How one agency is decriminalizing mental illness, saving money and bettering lives

Vision, collaboration, funding and officer buy-in have led to proven results


By Val Van Brocklin

Yavapai County (AZ) Sheriff Scott Mascher is so enthusiastic about his department’s Reach Out program that he met with me to talk about it on his day off. We were also joined by Chief Deputy David Rhodes. Both men’s eyes lit up when they spoke.

The problem

Reach Out’s goal is to reduce involvement in the justice system by people with mental health issues and substance use disorders.

A jail release coordinator using a custom data portal to connect an offender to treatment and other services upon release. The portal connects the criminal justice system's law enforcement and service providers and allows for data sharing and recidivism tracking. (Photo/Yavapai County Sheriff)
A jail release coordinator using a custom data portal to connect an offender to treatment and other services upon release. The portal connects the criminal justice system's law enforcement and service providers and allows for data sharing and recidivism tracking. (Photo/Yavapai County Sheriff)

I asked Sheriff Mascher what sparked his interest in such a challenge.

“My community,” he replied.

About five years ago, he was working on a voter issue to extend a jail sales tax. Everywhere he went he kept hearing citizens – families of people with a mental illness or substance abuse disorder – say they called the police for help and their family member ended up in the justice system, usually for a minor offense like disorderly conduct or trespassing.

We all know the problem. Every year more than 11 million people move through America’s 3,100 local jails, many on low-level, nonviolent misdemeanors, costing local governments about $22 billion annually. Sixty-four percent of them suffer from mental illness and 68% have a substance abuse disorder.

Sheriff Mascher said the recidivism rate for Yavapai County inmates with mental health issues is very high – in some cases approaching 80%. Moreover, nationally on average, people with mental illnesses remain incarcerated 4 to 8 times longer than people without mental illnesses arrested for the same charge.

With seven times more people with mental health problems in jails or prisons than treatment facilities, police, EMS providers and jails have become the first – and oft-times only – response for people in mental health crises. It can be an expensive and ineffective response.

Vision through collaboration

While the problem was apparent to Mascher and Rhodes, the solution wasn’t. Their vision came from collaborating with their community. They began meeting with their local judiciary, county attorney, legislators, mental health providers, schools and concerned citizens. They formed a local mental health coalition and invited the media. Mascher said one of the most challenging tasks was to get everyone onboard. But they did it.

The coalition chose the Sequential Intercept Model (SIM) as their blueprint. SIM was developed as a conceptual model to inform community-based responses to the involvement of people with mental and substance use disorders in the criminal justice system. The model was recognized by Congress in the 21st Century Cures Act (2016) and by the Substance Abuse and Mental Health Services Administration (SAMSHA).

Using SIM as a framework, Yavapai County’s Reach Out program has five major components:

  1. Pre-arrest diversion accomplished by officers trained to identify and deal with the mentally ill, mobile crisis response teams and community crisis stabilization units.
  2. Screening of all inmates at booking for mental health and substance use disorders, connection to appropriate providers and informing the court at initial appearance.
  3. Assessment and treatment plans for inmates that meet criteria. Collaboration among jail, mental health (MH) providers and the court to determine if alternative services are appropriate.
  4. Diversion to treatment through collaboration among the jail, pre-trial services (PTS) and the court. Transportation is provided, and services begin within 24 hours of release.
  5. Progress is tracked through jail, PTS and MH providers. Re-entry support is provided to released inmates via employment, housing, coaching and other community resources.

Funding

Once the coalition adopted SIM, they began identifying funding sources:

  • Chief Deputy Rhodes obtained a $250,000 grant from DOJ’s Bureau of Justice Assistance.
  • The County Attorney kicked in $224,290 from its pre-trial diversion funds saying that, “Reach Out is the most visionary program I have seen in my 35 years working in the criminal justice system in Arizona.”
  • The Northern Arizona Regional Behavioral Health Authority provided $140,000.
  • Last year, the state legislature appropriated $500,000 over the next 3 years.

Just last October, the Sheriff’s Office launched a new program supported by a $375,000 SAMSHA grant for three trainings:

  1. Mental Health First Aid;
  2. Applied Suicide Intervention Skills;
  3. Crisis Intervention.

The trainings are designed to provide community collaboration members with the tools to recognize mental health crises and to refer someone in crisis to the proper local resources.

A quote painted on the wall inside the Yavapai County jail's mental health unit. (Photo/Yavapai County Sheriff)
A quote painted on the wall inside the Yavapai County jail's mental health unit. (Photo/Yavapai County Sheriff)

Officer buy-in

I wanted to talk to a deputy sheriff on the front lines of Reach Out. Enter Deputy Ethan Stover, an 11-year patrol veteran. He confided he’d been a volun-“told” for his first mental health training. He was advised it was about “crisis something” and directed to attend. He quickly saw the benefit – for officer safety and the safety of the mentally ill or persons with mental challenges. He explained, “Once you learn to identify a mental health crisis, a lot of it is just slowing down, being patient, letting people talk or letting a person with autism fidget.”

Deputy Stover was very clear with me, “I still do the job. I’m not a social worker.” If force becomes necessary, he doesn’t hesitate. He had to use deadly force against an intoxicated man who suffered from a traumatic brain injury and was shooting a gun. Around the same time, he received an award from a mental health organization for his response to a suicidal man that ended well. He was very clear that it wasn’t about not doing the job of policing.  It’s that he’s experienced the value of the additional tools he acquired. And he feels good when he helps someone or a whole family. He didn’t say that last part. But I saw it in his face and heard it in his voice.

The results

Deputy Chief Rhodes says the collaborative response has led to a dramatic reduction in recidivism: “For a population that was probably 60% to 80%, today we have a recidivism rate of 19% to 26%.”

In just a portion of Yavapai County – the Verde Valley where they launched a pilot program three years ago – mobile crisis teams, in partnership with law enforcement, achieved the following estimated cost savings in 2018:

  • 912 ER visits averted saved $9,120,000;
  • 346 ER tests averted saved $1,245,600; 
  • 493 arrests avoided saved $3,944,000.

That’s a total of $14,309,600.

But there are things Reach Out has accomplished that are priceless.

“Bettering lives” is how April Rhodes, CEO of Spectrum Healthcare, which provides the Mobile Crisis Team Partnership Program in the Verde Valley, described it. And there’s the feeling officers get when they help people.

Sheriff Mascher summed it up: “This is the right thing to do for Yavapai County and our communities. You shouldn’t be a criminal for having a serious mental health issue.”

From the Sheriff’s lips to all of law enforcement’s ears. You can do it – just like they’re doing it in Yavapai County.  

The following video from Spectrum Healthcare, discusses the program’s origin, the process for establishing it and the results.

MENTAL HEALTH OUTREACH PROGRAM DEVELOPMENT RESOURCES

  • The U.S. DOJ, Bureau of Justice Assistance, and Justice and Mental Health Collaboration Program (JMHCP) offer grant funding for collaborative efforts between criminal justice and mental health providers.
  • The Data-Driven Justice Initiative Playbook: How to Develop a System of Diversion features best practices, strategies and lessons learned for implementing a coordinated community approach of effective and humane treatment for those with mental health or substance abuse problems while simultaneously increasing pre-arrest and post-arrest diversion and decreasing recidivism. Developed for local leaders and practitioners with a focus on “what works,” the playbook includes recommendations for funding sources.
  • The Police-Mental Health Collaboration Toolkit from the Bureau of Justice Assistance is designed to assist law enforcement leaders in developing and implementing collaboration in their communities.
  • The Sequential Intercept Model offers a conceptual model of community-based solutions for justice-involved people with mental and substance use disorders.

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