So, Dr. Pinal, there have already been a few questions that have been coming in, so let me just get started. Can you expand more on the, quote, dangerousness, unquote, definition, and what they use to determine that, and what actors in the court system determine this? So, generally, that will be determined legally, and it will be determined potentially by a variety of factors that are outlined in statute. And often, it will look at the nature of the offense itself. It might look at other variables, like whether the person has a history of not appearing in court. It might, even though it's a different issue, it might look at a history of prior criminal activity, and whether prior criminal activity involved victims. It might involve whether the person has a history of mental illness. That could be a factor in and of itself. And whether that's fair or not, or appropriate or not, is an issue that I think will probably be elucidated over time as we look at these issues more, and as advocates look at these issues more. But there's generally going to be a variety of factors that are considered just based on facts alone, that are legally put into a formula that the judge will consider. And at a hearing, there can be contested testimony between the defense and the prosecution about whether that particular defendant meets those standards for the bail determination. Now, I know you can't talk about this. I'm sorry, Amy. I'm sorry to interrupt. Go ahead. It won't involve... It will generally not involve expert testimony. So it's really just based on historical facts and what's in the record, and the nature of the crimes itself. Now, I know you just touched on a little bit on mental health treatment courts today, and you talked about it a little bit more in your last webinar. This individual asks, is there a facility, or I think they mean a way of diverting a service user to mental health treatment court? Well, the first question to ask back is to say, is there a mental health court in your jurisdiction? Through the state associations of treatment court professionals... So for example, I live in Michigan. We have something called the Michigan Association of Treatment Court Professionals. There's also something called the National Association of Drug Court Professionals, NADCP. Through those resources, you can find whether there is a mental health court and where the mental health courts are in your particular state and in your particular community. Now, as I showed you, there's not thousands of mental health courts. There's only hundreds of mental health courts around the country, so they may not be available in your community. So if they're not available, no, there is no way to route somebody to that. There may be some communities that allow cross-jurisdiction transfer, but if they're far away, it's not going to be practical for your patient. If there is a mental health court in your community, the best way to access it is to go meet with one of the staff members to understand how somebody avails themselves of it. And usually there's going to be a screening process that happens at the court, and it may be that if you know your patient with SMI was arrested, it may be that you want to work with your patient to say that they should talk to their lawyer or work with your patient's lawyer to see if they would advocate for that as a disposition option. Wonderful. Okay. How do we increase partnership with the police, especially when they can be so arrogant in working with people with SMI? Well, you'll be happy to know that when I do a lot of police training, and I've done lots of police training in my day and police collaboration, they think that the clinicians are arrogant, and they think that the clinicians are wrong. So one way we can get to partnership is to try and just meet each other in the middle and to recognize that we are where we are with the system. And so that the more we partner together, the better off all of us can be in terms of all of our jobs and roles. And so, you know, I have been privileged to be able to work at the police interface. And some of it is through my academic university that has a partnership, some of it has been because I've worked in, you know, through state departments of mental health and community mental health. So if you're in community mental health, there's some natural alliances that can be built. I've seen inpatient units reach out to local police to build partnerships. I've also seen individual practitioners literally go to their local police department and say, I want to build a relationship. So some of it is depending on where you sit in your system or in your role. Trying to coordinate across systems is probably the best way rather than just individual practitioners, because there may be more of a systems issue that's at stake. But I would say that we want to reach out and say, hey, we have mutual issues that we're both frustrated by, and we really would like to figure out how to decrease frustration and maximize good outcomes. We want police to feel confident that they can do better by people with mental illness. Oftentimes, police are frustrated that there's not places to send people. And so what we want to help them understand is how the system works and how we can, you know, be that safety net for those individuals with SMI. So it's really about kind of cross-training each other. And I would reach out to your state to see if there's any initiative going on, for example, or see if there's any kind of CIT going on in your community as well. Right. There are two questions around court diversion programs. One is around how do they determine which clients qualify for such a program. And another is how have you found prosecutorial diversion programs to be successful? Like are they successful, and who gets them? So again, the qualifications vary across jurisdictions. And who determines who qualifies will depend on how the program is staffed. For example, one of the mental health courts that I ran or oversaw, I should say, we had one where we had a social worker who was employed. We had another where a case manager was employed. Where we had the social worker employed, the social worker would do a diagnostic assessment of the particular participant, determine whether they had a serious mental illness, determine if the charge qualified for the mental health court, and then make the referral to the judge and the prosecutor and the defense attorney. And that's kind of how that played out. Where the case manager was employed, she would look for a record, a historical record of whether the person had a prior mental health history and present that information and kind of translate that information for the court participants. And there was a process. So again, I would go to your local mental health court and say, what are your qualifications and how do referrals get processed? In terms of how they work, prosecutorial diversion is, again, the way I'm using that phrase, and again, it may differ across jurisdictions because the word diversion is actually a very nuanced word. The way I used it in this presentation was to talk about that pre-arraignment diversion. Again, it can work really successfully as long as there's a safety net to send people to. Sometimes some jurisdictions like that arraignment to attach because once the arraignment attaches, then the person is officially considered pre-trial and they can be released on pre-trial conditions of release. And sometimes they can say, okay, you can be on pre-trial conditions of release for a year. And if you comply with all the terms of pre-trial conditions of release, at the end of the year, we'll dismiss the charge. It allows that charge to be held over the person's head. And if they don't comply, then the charge gets reinstated and they go back to trial. So usually what it depends on is, is there an alternative that will make the public safety professionals feel like that individual with SMI is going to be seen and in treatment and not involved in behavior that will come to the attention of public safety again? Excellent. Excellent. You know, we're hearing over and over again across these webinars, a lot about these transitions and that's sort of what you're speaking to, how important it is for the community to be ready to receive this person back or to help them when they're arrested so that they can, you know, have the safest experience possible and receive treatment during it. So this transition seems so important. Absolutely. Absolutely.

dangerousness

court system

mental health treatment courts

partnerships with police

court diversion programs