Travis County Behavioral Health Indicators Project

Susan Stone, J.D, M.D.Jim Van Norman, M.D.

Abraham Minjarez, LPC, MBATara Powell, MPH, MSW

Texas Service System Perspective

BACKGROUND

• Tragic Incident

• Community Response

• Mayor’s Mental Health Task Force

• Monitoring Committee

Community “Collaboration”

• Mental Health Coordination Committee• Healthy People 2000• Community Action Network• Integral Care Committee• Psychiatric Stakeholder’s Committee• Mayor’s Mental Health Task Force Monitoring

Committee• Crisis Implementation Committee

Travis County Criminal Justice/Mental Health Initiatives

• CIT• Community Court• RERT• Project Recovery• Mental Health Public Defenders Office

Travis County Criminal Justice/Mental Health Initiatives

• Criminal Defense Wheel• Specialist Prosecutors• Specialized Dockets• Veteran’s Court• Community Restoration of Competency

• Community Competency Restoration Project– Total Served: 65

• Felony: 25• Misdemeanor: 40

– Total Restored: 38 (58%)• Average days to restore

–Felony 44 days–Misdemeanor 40 days

• Community Competency Restoration Project– Homelessness Data

• 38% homeless prior to admission into program–50% of misdemeanants homeless–20% of felons homeless

– Previous Hospitalizations• Total # of previous hospitalizations prior to CCRP: 144

Using Community Indicators for Social Change

• Results Based Accountability: What works?• Building consensus around indicators• Blended funding

• ATCIC• St. David’s Foundation• Hogg Foundation for Mental Health• City of Austin• Travis County• Bazelon Center for Mental Health Law

Advisory Committee:MMHTFMC

Judge Sam Biscoe, Travis CountyDavid Evans, ATCICSherri Fleming, Travis CountyLynda Frost, Hogg Foundation

% individuals in Travis County jail with SPMI

Readmission to public psychiatric

hospital within 30 days of discharge

% of individuals reporting to various

settings with behavioral health needs who self

report housing instability

% of ED admissions with

primary substance use

Rate of Disciplinary

Referrals within AISD

Genevieve Hearon, ATCIC BOTDr. Philip Huang, City of AustinBecky Pastner, St. David's Foundation

Indicator Improvement Initiative Executive Committee

Steering Committees

Criminal Justice Indicator

• Data Analysis—Trends and Trajectories

• Hypotheses—Building the Story

• Root Cause Analysis

• No Cost/Low Cost Solutions

• Policy Solutions

• Funding Strategies

2005 2006 2007 2008 2009

# of Individuals incarcerated/detained with Behavioral Health needs

4,932

Juveniles in detention with Behavioral Health needs 67.2%

CIT number of cases 8132 7721 6361** 9675 10525

POEC’s 1120 1658 1251** 1799 1760

EDP Voluntary 707 638 663 681 637

EDP Intervention 1913 2165 2330 2401 2570

EDP 1531 1286 1279 1452 1642

Completed Suicides 93 110 96 105 88

Attempted Suicides 866 740 734 631 579

Summary of CIT Data

0

5

10

15

20

25

30

2005 2006 2007 2008 2009

POEC's

EDP Voluntary

EDP Intervention

• POEC’s• EDP Voluntary-Emotionally Disturbed person voluntarily committed• EDP Intervention-Emotionally disturbed person who received a CIT intervention

EDP Voluntary, Intervention & POEC’s

0

100

200

300

400

500

600

700

800

900

1000

2005 2006 2007 2008 2009

Completed Suicides

Attempted Suicides

Completed and Attempted Suicides

0

2000

4000

6000

8000

10000

12000

2005 2006 2007 2008 2009

# of Cases generated by CIT teams

CIT Number of cases

Crisis Intervention Team # of Cases

ROOT CAUSE ANALYSISCASE EXAMPLE

Turning the Curve

• Different ways to address 911 calls• Transportation issues• Housing, housing, housing• Use of incentives• Peer support• Enforcement of ACT• SSI Issues

Contact Information

Susan A. Stone, J.D., M.D.

Mayor’s Mental Health Task Force

sstonejdmd@attglobal.net

512-360-3557