Author: Joseph Magyar

With 555 participating counties across the U.S., the Stepping Up initiative is the nation’s most ambitious and far-reaching effort to reduce the prevalence of mental health conditions and substance use disorders in jails.

As Mental Health Awareness Month in May has concluded, Alamance County recognizes the seventh anniversary of Stepping Up, a national initiative reducing over-incarceration of people with mental illnesses. Stepping Up works with county and state leaders across the U.S. to collect and track baseline data on the number of people in jails with mental illnesses. Since launching in 2015, 555 counties across the U.S. have joined the Stepping Up movement. Today, more than half of the U.S. population lives in a county that has joined the Stepping Up initiative, including Alamance County.

As the Stepping Up initiative was launched nationally on May 15, 2015, by The Council of State Governments Justice Center, the National Association of Counties, and the American Psychiatric Association Foundation—it receives support from the U.S. Department of Justice’s Bureau of Justice Assistance. As a Stepping Up county, Alamance is part of a strong and expansive network of communities on the front lines of criminal justice reform across the U.S.

Alamance County Sheriff Terry Johnson has been at the forefront of these initiatives and remains a staunch supporter of Stepping Up, Crisis Intervention Team Training, and the much-needed Diversion Center.

Sheriff Johnson said, “I will not rest until we can provide those with mental illnesses the help and care they deserve such as a 24/7 Diversion Center instead of jail. We owe it to these folks and to the Citizens of Alamance County”.

As a member of the Stepping Up initiative since 2015, Alamance County has experienced a four percent reduction in jail bookings of people with mental health needs after implementing enhanced mental health screening, assessment, and treatment in the local jail—from 36% of the total jail population in 2019, to 32% in 2021.

In addition, Alamance County has made substantial progress over the past six years since joining the Stepping Up initiative, including but not limited to the following areas:

• Promoting CIT Training for law enforcement officers and others. Seeing that not only sworn officers receive 40 hours of Crisis Intervention Team (CIT) Training in mental health but also that there are detention officers, EMS staff and 911 operators who are CIT Trained—in addition to having Mental Health First Aid Training. The Sheriff and LE Chiefs in the county have made a commitment to having 100% of their sworn officers trained. Four to five local CIT Training classes are held annually towards this goal, with more than 200 completing the training in just over a two-year period.
• Through the addition of a licensed clinician, peer support specialist, and other behavioral health staff within the jail—there is earlier identification and treatment for those with mental illness and/or mental illness with co-occurring substance abuse. With a current rate of around 32% of detainees screening positive for mental illness, it is essential to have enhanced behavioral health services.
• The county’s ongoing and relentless commitment to seeing a 24/7 Diversion Center opened is actively being pursued and has been approved by the Board of County Commissioners with the hope of seeing such a center opened within the next twelve to eighteen months.
• All local Law Enforcement jurisdictions within the county now have access to Mental Health Co-Responders (licensed clinicians) through a partnership between the local Mental Health LME/MCO and the County Crisis Provider, RHA. In addition, our mobile crisis provider and other partners within the county are working to support the goal of diversion from jail and emergency room admission, whenever possible.
• A Quick Response Team is on the ground and actively working with law enforcement and EMS in the county to provide critical follow-up, treatment and resources to those who have experienced drug overdose—many of whom also have a mental health diagnosis.

In 2021, Alamance County Stepping Up Initiative further committed to the goals by participating in the SET, MEASURE, ACHIEVE program that was launched, establishing measurable goals to reduce the prevalence of behavioral health needs in jails. While data collection and evaluation is an ongoing and often difficult process, early data gathered in the third quarter of 2020—revealed that there was a 61% rate of those with mental illness returning to jail within one year of release, as opposed to only a 22% rate for the general jail population (those without identified mental illness). This data further validates why this work is so critical and reaffirms our county’s commitment to Stepping Up.

As data shows that individuals with a mental health diagnosis on average spend more days in jail than those without a mental health diagnosis; programs such as Alamance County Pretrial Release (a program initiated as part of the Stepping Up Initiative) are moving the needle. The number of days spent in jail for many with mental illness is decreasing, while at the same time, promoting earlier and more consistent intervention and treatment.

In 2021, the court appearance rate for Pretrial Release Program cases was over 89% and the safety rate (no additional crimes committed while in the program) was 95%. The addition in 2021 of a grant-funded Peer Support Specialist for detention, has also shown much success in connecting those in need of services post-release with treatment and services.

County leaders across the U.S. are encouraged to join the Stepping Up movement. Counties already participating in Stepping Up can sign on to the latest call to action, Set, Measure, Achieve, to receive tailored technical assistance with setting targets, collecting data, and analyzing results. Visit www.stepuptogether.org to learn more, subscribe to the Stepping Up mailing list, and follow #StepUp4MentalHealth on social media.

Counties can also leverage resources on the Stepping Up website such as the Stepping Up Self-Assessment Tool, Stepping Up Strategy Lab, briefs, case studies, and webinars to

learn more about how to form and engage a planning team, collect and analyze baseline data, and select programs, policies, and practices to implement in their counties.

Alamance County continues to support the work of the Stepping Up Initiative locally, statewide, and nationally, to promote awareness for those with mental illness and/or co-occurring disorders within our community.

The first CIT Training Class for 2022 was held at The Lamb’s Chapel in Alamance County May 23rd-27th with  23 graduates including 17 sworn LE Officers, 1 Detention Officer, one CSI Officer, 3 EMS Staff, and 1 telecommunicator. Alamance County continues its sincere commitment to seeing Law Enforcement and other first responders CIT trained. The Crisis Intervention Team Training course provides law enforcement officers and other first responders with the cognition, information, resources, and skills that allow effective problem solving, and promotes positive outcomes when responding to incidents involving consumers who are experiencing a mental health crisis. The county has three additional trainings scheduled for 2022—two of which will be offered locally. Congratulations to all the graduates including a few officers from surrounding counties who participated.

After more than a year without CIT Training in Alamance County due to the Global Pandemic, classes resumed the week of September 12-16 with 12 officers graduating and were held again in November the week of the 14^th-18 with 24 officers graduating.  All law enforcement jurisdictions in Alamance County have continued their commitment to this excellent training to better equip law enforcement and first responders ( including some from EMS and 911) to deal with those experiencing a mental health or substance abuse crisis.  We are grateful for all the professionals, advocates and agencies who make this happen and are hopeful for what 2022 holds, relative to increased opportunities for this transformative training.

In April 2021, the Alamance County Pretrial Supervision Program initiated a pilot program for Electronic Monitoring with GPS Satellite Tracking.  This is an additional program resource to enable individuals awaiting trial to be released from jail under electronic monitoring/supervision while they await trial.  The pilot is approved for a maximum of eight individuals at this time—and there is a contract in place with a highly experienced third party GPS monitoring agency for 24/7 security monitoring.

As with the current Pretrial Supervision Program, only after intense screening, a thorough criminal history review and completion of a validated risk assessment tool, and by order of a Judge—is a defendant approved for the program. Individuals with extensive criminal histories or those with a history of failing to appear in court are not considered for the program. There is an ‘Exclusion List’ of charges, which will NOT be considered for the Electronic Monitoring Pilot (unless specifically ordered by the Judge). Release conditions would be solely at the discretion of the presiding Judge and in collaboration with the DA’s Office and Pretrial Supervision staff—on a case-by-case basis. A signed agreement is entered into with the defendant listing specific court ordered requirements for compliance while on the Electronic Monitoring. Violations or any non-compliance with the conditions of release is immediately addressed and/or is grounds for an Order for Arrest being issued.   The Alamance County Pretrial Services Committee consisting of judiciary, DA Office staff, Sheriff’s Office Staff, Clerk of Court and others, is closely monitoring the pilot. There have been a total of 7 participants ordered into the program and 6 are currently participating with only one non-compliance as of August 1, 2021. 

January-June 2021

Appearance Rate:                                  93.8%   (30 out of 32 program participants)

Detainee Length of Stay in Jail:               3.4 days (time served prior to Pretrial Supervision)

Safety Rate (no new charges):                96.9%    (31 of 32 program participants)

Success Rate (program completion)       62.5%  (20 of 32 participants, some still in program)

Law Enforcement Officers within Alamance County Sheriff’s Office who respond to mental health calls for service are now able to enter this information in a quick mobile app which enables the county to be able to collect, track and analyze data specific to the number of calls, how many were responded to by a CIT Trained Officer, how many were resolved on the scene with no further action needed, how many were referred to a mental health provider, how many were involuntarily committed for evaluation, how many arrests were made—and other highly valuable information.  The county Stepping Up Initiative is very excited over this state-of-the-art, web-based app, designed by our very own County IT staff. We look forward to seeing this rolled out to all the local LE jurisdictions, hopefully, later in 2021.

While CIT Training for Law Enforcement and EMS was canceled in 2020 due to the COVID-19 Pandemic, we are happy to report that the Alamance County CIT Steering committee is again meeting and 2 training events have been scheduled for 2021, with a 3rd possible date being added. The training events are scheduled for September and November—each 40 hour, in-person training.  A possible 3^rd week may be added in December 2021 to accommodate the backlog of new officers and EMS staff who have been hired and are not yet CIT Trained. This training better equips Law Enforcement and EMS to utilize enhanced skills in dealing with mental health and substance abuse calls for service. A special thanks to Cardinal Innovations for coordinating and facilitating the scheduling of this highly sought-after training.

In October 2020, the Department of Justice, Office of Justice Programs awarded Alamance County a three-year grant for $741,678. The Sheriff’s Office applied for the grant in partnership with RHA Healthcare, as the sub-award recipient.  The four project deliverables for this grant include:

1)  Expanding current Behavioral Health Crisis Center operational hours by 40%,

 2) Enhancing community reentry services and referrals and decreasing jail recidivism by employing a Peer Support Specialist in detention,

3) enhancing the Behavioral Health crisis continuum of care in Alamance County so there is broad knowledge about where individuals go for services and seamless transition when referrals are made between mental health serving agencies, and lastly….

4) To relocate the Crisis/Diversion Center into a county-owned building with expanded hours of operation and continued progress toward the long-term community priority for a 24/7 Crisis/Diversion Center. 

While there were delays in implementing the grant due to federal system changes and issues with getting the sub-award agreements in place locally; we’re happy to report that the grant is moving along nicely and the Peer Support Specialist is on board in detention and additional staff will be hired through RHA in the fall to support the expanded hours of operation for the crisis center. In addition, monthly meetings of the community crisis continuum committee are happening with directed goals towards a more cohesive and collaborative service continuum—and resumed conversations relative to the long-awaited Mental Health Crisis Diversion Center.  More updates to come!

“Congratulations to all Law Enforcement Agencies in Alamance County. Their commitment to CIT leads to positive results like this.

The actions mentioned in the Washington Post story about the Burlington Police Department are exactly what my family experienced a few years ago in Burlington. The de-escalation skills work. My family has experienced incidents involving mental illness and Law Enforcement before and after CIT. The change is absolutely amazing. Thank you to all Law Enforcement in Alamance County. Thank you very much!”

Art Springer
President, NAMI Alamance, Caswell, Rockingham

Read more here: https://www.washingtonpost.com/local/deescalation-training-police/2020/10/27/3a345830-14a8-11eb-ad6f-36c93e6e94fb_story.html

The Stepping Up Semi-Annual Task Force meeting was held with approximately 35 community leaders and stakeholders in attendance. Highlights of the program featured updates as well as Chief District Court Judge Tom Lambeth speaking to the group relative to work being done in the county around Bail Bond Policy Revision and our Pretrial Supervision Program.  A former program participant told a very moving story about her decades long struggle with mental illness and substance abuse, and how the Pretrial Program made such a positive difference in her life.

This day and a half workshop focused on people with mental illness and co-occurring disorders, involved with the criminal justice system in our county and more than 25 participants from across the criminal justice continuum participated including advocates, law enforcement executives, behavioral health providers, judges and a host of community leaders—as well as individuals with lived experience.  Similar to a Community Dialogue event held in September of 2016 which engaged a wide range of community professionals and advocates; this exercise provided an opportunity to build on that work, as well as the Stepping Up Initiative work since 2016—at a much deeper level.

The purpose of the exercise was to evaluate the current process and resources available at 6 different intercepts within the criminal justice system including community services, law enforcement, detention and initial hearings, jail and court, reentry and community corrections. The aim was to also identify system gaps in service delivery and to identify strategies for optimizing local resources for enhanced service delivery across the criminal justice system in Alamance County.

The top priorities voted on by the participants are as follows:

• Create a Diversion Center
• Improve Communication between hospital and community
• Expand and coordinate crisis services
• Expand Co Responder/MH Crisis Response Team Models across county LE Jurisdictions
• Collect and Analyze Data in Decision Making

Under the oversight of the Justice Advisory Council, the county Stepping Up Initiative will be organizing and working to address these priority areas over the coming year by engaging the appropriate community partners with regular progress updates being provided to the Justice Advisory Council.