MOBILE OUTREACH SAFETY TEAM (MOST)
AND
FORENSIC ASSESSMENT SERVICES TRIAGE TEAM (FASTT)
Bekah Bock, LCSW
DPBH Rural Clinics
BACKGROUND…
• 1800’s- Individuals with mental illness in jails
• 1841- Dorothea Dix, journalist advocates for mental health hospitals
• 1960’s US deinstitutionalization of individuals with mental illness-
• Transitioning individuals with severe mental illness from long term psychiatric institutions
to the community
• Insufficient community supports lead to other types of institutionalization such as
incarceration
• In 44 states, more individuals are in single jail than the largest state psychiatric
hospital
• Largest mental health hospital in America- Cook County Jail in Chicago
CONSEQUENCES OF CRIMINALIZING MENTAL ILLNESS
• Individuals with mental illness on average:
• Have longer jail stays
• Have higher costs associated with incarceration
• Experience behavioral issues without treatment
• See symptoms of mental illness worsen without treatment
• Often don’t get connected to treatment upon release- revolving door
• Are more likely to be victimized
STEPPING UP INITIATIVE: DIVERSION OF INDIVIDUALS WITH MENTAL ILLNESS FROM THE CRIMINAL JUSTICE SYSTEM
STEPPING UP INITIATIVE PROGRESS IN NEVADA
CONNECTING INDIVIDUALS WITH COMMUNITY TREATMENT AND SERVICES
• Building initiatives to connect individuals with treatment to
break cycle of recidivism
• Successful treatment and community support
• Reduces disruptive, assaultive, self injurious behaviors in the
community
• Increases public safety
• Reduces public cost of repeat arrests and incarcerations
SEQUENTIAL INTERCEPT MODEL
“Predictable points of contact offering opportunities for intervention”
MOBILE OUTREACH SAFETY TEAM
• A clinician, law enforcement officer, (and
sometimes paramedic) team with the purpose of
providing community intervention and support to
individuals who are experiencing behavioral
health problems/ crisis
MOBILE OUTREACH SAFETY TEAM OBJECTIVES
• Respond to suicidal/ mentally ill subject calls for service.
• Respond to barricaded mentally ill individuals or other in-progress
mental illness related crisis situations.
• Follow-up on referrals generated by law enforcement, Mental Health
Court, mental health professionals, and emergency service workers.
• Outreach work with the mentally ill homeless population.
• Referral to community resources and connection with community
resource liaison
• Proactive work with known mental health clients to maintain proper
medication program compliance.
MOBILE OUTREACH SAFETY TEAM BENEFITS
• Jail and ER diversion
• Reduces call load for dispatch
• Reduces law enforcement contact time
• Increases public safety
• Community intervention and support for individuals in
chronic crisis
M.O.S.T. REFERRALS
1. To make a non-emergency referral for MOST :
2. Call dispatch
3. Tell dispatch you wish to make a MOST referral
4. Provide the following:
5. Your name, agency and contact information
6. Name of individual / individuals being referred
7. How the individuals can be contacted, i.e. address, phone number, etc.
8. Reason for referral: remember the more detail provided the better the
MOST Team will be able to maintain safety and provide adequate service
FASTT: FORENSIC ASSESSMENT SERVICES TRIAGE TEAM
• Treatment intervention and reentry program that is offered in
the county jail.
• Multi-disciplinary team from social services, mental health,
substance use providers
• Assesses the individual’s mental health, substance use, basic
needs, (housing, medical, employment, transportation), and risk of
reoffense.
FASTT BACKGROUND
• Carson City 2013-
• Partnership between State DPBH mental health, community
coalitions, and forensic director of Carson City Jail, Dr.
McEllistrem
• Replicated in Lyon and Douglas Counties, coming soon to
Churchill
• Spreading statewide
FASTT OBJECTIVE
• To reduce or eliminate reoffending and re-arrests by
coordinating to connect individuals with needed treatment
and services in the community
FASTT REFERRALS
• From deputies
• Judges
• Clinician assessing in jail
• Community providers
• Family members