Jail Diversion Outreach Team (JDOT)

This multidisciplinary team includes a social worker, case manager, nurse, peer mentors, and a APRN to serve individuals who have been unsuccessful in mental health treatment in the past, are homeless, in poverty, and have cycled through the jail. This collaborative effort between  Mental Health Services, Criminal Justice Services, the County jail, housing, and NAMI has been very successful in reducing participants’ jail time.

The team works out of Valley Mental Health to provide in-home services to people who have multiple incarcerations and serious mental illness. The mental health services coordinators at the jail connects those appropriate for JDOT through their discharge planning process. The team provides intensive, community-based services to a minimum of 60 criminal-justice involved persons with mental illness. Services emphasize integrated mental health and substance abuse interventions.

As part of the jail diversion services provided in Salt Lake County, JDOT is showing impressive outcomes in keeping individuals with serious and persistent mental illness out of the jail and in the community, with the goal of helping them to be contributing members of society.

For more information contact Peer Mentor, Liz Felt, This e-mail address is being protected from spambots. You need JavaScript enabled to view it

SAMHSA: Community Re-entry from Jails for Inmates with Co-occurring Disorders

Here are some of the findings from the Salt Lake County 2009 Human Services Budget Report:

NAMI Utah is a resource for information that provides a framework for the adoption of policies and procedures that benefit individuals, families and the community.  The information on this page is meant for community use in discussing the options available.

Jail Diversion Outreach Team (Forensic Assertive Community Team) Information contributed by Brian Miller, PhD

Concept

The forensic assertive community team, or F/ACT , is a team of mental health professionals that function as a “hospital without walls”. The team can take deliver clinical support services into the community wherever the client may be in order to provide a high level of service without requiring that the client be in a hospital. These teams have demonstrated benefits in supporting persons with mental illness and reducing the number of inpatient hospitalizations, use of emergency rooms, homelessness, re-offense rates, and substance use.

The distinguishing characteristics of a F/ACT are:

• TEAM AVAILABLE 24/7: The team is always available to assist clients with crisis situations and urgent needs, is always aware of the condition of the client.
• TEAM IS PRIMARY PROVIDER OF SERVICES: The multidisciplinary makeup of each team (psychiatrist, nurses, social workers, rehabilitation, etc.) and the small client to staff ratio, helps the team provide most services with minimal referrals to other mental health programs or providers. The team members share offices and their roles are interchangeable when providing services to ensure that services are not disrupted due to staff absence or turnover.
• SERVICES ARE PROVIDED OUT OF OFFICE: Services are provided within community settings, such as a person's own home and neighborhood, local restaurants, parks and nearby stores.
• HIGHLY INDIVIDUALIZED SERVICES: Treatment plans, developed with the client, are based on individual strengths and needs, hopes and desires. The plans are modified as needed through an ongoing assessment and goal setting process.
• ASSERTIVE APPROACH: Team members are pro-active with clients, assisting them to participate in and continue treatment, live independently, and recover from disability.
• LONG-TERM SERVICES: Services are intended to be long-term due to the severe impairments often associated with serious and persistent mental illness. The process of recovery often takes many years.
• SUBSTANCE ABUSE SERVICES: The team coordinates and provides substance abuse services.
• COMMUNITY INTEGRATION: Staff help clients become less socially isolated and more integrated into the community by encouraging participation in community activities and membership in  organizations of their choice.

Benefits

Assertive Community Teams are a demonstrated “evidence-based practice” that havebeen shown for many years to improve client outcomes:

• Reduced Hospital Inpatient Usage;
• Retention of Housing;
• Recidivism in mentally ill offenders is reduced;
• Overall community costs are lower

Implementation Plan

Clients served by F/ACT: are individuals with serious and persistent mental illness with severe functional impairments, who have avoided or not responded well to traditional outpatient mental health care and psychiatric rehabilitation services. Persons served by F/ACT often have co-existing problems such as homelessness, substance abuse problems, and are selected for the team because of multiple involvements with the criminal justice system.

Implementation Guidelines:

A Manual for ACT Start-Up: Based on the PACT Model of Community Treatment for Persons with Severe and Persistent Mental Illnesses.

Allness, D. J., & Knoedler, W. H. (2003). Arlington, VA: NAMI. Order at: www.nami.org
This “how to” manual provides practical information on how to develop and implement ACT teams, including recommended admission criteria, staffing configuration and roles, hours of operation,
administrative requirements, team communication and organization, client-centered comprehensive assessment and individualized treatment planning, service array, and development of a steering committee and stakeholder advisory group. This manual also includes all sample forms (e.g., assessments, staff scheduling).

SAMHSA ACT Toolkit

Find at: http://mentalhealth.samhsa.gov/cmhs/communitysupport/toolkits/community/
Based on the Manual for ACT Start-Up (see above), this toolkit provides similar practical information for ACT implementation. In addition, the ACT Toolkit includes background information sheets for various stakeholder groups (consumers, families and natural supports, practitioners and clinical supervisors, mental health program leaders, and public mental health authorities), introductory videos, practice demonstration videos, and a workbook for practitioners. An updated version is in the process of development by SAMHSA.