Over the past year we have been working with the Chambers County Commission to develop a program to address mental health issues in our local jails. Thanks to our County Commissioners and East Alabama Mental Health great strides have been made in getting this program going. With May being Mental Health awareness month, we thought this would be a good time to share what this program is about. Below is an article by Jessica Driggers of the local Stepping Up program telling you just that.

The Need for the Stepping Up Initiative

Approximately two million times each year, people who have serious mental illnesses are admitted to jails across the nation. Almost three-quarters of these adults have drug and alcohol use problems. The Stepping Up Initiative is a national program with the goal to reduce the number of individuals in jails with mental illness. It is managed at the county level to establish effective partnerships across individuals in law enforcement, local governmental entities, elected officials, mental health and healthcare providers, courts, and any others needed to meet the goal.  

Currently fifteen counties in Alabama have passed the Stepping Up resolution, along with 498 counties in the nation, to work with local law enforcement, mental health providers and advocates. They have committed to create a data-driven, systems-level plan to reduce the prevalence of mental illness in their jails and improve outcomes for people with mental illnesses in their communities.  

If continued progress is made and an investment by all partners is sustained, communities can benefit from:  

In September 2019, ADMH offered a grant opportunity to community mental health centers to expand Stepping Up in our state.  

The awardees for fiscal year 2019 were:

• Wellstone Behavioral Health: Madison County and Cullman locations 
• Mental Health Board of Chilton and Shelby Counties, Inc. 
• Cherokee-Etowah-Dekalb Mental Health Center 
• Marshall-Jackson Mental Health Board. Inc. 
• Mental Health Center of North Central Alabama Inc. 

The awardees for the fiscal year 2020 are: 

• AltaPointe Health
• East Alabama Mental Health Center
• Indian Rivers Mental Health Center;
• Mental Health Center of North Alabama Inc.
• West Alabama Mental Health Center

The Stepping Up programs from each area have made presentations to numerous entities in their communities to develop partnerships that enable Stepping Up to expand. The groups presented to and in partnership with the awardees range from the county commission, police department, sheriff’s office and local jails, specialty courts and probate judges, county corrections, District Attorney’s office, Public Defender’s office, advocacy organizations such as NAMI Alabama and Recovery Oriented Peer Specialists and local hospitals.  

Examples of Work:  

Wellstone Behavioral Health in Cullman, a case manager works with local hospital and county jail to help identify persons with a serious mental health illness or addiction and find relevant services. The case manager has successfully linked clients to treatment, housing, and crisis resources, helping to reduce their rate of return to emergency rooms.  

Wellstone Behavioral Health in Madison County’s relationship with the local hospital has improved because Stepping Up creates partnerships that make each other more aware of individuals’ needs. When individuals who are in need are receiving case management services from partners like Wellstone, they are less likely to be involved with the justice system. For example, the hospital had an individual with depression and suicidal thoughts, visiting three times a month, every year for three years, after losing his mother. His ER visits would often turn into lengthy hospital stays. In 2019, he enrolled with Wellstone and he has not been back to the emergency room. He is now seeing a mental health clinician consistently.  

At the Chilton Shelby Mental Health Center, task force and needs assessment meetings have been held to identify outcome measures and measurable objectives. The case manager at Chilton Shelby also works to create better outcomes for the individuals in the criminal justice system.  

All inmates booked into jail now receive screenings for mental health and substance use issues allowing for appropriate referrals for assessment and treatment options. 

The Cherokee-Etowah-Dekalb Mental Health Center’s case manager has completed several crisis intervention services inside of the jail as well as traveled with officers into the field to perform crisis intervention services. Having a case manager dedicated to working with law enforcement and the hospital has helped to cut down response time and give a presence in the court room for court officials to see mental health in action. Case managers also assist individuals when they are ready to return to their communities. In 2018, a young man was being released from incarceration, however he had no income nor housing to return to. The case manager was able to guide the individual in the direction to secure disability and housing.  

Mountain Lakes Behavioral Healthcare of Marshall-Jackson Mental Health Board. Inc. hired a case manager to kickstart their Stepping Up program and since its implementation, the work has brought to light many of the ways that people who are seriously mentally ill are falling through the cracks of the system. The program for the county encourages partnerships with the Highlands Medical Center, Jackson County Jail, Jackson County Probate Office, and Jackson County Sherriff’s office. The case manager helps to identify individuals in need and they are then connected with the appropriate level of care needed. The program has assisted in giving the court system and hospital one “go to” person allowing for a simplified process. 

At the Mental Health Center of North Central Alabama, referrals are received from the Morgan County Jail, Morgan County Circuit and District Courts, Decatur Municipal Court, and Decatur Morgan Hospital staff to their Stepping Up program. The case manager assists with the timely linkage to resources and monitors individuals who are referred to the program. Since the inception of Stepping Up in Morgan County, over 50 people have been referred and more than 20 have been directly assisted by the case manager with mental health and substance abuse services.  

Here in Chambers County, we are in the early stages of implementing this program. Looking at what is being accomplished across the state and throughout the country through Stepping Up excites us about the impact on local lives and families we have in our future.