Pilot program at SCORE Jail sees early success in providing enhanced behavioral health services
Incarcerated people with urgent behavioral health needs in King County are benefiting from an innovative pilot program that may eventually be implemented around the state.
Since October, the Department of Social and Health Services and South Correctional Entity, also known as SCORE Jail, have collaborated on a pilot program initiated by Senate Bill 5440 to provide enhanced behavioral health services for incarcerated people.
Utilizing contracted clinical intervention specialists, DSHS clinicians, and SCORE staff, the SCORE Clinical Intervention Specialist Pilot Program assesses and provides additional support for improved behavioral health outcomes for incarcerated people.
The program has served more than 300 people in less than six months, said Asen Deshev, SCORE pilot program manager.
“Our goal is to connect with them, assess their overall mental state, provide needed medication, and teach them coping skills,” Deshev said. “We are a neutral party. Our services are not intended to affect the legal outcomes but to care for the overall health of these class members.”
This program is a component of a much larger initiative that grew out of the ruling in Trueblood vs DSHS in 2015 and the implementation of Substitute Senate Bill 5444 in 2018. Following this bill’s passage, DSHS, in partnership with the Health Care Authority, Criminal Justice Training Commission, and Disability Rights Washington, and with the cooperation of other state agencies, aggressively worked to implement and expand diversion services throughout the state at every level. Most recently this has been accomplished through programs like the one at SCORE.
“We work to fill in the gaps. From the point we hear that class members are going to be released, we work to provide them a plan,” Deshev said. “The reality is when someone gets arrested, they get locked up and usually don’t see any services until some major events occur. Our program is intended to be proactive by engaging with them from the moment they come to the door.”
This pilot program is unique in that it addresses the gap in diversion services in jails. This initiative aligns with the Sequential Intercept Model, which works to identify resources and gaps in services at each intercept and develop local strategic action plans to divert people with behavioral health and substance use disorders from the criminal justice system. It is the state’s guide for implementing diversion/deflection services at every level for people with behavioral health needs who are involved in the criminal court system.
Class members participating in the pilot program who are found incompetent may be ordered to participate in an inpatient competency restoration program at a DSHS Behavioral Health Administration facility or an outpatient competency restoration program. However, for many class members, this will be their first opportunity to receive access to medications and behavioral health services before they are released back into the community.
“We are taking a very intense approach to how we help people,” said Deshev. “We are not waiting for them to decompensate and say they are suicidal. As soon as we get people engaged and they start improving, we start talking to them about the aftercare piece and attempt to connect them with community partners.”
The outcomes of this jail pilot program include motivational interviewing to help with medication compliance, group and individualized therapy, and specialized programming to support class members in achieving stability.
“A success metric is stabilizing class members on medication which is important to help create a strong foundation so they can receive other services,” said Harrison Lo, SCORE pilot program management analyst. “As soon as the class members take their medications, they become more cognitive and receptive to receive other services.”
Currently, these services are offered only to Trueblood class members. Trueblood class members are those charged with a crime in Washington state and ordered by the court to receive competency services through DSHS’ Behavioral Health Administration. Although the scope of who the program can serve is limited to class members, the program’s potential to make a positive impact on improving in-jail behavioral health has not gone unnoticed by DSHS and other jails interested in partnering.
“The model is to figure out what’s occurring at the intersection of forensics and the jail system,” said Deshev. “Almost all cases we have seen are misdemeanor charges and more than 90 percent of people we’ve seen have been released to the community. We are working hard to connect them to services from the time they leave to help them have their basic needs met: a place to sleep, food to eat, and health services.”
To better assess and understand the needs of jails across the state, officials with BHA’s Office of Forensic Mental Health Services in partnership with the Washington Association of Sheriffs and Police Chiefs visited seven state jails last fall to determine if they might benefit from a similar program. During these visits, WASPC, OFMHS, and jail leadership discussed the complexities of serving this population and the feasibility of creating comparable programs.
“It was a great opportunity to see the differences in behavioral health challenges from one facility to another,” said Curt Lutz, jail program coordinator for WASPC, and a member of WASPC’s leadership to tour jails.
Although discussions are predominantly focused on Trueblood class members, this collaboration and others like it aim to address the greater question of how jails throughout the state can better meet the behavioral health needs of incarcerated people.
“Our program opens the door to allow for conversations, to engage with services and long-term access to medication,” said Harrison. “This whole part of stabilization is the most important piece so we can tackle challenges head-on and identify what will work best to get class members on the right track for success.”
(By Jacob Jimenez and Tracy Grunenfelder)