Pilot for mental health and substance use diversion program picks up steam | Local News

During her entire time there, a man screamed obscenities from a booking cell — a constant stream of profanity. Jail staff reported he never stopped, yelling every waking moment, as he had every day while in the jail.

He had been incarcerated for nearly a year and a half, throwing his feces against the wall as he waited for an evaluation and then competency restoration, the process during which a person who has a mental illness or an intellectual disability and has committed a crime undergoes treatment to “restore” their fitness to stand trial, Fox recalled.

“We like to tell the stories that’ll get your attention,” she said. “It’s a real thing all over the state. And then we see them back in jail again because nothing has actually been accomplished for them.”

Though Fox noted that the story was an extreme example, she used it to illustrate the need to rethink how the state’s judicial and criminal justice systems approach mental health and to reinforce the significance of the diversion pilot project that the state will begin in Gillette next year.

Fox, lawmakers and state department leaders met Tuesday morning in Lander for the second meeting of the Mental Health and Vulnerable Adults Task Force to discuss the outline of the diversion program, and to sort through and identify action the Legislature could take.

During the task force’s first meeting in May in Cheyenne, lawmakers largely heard why the state was pursuing the pilot project, as well as the initial steps that they were taking.

Though the diversion program aims to curb backlogs in the courts, jails and at the Wyoming State Hospital, and reduce the tremendous cost and inefficiency of incarcerating low-level offenders, the program’s ultimate goal is to better serve those who have mental health concerns, Rep. Lloyd Larsen, R-Lander, the co-chair of the task force, said during the May meeting.

“Yes, it will reduce impacts on courts. Yes, it will reduce congestion at state hospitals and in jails,” he said. “But, more importantly, rather than punishing people through the court system, we’re trying to get them the help they need.”

Tuesday’s panel gave a clearer picture of the program as the state, Campbell County and Gillette formulate plans to divert a specific group of nonviolent offenders to mental health services, rather than jail.

According to a draft plan, the diversion program will have two parts. In the first, law enforcement will direct people to community mental health providers before they ever enter the criminal justice system.

Local law enforcement and first responders will use crisis intervention training to step in when a person is experiencing a mental health crisis and identify if they could be a part of the program. Rather than taking the person to jail, officers will instead bring them to a mental health provider, who can then help them manage and treat their mental illness.

Roughly 16 officers with the Gillette Police Department underwent crisis intervention training in 2022, according to data from the Wyoming Association of Sheriffs and Chiefs of Police.

The second part involves the diversion of a person once they are in the judicial and criminal justice systems. When first responders can’t intervene early and a person does face criminal charges, they will be booked into jail, where they will receive a brief mental health screening. If the screening identifies the person as someone within the program’s target groups, the jail will contact local mental health providers for a more extensive screening. At the same time, prosecutors will review the person’s criminal history to ensure that they are not violent.

If the person is eligible, they will be given the option to undertake a treatment program and have their criminal charges suspended. Mental health providers and the courts will oversee the plan, which will include supervision by a case manager, peer support, and any medication or mental health treatment, as well as help with “social determinants of health,” the overarching term for factors like housing, employment and community engagement that research increasingly shows also influence a person’s health.

If the person completes the program, their case will be dropped. If they don’t — either opting out or otherwise — they will face the original charges.

The pilot project will target a limited pool of people as the state and its local partners test the first iteration of what they hope will eventually be a statewide strategy.

Only people who have been charged with a select number of nonviolent misdemeanors and who have the three diagnoses of schizophrenia, schizoaffective disorder and major depression will be eligible, Fox and Stefan Johansson, the director of the Wyoming Department of Health, said.

The state chose Gillette and Campbell County for its “three branch” diversion project for a handful of reasons, Fox and Johansson said.

The city is smaller than Casper and Cheyenne, and will have fewer people who enter the program, allowing the group to start sooner and more easily refine the trial. Campbell County also has “robust treatment courts” intended for those struggling with substance use and addiction. While the county’s treatment courts won’t run the program, they will provide the group with a model, as well as the knowledge, infrastructure and other resources necessary to kickstart the diversion program, Fox said.

The greatest driver, however, was community support.

“We had a meeting in Gillette to start our planning for the pilot, and we had law enforcement, prosecutors, public defenders, behavioral health providers, the sheriff and the police chief,” Fox said. “There was nobody at the table who wasn’t saying, ‘Yes, let’s do this.’ You might think the prosecutors would say, ‘No, he committed the crime. Let’s lock him up.’ No, they see that this is something that needs to be done for the community, for the resources of the courts and the jails, and so that Joe the shoplifter doesn’t come out of jail after he’s had his competency [evaluation] and go shoplift again.”

In all, the pilot project will involve judges, the Campbell County Sheriff’s Office, Gillette Police Department, prosecutors and county attorneys, public defenders, mental health providers, county commissioners and lawmakers on the Mental Health and Vulnerable Adults Task Force.

According to the draft plan, the group will assess the program’s hypothesis that “diversion and treatment will cost less and improve public safety” by collecting a range of data. They will track recidivism rates, jail time, arrest data and the costs of the program broadly, comparing them to Campbell County’s current baselines. Currently, costs reach from $110 to $150 every day for a person to be incarcerated in Wyoming, Fox said.

“What we’re doing now is the least effective and most expensive approach,” she said. “Whatever we do can only be an improvement.”

The Campbell County diversion pilot aligns with the state’s broader effort to rethink how Wyoming approaches mental and behavioral health.

In March 2021, lawmakers passed a bill that required the state to study and rework Wyoming’s entire state-funded community behavioral health system. As part of that process, the state identified “priority populations.” In the first tier were people involved in the justice system.

The state’s behavioral health redesign, which will include funding for social determinants of health for the first time, is set to take effect in July 2024.

Fox would like the diversion pilot project to follow a similar timeline. She said she hopes the program will be up and running in the first quarter of 2024, but those on the ground estimate it will come online in the second quarter of next year.

Lawmakers on the task force, including Speaker of the House Albert Sommers, R-Pinedale, asked Fox about the action needed from the Legislature ahead of the project’s start. As it stands, the pilot doesn’t need any legislation, she said, but if it proves successful and scales to the rest of the state, lawmakers will likely have to step in to allow prosecutors some discretion to delay charges for participants.

While the pilot is beginning to take shape, Johansson, Fox and the panel acknowledged that the group still has a number of unanswered questions that it needs to address. If the project indeed becomes a statewide initiative, lawmakers will have to decide if the state should require law enforcement to undergo crisis intervention training — it’s currently not mandatory — and, if so, who should foot the bill and how to incentivize it, Sen. Eric Barlow, R-Gillette, said. The state will also have to figure out how to ensure patients have access to medication even beyond their time in the diversion program, he added.

The Campbell County group’s chief concern as it moves to start the diversion project is finding a coordinator to handle the logistics of the program and help participants navigate it. Johansson advocated for a dedicated position, which the Department of Health would help to finance in the short term.

“It’s a small investment to make for someone’s time, even if it’s 40 hours a week, when you think of the system and the dollars that are going into this inefficient way to treat people,” he said.

Those at the meeting recognized that there will be growing pains as Wyoming adapts the diversion model to its own justice system, but they praised the project as an important and necessary step.

“What we’re trying to do here is prepare for the long term,” Larsen said.