MOBILE OUTREACH SAFETY TEAM (MOST)

AND

FORENSIC ASSESSMENT SERVICES TRIAGE TEAM (FASTT)

Bekah Bock, LCSW

DPBH Rural Clinics

BACKGROUND…

• 1800’s- Individuals with mental illness in jails

• 1841- Dorothea Dix, journalist advocates for mental health hospitals

• 1960’s US deinstitutionalization of individuals with mental illness-

• Transitioning individuals with severe mental illness from long term psychiatric institutions

to the community

• Insufficient community supports lead to other types of institutionalization such as

incarceration

• In 44 states, more individuals are in single jail than the largest state psychiatric

hospital

• Largest mental health hospital in America- Cook County Jail in Chicago

CONSEQUENCES OF CRIMINALIZING MENTAL ILLNESS

• Individuals with mental illness on average:

• Have longer jail stays

• Have higher costs associated with incarceration

• Experience behavioral issues without treatment

• See symptoms of mental illness worsen without treatment

• Often don’t get connected to treatment upon release- revolving door

• Are more likely to be victimized

STEPPING UP INITIATIVE: DIVERSION OF INDIVIDUALS WITH MENTAL ILLNESS FROM THE CRIMINAL JUSTICE SYSTEM

STEPPING UP INITIATIVE PROGRESS IN NEVADA

CONNECTING INDIVIDUALS WITH COMMUNITY TREATMENT AND SERVICES

• Building initiatives to connect individuals with treatment to

break cycle of recidivism

• Successful treatment and community support

• Reduces disruptive, assaultive, self injurious behaviors in the

community

• Increases public safety

• Reduces public cost of repeat arrests and incarcerations

SEQUENTIAL INTERCEPT MODEL

“Predictable points of contact offering opportunities for intervention”

MOBILE OUTREACH SAFETY TEAM

• A clinician, law enforcement officer, (and

sometimes paramedic) team with the purpose of

providing community intervention and support to

individuals who are experiencing behavioral

health problems/ crisis

MOBILE OUTREACH SAFETY TEAM OBJECTIVES

• Respond to suicidal/ mentally ill subject calls for service.

• Respond to barricaded mentally ill individuals or other in-progress

mental illness related crisis situations.

• Follow-up on referrals generated by law enforcement, Mental Health

Court, mental health professionals, and emergency service workers.

• Outreach work with the mentally ill homeless population.

• Referral to community resources and connection with community

resource liaison

• Proactive work with known mental health clients to maintain proper

medication program compliance.

MOBILE OUTREACH SAFETY TEAM BENEFITS

• Jail and ER diversion

• Reduces call load for dispatch

• Reduces law enforcement contact time

• Increases public safety

• Community intervention and support for individuals in

chronic crisis

M.O.S.T. REFERRALS

1. To make a non-emergency referral for MOST :

2. Call dispatch

3. Tell dispatch you wish to make a MOST referral

4. Provide the following:

5. Your name, agency and contact information

6. Name of individual / individuals being referred

7. How the individuals can be contacted, i.e. address, phone number, etc.

8. Reason for referral: remember the more detail provided the better the

MOST Team will be able to maintain safety and provide adequate service

FASTT: FORENSIC ASSESSMENT SERVICES TRIAGE TEAM

• Treatment intervention and reentry program that is offered in

the county jail.

• Multi-disciplinary team from social services, mental health,

substance use providers

• Assesses the individual’s mental health, substance use, basic

needs, (housing, medical, employment, transportation), and risk of

reoffense.

FASTT BACKGROUND

• Carson City 2013-

• Partnership between State DPBH mental health, community

coalitions, and forensic director of Carson City Jail, Dr.

McEllistrem

• Replicated in Lyon and Douglas Counties, coming soon to

Churchill

• Spreading statewide

FASTT OBJECTIVE

• To reduce or eliminate reoffending and re-arrests by

coordinating to connect individuals with needed treatment

and services in the community

FASTT REFERRALS

• From deputies

• Judges

• Clinician assessing in jail

• Community providers

• Family members