Joint Committee Studying Treatment Options for Offenders with Mental Illness or Substance Abuse Disorders
November 8, 2001; November 29, 2001, Richmond
The joint committee held a public hearing on its preliminary recommendations on November 8, 2001, and on November 29, the committee made its final recommendations for 2001. The committee categorized its findings and recommendations into five areas related to adult and juvenile offenders: Interagency Collaboration, Capacity, Clinical Guidelines, Cross Training, and Data Collection, Evaluation and Information Sharing. Because of the current budgetary situation, most of the recommendations are designed to lay the groundwork for future action: maintaining funds that are appropriated in the current biennium budget; gathering information about unmet needs; fostering interagency collaboration and planning; establishing minimum clinical guidelines; and providing a framework for information sharing and evaluating the effectiveness of current programs. Due to the size and scope of the problem, the committee plans to ask the General Assembly to expand its membership to include the Secretaries of Health and Human Resources and Public Safety and to continue its work for another year. Highlights of this years findings and recommendations follow.
Findings: Interagency collaboration and clearly defined responsibilities for serving adult and juvenile offenders with mental illness do not exist in many communities. Moreover, there does not appear to be a consensus as to whether the responsibility for providing treatment services should lie with the criminal justice or the mental health treatment system.
Findings: Many communities lack sufficient capacity, including the availability of acute psychiatric care, to treat offenders with mental illness and substance abuse disorders while they are incarcerated and when they are released from state correctional facilities, jails or detention homes. Lack of a comprehensive and systemic approach to finding these services has resulted in inequitable access to care across Virginia. The community services boards estimate that the cost of meeting the unmet need for mental health and substance abuse services in local jails is approximately $34 million per year. The estimated cost of meeting the unmet need for mental health and substance abuse services in detention homes is approximately $3.4 million per year.
Findings: The state has not developed clinical guidelines for local and regional jails or detention homes to ensure an adequate level of mental health services for persons who are incarcerated. Uniform screening and assessments, access to services, and discharge plans are not available in many jails or detention homes.
Key Recommendation: Direct the State Board of Corrections, the State Mental Health, Mental Retardation and Substance Abuse Services Board and the Board of Juvenile Justice as appropriate to develop minimum guidelines for the provision of mental health and substance abuse treatment services in jails and detention homes and a plan, including the necessary fiscal and staff resources, for meeting the guidelines.
Findings: Cross training in balancing therapeutic goals with security needs and public safety is needed for law enforcement, judges, jail and detention staff and community treatment staff.
Key Recommendation: Request that the Department of Mental Health, Mental Retardation and Substance Abuse Services develop and make recommendations for implementing a curriculum for cross training law enforcement officers, judges, jail staff, and community treatment staff in security and treatment.
Data Collection, Evaluation and Information Sharing
Findings: No comprehensive mechanism exists to systematically collect complete and accurate data on treatment services provided to and needed by adult and juvenile offenders or to evaluate the effectiveness of the services.