We are requesting a Sequential Intercept Model (SIM) Mapping Workshop for Craighead County. We are familiar with SIM, we had one conducted in 2016 which was at the beginning of creating a Mental Health Court, before the development of the Veteran’s Treatment Court, and before the development of CIT training locally and the CSU. We would like to utilize the SIM process to identify critical gaps in our organization(s) so those can be evaluated further by our stakeholders with contingency plans identified.
We know that persons with behavioral health impairments regularly become involved with law enforcement officers across our county. Although individuals with behavioral health impairments frequently encounter officers, their behavioral health needs are not being addressed. These encounters lead to unnecessary arrests, incarcerations, and sometimes injury. In fact, the likelihood of incarcerations versus hospitalization in Arkansas is 3.1 to 1. Moreover, in 2021, approximately 823 crisis screenings were provided by Mid-South Health Systems in all of Craighead County for persons in need. However, 620 of those crisis screenings took place at the Craighead County Jail. This startling number reflects our critical need for cross-system collaborations aimed to appropriately engage individuals with behavioral health concerns prior to arrest or incarceration.
We believe that establishing and organizing Crisis Intervention Teams (CIT) in Craighead County is needed, but has been a challenge in the past several years. ACT 423 of 2017 in Arkansas established CIT teams locally as well as Crisis Stabilization Units (CSU). Although CSU’s were designed for CIT officers, and although initial funding was provided for their development in our state and for CIT training, the funding was limited. Frequency of CIT trainings is limited due to funding and referrals to the CSU have been less than desirable due to a lack of coordination. The underutilization of the CSU by CIT officers, we believe, is directly tied to a need for coordination and cooperation between vested parties within the county. Individuals with behavioral health impairments are missing the opportunities for care and treatment locally and instead, continue to face arrest and incarceration.
One barrier is the lack of a(n) organized CIT team(s) within Craighead County’s various jurisdictions of policing agencies. Although various agencies have been directly involved and very vested in the training of CIT officers, the trained CIT officers are returning to departments without clear procedures on how to utilize their CIT training. Furthermore, CIT officers regularly report issues with accessing the CSU and getting clients accepted and report a lack of knowledge of what type of client can go to the CSU. Also, CIT officers report frustration with their lack of knowledge of other mental health care options available in the community. This lack of awareness between agencies leads to clients that simply fall through the cracks. Furthermore, when clients are not willing (voluntary) to enter the CSU, confusion about other options available to the CIT officer ensues and individuals can be arrested, detained, or incarcerated – all as a means to help that individual get an emergency screening but it’s simply not appropriate. The accessibility of other modalities of care or other community options should be easier for a CIT officer to navigate locally. Additionally, CIT officers at times lack the ability to connect an individual to the local mental health systems, further limiting the options for a client and for the CIT officer involved. Therefore, opportunities to intervene and divert persons with mental health impairments from the criminal justice system and into treatment have not been as effective as vested parties would like to see given the resources locally.
Peers that have received services, have lived experience with behavioral health services, and are in recovery are also expected to be a targeted audience to benefit from a SIM workshop.
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We have a working relationship across our county, with several vested entities at state and local local levels on several projects. We are part of the Stepping Up Initiative as a county and we are seeking additional resources to assist in bridging gaps without our local systems to promote health and safety of individuals we serve. CIT and CSU is a newer addition to our crisis respond in Craighead County. We have recently received state funding to create an additional branch of crisis response via the Crisis Now national model. Ultimately, we seek SIM in order to identify, resolve, and alleviate critical shortcomings of our existing crisis service system in Craighead County.