say whether in these studies they did not also look at chronic homelessness. So I can't say for these particular studies. But we do know, and it's interesting because some of the work that I've done in developing, for example, wraparound support services, one of them is written up in the editor's pick of psychiatric services, something called our Mission Criminal Justice Model. That model actually started with a homeless population, and we shifted it towards a criminal justice model. But the population needs and overlap were tremendous. So I think you will see those numbers that you will see SMI at high prevalence, if not higher prevalence rates, because you're silting down with that population that has really kind of struggled in a variety of dimensions.
Video Summary
In this video, the speaker discusses the difference between parole and probation. Probation is assigned at the court level and is under the review of a judge. Compliance with probation means following the terms set by the judge, which can include mental health treatment and avoiding certain people. Probation officers ensure compliance with these terms. Parole, on the other hand, is determined by a parole board and allows an individual to be released from prison before completing their full sentence. Parole supervision can vary depending on the case. The video also mentions the role of peer forensic specialists in supporting individuals in the criminal justice system. The speaker also talks about the prevalence of mental health conditions among incarcerated individuals and the importance of collaboration between mental health professionals and parole and probation officers. Unfortunately, no credits were provided in the video.
Keywords
parole
probation
court level
parole board
mental health treatment
Funding for SMI Adviser was made possible by Grant No. SM080818 from SAMHSA of the U.S. Department of Health and Human Services (HHS). The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement by, SAMHSA/HHS or the U.S. Government.
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