Hello and welcome. I'm Alexia Wolfe, Director of the Delaware Behavioral Health Consortium and SMI Social Determinants of Care Expert for SMI Advisor. I'm pleased that you're joining us for today's SMI Advisor webinar, Meaningful Community Participation for People with Mental Illness, a Model and a Movement. SMI Advisor, also known as the Clinical Support System for Serious Mental Illness, is an APA and SAMHSA initiative devoted to helping clinicians implement evidence-based care for those living with serious mental illness. Working with experts from across the SMI clinician community, our interdisciplinary effort has been designed to help you get the answers you need to care for your patients. Next slide. Today's webinar has been designated for one AMA, PRA, Category 1 credit for physicians, one continuing education credit for psychologists, one continuing education credit for social workers. Credit for participating in today's webinar will be available until August 28th, 2023. Next slide. Slides from the presentation today are available to download in the webinar chat. Select the link to view. Next slide. Captioning for today's presentation is available. Click show captions at the bottom of your screen to enable. Click the arrow and select view full transcript to open captions in a slide window. Next slide. Please feel free to submit your questions throughout the presentation by typing them into the question area found in the lower portion of your control panel. We'll reserve 10 to 15 minutes at the end of the presentation for Q&A. Now I'd like to introduce you to the faculty for today's webinar, Dr. Jessica Klaver and Ms. Helen Skipper. Jessica Klaver PhD is a clinical and forensic psychologist with more than 15 years of clinical research, administrative and teaching experience in behavioral health settings. She joined CASES in 2016 and is currently the chief program officer overseeing our behavioral health forensic case management alternative to incarceration pretrial services and youth focused programs. Helen Skipper is the executive director of the New York City Justice Peer Initiative and NYAPRS New York City regional coordinator where she is intentional in creating space for individuals with lived experiences. Thank you for leading today's webinar. Good afternoon, everyone. Thank you, Alexia. Thank you to SMI advisor for hosting this webinar today. This slide is to let everyone know that both Skip and myself do not have any disclosures for the group. Here are the learning objectives for our webinar today. These will be available to you because the slides will be available to everyone attending. And so today I'd like to present to you a model called forensic assertive community treatment or forensic act as implemented in New York City. And I would like to share with you all today how this model can be an example of meaningful community participation for people with serious mental illness. So just a little bit about CASES. We are a nonprofit agency in New York City. Here is our mission statement. And essentially we aim to tackle public safety issues. And one way we do it is through public health or public mental health solutions. We provide a variety of services at our agency from pretrial services, alternative to incarceration. We work a lot in the courts. And we have a whole youth and young adult division providing preventative services. And we have a continuum of outpatient behavioral health treatment. One program of which I'll be talking about today. And our reach as of last year, we served over 9,000 people in over 30 programs at CASES. So just a little bit about assertive community treatment or act. For those of you who are not familiar with the model, in New York State, we have a lot of different flavors of act. And increasingly specialized innovative act teams. So we have kind of classic act teams. We have act teams for younger people. We have act teams for older people. We have some act teams that are connected to certain types of housing. And today I'm going to be talking about forensic act teams and also one specific program we have that's an alternative to incarceration program as well as an act team. So to be eligible for act services, generally, a person needs to have a serious mental illness. So this is typically schizophrenia, bipolar disorder, major depression. And not only a diagnosis, but also have had challenges engaging in traditional outpatient treatment. For example, going to a clinic. That makes someone eligible for an act team. And a forensic act team, there's an additional eligibility that someone needs to have a recent or current involvement or impact from the criminal legal system. In New York City, an act team referral comes through our single point of access system. This is run by the city, Department of Health and Mental Hygiene. The one priority in terms of the wait list for act is for those who are on court orders for outpatient mental health treatment, assisted outpatient treatment or AOT orders. And I included a link below for anyone who would like to learn more about act in New York State. So just some of the basics of the act model. An act team is a multidisciplinary team. I like to call it a transdisciplinary team. This is because everyone has their specialization. But everyone also does a little bit of everything, which is part of the magic of an act team. There's usually about 10 staff on the team. We'll go through the staffing in a second. But there are 68 clients maximum on an act team. And so if you do the math, you can see that we really try to never go over a 10 to one client to staff ratio on the team. So it's an intensive service. The caseloads are shared. And so I kind of alluded to this before. This means that every client is seen by every staff member. So it's not these are your clients, these are mine. Every staff member sees every client. And one of the ways information is shared is through a daily morning rounds. So there's a morning meeting where every client on the team is reviewed. And every member of the team attends that meeting. So as you can see already, part of the model is this very intensive kind of collaborative process. Also important for act is most of the services are delivered in the community. So this can be wherever people are, their residence, it could be a shelter, it could be out on the street, an act team will meet you where you are, and they will meet you often. So at least six visits a month are happening in the community for each client. And act team will also do what we call assertive outreach and engagement, sort of the A of act. And so if someone is kind of off the radar, one of the services of act is actually to re-engage the person. So we will spend lots of time trying to find the person calling hospitals, calling family members, and out there looking for someone to re-engage them in care with the act team. Act teams are very involved in hospital admissions and discharges. One of the goals of an act team is to keep people out of the hospital as much as possible. But we do understand that sometimes a short hospital stay is part of the continuum of care that is important. Act teams tend to have wraparound funds, which are essential. In the beginning, it's usually around engagement. This is a cup of coffee, it's a sandwich, it's a metro card to get around New York City. And as we work with someone, it may look different later on. It may be supplies for going back to school or something to wear to a job interview. Another vital part of the act program model is that we do have 24-hour crisis coverage. So we will go out, we will answer the phone any time of day or night, again, to avoid kind of emergency psychiatric services use. And act is pretty long term treatment. In New York State, people stay on act teams usually about three or four years. So here's the staffing for an act team. As you can see, there are many different disciplines. There's psychiatry services, nursing services, a variety of clinicians, and the blue boxes highlight kind of the enhancement on a forensic act team. So we have a criminal justice specialist solely dedicated to helping people navigate their criminal legal system situations. That could be parole, that could be an open charge. And we have a housing specialist. And I think this goes into some of these positions I think really get to the heart of this meaningful community participation. So living in the community, it doesn't mean living on the streets. We want to get people into housing, into an apartment where they're living alongside. We want to help people reconnect with their loved ones, whatever family means to them. We have a family specialist who can help them with that. Often our clients want employment. So we have an employment specialist, which is a really key participation in one's community. And finally, we have two peer specialists on a forensic act team. And these are very exciting roles and I think also get to the heart of this idea of meaningful community participation. And I want to say a little bit more about this role, especially for this talk today, is a peer specialist. For those of you who are unfamiliar, is someone who has lived experience that's similar to the population that we serve. So they can relate to the person in a very, very unique way through engagement, all the way to providing hope for that person, living a life of meaning in the community, where their mental health diagnosis is just one of many, many different parts of their life. So it's extremely important having a forensic act peer specialist on a FACT team. And they offer this intentional peer support to our participants. And they really also kind of teach the team. So ACT is a recovery-oriented, strengths-based, person-centered, trauma-informed model. And it's often the peers that really keep us connected to that philosophy of care. So they can help with developing crisis plans. Our peers are really our experts in harm reduction and motivational interviewing. And our peers are also well-connected. Sometimes they are accessing the same services themselves. And so they are available to help connect people to any kind of networks in the community that might be helpful for them. And so a peer specialist on an ACT team is a way for someone with mental health issues to be able to give back and to participate themselves in the community through their own employment and sort of pay this forward through their own work. Some of my favorite stories on our ACT teams are when our ACT clients go to school and become peer specialists themselves. So here are some of the trainings that our ACT teams staff undergo. I'm not going to go through all these trainings, but I will say that the Forensic ACT teams do receive some extra specialized training. And this ranges from just some information about the criminal legal system itself, like how do you talk to a defense attorney? How do you talk in court? What's the difference between probation and parole? All the way through really first-person perspectives, which again is hearing from people with lived experience about how we can best do the work. The staff also get training in some specialized risk assessments, and these allow the team to really identify some vulnerabilities that might be present in our Forensic ACT population. For example, vulnerability to being rearrested and also a violence risk assessment. So these are the ACT core services in New York State, and so I won't go through all of them, but I do think that it's just important to note in terms of helping people be members of the community and being citizens, that many of the ACT core services map directly onto helping people be in the community, from just basic daily activities of living to really getting a job, going back to school, and managing their wellness. Forensic ACT teams provide some extra services to people, and so we do an expanded legal history assessment. Not all ACT teams might be asking people about their experiences, maybe in jail or in prison. I mentioned the risk assessments, but we also do a lot of close handoff work with our partners, state prisons, city jails, where people are often released right to a Forensic ACT team, so we are going to meet that person right at the point of handoff, and if they happen to go back into incarceration setting, we will not abandon them. We will definitely stay in contact with them and with the facility and advocate for them to come back into our team, and most of us, I think, are pretty well-versed in trauma-informed care, and I do like to think that there's a special version of trauma-informed care that we provide for a forensic population, which is enhanced by having people on the team, working on the team, who've been in those situations before, just thinking about even space, like where to meet with someone who's maybe come out of an incarceration setting and might have been in solitary confinement, for example, just thinking about the little things to make sure that we're fully trauma-informed, and a Forensic ACT team also, in addition to focusing on sort of psychiatric utilization, like reducing ER visits, is also going to explicitly focus on legal outcomes, like how do you not get arrested again, so this is kind of a unique focus as well. Some of you might be wondering, how is all this funded? I think it's funded in a lot of different ways across the country, actually internationally, so I will just let you know how it's funded in New York. Specifically, ACT is a Medicaid service in New York, and so the funding from Medicaid kind of maps on to the visits, so as I said before, really, fidelity to ACT is that you're getting those six or more community visits every month, and so there's a rate for sort of full fidelity, like you saw someone as much as you were supposed to to meet the ACT fidelity, and there are other rates if you see someone fewer times or if they're in the hospital, but you do visit them, and no reimbursement if you see them either zero or one time in the month, and so an ACT team that's kind of fully up and running can usually count on a little over a million dollars a year in Medicaid funding in New York state, but the city and the state both realize that this is not all the funding that's needed to sort of run an operational ACT team, so there is some net deficit funding from the city, and so for ACT teams, they get a little over $150,000 a year. This comes from the city, and forensic ACT teams are actually more richly subsidized at a little over $670,000 a year, and this is to account for the nature of the population and the work that all the Medicaid revenue is not necessarily going to be captured, so this makes for a total budget, so if there's any fiscal people out there looking to start a forensic ACT team, the total budget for an ACT team in New York state is about $1.3 million, but for a forensic ACT team, it's about $1.8 million. So, some data from our forensic ACT clients thus far, since about 2016. The demographics are what you might expect in a very, very urban New York City area. One thing that always sticks out to me, it's interesting, almost 20% of our ACT clients are not born in the United States, so that statistic has been kind of stable and interesting to me, and we assess immediate needs right away when we meet someone. This is one way we can engage with them, so obviously, many of them have urgent legal needs, but then clothing, food, shelter, some things that we can help them with sort of urgently using the wraparound funds also to engage them into the program. So I did mention that we want one alternative to incarceration act team at cases, and it's called the Nathaniel Act Team. So this is for people who are act eligible, but they're actually in the legal system, and so they have a felony charge and they're facing prison time, often a violent felony, most often assault, second degree. We have staff in the court system who are screening people for eligibility to come and receive act services in the community as an alternative to incarceration. And so the team not only does the treatment, the rehabilitative supportive services, but they also report back to the court on compliance and the person's sentencing is deferred. So oftentimes if they successfully complete their alternative to incarceration conditions, which includes act for maybe six months, 12 months, that felony gets reduced to a misdemeanor or, or may get completely dismissed. So this is a very unique model we have here in New York City. Very good outcomes for this team. This is some outcomes from the state database from admission to discharge on our Nathaniel Act Team specifically since inception. So as we see here, we have increases in things we want to see like educational activity, employment, um, and also, um, Oh, sorry, let me go back. And forensic involvement, we want to see decreasing, um, or sorry, uh, decreasing as well as psychiatric hospitalization and homelessness. So I think one of the most important outcomes actually is, is recidivism. And so we are pretty proud of this program because people come in on violent felony charges often. And, um, just some of the most recent data, um, two years post discharge, um, 94% of people have no new felony conviction and a hundred percent have no new violent felony conviction. So we're pretty proud of this outcome data at cases. Um, and so on the left here is, uh, this is, this is Nathaniel, um, a New York Times article about him from 1999. Um, the young man who the team was named after, who sort of cycled through, uh, the jail mental health system in New York city, um, and was, uh, our, our very first client on Nathaniel Act, um, when we started the team, um, in the early two thousands, and we will, we were able to stop that cycle for him. Um, and we are, we're grateful to, um, Mutual of America and also SAMHSA, um, for some, uh, awards that this program continues to receive, um, the community partnership award, um, for Mutual America and also the recovery innovation challenge award from SAMHSA this past year. And I would like to end my section just with a quick video, um, that shows some of the great work of the Nathaniel Act team. The mental health system failed though, because I begged for help. Unfortunately, he had to be arrested to get help. My mental illness is, it's a life that I've been given and that I have to live. My diagnosis is schizophrenia. It progressively worsened. I was hallucinating. The reason that I struck the man I struck is because I thought he was the devil and he wanted to hurt me somehow. And out of a state of fear, I reacted. I spent 29 months behind bars at Rikers Island. I was in mental health units. I was compliant with my medication. I was attending therapy sessions. I was in court with these charges of assault. The judge acknowledging that I had suffered from mental health problems when I committed my crime and knowing that I was working really hard to be better offered to release me into the Nathaniel Act team's care. When people come out of jail, we literally meet them at the moment they're released. They're hungry. They may not have anywhere to live. They may come out with a MetroCard and one outfit. We may buy them a bag of toiletries, a sweatshirt, and some boots. They helped me get housing. They would fill up my fridge, deal with the pharmacy, take me to doctor's appointments, and they were showing up at my house. I could see them anywhere from two to six times a week. To have someone that you can just dial at any time, that was really essential for me to get over the trauma I sustained while I was incarcerated. Had I failed to complete the program in the mental health court, I would have had to go to prison for seven and a half years. And the person who I actually struck, he found it in his heart to forgive me. He wanted me to get help. Jesus gave him a second chance. He's going back to college, and he's working hard to make sure people understand the mental illness is real. I didn't think, finally I'm free. I thought about everybody who was not going home. They needed the same kind of empathy that I needed. Our crimes may have been different, but the circumstances were somewhat similar. All right, and now it is my pleasure to pass it over to Skip. Thank you, Jessie. Thank you. You know that video is always so impactful. It just shows how we can succeed. We can thrive. My name is Skip. I am the Executive Director of the New York City Justice Peer Initiative. We are transforming the criminal justice landscape and developing a system-impacted workforce. And we are also, in doing so, decriminalizing behavioral health, creating an opportunity for community, for communion, for relationship building. Next slide. So, as I said before, I'm Skip. But something you might not know about me is I have multiple systems lived experiences. I am heavily impacted by all systems. I know that says the criminal justice system, but it's actually all systems. I've worked in peer support for over 15 years since my final release from incarceration. I am duly certified in both mental health and substance abuse and incarceration. I am duly certified in both mental health and substance abuse misuse. Peer support. I'm a practitioner. I'm also an academic. I just graduated with my BS with honors in criminal justice. I'm going on to grad school, on my way to my PhD. I am a researcher. But what I am, more importantly, is deeply impacted and affected by the criminal justice system, by multiple systems involvement. And every time I went into a system, homeless, addicted to drugs, suffering from an unchecked mental illness, I never received any treatment or support. They just wanted to put me up under the jail. And then I would go from one system to the next and always end up back in jail. This is why at my tender age of two days over 18, I have done 25 years going back and forth throughout these systems. I didn't do long time, but I did my time in an installment plan, which really means that every year I was either locked up, getting released, violating parole, or as they say on the streets, throwing bricks at the penitentiary, trying to get in. Next slide. What I want to do is just to find the justice peer. We're going to understand the movement. We're going to recall what we've done so far and where we're heading to next. We're definitely going to celebrate those next steps. And I'll also offer a chance to collaborate with the justice peer initiative. Peer support has taken off widely throughout the United States, but in this stage of mass incarceration, we need to combine that to take that needed element and put that within the criminal justice system. And I guarantee you, we will decarcerate. Next slide. My favorite quote, I don't know about you guys, but I was sitting on my couch in the midst of a pandemic, trying to work on the couch, shuffling papers from one side to the couch to the other, rocking my back. And then something happened and made us really look at what our country is and does. But in the midst of all of that, there was this one young girl, a shining example who spoke at the inaugurations. And she is our nation's poet laureate, if I'm saying it right. But she spoke about something that lit a fire within me. And here is a snippet of what she said. There is always a light. If only we are brave enough to see it. If only we're brave enough to be it. That was Amanda Gorman. And I assure you, I'm brave enough to see it. And not only that, I'm brave enough to be it. Next slide. So what is this movement about? We're going to talk about what is the New York City Justice Peer Initiative. Next slide. So real briefly, in 2020, a few of us got together, including CASES, which is the largest behavioral health agency here in New York City, and which is also one of my first peer jobs back in, oh my God, I'm really going to date myself. Don't nobody laugh. I think I worked for CASES in like 2009, 2010, something like that. You know, we were all working in programs within the criminal legal system. We were all peers. We all had lived experience in behavioral health. And as the pandemic raged on, we kind of wondered, like, why is there not a certification or any type of training for what we like to call justice peers? And there wasn't. So we decided to get together and build it. And in 2020, we were just volunteers. We all had jobs elsewhere. And we were volunteers. And we just got together and started talking. And we formed the JPI. And over, it's not even two years, over the past three years, we've attracted so much participation, so much support, so much collaboration, that tomorrow, for the first time in New York State and New York City, in our part of the country, we will be hosting a one-day justice peer conference for all people who are justice peers working in the criminal justice system. Completely, totally excited about that. This is the first time New York State has ever had something like this. And we're doing it. And who are we? We're led by a founding executive director. That would be me. And I have a governing executive committee consisting of more than 95 percent peers and people with lived experience. Our membership, and this is a little old, so let me update that. It consists of almost 800 members and more than 160 agencies and organizations, not just in New York City, but in New York State and also nationwide, because we are pushing nationally. Next slide. What is a justice peer? Let's just talk about what is a justice peer. Next slide. A justice peer is someone who uses their lived experience with the criminal legal system to support others who are ensnared or impacted by that system. We use the principles of peer support, which at its basic is shared understanding, respect, and mutual empowerment. We heavily use the power of storytelling. We lead by example. We instill hope and determination. So at the end of the day, I can give someone my story and tell them how I fought and made it over these hurdles. And people can take snippets of my story and use that to galvanize their own movements and kind of avoid the pitfalls and snares that I've already been through, that I've already been caught by, that I can be like, hey, look out for this. This is going to happen. Here is how I got through it. Next slide. All of this is critical for successfully navigating these complex systems, and these systems always exclude those of us with conviction histories and or behavioral health diagnosis. See, peer support is firmly integrated in behavioral health, but it's underutilized in a criminal justice system. But there's another thought that I want to give you. When you are a returning citizen, when you are reentering from a period of incarceration, it is so hard for you to get situated, so hard for you to get the proper support and and network and collaborations that you need. That's just you being a returning citizen. Imagine if you took all of that, all these barriers, and then added another hundred more barriers because you have behavioral health concerns. How is that going to help? It doesn't. Peer support is underutilized in a criminal justice system. Next slide. So, what is our goal and value at? I'm sorry, I built the business when I came home, so I'm a little business orientated. I should have put a SWOT analysis up here. We're going to establish a strong justice peer workforce in New York City. We're going to build author successes and lessons learned from the broader peer worker movement. We are going to advocate for the peer workforce to become a critical component to a successful criminal justice reform and transformation. We're going to reimagine the justice system. We're going to refocus on rehabilitation and recovery with peer support as a central component to decriminalize behavioral health. You know, we say no walking while peer. You can get locked up for suffering from behavioral health issues. You can't here in the city. Next slide. So, just to, like, boil all that down, get out of the weeds, and just give you one short, simple sentence, we are peers who use the framework of peer support within the criminal justice space. Next slide. Some fun facts. Fun. 90% of those caught up in the criminal justice system have behavioral health challenges. And behavioral health, when I speak of behavioral health, I include substance misuse and mental health diagnosis. Peer support is already heavily researched. It is an evidence-based practice. We have empirical evidence and research data that has shown it to be extremely beneficial in behavioral health and the medical field. Peer support is so underutilized in the criminal justice space. Under the tenets of the sequential intercept model, SAMHSA has delineated specific points where someone can be intercepted by the criminal justice system. All, that reads all, all six, or is it five, intercepts can be successfully served by a justice peer. Next slide. And in case we have a little questions about the sequential intercept model, it definitely starts at intercept zero, which is the community level. This is people running and building and working in the community before they come in contact with the criminal legal system. The sequential intercept model ends at reentry, but reentry with community supervision. Read that as parole, probation, always getting violated because you come in late or you don't have a job, things like that. So we got funded. Yeah, we got funded. We've been funded to build a workforce of system impacted folks. And in doing so, in order to make sure that they have retention and they are fully supported, we implement professional development. And we do that through support circles. We do that through our technical assistance, which I will talk about soon. And we also offer technical assistance to employers. We are creating pathways for employers to hire justice peers. Next slide. Let's talk about the elephant in the room, or as I like to call it, the gravy on top of the meat and potatoes. You can't have meat and potatoes without some gravy. Technical assistance. What is it? What does it entail? Next slide. So examples of the technical assistance we offer include organizational culture. So we can come in, we can review your organizational policies and practices. If you have never hired someone who is directly impacted and also has behavioral health concerns, we need to look at your organizational culture because there could be some traumatizing or harmful practices that you do on a daily that doesn't really bother people. But for someone who is directly impacted or has behavioral health challenges, it would kind of harm us and make that not a safe space. We look at job and position development. We'll review your current or pending jobs descriptions because when you're hiring for peers, you need to include peer support competencies and values into these job and position paper. Capacity building. There seems to be some school of thought that seems to think that people who are directly impacted don't want to become better at the job they're doing. We don't want professional development activities. We don't want promotional opportunities. I don't know where that came from, but that is so wrong. So we also help with capacity building. In other words, we can review your workflow and your target audience and we can help develop a professional development regime that can help elevate and escalate justice peers and all peer support workers. We look at HR concerns. We look at best practices for employee relations. We help remove potential barriers. Let me just say some barriers are not removable when it comes to things like regulatory agencies. There are always going to be extra hoops and whistles that those of us who were directly impacted have to jump through. But what we can do is come in there and kind of show you how to make that as less harmful and threatening as possible. I know a lot of people, when they try to work and they are told, oh, you got to go get this paper and you got to get this stamped by the court saying you don't have any open cases, that's too traumatizing and daunting for them. So what we do is we try to make that process as simple as possible. Sometimes it's just about, let's write a one pager with all the helpful information so people know what they're stepping into, where do they need to go, who do they need to talk to, what do they need to have in their pockets to achieve what they want to achieve, instead of being twisted around in the wind going from one government office to the next without getting proper closure. Professional development, my favorite piece. I don't know, there's that thought in the wind that we don't want promotional opportunities and we don't want to move up. So we help you develop specific training and onboarding regimens. We help you develop these lines where that peers can move up. When I was hired in a city by CJA to develop a team of peer specialists, I developed promotional opportunities. Because if I hire you as a line peer specialist, in five years, I do want you to have gained enough acumen and experience in order to move up to a peer specialist supervisor or peer coordinator or a peer manager. My last position at this agency was senior manager of peer service. And I told my staff every day, I have opened the door for you. You can come take my job. I have prepared this. I have laid the way. I'm building you up. When I ask you to take trainings, I am building you up so that yes, you can come take my job. And I want you to take my job. Next slide. So we're building a systems impacted workforce. We will build a workforce for us, by us, using our justice peer curriculum. We will ensure our workforce is protected from harm by implementing those support development circles, a safe space for us to build community and offering technical assistance to employers, building their capacity to safely welcome justice peers into their organizational culture without further traumatization. Read that as making sure that peers, people who have been impacted by the criminal legal system and behavioral health challenges have a safe space within their employment. Next slide. And in doing so, here's my little lofty statement. I feel like I should stand on a rock. Hear ye, hear ye. And in doing so, we will assist in decriminalizing behavioral health. Next slide. So I'm almost at the end. I know you want to spend a lot of time with me and I would love for you to do that. But like I said, I am preparing for this big conference tomorrow with over 200 people and presentations and keynotes and ID cards and things like that that I have to wrangle. But let me tell you what we have accomplished. This is just a look at where we have been and where we're going. Where we have been and where we're going. Next slide. I developed the Justice Peer Specialty Track for the New York State Certified Peer Specialist. This is under the OMH Office of Mental Health. So I helped develop that specialty track so people can become certified in justice. This actually rolls out in the fall for our almost 7,000 certified peer specialists here in New York State. I am now replicating that work with OASIS, which is the Office of Alcoholism and Substance Abuse Services. Unfortunately, New York State is one of those states that divides peer workers. So you have one that governs mental health peer workers and you have another agency that governs substance abuse peer workers. That work has started. Our curriculum, which these two curriculums are for certified peers. We are also working on a standalone curriculum for those who have been impacted by the criminal justice system who wants to take training in how to be a justice peer. We are not training certified peers, however, but we can train you about the criminal justice system and how to support and mentor others using your lived experience. We're going to roll that out by the end of this summer. We are expanding. We have received additional funding from our original grant. I don't mind saying that I have a wonderful team with me, but they're all volunteers, but they have still pushed with me. But I finally received enough funding where I can finally hire and I will be hiring next month. When we started doing technical assistance, we realized that that was literally in two chunks. So the advocacy is talking up the justice peer and creating the interest and showing the feasibility and validity of the second half of that is the actual direct implementation, which is what we also work on through my advocacy. There have been some several lucrative RFPs that have come out in New York City, putting neighborhood navigators in the streets of New York City, doing outreach with lived experience and putting peers and criminal court services. I can't ask for nothing better. I'm waiting for you guys out there in the interwebs to start impacting this too. Next slide. Our future goals. We're going to host the one day convening. Guess what? That day is tomorrow. You see that flyer? I am so far over capacity. I don't even want to tell my alma mater where I am hosting this conference at how many I got coming in, but I am definitely over capacity and I'm so overjoyed by that. This is the first time New York state has ever had a your conference like this. We're also partnering with another organization in the middle states to hold a national justice peer summit, because at the end of the day, we're not the only ones doing this type of work. And I think it's imperative that we all sit down and we all build community and learn from each other. Some states call it forensic peer. Some states call it reentry peer, but it's basically along the same lines. Some states even have an indigenous peer. Like, isn't that so cool? Because at the end of the day, we all come from different cultures and different worldviews. We need to work together to make sure everybody is encompassed. My worldview is not your worldview, and it's not the same as someone who grew up in an indigenous culture. So cool. Next slide. Now, in a joint application with cases where you just heard from with Jesse, we won the SAMHSA Recovery Innovation Challenge. So I just want to play the first few minutes. Forgive me. I think I was coming in from a presentation that I had flew out to do. I was probably a little tired, but I just want you to hear like the first few minutes. Go ahead, Jesse. Take it away. Hi, my name is Gip. Cases was one of my first peer specialist jobs. In a little over 10 years, my recovery has come full circle. I am a peer supervisor, duly certified in both mental health and substance abuse. When I entered into the criminal justice system, I was addicted to drugs. I was suffering from a mental illness. My purpose today is to infuse recovery into that system. I am doing that by building community. I'm creating relationships and networks between those who are directly impacted and those who are formally impacted. Thank you, Jesse. So questions, collaborate. Closing. Here's something about how to reach out to us. Some contact information. Get those phones out. Y'all know y'all got iPhones. Snap this QR. Reach out. Next slide. Join the JPI. Please join my list, sir, so you can hear about the exciting things we're doing. I promise I will not spam your inbox. Lord knows I have enough of that on mine, but I do send out helpful information. So please scan that. Next slide. Scan this one. This is a created direct appointment with me and links directly to my calendar. I love to meet you all. I love to talk with you all. I love to hear about what you and your different geographical location is doing. I love to come out to talk to you. I love to travel. I do for a certain period every year when I call conference month, which is like October and November, kind of live in airports and going to so many different conferences. I'm presenting. I'm doing keynotes, whatever, but I don't have a problem with traveling. Do you need me? Do you need me to come work with you? Would you like me to come work with you? Please hit this QR, create an appointment and meet with me. Next slide. Let's definitely keep in touch. And I'm talking to all you out there in the interwebs. All of you. I can see you. Every single one. I'm kidding, of course. But I see the interwebs. This is my email. Please use it if you ever have need of my assistance. Thank you so much for letting me present to you today. Next slide. Thank you both for such an interesting presentation. And before we shift into Q&A, I want to take a moment. Next slide. And let you know that SMI Advisor is accessible from your mobile device. Use the SMI Advisor app to access resources, education and upcoming events, complete mental health rating scales and even submit questions directly to our team of SMI experts. Download the app now at smiadvisor.org backslash app. And with that, we'll transition into questions from our audience. One question for New York's ACT peer specialist team members. Do you have peer specialists with living experience of mental illness and criminal justice involvement? Yes. Thank you for that question. Our peer specialists on our forensic ACT teams, I think most often what they lived experience they most often have is with the criminal legal system. And almost all the time, they also have experience in their own recovery, whether that's from substance use, whether they're in mental health recovery, or both. So sometimes it's all three. Excellent. And are you collaborating with the DOJ's medical legal partnership program that provide a robust array of free legal services in New York City and across the country? I am not sure if we are, but I see it in the chat. So I'm going to write it down and make sure that all of our teams have this resource. It looks like an excellent resource. So thank you for that. Wonderful. And there is a comment about 68 clients in the ACT program. Does that mean that in all of New York City, there are only 68 clients? Oh, yes, I can clarify. So each ACT team has 68 clients in New York State. And actually in New York State, I think there are, last I heard, 111 ACT teams in New York State, which means there are over 7,500 slots for ACT across the state. Wonderful. And Jesse and Skip, I know that our audience is interested in a deeper dive into the role of community inclusion and community participation for people with serious mental illness and the work that both of you are doing. So I'll give you a chance to comment on that in more depth. So maybe I'll talk about the ACT side and then Skip, maybe I can pass it to you for the peer side. So I think ACT itself, I think is designed intentionally actually to promote community, meaningful community participation for people with mental illness. This is so that people with mental illness are not living their lives in hospitals. They're not living their lives in jails, being criminalized. So the model itself is actually designed with its staffing, with its services to help people stay in the community. And this community tenure, it could be through employment, through education, through family relationships, through any kind of civic engagement. The model itself is actually directly designed to help people with this community engagement. And I think the job of a peer, I'm going to kick it to you, Skip, is a beautiful example of meaningful community participation itself. So one thing about us who are directly impacted by the criminal justice system, we come home and we find it hard to access jobs, to access housing, to access health care, to access collaborative support. We are often treated as second-class citizens. Matter of fact, one of our names for ourselves is the carceral citizenry. You know, even myself, as an executive director of an agency, someone who takes cruises every year, who buys a new car straight off the showroom lot. But if I was to go through the New York City transit system and not pay my fare, I would have to be arrested because I have a felony background, which means I would have to go through the system. And it might not even be my fault. It could be that the transit system, the machine doesn't work. It's not reading my card that has fares on it. And I did what everybody else did and just walked through the turnstile. But if they pick me up because of my background, because of my history, and let's not get it twisted, I've been home since 2007. But here we are in 2023, and I'm still penalized, which means I still might have a problem finding housing. If someone wants to run a criminal background check, like I said, if I happen to walk through the turnstile, I won't get what's called a DAT, which is just a ticket saying, come back to court. No, I'll have to be arrested and go through the system because I have a criminal justice history. But why does what happened back there affect me now? See, that is one of the things that a justice peer is kind of moving against. So not only are we creating community, not only are we creating inclusion, we are lifting up everybody's economic value. We are looking at everybody's social determinants of health. We're looking at everybody's eight dimensional wellness. If you've ever heard of the eight dimensions of wellness, there are separate dimensions, not just physical health, but emotional, financial, occupational, financial. That's emotional, financial, occupational, financial. That's money in your pocket. If I can't get a job because I'm directly impacted, is my financial wellness up to par? No. Occupational, same thing. I did say occupational, didn't I? Okay. But emotional, stress leads to depression, which is a mental illness. I'm stressed. If I can't find a job to feed my family, I can't find adequate housing and ask for support. The minute somebody figures out that I've been in jail, it's like I get backs. I don't get a welcome. I get a turnaround. And yeah, come back. Come back next week. And no, we don't have anything for you. Now, this happens to people who will reenter in society. Now, suppose all of this happened. And like I said before, we also have behavioral health challenges. How are we to support ourselves? How are we to move into a period of thriving when we cannot get the appropriate supports and assistance? This is what the Justice Peer do. We create community inclusion. So not only are we trying to train you up and put you to work, we also provide other supports that really speak to community inclusion. We are included in the community when we treat it and we act like everybody else. Everybody else wants to get up and go to work. So do I. So does everybody that comes home from jail. But it doesn't happen like that. And we create a way so that it does happen. Everybody wants to create some type of wealth. A lot of people have generational wealth. Most of us that has been impacted by the criminal justice system do not have that. We can't even find a job, much less buy a house or a car. But the Justice Peer initiative is creating pathways for that. We are rethinking and moving to re-deliver this model of services in the criminal justice system. Why can't we be the service deliverer? We're the ones with the experience. Why can't we go back into the criminal justice system as a mentor and help people over that hump of direct impacts? There's so many ways that we do that. But thank you. Thank you, Skip, for wrapping up the Q&A on such a hopeful note. And with that, we'll transition to the next slide. If there are any topics covered in this webinar that you would like to discuss with colleagues in the mental health field, post a question or comment on SMI Advisors' Discussion Board. This is an easy way to network and share ideas with other clinicians who participate in this webinar. If you have questions about this webinar or any other topic related to evidence-based care for SMI, you can get an answer within one business day from one of SMI Advisors' national experts on SMI. This service is available to all mental health clinicians, peer support specialists, administrators, and anyone else in the mental health field who works with individuals who have SMI. It is a completely free and confidential service. Next slide. SMI Advisor offers more evidence-based guidance around the integration of peers, such as the video series, Windows of Wisdom, Shape Your Own Journey with Insights from Experienced Peers. These videos contain valuable firsthand advice from seasoned peer specialists around systems of care, navigating relationships, understanding your role, and establishing boundaries, and much more. Access the videos by clicking on the link in the chat or by downloading the slides. Next slide. To claim credit for participating in today's webinar, you need to meet the requisite attendance threshold for your profession. After the webinar ends, please click Next to complete the program evaluation. The system then verifies your attendance for claim credit. This may take up to one hour and can vary based on local, regional, and national web traffic and usage of the Zoom platform. Next slide. Please join us next week on July 7th as Edgar Ramos and Sylvia Diaz present The Impact of Immigration on SMI in Undocumented Latinx Population. Again, this free webinar will be July 7th at 12 p.m. Eastern Time on Friday. Thank you for joining us, and until next time, take care.

meaningful community participation

mental illness

Delaware Behavioral Health Consortium

SMI Advisor

CASES

forensic assertive community treatment

peer specialists

ACT teams

New York City Justice Peer Initiative

collaboration