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**The Complete Package: Yavapai County Gets Everyone on Board to Decriminalize Mental Health**
 February 2019 | Volume 12 | Issue 1

Yavapai  County sits in central Arizona, north of Phoenix and west of  Flagstaff. “We’re a very, very large county, about 8,300 square miles. It’s as  big as some eastern states back there on the seaboard,” said Sheriff Scott  Mascher. Mascher and a coalition of partners have dramatically shifted the  practice of co-promoting public safety and mental health in Yavapai County through  a series of programs and initiatives including their popular “Reach Out”  program. Mascher was kind enough to give the *Dispatch* an interview:

**What was the genesis  of this initiative?**“What we found was that about 52 percent of our jail  population had diagnosed mental health conditions, many times dual-diagnosed  with substance abuse. These were more of our low-level offenders with a lot of  recidivism and minor-type crimes. These weren’t serious felony-type crimes.  People were off their medication or had issues with, substance abuse, self-medicating,  those types of things.

 “The first thing we did was we sat down with this group of  outside providers and we looked at our local Medicaid in the state of Arizona,  which is through Arizona Health Care Cost Containment System (AHCCCS). We looked at what it would  take to get these people signed up for Medicaid so that we could get payment  for their resources. Our Medicaid worked very well with us to get that done  within about 24 hours, because if people get arrested, Medicaid gets suspended.  If we get them out of jail, it would take up to a month to get them signed back  up for Medicaid. AHCCCS agreed to help us get anyone re-enrolled within 24 hours  so that treatment could be paid for. That was a big deal for us and it worked.”

**Once rapid Medicaid  re-renrollment was in place, what was your next step?**“We thought, Let’s train all of the police  officers in a part of the county, if they are able to identify a low-level  mental health issue, to identify that up front. Officers contacted Spectrum  Healthcare in the Verde Valley and in the first year of the plot  project, they diverted 487 cases to Medicaid resource treatment rather than to  the jail.”

**That’s almost the  entire population of your jail, isn’t it?**“Yes, actually. We have a 600-bed  jail with about 400 staff. So normally, once we stabilize the scene, we call  the mobile crisis response team from Spectrum Health who would say, ‘Oh, that’s  Joe. We know him, we’ll take care of this.’

 “We started working hand in hand with our medical providers  and we started realizing what a huge success this was. Then we again sat down  with the criminal justice stakeholders like the judges and the prosecutors and  the public defenders. Then the community started realizing that we were  decriminalizing mental health. This happened because it’s a mental health  issue, and that’s where the focus should be, not on ‘Okay you have initial  appearance, okay here’s your follow-up court-date.’ That shouldn’t be the  priority.

 “Let’s say people end up in jail anyway, what can we do? We  started a program called Reach Out. The Reach Out program involving all the  stakeholders. If that person gets to jail, one of the biggest concerns for the  judges, for the prosecutors, is that we need to know  what these risks are if there is a mental  health concern before the initial appearance which is within 24 hours so we can  divert them into treatment instead of jail. We started a screening and  assessment for everyone that gets arrested, during booking. It’s Joe again,  he’s being treated by Spectrum. We screen that at booking and then we provide  that to the judge, the prosecutor, and the public defender before the initial  appearance. We’re not telling the judge what he has to do, but we’re simply  saying, giving the judge the option of saying if you don’t go and get this treatment,  you may end up back in jail.”

**How did you pay for  the project?**          “We started seeing a decrease in recidivism, but we needed  more funding. State Senator Sylvia Allen came to visit and said, ‘Let’s get 3  years of funding.’ We got $1,500,000 for three years for a pilot project. We  also got a grant from the U.S. Department of Justice’s Bureau of Justice  Assistance to staff the assessments and collect the data. 

 “We also developed a community and criminal justice  coalition called the Mental Health coalition. On that group are judges, the  legislators that helped us get the appropriation, and the executive branch, the  mental health providers within the county, and community members who are  invested in the wellness of the community. It involves everybody in the  community and everybody in government. Everybody wants to participate in this  because mental health and substance abuse has fallen on local jurisdictions to  deal with.”

**What are your  long-term goals for the model you are developing in Yavapai County?**“We  hope that there will be spillover effects into the prison population. The  sheriffs of Arizona release over 200,000 inmates from jail back into the  community. Many of them have the recidivism issues of coming back. If we can  address these recidivism issues on the sheriffs’ end, they are less likely to  keep coming back to jail and going to prison. The prison does what they call a  re-entry program into the community. Now we’re doing a program on the front end.  If we can keep these people out of jail, it’s going to keep them from going to  prison. We are hoping to see the some result in lessening the number of people  from our county entering corrections at the state level.”

Sarah Estill, Social Science Analyst         COPS Office

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