# Presentation: 896918

## Returning[NAME OF PRESENTER HERE]

***Restoring Hope at the Intersection ******of the Behavioral Health and Criminal Justice Systems***CMHS National GAINS Center 2008 National ConferenceMarch 18, 2008

*A. Kathryn Power, M.Ed.*
*Director, Center for Mental Health Services*

## One in 100 Behind Bars in America

- Source:** ***One in 100: Behind Bars in America 2008*, _[www.pewcenteronthestates.org](http://www.pewcenteronthestates.org/)__  _
- Used with permission.

## The Governor of Virginia expressed dismay that he was “forced to authorize the confinement of [persons with mental illnesses] in the Williamsburg jail, against both his conscience and the law” because of lack of appropriate services.
This occurred in 1773. 

- This occurred in 1773.

## Benefits help secure needed services

- People with serious mental illnesses leaving jails and prisons need access to the benefits for which they are eligible immediately on their return to the community.
- Confusion about eligibility may delay this process.
- The CSG Justice Center has created tools for case managers and corrections administrators.
- Beginning today, you can access these tools at _[www.reentrypolicy.org](http://www.reentrypolicy.org/)__. _

## NLF to address lack of services

- The National Leadership Forum on Behavioral Health—Criminal Justice Services builds on prior efforts:
- The New Freedom Commission report
- The Council of State Governments Consensus Project
- The Annapolis Coalition
- The Institute of Medicine Report
- The group will develop an annual State of the Field Report.
- It will meet 3 times a year for the next 5 years.

## “The world breaks every one and afterward, many are strong at the broken places.” 

- “*The world breaks every one and afterward, many are strong at the broken places*.”
- Ernest Hemingway

## Trauma-informed systems

- Trauma-informed systems, according to Roger Fallot, Director of Research and Evaluation at Community Connections in Washington, DC:
- Incorporate knowledge about trauma—including its prevalence and impact—in all aspects of service delivery;
- Are hospitable and engaging for survivors;
- Minimize revictimization; and
- Promote resilience and facilitate recovery.

## Focus on integrated services

- SAMHSA’s Women and Violence Study is the most comprehensive study to date on the impact of a trauma-integrated approach.
- “Treatment as usual” for consumers with trauma histories thwarts recovery.
- Integrated counseling—for example, group and individual therapy that address trauma, mental health, and substance use conditions—is the key element associated with better outcomes.

## The “signature wound” of the Iraq War

- Traumatic brain injury (TBI), often resulting from a blow to the head, can cause a wide range of functional changes affecting thinking, sensation, movement, language, and/or emotions.
- Patients with moderate to severe TBI may never fully recover.
- Nearly 30% of all patients with combat-related injuries seen at Walter Reed Army Medical Center from 2003-2005 sustained a TBI, usually from blast injuries.
- Symptoms can mimic PTSD.
- Deployment Health Clinical Center, 2008

## Women veterans suffer sexual assaults

- Female veterans report sexual assaults at higher rates than non-veteran women.
- Sexual assaults have been linked to post-traumatic stress disorder (PTSD), depression, alcohol and drug use, disrupted social networks, and difficulties with employment.
- Female active duty soldiers have PTSD at higher rates than male soldiers.
- Services for the small percentage of female veterans may be inadequate.
*CRS Report for Congress, 2007*

## Veterans in State and Federal prisons

- 	Source: Bureau of Justice Statistics, 2004

## SAMSHA activities for returning veterans

- Added a feature to the National Suicide Prevention Lifeline to connect veterans to VA professionals
- Established a Workgroup on Returning Veterans and Their Families
- Updated resources for Returning Veterans and their Families: _[www.samhsa.gov/vets/index.aspx](http://www.samhsa.gov/vets/index.aspx)__ _
- Identified veterans as a priority population
- Will hold a second national conference August 11-13
- Will convene a meeting May 9 on returning veterans and trauma

## “The world is moved along, not only by the mighty shoves of its heroes, but also by the aggregate of tiny pushes of each honest worker.”

	Helen Keller

- 	Helen Keller