Oklahoma Collaborative Mental Health Re-Entry Program

1. Oklahoma Collaborative Mental Health Re-Entry Program Oklahoma Department of Corrections (ODOC) and Oklahoma Department of Mental Health & Substance Abuse Services (ODMHSAS) Bob Mann, RN, LSW Administrator of Mental Health Operations Oklahoma Department of Corrections

2. Why Do We Need A Mental Health Re-Entry Program ? • Today’s frontline mental health workers are law enforcement officers, and today’s mental health hospitals are jails and prisons • In the ODOC, approximately 13,000 (50%) out of 25,600 incarcerated offenders have a history of, or are currently exhibiting some form of mental illness. Approximately 6,500 (26%) currently exhibit symptoms of a serious mental illness • ODOC data revealed that 41% of offenders with a serious mental illness who discharged prior to 2007 returned to prison within three years after their release

3. Why Do We Need A Mental Health Re-Entry Program?

4. How is this Interagency Mental Health Re-Entry Program Unique? Beyond Collaboration • ODMHSAS has taken ownership for the continuity of mental health services for those offenders with the highest level of mental health need • ODMHSAS Discharge managers are boundary spanners officed in DOC mental health units and member of correctional mental health treatment team • The discharge managers serve as part of the ODOC institution mental health treatment team that creates and implements the individualized treatment plan, including the reentry planning for offenders with a serious mental illness

5. How is this Interagency Mental Health Re-Entry Program Unique? Funding Source for Services • The goal is for the individual to leave prison with their Social Security benefits in place and have the Medicaid entitlement aligned so funding is in place for medical and mental health services following release from prison • The discharge managers start the social security and Medicaid application process 120 days prior to an offender’s scheduled discharge • Collaboration with SSA and OK Disability Determination Division has increased the “Allowance Rate” of SSI/SSDI applications from 36% to 90%

6. How is this Interagency Mental Health Re-Entry Program Unique? “In-Reach” and Intensive Services Post Release • Re-entry Intensive Care Coordination Teams (RICCT) staff meets with the offender at a minimum of 90 days before a projected release date from prison and then works with the offender in the community until such time as the offender has adjusted to life following incarceration • An innovative and vital component of the RICCT program is the inclusion of a Certified Peer Recovery Support Specialist on the team. These team members have life-experience with a mental illness and/or substance abuse and have been trained to offer peer support

7. Offenders Enrolled In Medicaid MHRP offenders were over 4 times more likely to be enrolled in Medicaid at prison release than the baseline comparison group.

8. Rate of Engagement Offenders Receiving 4 Services Within 44 Days of Release from DOC Service engagement rates for MHRP offenders were over 5 times more than the baseline comparison group.

9. Inpatient, Outpatient & Pharmacy Services MHRP offenders showed 80% less inpatient admissions than the baseline comparison group. MHRP offenders received over 50% more outpatient services than the baseline comparison group.

10. Offenders Returning to Prison Within 36 Months Returns to prison for RICCTS offenders were 41% lower than the baseline comparison group.

11. “Walter’s” Story • “Walter” was 8 years old when he started injecting heroin. By age 11, he was living in a boy’s ranch, and then was placed in a long-term boy’s home until he was 18. After a short period on the street, Walter “hooked up with my best friend heroin” and he shortly began his first prison term • After a brief period of time on the street, Walter was again incarcerated. Prior to his last incarceration  (that began at the age of 35), Walter was sent for a psychiatric evaluation and was diagnosed with Schizophrenia, Paranoid type • Walter’s last incarceration was different.  He started taking  medications for his mental illness and started to think more clearly. Walter also made the decision to quit taking drugs

12. “Walter’s” Story • From the age of 11 until he was 53, Walter had only been out of institutions for a total of five and a half years • As Walter approached his discharge from prison , his case manager asked him if he would like to participate in a new mental health reentry program • Walter told the case manager that he’d never heard of a Reentry Intensive Care Coordination Team (RICCT) before, but that “no one has every helped me before, and if they will help me get my psych meds, then I’m willing to give them a try”

13. “Walter’s” Story • Immediately after Walter discharged from prison, the RICCT staff worked to connect him to federal benefits and to address his immediate needs. Walter was enrolled in a mental health recovery group that is designed to help individuals with a serious mental illness develop skills at managing their recovery • At first, Walter had difficulty working in a group, “I still didn’t like being around people and walked out of group at first, but I kept coming back” • In April 2011, Walter told his story of recovery at the Oklahoma Department of Mental Health and Substance Abuse Services Board meeting. “I know in my heart that had it not been for the RICCT staff that I would be back in prison (Walter discharged from prison in 2009) but instead I’m doing better than I’ve ever done in my life”

14. Questions?