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	<title>Mental Health Archives - AdvocacyDenver</title>
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	<title>Mental Health Archives - AdvocacyDenver</title>
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		<title>Mental Health Crisis: Part 3, Services and Programming for Children</title>
		<link>https://www.advocacydenver.org/mental-health-crisis-3-services-programming-children/</link>
		
		<dc:creator><![CDATA[Pamela Bisceglia]]></dc:creator>
		<pubDate>Thu, 05 Dec 2019 16:01:43 +0000</pubDate>
				<category><![CDATA[eVOICE]]></category>
		<category><![CDATA[Mental Health]]></category>
		<guid isPermaLink="false">https://www.advocacydenver.org/?p=7297</guid>

					<description><![CDATA[<p>From The Desk of Pamela Bisceglia Ten years ago, a child in crisis could be transported from a school or their home to Denver Health or The Children’s Hospital for a 72-hour hold for professional/psychiatric evaluation. Today, the child of a family with resources is more likely to be admitted and care is taken to [&#8230;]</p>
<p>The post <a href="https://www.advocacydenver.org/mental-health-crisis-3-services-programming-children/">Mental Health Crisis: Part 3, Services and Programming for Children</a> appeared first on <a href="https://www.advocacydenver.org">AdvocacyDenver</a>.</p>
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<figure class="wp-block-image"><img fetchpriority="high" decoding="async" width="1024" height="313" src="https://www.advocacydenver.org/wp-content/uploads/2019/07/evoice-logo-1024x313.png" alt="eVoice" class="wp-image-6688" srcset="https://www.advocacydenver.org/wp-content/uploads/2019/07/evoice-logo-1024x313.png 1024w, https://www.advocacydenver.org/wp-content/uploads/2019/07/evoice-logo-300x92@2x.png 600w, https://www.advocacydenver.org/wp-content/uploads/2019/07/evoice-logo-300x92.png 300w, https://www.advocacydenver.org/wp-content/uploads/2019/07/evoice-logo.png 1040w" sizes="(max-width: 1024px) 100vw, 1024px" /></figure>



<p><em>From The Desk of Pamela Bisceglia</em></p>



<span id="more-7297"></span>



<p>Ten years ago, a child in crisis could be transported from a school or their home to Denver Health or The Children’s Hospital for a 72-hour hold for professional/psychiatric evaluation. Today, the child of a family with resources is more likely to be admitted and care is taken to make sure that wrap around services are put in place to support the child and family. However, today the larger group of children in crisis never make it past the emergency room; they are drugged and sent home with their parents and put on a list for mental health services. If the family has private insurance the family may need to wait until their child’s name comes to the top of the list or the family may also find the child is discharged based upon an insurance company’s determination of medical necessity (a standard which does not often mean the child is ready for discharge but rather that private insurance will no longer cover the child’s care). If the child is Medicaid eligible, the rules prohibit a wait list; if that child is lucky he/she might see a counselor bi-monthly. If the child needs a therapeutic day treatment program, there is not always clear path to treatment.</p>



<p>Over the past ten years, over 50 percent of licensed facility programs for school age children within the metro area/Colorado have closed; today there are 37 left in the State. Facility programs are licensed through the Colorado Department of Education and Colorado Human Services. Some facility programs are designed for children with significant emotional disabilities; some of the up and coming programs target children with autism, a few treatment programs specialize in treating trauma. A school district can refer a child to a facility program, but the facility selects who they enroll, who they serve. Most facility programs offer therapeutic services (day treatment services). By definition, day treatment services are daytime programs that provide integrated, comprehensive treatment; educational, pre-vocational or vocational, and activity services to individuals; and therapeutic services to their families.</p>



<p>As facilities closed, but children’s needs remained constant, Denver Public Schools opened a “District run” facility program. Denver Public Schools first approached the for-profit Arizona subsidiary of Cenpatico Behavioral Health, LLC (Cenpatico) in 2012. The elementary and middle school programs opened fall 2013. The elementary facility program was located on the 3rd floor of Trevista Elementary School; the Middle school facility program was located on the 2nd floor at Skinner Middle School. Students were provided instruction in grade level curriculum. For behavior, the facility used a daily and ongoing level system. All students were required to have five behavior goals. The privilege earned for the day was in accordance with points earned; if the student was able to demonstrate appropriate behavior over the course of time they earned additional privileges. </p>



<p>AdvocacyDenver began receiving reports in relation to the excessive use of (prone) restraint. Agency staff placed their hands on children over and over again in order to gain compliance; the agency failed to provide the parent/district with a written report when restraint was used. The agency had DPS Safety and Security on speed dial; if the school could not gain compliance via restraint, Safety and Security offered mechanical restraint and would handcuff the child until they calmed or with older youth, until Denver Police Department arrived. On a good day the elementary and middle school program shared a psychologist. The school did not offer therapeutic services. Almost the entire enrollment were students (males) of color. The students did not “get better” nor did they transition back to a less restrictive environment. The trauma and emotional scars were significant.</p>



<p>There were significant concerns with the middle school program (small number of students, significant number of arrests, disciplinary removals, restraints) and so the contract with Cenpatico for the middle school program ended in 2016. That same year Cenpatico provided a report in relation to the number of restraints (prone restraints) used in their elementary school program for the 2015-2016 school year. The average enrollment was 15 and the number of restraints lasting 5 minutes or longer was 557 for the school year. The next year Cenpatico changed their name to Lifeshare and the elementary program remained open through the 2018-2019 school year. </p>



<p>In 2019 Denver Public Schools entered into a contract with out-of-state, for-profit Catapult Learning to take over DPS “District run” facility program. AdvocacyDenver received blueprints for locked seclusion rooms to be constructed at District run facility school (Sierra at Barret School). Denver Public Schools Board of Education policy bans the use of seclusion, accordingly, Special Education Director assured AdvocacyDenver that the seclusion rooms would not be built. In June, the Executive Director for Catapult invited AdvocacyDenver to tour their contract facility program in Littleton Public Schools. They discussed their philosophy, educational programming, point system; they explained that their model calls for staff to be trained in physical restraint, but also their model calls for seclusion. Like Cenpatico, the school does not offer therapeutic services.</p>



<p>“Seclusion” means the placement of a student alone in a room from which egress is prevented. A seclusion room must have adequate veneration, lighting (not natural light) and size (approximately 4 feet by 4 feet). The primary purpose of a seclusion room is to confine or isolate a student. The Director walked us to the area to view their seclusion rooms. There was a small child standing just inside one of the rooms, a member of staff stood close by. The Director said that sometimes children take comfort just standing inside the room. (In most instances physical force is used to “escort” the child to the seclusion room.) The walls of the room had once been painted; however, the paint, child height down had been scratched off the walls- the top of the room was sky blue, the bottom was brown/bare wood. We walked away for a moment and when we returned the door for the 1st seclusion room was closed, the door handle was pushed down in a locked position, and an adult stood by the door peered down at the child through wire vent (adult height) we could hear the faint cries of a child pleading for the adult to open the door… The Director asserted that seclusion is a better safer way to address behavior.</p>



<div class="wp-block-image"><figure class="aligncenter size-large"><img decoding="async" width="1024" height="423" src="https://www.advocacydenver.org/wp-content/uploads/2019/12/childs-sketch-of-quiet-room-1024x423.png" alt="A child's drawing of the Quiet Rooms" class="wp-image-7298" srcset="https://www.advocacydenver.org/wp-content/uploads/2019/12/childs-sketch-of-quiet-room-1024x423.png 1024w, https://www.advocacydenver.org/wp-content/uploads/2019/12/childs-sketch-of-quiet-room-300x124@2x.png 600w, https://www.advocacydenver.org/wp-content/uploads/2019/12/childs-sketch-of-quiet-room-300x124.png 300w, https://www.advocacydenver.org/wp-content/uploads/2019/12/childs-sketch-of-quiet-room.png 1180w" sizes="(max-width: 1024px) 100vw, 1024px" /><figcaption>A child&#8217;s drawing of the Quiet Rooms</figcaption></figure></div>



<p>Starting in 2012 and continuing up until today AdvocacyDenver and other like disability rights agencies met with DPS to discuss concerns in relation to the District run facility program pipeline; the disproportionate number of minority males sentenced to the program, the use of physical restraint, and DPS Safety and Security/Campus Resource Officers (Denver Police Department) handcuffing children. In spring 2019 Denver Public Schools Board of Education and Superintendent publically put a ban on handcuffing young children. The Board directed the District to review and modify policy in relation to Student Restraint. The policy then and now bans the use of prone restraints, mechanical and chemical restraints as well as seclusion. However, just as the policy was being drafted, the district moved forward constructing the seclusion rooms at Barret; for the moment the doors have not been placed on rooms (“recovery bays”). There is no evidence that seclusion has therapeutic or educational value. Nineteen states prohibit secluding children in locked rooms; four of them ban any type of seclusion. Colorado’s law is well defined, but it does not demand meaningful oversight and monitoring, in relation to restraint (physical, mechanical, chemical) and/or seclusion. </p>



<p>Since 2012 AdvocacyDenver and other like disability rights agencies have met with a long list of public agencies, leaders, representatives to discuss and forward systemic change in relation to mental health crisis. Restraint, seclusion, removal does not address or replace behavior. The Mental health crisis is not an issue that can be addressed in isolation by the public school system. Instead the state, each city, must develop a blueprint to address the mental health crisis, hospitals, public and private providers must roll up their sleeves and make a commitment to serve all children in need.</p>



<p><a href="https://www.advocacydenver.org/mental-health-crisis-1-framing-the-issues/">Part I discussed </a><strong><a href="https://www.advocacydenver.org/mental-health-crisis-1-framing-the-issues/">FRAMING THE ISSUES</a></strong><a href="https://www.advocacydenver.org/mental-health-crisis-1-framing-the-issues/"><br></a><a href="/mental-health-crisis-2-long-term-competency/">Part II discussed <strong>LONG TERM COMPETENCY</strong></a></p>
<p>The post <a href="https://www.advocacydenver.org/mental-health-crisis-3-services-programming-children/">Mental Health Crisis: Part 3, Services and Programming for Children</a> appeared first on <a href="https://www.advocacydenver.org">AdvocacyDenver</a>.</p>
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		<title>Mental Health Crisis: Part 2, Long Term Competency</title>
		<link>https://www.advocacydenver.org/mental-health-crisis-2-long-term-competency/</link>
		
		<dc:creator><![CDATA[Pamela Bisceglia]]></dc:creator>
		<pubDate>Tue, 05 Nov 2019 22:10:43 +0000</pubDate>
				<category><![CDATA[eVOICE]]></category>
		<category><![CDATA[Mental Health]]></category>
		<guid isPermaLink="false">https://www.advocacydenver.org/?p=7124</guid>

					<description><![CDATA[<p>From The Desk of Pamela Bisceglia “Jane Doe” had charges brought against her January 2016 and June 2017.&#160; She was released on bail.&#160; A competency evaluation was ordered and in December 2017, it was determined she was not competent.&#160; She was ordered to participate in a competency restoration program.&#160;&#160;Competency restoration&#160;is the process used when an [&#8230;]</p>
<p>The post <a href="https://www.advocacydenver.org/mental-health-crisis-2-long-term-competency/">Mental Health Crisis: Part 2, Long Term Competency</a> appeared first on <a href="https://www.advocacydenver.org">AdvocacyDenver</a>.</p>
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<figure class="wp-block-image"><img decoding="async" width="1024" height="313" src="https://www.advocacydenver.org/wp-content/uploads/2019/07/evoice-logo-1024x313.png" alt="eVoice" class="wp-image-6688" srcset="https://www.advocacydenver.org/wp-content/uploads/2019/07/evoice-logo-1024x313.png 1024w, https://www.advocacydenver.org/wp-content/uploads/2019/07/evoice-logo-300x92@2x.png 600w, https://www.advocacydenver.org/wp-content/uploads/2019/07/evoice-logo-300x92.png 300w, https://www.advocacydenver.org/wp-content/uploads/2019/07/evoice-logo.png 1040w" sizes="(max-width: 1024px) 100vw, 1024px" /></figure>



<p><em>From The Desk of Pamela Bisceglia</em></p>



<p>“Jane Doe” had charges brought against her January 2016 and June 2017.&nbsp; She was released on bail.&nbsp; A competency evaluation was ordered and in December 2017, it was determined she was not competent.&nbsp; She was ordered to participate in a competency restoration program.&nbsp;&nbsp;Competency restoration&nbsp;is the process used when an individual is found by a court to be incompetent to stand trial.&nbsp; Simply put, “Jane Doe” must be&nbsp;restored&nbsp;to&nbsp;competency&nbsp;before the legal process can continue.&nbsp; In November 2018, it was determined that competency could not be restored.&nbsp; “Jane Doe” is labeled as having a dual diagnosis: an intellectual and developmental disability and mental health issues.&nbsp; On July 9, 2019, “Jane Doe” was arrested and charged with aggravated assault.&nbsp; On day three of her incarceration, “Jane Doe” was arraigned. The judge was privy to: her history, the list of her past charges, her competency evaluations and her return to the community. Now, because she is charged with aggravated assault, the court will no longer entertain her return to the community.&nbsp;&nbsp;</p>



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<p>During the 2018 legislative session, four bills were introduced to address the handling of cases where competency is at issue in Colorado courts.&nbsp; Three of those passed.&nbsp; Senate Bill 18-249,&nbsp;<em>Redirection Criminal Justice Behavioral Heath</em>,&nbsp;requires the establishment of alternative programs in the criminal justice system to divert individuals with a mental health condition to community treatment.&nbsp; Senate Bill 18-250,&nbsp;<em>Jail–based Behavioral Health Services</em>,&nbsp;allows the correctional treatment cash fund to be used to provide adequate staff to: complete competency and behavioral health screenings, prescribe psychiatric medications, provide mental health counseling, and train jail staff.&nbsp; The training is designed to educate jail staff on behavioral health disorders and best practices in working with individuals with mental health, substance use, and co-occurring disorders.&nbsp;&nbsp;House Bill 18-251&nbsp;created the Statewide Behavioral Health Court Liaison Program in the Judicial Department&#8217;s Office of the State Court Administrator. This program was created to identify local behavioral health professionals to serve as court liaisons in each judicial district and to facilitate communication and collaboration between the judicial and behavioral health systems.</p>



<p>On March 15, 2019, Disability Law Colorado announced that an agreement had been reached in a long-standing legal battle over extended waits for court-ordered mental health evaluations and &nbsp;competency restoration. The consent decree filed ends eight years of legal disputes between the Colorado Department of Human Services and Disability Law Colorado.&nbsp; It will set new deadlines and create a triage system.&nbsp; A representative from Disability Law Colorado said the consent decree will “ensure sweeping reforms to Colorado’s broken competency system.”</p>



<p>On April 8, 2019, Governor Jared Polis directed the Colorado Department of Human Services to spearhead Colorado’s Behavioral Health Task Force.&nbsp; The mission of the task force is&nbsp;to evaluate and determine the roadmap to improve the current behavioral health system in the state. This includes developing Colorado’s “Behavioral Health Blueprint” by June 2020. It is anticipated that the implementation of these recommendations will start in July of 2020.&nbsp; The task force is comprised of 25 members. There are also&nbsp;three subcommittees with 25 members each. One subcommittee is focusing on Long-Term Competency.&nbsp;Consistent with a recent consent decree entered into by the Colorado Department of Human Services and Disability Law Colorado, this subcommittee will develop a comprehensive plan for individuals in the criminal justice system who have been identified as having competency issues; and will develop future solutions to increase community interventions as a means of reducing demand on forensic mental health results.</p>



<p>On May 20, 2019, Senate Bill 19-223 was passed.&nbsp; The timeline for implementing some of the more important features of Senate Bill 2019-223 is July of 2020.&nbsp; Colorado revised statute&nbsp;&nbsp; shortens the timeframe for the completion of competency evaluations.&nbsp; The statute defines ‘inpatient program’ to mean either in a hospital, or unfortunately, in a&nbsp;<strong>full-time, jail-based&nbsp;</strong>restoration program.&nbsp;&nbsp;Colorado’s jail-based competency program,&nbsp;<em>Restoring</em>&nbsp;Individuals Safely and Effectively (RISE),&nbsp;requires that patients be separated from the general population at all times and be in a “therapeutic setting.”&nbsp;</p>



<p><strong>On Day 76 of jail confinement,</strong>&nbsp;“Jane Doe” was transported to the Colorado Mental Health Institute at Pueblo for a competency evaluation.&nbsp; Upon completion of the evaluation, she was transported back to the Denver jail.&nbsp; The evaluation&nbsp;<strong>confirmed</strong>&nbsp;she is incompetent to proceed.&nbsp; Incompetent to proceed means, as a result of an intellectual disability and co-occurring mental disability, “Jane Doe” does not have sufficient present ability to consult with her lawyer with a reasonable degree of rational understanding in order to assist in the defense. Nor, as a result of her mental disability and intellectual disability, does “Jane Doe” have a rational and factual understanding of the criminal proceedings. On Days 3, 76, and 120, the system has failed to determine whether restoration services will be provided, in a community setting, a state hospital, or a jail-based program.&nbsp; Today “Jane Doe” is still in jail and not getting the treatment she needs.</p>



<p>We are certain that most individuals with intellectual and developmental disabilities and with serious mental health issues can be treated in the community.&nbsp; “Jane Doe” falls into a second category of these individuals.&nbsp; That is: it has been determined she presents a danger to others.&nbsp; However, Colorado state mental health institutions are at capacity and do not have the beds, staff, therapy providers and/or services to accommodate these individuals.&nbsp; The Denver jail is able to offer “Jane Doe” a bed.&nbsp; Yet AdvocacyDenver is questioning if the Denver jail has the appropriately trained staff, the tools and/or programming specifically designed for an individual with a dual diagnosis.&nbsp; The 2020 timeline provides Colorado Human Services an opportunity to define best practices for increasing the number of beds, growing the number of trained professionals, and (maybe, just maybe) earmarking the funding needed to implement the plan.&nbsp; For “Jane Doe”, and others like her, this is a human rights issue.&nbsp; “Jane Doe” has an intellectual disability which cannot be restored.&nbsp; “Jane Doe” spending her days in jail, and, not getting the treatment she needs, is inhumane.</p>



<p><a href="https://www.advocacydenver.org/mental-health-crisis-1-framing-the-issues/">Part I discussed </a><strong><a href="https://www.advocacydenver.org/mental-health-crisis-1-framing-the-issues/">FRAMING THE ISSUES</a></strong><a href="https://www.advocacydenver.org/mental-health-crisis-1-framing-the-issues/"><br></a><a href="/mental-health-crisis-3-services-programming-children/">Part III will discuss <strong>CHILDREN&#8217;S BEHAVIORAL HEALTH</strong></a></p>
<p>The post <a href="https://www.advocacydenver.org/mental-health-crisis-2-long-term-competency/">Mental Health Crisis: Part 2, Long Term Competency</a> appeared first on <a href="https://www.advocacydenver.org">AdvocacyDenver</a>.</p>
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		<title>Mental Health Crisis: Part 1, Framing The Issues</title>
		<link>https://www.advocacydenver.org/mental-health-crisis-1-framing-the-issues/</link>
		
		<dc:creator><![CDATA[Pamela Bisceglia]]></dc:creator>
		<pubDate>Thu, 01 Aug 2019 14:30:13 +0000</pubDate>
				<category><![CDATA[eVOICE]]></category>
		<category><![CDATA[Mental Health]]></category>
		<guid isPermaLink="false">https://www.advocacydenver.org/?p=6686</guid>

					<description><![CDATA[<p>From The Desk of Pamela Bisceglia While some maintain Denver Public Schools (DPS) offers students “equitable” opportunities, others assert the school-to-prison pipeline is alive and well in DPS. The partnership between DPS, Colorado Department of Human Services (CDHS) and what was the Division of Youth Corrections (currently known as the Division of Youth Services) provides [&#8230;]</p>
<p>The post <a href="https://www.advocacydenver.org/mental-health-crisis-1-framing-the-issues/">Mental Health Crisis: Part 1, Framing The Issues</a> appeared first on <a href="https://www.advocacydenver.org">AdvocacyDenver</a>.</p>
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<figure class="wp-block-image"><img loading="lazy" decoding="async" width="1024" height="313" src="https://www.advocacydenver.org/wp-content/uploads/2019/07/evoice-logo-1024x313.png" alt="eVoice" class="wp-image-6688" srcset="https://www.advocacydenver.org/wp-content/uploads/2019/07/evoice-logo-1024x313.png 1024w, https://www.advocacydenver.org/wp-content/uploads/2019/07/evoice-logo-300x92@2x.png 600w, https://www.advocacydenver.org/wp-content/uploads/2019/07/evoice-logo-300x92.png 300w, https://www.advocacydenver.org/wp-content/uploads/2019/07/evoice-logo.png 1040w" sizes="auto, (max-width: 1024px) 100vw, 1024px" /></figure>



<p><em>From The Desk of Pamela Bisceglia</em></p>



<p>While some maintain Denver Public Schools (DPS) offers students “equitable” opportunities, others assert the school-to-prison pipeline is alive and well in DPS.  The partnership between DPS, Colorado Department of Human Services (CDHS) and what was the Division of Youth Corrections (currently known as the Division of Youth Services) provides new meaning to the school-to-prison pipeline.  DPS charter school Rite of Passage is housed in youth correction facility in Watkins, Colorado.  Thirty-five percent (or more) of the youth assigned to the facility are identified as having a disability (eligible under the Individuals with Disabilities Education Act).  Ridge View Academy is a boys’ correction facility located in a remote area surrounded by fields.  Ridge View Academy does not have a barbed wire fence, rather the youth understand if they run they will be sent to a more secure correction facility.  DPS’ Board of Education approved the Rite of Passage charter school in 2001. </p>



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<h2 class="wp-block-heading">February 2018</h2>



<p>Advocacy Denver’s February 2018 E-Voice discussed the school to prison pipeline and reported:</p>



<blockquote class="wp-block-quote is-layout-flow wp-block-quote-is-layout-flow"><p>There are two ways that a youth can be placed at Ridge View Academy. The most obvious is the youth has been charged and convicted of a crime and that youth is sentenced to the correction facility. There is a second group of youth housed in the same facility, foster children. The (Denver) Division of Human Services Child Protection Services is charged with keeping children safe. When Human Services removes a child from home because of abuse or neglect, if they do not have a foster home for the child age 12 and older, they are assigned to Ridge View Academy. The correction facility has “empty beds” and facility staff assert that they try to keep foster children separate from incarcerated youth but all youth are educated in the same classroom.  </p></blockquote>



<figure class="wp-block-image"><img loading="lazy" decoding="async" width="1024" height="350" src="https://www.advocacydenver.org/wp-content/uploads/2019/07/Ridge_View_crop-1024x350.jpg" alt="Ridge View Academy" class="wp-image-6689" srcset="https://www.advocacydenver.org/wp-content/uploads/2019/07/Ridge_View_crop-1024x350.jpg 1024w, https://www.advocacydenver.org/wp-content/uploads/2019/07/Ridge_View_crop-300x103@2x.jpg 600w, https://www.advocacydenver.org/wp-content/uploads/2019/07/Ridge_View_crop-300x103.jpg 300w, https://www.advocacydenver.org/wp-content/uploads/2019/07/Ridge_View_crop.jpg 1280w, https://www.advocacydenver.org/wp-content/uploads/2019/07/Ridge_View_crop-600x205@2x.jpg 1200w" sizes="auto, (max-width: 1024px) 100vw, 1024px" /></figure>



<p>When asked whether incarcerated youth and Denver foster care children are housed together at this youth correction facility, Joe Homlar Deputy Executive Director Protection and Prevention Services/Denver Human Services asserted that all youth are assigned through the courts:</p>



<blockquote class="wp-block-quote is-layout-flow wp-block-quote-is-layout-flow"><p>When we receive concerns about a child who may be in danger, unsafe in their living environment, that’s something we look into and make plans with families to address and remedy. That is the majority of the work we do. There are situations, however, where we make determinations with courts. The same judges who work with kids in our juvenile delinquency system are the same judges who work with our families who experience abuse issues at home.  All of those judges are working with our Department, with families, with guardians, to make sure the child’s best interest is served.  Through the juvenile justice system, a child is adjudicated in a civil finding because of a delinquency issue they are struggling with. Through the traditional child welfare system, the same civil finding of an adjudication and a finding that the child requires an out of home placement . . . .  Kent (Kent Moe, Executive Director) runs a facility that provides a specific clinical service to children that require that need based on our assessment, assessments from courts, as well as assessments to make sure a child is a good fit for Rites of Passage.</p></blockquote>



<p>Kent Moe, Executive Director, Ridge View Academy, further explained: </p>



<blockquote class="wp-block-quote is-layout-flow wp-block-quote-is-layout-flow"><p>We are a Trauma-Informed care facility. There’s an assessment done at the very beginning to measure the degree to which a child is traumatized. There is a daily and weekly regiment of coping skills, therapy, group interventions, and individual (interventions) as well. Each week, each student gets prescriptive treatment related to their diagnosis or to their needs. Those things look primarily like cognitive behavioral interventions that tie to whatever risk they present. You’re talking about trying to get the student to understand the thought/ behavioral link. That’s what evidence has shown to be the best intervention. We do group and individual therapy, prescriptive to the child’s presented needs.</p></blockquote>



<p>Mr. Homlar and Mr. Moe argue that Ridge View Academy is a treatment facility, designed to provide “staff secure” programming (academic and social/emotional services) to adjudicated youth and foster care youth. </p>



<h2 class="wp-block-heading">December 2018 </h2>



<p>December 2018 Letter to Fort Logan Staff:</p>



<blockquote class="wp-block-quote has-text-align-left is-layout-flow wp-block-quote-is-layout-flow"><p>The Colorado Division of Human Services (CDHS) is facing a crisis in its ability to timely admit the people the courts are ordering to the Department for competency evaluations and restoration services.  It is with reluctance that we announce that there will be a freeze on the admissions of civil clients to the Colorado Mental Health Institute at Fort Logan, effective immediately . . . .</p><cite>Robert Werthwein, Ph.D.<br>Director<br>Colorado Mental Health Institute at Fort Logan</cite></blockquote>



<p>The letter says that from 2000 to 2018, CDHS saw a 592 percent increase in the number of court-ordered individuals sent for competency evaluations and a 1251 percent increase in those ordered to receive inpatient competency restoration services.  CDHC was party to a federal court settlement, which requires the Department to offer a bed to those needing competency-related services within 28 days of receiving a judge’s order and collateral materials.  CHHC admits they been unable to meet the settlement agreement timelines since mid-2017 (Disability Law Colorado).  </p>



<p>According to the letter:</p>



<blockquote class="wp-block-quote is-layout-flow wp-block-quote-is-layout-flow"><p>On Dec. 10, the Department submitted a request to the legislature’s Capital Development Committee for $3.7 million for the first of three phases of construction, totaling $34.1 million, to be used to repurpose Ridge View Academy. The renovated campus would provide secure, inpatient psychiatric beds for up to 210 adults who need mental health services. That cost is approximately one-tenth the cost of building a new mental health hospital and can be achieved far more quickly. The renovated facilities would be finished by March of 2022.</p></blockquote>



<h2 class="wp-block-heading">July 2019</h2>



<p>Mark Techmeyer, Director of Communications, Colorado Division of Human Services:</p>



<blockquote class="wp-block-quote is-layout-flow wp-block-quote-is-layout-flow"><p>The Department&#8217;s request to repurpose Ridge View was not funded and is not currently under consideration. Also for clarity, the freeze on the admission of civil patients by the department was no longer in effect as of February 7, 2019.  </p></blockquote>



<p>On April 8, 2019, Gov. Jared Polis directed the Colorado Department of Human Services to spearhead Colorado’s Behavioral Health Task Force. </p>



<p>The mission of the task force is to evaluate and set the roadmap to improve the current behavioral health system in the state. This includes developing Colorado’s “Behavioral Health Blueprint” by June 2020, with anticipated implementation of recommendations starting in July 2020.  The task force is comprised of 25 members. There are also three subcommittees with 25 members each. Those subcommittees are:</p>



<ul class="wp-block-list"><li>State Safety Net: This subcommittee shall offer a roadmap to ensure that every Coloradan, regardless of acuity level, ability to pay, or co-occurring disabilities, can obtain appropriate behavioral health services in their community. </li><li>Children&#8217;s Behavioral Health: This subcommittee should develop a plan to address how we deliver and manage children’s behavioral health and improve outcomes. </li><li>Long-Term Competency: Consistent with a recent consent decree entered into by the Colorado Department of Human Services, this subcommittee should develop a comprehensive plan for individuals in the criminal justice system who have been found incompetent to proceed and future solutions to increase community interventions as a means to reduce demand on forensic solutions to mental health.</li></ul>



<p><a href="https://www.advocacydenver.org/mental-health-crisis-2-long-term-competency/">Part II will discuss </a><strong><a href="https://www.advocacydenver.org/mental-health-crisis-2-long-term-competency/">LONG TERM COMPETENCY</a></strong><br><a href="/mental-health-crisis-3-services-programming-children/">Part III will discuss <strong>CHILDREN&#8217;S BEHAVIORAL HEALTH</strong></a></p>
<p>The post <a href="https://www.advocacydenver.org/mental-health-crisis-1-framing-the-issues/">Mental Health Crisis: Part 1, Framing The Issues</a> appeared first on <a href="https://www.advocacydenver.org">AdvocacyDenver</a>.</p>
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		<title>Mental Health Competency Addressed In Criminal Justice Bills</title>
		<link>https://www.advocacydenver.org/mental-health-competency-addressed-in-criminal-justice-bills/</link>
		
		<dc:creator><![CDATA[Catherine Strode]]></dc:creator>
		<pubDate>Thu, 04 Apr 2019 16:00:34 +0000</pubDate>
				<category><![CDATA[Interview]]></category>
		<category><![CDATA[Legislation]]></category>
		<category><![CDATA[Mental Health]]></category>
		<category><![CDATA[Policy Perspective - Interviews with Policy Makers]]></category>
		<guid isPermaLink="false">https://www.advocacydenver.org/?p=6154</guid>

					<description><![CDATA[<p>An Interview with Catherine Strode It is estimated that the incidence of mental illness among prison inmates is three times more prevalent than in the general population.  Nationally, more than a third of inmates are reported to suffer from some form of mental illness.  Colorado statistics reflect nearly 40 per cent of the state’s inmates [&#8230;]</p>
<p>The post <a href="https://www.advocacydenver.org/mental-health-competency-addressed-in-criminal-justice-bills/">Mental Health Competency Addressed In Criminal Justice Bills</a> appeared first on <a href="https://www.advocacydenver.org">AdvocacyDenver</a>.</p>
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										<content:encoded><![CDATA[
<p><em>An Interview with Catherine Strode</em></p>



<div class="wp-block-image"><figure class="alignleft"><img loading="lazy" decoding="async" width="200" height="300" src="https://www.advocacydenver.org/wp-content/uploads/2019/04/2019a_lee_sanford_pete-200x300.jpg" alt="Colorado State Senator Pete Lee, Senate District 11" class="wp-image-6155" srcset="https://www.advocacydenver.org/wp-content/uploads/2019/04/2019a_lee_sanford_pete-200x300.jpg 200w, https://www.advocacydenver.org/wp-content/uploads/2019/04/2019a_lee_sanford_pete.jpg 300w" sizes="auto, (max-width: 200px) 100vw, 200px" /><figcaption>Colorado State Senator Pete Lee, Senate District 11</figcaption></figure></div>



<p>It is estimated that the incidence of mental illness among prison inmates is three times more prevalent than in the general population.  Nationally, more than a third of inmates are reported to suffer from some form of mental illness.  Colorado statistics reflect nearly 40 per cent of the state’s inmates are in need of mental health intervention. A package of bills is being introduced this Session to address the issue of competency for individuals with mental illness in the criminal justice system.</p>



<p><strong>Senator Pete Lee</strong>, Chair of the Senate Judiciary Committee, has been one of the architects of the bills.  He says the goal is to establish a protocol where individuals in need of mental health care are identified and expediently moved out of the criminal justice system into community treatment care programs.<br></p>



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<p><em>What is your role in bringing the competency bills?</em></p>



<p>I have been on the Judiciary Committee in the House for eight years and am now Chair of the Senate Judiciary Committee. &nbsp;I’m at the intersection of a lot of what goes on within the criminal justice system. We hear over and over in testimony the increased number of people going into jail who have: mental health issues, developmental disabilities, and drug and alcohol problems. The criminal justice system was not designed to deal with people with mental health, or substance abuse, or intellectual or developmental disabilities. We have far too many people in the system who are incompetent to proceed. They need to have either restoration services (so they can be restored to competency), be institutionalized, or put into some sort of treatment program.&nbsp; We hear about the amount of time they’re spending in jail and not getting treatment. I have been working with people from Mental Health Colorado, the Colorado Behavioral Healthcare Council, and the Public Defender’s Office.&nbsp; I’m a conduit to carry the proposals and recommendations they have made into the legislative process.&nbsp; These bills this Session are an attempt to integrate, coordinate, and bring the system together with better resources between various departments. This is the epicenter of a huge problem that affects every jurisdiction around the state.&nbsp;&nbsp;</p>



<p><em>What bills are being introduced to address the issue?</em></p>



<p>I refer to them as Competency Bill Number Two and Competency Bill Number Three. &nbsp;Number Two is the ‘Safety Net’ Bill.&nbsp; It is to set up a system to keep people from entering the criminal justice system who have mental illness. This will necessarily mean conducting mental health assessments. Assessments will be conducted early on. If individuals are then soon determined incompetent to proceed, they will be referred for jail based treatment (if that’s a possibility) or to community resources for restoration services.&nbsp; That’s in the second bill. We want to get the local community behavioral health providers to be part of a safety net.&nbsp; There are 15 or 20 of those around the state.&nbsp; This is so people can get treatment rather than go to jail.&nbsp; It’s a way to try and stitch them all together in a comprehensive network to provide services.&nbsp;</p>



<p><em>What is in Competency Bill Number Three?</em></p>



<p>Bill Number Three is to prioritize community treatment for people with serious mental illness or intellectual or developmental disabilities.&nbsp; It is to get people determined incompetent to proceed into programs for restoration of competency.&nbsp; Restoration is a legal term dealing with being able to understand how the legal system works.&nbsp; It isn’t restoration to full robust mental health.&nbsp; It’s not that because some of those people aren’t going to get to that point.&nbsp; It is designed to get them to the point where they understand what’s going on in the legal system. They commit some minor offense. They are doing things which may be quote, “criminal,” but which are fairly benign: peeing in the park, minor destruction of property, cursing and interfering with law enforcement. They’re not restorable in a foreseeable period of time.&nbsp; How long are you going to keep them in jail?&nbsp; Right now in Colorado you can’t keep them in jail longer than what their sentence would be if found guilty.&nbsp; But that’s way too long. Those people don’t belong in jail.&nbsp; They need community mental health resources.&nbsp;</p>



<p><em>Do you think judges will be amenable to letting people out of jail to receive restoration in the community?</em></p>



<p>I think they will.&nbsp; I think the key is for judges to feel comfortable that the people they are releasing are not a danger to the community.&nbsp; That will be predicated on having appropriate risk assessments.&nbsp; What will enhance the judges’ comfort level is to have a professional evaluator sit down and talk to them about what conditions might be appropriate to release them under.</p>



<p><em>What systemic changes do you think will result from these bills?</em></p>



<p>Hopefully, overall they will reduce the number of people languishing in county jails.&nbsp; To me, that’s a huge systemic change.&nbsp; We want to put money into evaluation, restoration, and treatment. That’s what we are going to do.&nbsp; We need to help people who are struggling with these kinds of conditions.</p>



<hr class="wp-block-separator"/>



<div class="wp-block-image"><figure class="alignleft"><img loading="lazy" decoding="async" width="300" height="150" src="http://www.advocacydenver.org/wp-content/uploads/2016/08/AD_-Strode_DSC_8208-copy-300x150.jpg" alt="Catherine Strode" class="wp-image-3392" srcset="https://www.advocacydenver.org/wp-content/uploads/2016/08/AD_-Strode_DSC_8208-copy-300x150.jpg 300w, https://www.advocacydenver.org/wp-content/uploads/2016/08/AD_-Strode_DSC_8208-copy-600x300.jpg 600w, https://www.advocacydenver.org/wp-content/uploads/2016/08/AD_-Strode_DSC_8208-copy-768x384.jpg 768w, https://www.advocacydenver.org/wp-content/uploads/2016/08/AD_-Strode_DSC_8208-copy-1024x512.jpg 1024w, https://www.advocacydenver.org/wp-content/uploads/2016/08/AD_-Strode_DSC_8208-copy.jpg 1200w" sizes="auto, (max-width: 300px) 100vw, 300px" /></figure></div>



<p>Catherine Strode is Advocacy Denver&#8217;s Communications and Policy Specialist.&nbsp; She holds a Masters&nbsp;degree in Public Administration with an emphasis in Health Care Policy. Catherine publishes&nbsp;Policy Perspective,&nbsp;featuring interviews with state policy makers on issues that affect the work and mission of Advocacy Denver.</p>
<p>The post <a href="https://www.advocacydenver.org/mental-health-competency-addressed-in-criminal-justice-bills/">Mental Health Competency Addressed In Criminal Justice Bills</a> appeared first on <a href="https://www.advocacydenver.org">AdvocacyDenver</a>.</p>
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		<title>Bipartisan Support to Combat Colorado’s Youth Mental Health Crisis</title>
		<link>https://www.advocacydenver.org/bipartisan-support-to-combat-youth-mental-health-crisis/</link>
		
		<dc:creator><![CDATA[Catherine Strode]]></dc:creator>
		<pubDate>Thu, 28 Mar 2019 21:00:05 +0000</pubDate>
				<category><![CDATA[Interview]]></category>
		<category><![CDATA[Juvenile Justice]]></category>
		<category><![CDATA[Mental Health]]></category>
		<category><![CDATA[Policy Perspective - Interviews with Policy Makers]]></category>
		<guid isPermaLink="false">https://www.advocacydenver.org/?p=6109</guid>

					<description><![CDATA[<p>An Interview with Catherine Strode Democrat Rhonda Fields and Republican Lois Landgraf are each sponsoring the same bill, in the State Senate and in the House, to fight the rising youth suicide rate in Colorado. Senate Bill 19-195, Child and Youth Behavioral Health System Enhancements, creates a policy office and a commission to direct, coordinate, [&#8230;]</p>
<p>The post <a href="https://www.advocacydenver.org/bipartisan-support-to-combat-youth-mental-health-crisis/">Bipartisan Support to Combat Colorado’s Youth Mental Health Crisis</a> appeared first on <a href="https://www.advocacydenver.org">AdvocacyDenver</a>.</p>
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<div class="wp-block-image"><figure class="aligncenter is-resized"><img loading="lazy" decoding="async" src="https://www.advocacydenver.org/wp-content/uploads/2018/04/colorado-state-senator-rhonda-fields.jpg" alt="Colorado State Senator Rhonda Fields, Senate District 29" class="wp-image-4928" width="200" height="300" srcset="https://www.advocacydenver.org/wp-content/uploads/2018/04/colorado-state-senator-rhonda-fields-200x300@2x.jpg 400w, https://www.advocacydenver.org/wp-content/uploads/2018/04/colorado-state-senator-rhonda-fields-200x300.jpg 200w" sizes="auto, (max-width: 200px) 100vw, 200px" /><figcaption>Colorado State Senator Rhonda Fields, Senate District 29</figcaption></figure></div>



<div class="wp-block-image"><figure class="aligncenter"><img loading="lazy" decoding="async" width="200" height="300" src="https://www.advocacydenver.org/wp-content/uploads/2018/02/2018a_rsz_landgraf-c-17.jpg" alt="Colorado State Representative Lois Landgraf, House District 21" class="wp-image-4768"/><figcaption>Colorado State Representative Lois Landgraf, House District 21</figcaption></figure></div>
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<div class="wp-block-column is-layout-flow wp-block-column-is-layout-flow">
<p><em>An Interview with Catherine Strode</em></p>



<p>Democrat Rhonda Fields and Republican Lois Landgraf are each sponsoring the same bill, in the State Senate and in the House, to fight the rising youth suicide rate in Colorado.  Senate Bill 19-195, Child and Youth Behavioral Health System Enhancements, creates a policy office and a commission to direct, coordinate, and implement children’s behavioral health services across various state agencies. </p>



<p>The bill also provides for standardized behavioral health screening tools for children and wraparound services. Both legislators say wraparound services will reduce the need for facility-based care and out-of-home placements.  In addition to addressing the youth mental health crisis, they agree that the bill will result in significant cost savings to the state. Moreover, it will save lives.</p>
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<p><em>How do you characterize the state of mental health for children in Colorado?</em></p>



<p><strong>Senator Fields (Senate Sponsor):</strong></p>



<p>Colorado is experiencing a mental health crisis as it relates to our children and youth.&nbsp; The indicators for that would be the increased number of teen suicides.&nbsp; For kids between the ages of 10 and 24, the highest rate of death for them is suicide. That is a Colorado statistic.&nbsp; The health survey that kids take says, ‘Kids are feeling sad for more than two weeks in the past 12 months.’&nbsp; We have a tremendous number of kids who are feeling sad while in school.&nbsp; What is causing that sadness? &nbsp;We don’t know.&nbsp; Kids are dealing with all kinds of gender identification issues and bullying. &nbsp;&nbsp;&nbsp;We know kids at risk have issues of income insecurity and food insecurity.&nbsp; It has a lot to do with poverty. &nbsp;If you are living in a neighborhood, where there are concentrated areas of crime, violence, and poverty all of that is going to impact a child’s behavioral health.</p>



<p><em>Why is the bill necessary?</em></p>



<p>Our youth, our kids, our families need a system of care coordination.  Our kids are falling through the cracks because they are not identified early if they have a behavioral health issue.  Typically, what might happen is a kid might be defiant or acting out in school, they get expelled or suspended and their families later find out that they had a behavioral health issue.  If we could start identifying kids who are experiencing issues, like depression, early on, we could start coordinating wrap around services.  We could save lives.  Far too many kids are committing suicide and/or are experiencing issues of addiction. What happens in our state agencies is we have pockets of different departments doing a variety of different things.  If we can have one-person work across the state within our state organizations to find ways to be much more efficient in our delivery of care for kids, we can save lives.</p>



<p><em>How will this bill specifically impact the youth mental health crisis?</em></p>



<p>Right now, our coordination of care is disjointed.&nbsp; You have people operating as independent departments. You have a criminal justice system that is working with juveniles.&nbsp; You have a welfare system that is dealing with youth.&nbsp; You have school systems dealing with kids and the trauma they bring into the classroom every day.&nbsp; You have hospitals dealing with an increased number of kids with attempted suicides. We need to have more of a coordinated approach when dealing with behavioral health and our kids. One part of the bill is to have a Commission that looks at all the different delivery resources available for behavioral health. &nbsp;Where is there duplication? &nbsp;What are the trends they’re seeing? &nbsp;What kinds of resolution can be tied to problems?&nbsp;&nbsp; It is an action orientated Commission. &nbsp;If we have someone looking at this on a larger strategic scale, I think we would see that crisis number go down.</p>



<p><em>How important is the bill’s implementation of wraparound services?</em></p>



<p><strong>Representative Landgraf (House Sponsor):</strong></p>



<p>Colorado taxpayers are spending hundreds of millions of dollars across a range of intensive services. These include: Medicaid inpatient stays in hospitals, emergency department visits, residential treatment, expensive psychotropic medication, child welfare, juvenile justice and supports in the K through 12 school system. &nbsp;With these kids, it’s often a multiple number of entities that are involved from schools to inpatient treatment and everything in between. &nbsp;Kids are not getting proper treatment but we are paying for it. &nbsp;Or, they are languishing because there’s no place for the child to go. Wraparound services should reduce the need for residential treatment. If you can figure out what the problem is, you can avoid some of these things.&nbsp; This bill saves money by providing the proper treatment instead of a shotgun approach.</p>



<p><em>How much is the fiscal note?</em></p>



<p>It’s about 1.3 million. &nbsp;A large part of that amount is coming from the federal government.&nbsp; It is not all coming from the General Fund.&nbsp; About $500,000 of that will come from the state. You can’t put a price on a kid.&nbsp; When you think about the number of children who have problems, if you divide 1.3 million among all those kids, it’s nothing. Colorado right now is one of the worse states in the nation for kids with mental health issues. &nbsp;We’re at the bottom, because of lack of mental health services, lack of wraparound services, lack of recognition. &nbsp;We have to make a change so kids get the right diagnosis and the right treatment.&nbsp; When they don’t get that treatment early, by the time they do get it, they are too far gone. This bill can take Colorado from being one of the lowest states in helping children with behavioral health issues to being one of the best states in the country.</p>



<p><em>Is the high youth suicide rate the reason you have thrown your support behind this bill?</em></p>



<p>Suicide is the startling point of the whole conversation, but suicide is not the only point of the conversation.&nbsp; We’re trying to help kids who maybe will never be suicidal but have behavioral health problems. Maybe they don’t want to kill themselves but they want to kill somebody else. &nbsp;They will end up in jail. &nbsp;We want to avoid all of that.&nbsp; I think Colorado should be the state that does not fail its kids.&nbsp; We are a beautiful state and we have a lot to offer.&nbsp; We need to have this to offer too. &nbsp;</p>



<hr class="wp-block-separator"/>



<div class="wp-block-image"><figure class="alignleft"><img loading="lazy" decoding="async" width="300" height="150" src="http://www.advocacydenver.org/wp-content/uploads/2016/08/AD_-Strode_DSC_8208-copy-300x150.jpg" alt="Catherine Strode" class="wp-image-3392" srcset="https://www.advocacydenver.org/wp-content/uploads/2016/08/AD_-Strode_DSC_8208-copy-300x150.jpg 300w, https://www.advocacydenver.org/wp-content/uploads/2016/08/AD_-Strode_DSC_8208-copy-600x300.jpg 600w, https://www.advocacydenver.org/wp-content/uploads/2016/08/AD_-Strode_DSC_8208-copy-768x384.jpg 768w, https://www.advocacydenver.org/wp-content/uploads/2016/08/AD_-Strode_DSC_8208-copy-1024x512.jpg 1024w, https://www.advocacydenver.org/wp-content/uploads/2016/08/AD_-Strode_DSC_8208-copy.jpg 1200w" sizes="auto, (max-width: 300px) 100vw, 300px" /></figure></div>



<p>Catherine Strode is Advocacy Denver&#8217;s Communications and Policy Specialist.&nbsp; She holds a Masters&nbsp;degree in Public Administration with an emphasis in Health Care Policy. Catherine publishes&nbsp;Policy Perspective,&nbsp;featuring interviews with state policy makers on issues that affect the work and mission of Advocacy Denver.</p>
<p>The post <a href="https://www.advocacydenver.org/bipartisan-support-to-combat-youth-mental-health-crisis/">Bipartisan Support to Combat Colorado’s Youth Mental Health Crisis</a> appeared first on <a href="https://www.advocacydenver.org">AdvocacyDenver</a>.</p>
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