treatment capacity in illinois wednesday, june 3 rd, 2015 1:00pm to 5:00pm commission on criminal...
TRANSCRIPT
Treatment Capacity in IllinoisWednesday, June 3rd, 2015
1:00pm to 5:00pm
Commission on Criminal Justice and Sentencing Reform
Introduction• What is the treatment capacity in Illinois?• For mental health?• For substance abuse?• For forensic population?
• Where are the resources located?
• What are the data limitations?
2
Mental Health Treatment Capacity
3
Mental Health Treatment Numbers in Illinois
Source: Illinois Department of Human Services, Illinois Mental Health 2013-2018 Strategic Plan; Dr. Anderson Freeman and DMH staff.
State HospitalsPrivate Hospitals
Incarceration (Prisons)
8,586 admissions to 1,324 beds in FY2012
113,781 admissions to 3,481 beds in 2010
11,300 with mental illness needs in FY2012
Incarceration (Jails)1,400 of the 9,600
inmates in Cook County Jail receive DMH-Funded
psychiatric services
State Community-Based136,047 receiving
treatment in FY2012
Private Community-BasedCurrently researching for
additional data
4
Psychiatric Hospital; 18;
4%
Separate inpa-tient psychiatric unit of a general
hospital; 58; 11%
Residential treatment center for children; 34;
7%
Residential treatment center
for adults; 88; 17%
Outpatient, day treatment or par-
tial hospitaliza-tion mental
health facility; 291; 57%
Multi-setting (non-hospital) mental health
facility; 23; 4%
Source: SPAC analysis of N-MHSS data, SAMHSA, 2010.
Illinois Mental Health Facilities by Type512 Respondents
5
Civil admissions and presentations (sent to hospital, may not end in admission), as well as total served, are down almost 40%.
Source: SPAC analysis of figures provided by Dr. Anderson Freeman and DMH staff. 6
2005 2006 2007 2008 2009 2010 2011 2012 2013 20140
2,000
4,000
6,000
8,000
10,000
12,000
14,000
Division of Mental Health State Hospital Services: Civil and Total
Unduplicated Count of Individuals Re-ceiving Services
Civil Admissions
Civil Presentations
Fiscal Year
• Illinois has 222 hospitals spanning 80 counties in Illinois.
• 22 counties do NOT have a hospital.
• 80 hospitals have authorized psychiatric beds, for a total of 3,927 authorized psychiatric beds.
• 52 counties do NOT have authorized psychiatric hospital beds.
• 28 counties have inpatient behavioral health providers.
• 75 counties do NOT have inpatient behavioral health providers .
• Over half of Illinois counties lack sufficient numbers of psychiatrists.
Source: Illinois Hospital Association, Facts & Figures, 2015. 7
Programs for Co-occuring Dis-
orders, 42%
No Co-occurring Programs,
58%
Percent of Facilities with Programs for Co-occurring Disorders
Special Programs in Illinois Mental Health Facilities
Source: SPAC analysis of N-MHSS data, SAMHSA, 2010. 8
Substance Abuse Treatment Capacity
9
Admissions of Chicago Residents to Publicly Funded Treatment Programs, by Primary
Substance: FY2007 – FY2012
FY2007 FY2009 FY2010 FY20120
5,000
10,000
15,000
20,000
25,000
30,000
CocaineHeroinCannabisAlcohol
Source: Dr. Larry Ouellet of UIC, data from the Illinois Department of Alcohol and Substance Abuse
Largest reduction: cocaine 66%
10
Declining Admissions for Substance Abuse
The number served declined over 21% since 2003.
Declining admissions do not mean declining need. 11
2003 2004 2005 2006 2007 2008 2009 2010 201165,000
70,000
75,000
80,000
85,000
90,000
95,000
Unduplicated Number Served For Alcohol and Substance Abuse
Fiscal Year
Source: Illinois Auditor General DHS Financial Audits.
2002 2003 2004 2005 2006 2007 2008 2009 2010 201130,000
32,500
35,000
37,500
40,000
42,500
45,000
47,50043,971
Number of Clients in Community-Based Treatment as of March 30th of Each Year
Source: N-SSATS Illinois State Profile, SAMHSA, 2002-2011.12
Geographic Distribution of Substance Abuse Treatment Facilities In Illinois
Source: N-SSATS Illinois State Profile, SAMHSA, 2011.
• 11 counties had no one respond to the survey.
• 638 facilities responded to a survey by the National Survey of Substance Abuse Treatment Services Survey (N-SSATS) out of 663 surveyed.
• Each red dot on the map represents one responding facility.
13
2002 2003 2004 2005 2006 2007 2008 2009 2010 20110
10,000
20,000
30,000
40,000
50,00040,687
3,014270
Patients by Type of Facility
Outpatient
Residential
Hospital Inpatient
2002 2003 2004 2005 2006 2007 2008 2009 2010 20110
100200300400500600700
Care Facilities by Type
OutpatientResidentialHospital Inpatient
Source: N-SSATS Illinois State Profile, SAMHSA, 2002-2011.14
2002 2003 2004 2005 2006 2007 2008 2009 2010 20110
10203040506070
Number of Illinois Facilities with Medi-cation-Assisted Treatment for Opioid
Dependence
Faci
lities
Source: N-SSATS Illinois State Profile, SAMHSA, 2002-2011.15
Source: N-SSATS Illinois State Profile, SAMHSA, 2002-2011.
2002 2003 2004 2005 2006 2007 2008 2009 2010 20110.0
1.0
2.0
3.0
4.0
5.0
6.0
7.0
8.0
6.3
1.4
3.4
Substance Abuse Treatment Rate per 1,000 Population
New YorkCaliforniaFloridaTexasIllinois
Per
son
s in
Tre
atm
ent p
er 1
,00
0 o
f Pop
ulat
ion
Treatment rate provides a metric to compare between states. Calculated by dividing the total number receiving treatment by the state population.
16
Source: N-SSATS Illinois State Profile, SAMHSA, 2002-2011.
20022003
20042005
20062007
20082009
20102011
0.0
1.0
2.0
3.0
4.0
5.0
6.0
7.0
8.0
IllinoisMissouriIndianaWisconsin
Per
son
s in
Tre
atm
ent p
er 1
,00
0 P
opul
atio
n
Treatment Rate Comparison With Regional States
17
Forensic Population
18
Forensic admissions to state mental health hospitals have increased 15% since 2005.
These admissions are for those found Unfit to Stand Trial (UST) or Not Guilty by Reason of Insanity (NGRI), and nearly 20% are for misdemeanor offenses.
Waiting list for admission is 80+ persons, with wait times 30 to 40 days.
Source: SPAC analysis of figures provided by Dr. Anderson Freeman and DMH staff. 19
2002 2003 2004 2005 2006 2007 2008 2009 2010 20110
50
100
150
200
250
300
350
400
163140
361
Number of Special Programs in Treatment Facilities
Co-occuring Disorder Criminal Justice clients DUI/DWI offenders
Source: N-SSATS Illinois State Profile, SAMHSA, 2002-2011.20
No67%
Yes19%
Un-known
13%
Forensic Programs in Illinois Mental Health Facilities
Source: SPAC analysis of N-MHSS data, SAMHSA, 2010. 21
Impact of Reduction
22
Impact on Mental Health Capacity
The Bureau of Justice Statistics estimates that 55% of male inmates and 73% of female inmates have mental health needs. Applying this estimate to the reduction goal of 12,000 means an additional 7,000 individuals accessing mental health treatment in the community.
That is a 5% increase over 2014 numbers. 23
Source: SPAC analysis of figures provided by Dr. Anderson Freeman and DMH staff.
2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 100,000
110,000
120,000
130,000
140,000
150,000
160,000
170,000
180,000
190,000
142197
135,197
Number of Individuals Receiving Community-Based Mental Health Treatment: Historical and Predicted
Fiscal Year
Impact on Substance Abuse Capacity
The Centers for Disease Control and Prevention estimates that 80% of inmates have substance abuse problems. Applying that to the reduction goal would mean 9,600 individuals will have substance abuse issues and will need community-based treatment.
That is a 21% increase in population served. 24Source: N-SSATS Illinois State Profile, SAMHSA, 2002-2011.
2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 20150
10,000
20,000
30,000
40,000
50,000
60,000 53571
Number in Substance Abuse Treatment: Historical and Predicted
Funding
25
Funding for DMH has decreased 10% since FY2005.
State appropriations to DHS has decreased 39% since 1998.
26
19981999
20002001
20022003
20042005
20062007
20082009
20102011
20122013
20140
1,000,000
2,000,000
3,000,000
4,000,000
5,000,000
6,000,000
State Appropriations to Department of Human Services (2015 Dollars)
App
ropr
iati
ons
Am
ount
(201
5 D
olla
rs)
FY05 FY06 FY07 FY08 FY09 FY10 FY11 FY12 FY13 FY14 FY150
100,000
200,000
300,000
400,000
500,000
600,000
700,000
800,000
900,000
Division of Mental Health Expenditures: (2015 Dollars)
Spen
t (20
15 D
olla
rs)
Source: SPAC analysis of figures provided by Dr. Anderson Freeman and DMH staff; Illinois Auditor General DHS Financial Audits
Medicaid
State Mental Health
State Child Welfare
US Veterans Admin
Private Insurance
Medicare
Other
0.0% 10.0% 20.0% 30.0% 40.0% 50.0% 60.0%
48.0%
26.5%
10.3%
4.6%
3.6%
2.0%
5.0%
Primary Funding Source in Illinois Mental Health Facilities
512 Facilities Surveyed in IllinoisOf 442 responses, 306 (69%) had one primary funding source that made up over half of their overall revenue.
Source: SPAC analysis of N-MHSS data, SAMHSA, 2010. 27
General Sources• This information is specific to the state of Illinois. • Information was gathered from: • Special thanks to Dr. Anderson Freeman and his staff at the Division of Mental Health
for their data on funding and numbers served.• Illinois Auditor General Financial Audits on Department of Human Services. • the National Survey of Substance Abuse Treatment Services (N-SSATS) Survey. This
annual survey collects information on all substance abuse facilities, including both alcohol and drug abuse, and in facilities private and public. They produce state profiles of their findings for 2002 through 2011, available on their website.
• the National Mental Health Services Survey (N-MHSS). Surveys all mental health facilities in US, both private and public, available for 2010.
• Both surveys are conducted by Substance Abuse and Mental Health Services Administration (SAMHSA).
• University of Illinois at Chicago (UIC) School of Public Health professor Larry Ouellette prepared the analysis of Illinois’ publicly-funded admissions for substance abuse.
• Illinois Hospital Association tallies the number of hospitals, authorized beds, and behavioral health providers by county across the state of Illinois.
• Other figures gathered from various sources such as the National Alliance on Mental Illness (NAMI), Illinois Department of Health Services, and Illinois Department of Public Health (Center for Rural Health). 28
References• Slide 4: Illinois Department of Human Services, Illinois Mental Health 2013-2018 Strategic Plan. Available
at: https://www.dhs.state.il.us/onenetlibrary/27897/documents/mental%20health/marysmith/strategicplan/mentalhealthservicesfiveyearstrategicplan2013.pdf, p.3 of Appendix B.
• Slide 7: Illinois Hospital Association. (2015). Facts & Figures. Available at: http://www.ihatoday.org/News-and-Reports/Facts-and-Figures/Maps.aspx
• Slide 7 map: Generated by IHA COMPdata informatics (April 02, 2014). Available at: http://www.ihatoday.org/uploadDocs/1/bhcountymap.pdf
• Slide 8: Estimate of comorbidity: National Institute on Drug Abuse. (2010). Comorbidity: Addiction and Other Mental Illnesses. Research Report Series. Available at https://www.drugabuse.gov/sites/default/files/rrcomorbidity.pdf
• Slides 8-9: Substance Abuse and Mental Health Services Administration (SAMHSA). (2010). National Mental Health Services Survey (N-MHSS). Available at: http://www.icpsr.umich.edu/icpsrweb/SAMHDA/studies/34945#datasetsSection
• Slide 12: Graph created by Dr. Larry Ouellet of UIC, with data from the Illinois Department of Alcohol and Substance Abuse.
• Slides 13-17: Substance Abuse and Mental Health Services Administration (SAMHSA). (2002-2011). National Survey of Substance Abuse Treatment Services (N-SSATS) State Profiles. Available at: http://wwwdasis.samhsa.gov/webt/tedsweb/tab_year.choose_year_state_profile?t_state=IL
• Slide 23: Estimate of mental health issues: Glaze, L.E. & James, D.J. (2006). Mental Health Problems of Prison and Jail Inmates. Bureau of Justice Statistics Special Report. Available at http://www.bjs.gov/index.cfm?ty=pbdetail&iid=789.
• Slide 24: Estimate of 80% with substance abuse issues from CDC report. U.S. Centers for Disease Control and Prevention, Substance Abuse Treatment for Drug Users in the Criminal Justice System, (Aug. 2001), available at: http://www.cdc.gov/idu/facts/cj-satreat.pdf 29