The Center Collaborative Podcast Archive

Diane Scottaline, Executive Director of The Arc of Benton County, and Members of The Arc of Benton County, John and Cody, discuss:

What kinds of disabilities are included in this population?

Why is the community experiencing I/DD considered a hidden population regarding the intersection of behavioral health and criminal justice?

The importance of providing accommodations, not just services.

The use of CommCards to support communication and accommodation in educational, medical, and legal settings.

For more information about the intersection between criminal justice and behavioral health in Oregon, please reach out to us through our website or Facebook page. We’d love to hear from you.

Danielle Hanson, Oregon Judicial Department Statewide Specialty Court Coordinator, discusses:

What are treatment/speciality courts?

How do they work?

How do they change lives?

Why is it important to adhere to evidence based practice?

How have the courts adapted to COVID?

Stan Gilbert, Klamath Basin Behavioral Health (KBBH) Executive Director, discusses how collaboration with community stakeholders has resulted in the following innovations:

Behavioral Health embedded in the Community Corrections office, resulting in same day warm handoffs to behavioral health staff upon first check in upon release from prison/jail;

KBBH’s certification as a yoga studio, so therapists can be certified in yoga for bodywork for trauma work;

KBBH’s certification as a Certified Community Behavioral Health Center (CCBHC), which has been a gamechanger for funding, and thus has fueled more innovations; and

Klamath County stakeholders’ commitment to braided funding to support the upcoming sobering center.

Commissioner Sharon Meieran, Multnomah County Commissioner, lawyer, and ER doctor discusses:

What fuels her passion for her work around behavioral health as a commissioner and an ER doctor;

The importance of intervening upstream and meeting people where they are when providing behavioral health and wraparound services, as well as the importance of engaging people with lived experience while designing interventions;

How Sequential Intercept Mapping (SIM) helps identify gaps, opportunities, and duplications within the behavioral health and criminal justice systems; and

New programs in Multnomah County: provider-based crisis response; a no wrong door crisis center with drop off or walk in to access services; a resource and respite center with peers to meet people where they are along with a mental health based shelter and longer term transitional housing.

Ross Acker, Advanced Health CCO Director of Coordinated Care & a Licensed Professional Counselor; Megan Ridle, Coos Health and Wellness Brief Treatment Crisis Services Manager & a Licensed Professional Counselor; and Kelley Andrews, Retired Coos County Sheriff Office Captain discuss:

Building relationships with partners from the ground up;

The evolution of partnerships and programs within Coos County;

The importance of CIT being about relationships and not just a training;

Coos County’s work on starting a sobering center; and

Discussion of cases that highlight the importance of behavioral health and law enforcement working together.

Ann-Marie Bandfield, Manager of Crisis Services for Marion County Health and Human Services, discusses:

How Marion County’s 24/7 Psychiatric Crisis Center (PCC), which just celebrated its 25 year anniversary in August 2020, got started and how it focuses on community based services;

The business culture focusing on compassion and welcoming service, as well as building trust over time with consumers;

Thinking outside the box regarding small steps to support psychiatric and social stability; and

Starting small to build services over time within the community.

Judge Pat Wolke, Josephine County Mental Health Court Judge; Co-Chair of the Workgroup to Decriminalize Mental Illness; and Member of the Chief Justice’s Behavioral Health Advisory Committee discusses:

His work to strengthen the pathways into the civil system as a diversion from the criminal justice system, particularly in regards to civil commitment and assisted outpatient treatment (AOT).

Provides clarity about what AOT is and how it can be useful.

The connection between the difficulty around the civil process and fitness to proceed numbers.

The importance of mental health courts in changing people’s lives while supporting public safety.

Juliet Britton, Beaverton Municipal Court Presiding Judge, discusses:

The importance of addressing concerns early with repeated low level crimes to connect people to services to support long term stability and decrease recidivism in the future at the municipal court level;

The Mental Health Liaison position at the court - a clinician in court to provide coordination and connection to civil services and housing, which has lowered the court’s failure to appear rate and is showing a promising reduction in recidivism rates;

The comfort dog program for court participants and for staff through a partnership with Dove Lewis. Dogs in court (virtual and in-person) increase feelings of calm and relaxation with participants who are coping with significant symptoms and trauma history. The dogs are also brought in for staff as a way to promote staff wellness within a stressful work environment; and

Beaverton Police Department’s Community Policing Program and their collaboration with the court. Police build rapport with participants in the community and take the time to have conversations with participants to support their involvement in programming and the court.

Captain Lee Eby, Clackamas County Jail Commander; and Galli Murray, Clackamas County Health, Housing, and Human Services Suicide Prevention Coordinator discuss:

Collaborative mapping of the incarceration process and data collection to uncover opportunities for improvements to the system;
Common myths about suicide;
The impact of suicide on fellow Adult In Custody (AIC) and the staff, as well as to the loved ones of the person who died;
Normalizing talking about suicide; and
An improved screening process for suicide.

NOTE: Please listen to episode #9 to hear part one of this interview.

Captain Lee Eby, Clackamas County Jail Commander; and Galli Murray, Clackamas County Health, Housing, and Human Services Suicide Prevention Coordinator discuss:

Re-screening at the 2 week mark using the Adult In Custody’s (AIC) tablet. This volunteer screening works great for people who are hesitant to talk, but will respond to electronic questions. The tool automatically sends alerts so the AIC can be seen by behavioral health;
Increased communication in the institution for AICs- brochures, information on ID cards, posters, orientation video;
AIC’s free access to the Clackamas County Crisis Line;
Increased communication with loved ones - jail website, posters in visiting, and the message loved ones hear when they call to talk to AICs;
Enhanced training for staff;
The new Behavioral Health Discharge Planner position, which coordinates continuity of care for AICs upon release; and
The importance of a robust staff wellness program.

Ari Wagner, Chief Operating Officer for Greater Oregon Behavioral Health, Inc (GOBHI) and the Director of Operations which is the department that OCBHJI is under discusses:

Ari’s position as the first juvenile justice researcher in Oregon and the significant role she played in determining the recidivism rate for juvenile offenders, as well as development of a risk assessment tool to help determine placement within the system;

How the juvenile system is different from the adult system and how a majority of youth in the system receive treatment in the community instead of within an institution;

The importance of preventing juveniles from further penetration into the criminal justice system by encouraging treatment engagement while supporting public safety; and

We also discuss the risk factors for juvenile criminal behavior, how that informs treatments, and some of the factors that must be addressed to help a youth engage in treatment.

Ari Wagner, Chief Operating Officer for Greater Oregon Behavioral Health, Inc (GOBHI), discusses:

Why scaring, educating, and exercising someone out of crime doesn’t work;

Exposure to childhood trauma as a risk factor for engagement in the criminal justice system and the importance of one stable and supportive adult in a child’s life as a protective factor;

Juvenile SIM work at The Center;

The importance of looking at the data and asking questions around over representation in the juvenile justice system, so changes can be made; and

Ari’s book about the juvenile justice system, “Dispatches from Juvenile Hall: Fixing a Failing System” under the name Linda Wagner.

Terry Schroeder, OHA Civil Commitment Coordinator within the Certification, Licensure, and Technical Assistance Department discusses:

What civil commitment looks like in the state of Oregon;

Civil commitment placements within the continuum of care, not just at the state hospital;

What is considered at different steps within the civil commitment process;

The emphasis on due process and voluntary engagement in treatment;

The importance of coordinated work between law enforcement and the crisis worker;

The sticking point in switching lanes between the forensic track and the civil track;

What the crisis worker and physician consider for holds;

Who is the investigator and what are they responsible for;

The impact of vicarious trauma on crisis workers & the importance of self care and postvention interventions.

Terry Schroeder, OHA Civil Commitment Coordinator within the Certification, Licensure, and Technical Assistance Department discusses:

Who is the examiner and what do they do in the process;

What the bar is for an initial commitment versus if there is expanded criteria;

The nuance around if someone is willing and able to participate voluntarily in treatment;

Assisted Outpatient Treatment (AOT) - What is the bar? What is the process?;

The importance of meaningful treatment; and

The importance of families continuing to reach out for help.

Judge Suzanne Chanti & Judge Nan Waller, Circuit Courts Judges and Co-chairs of the Chief Justice’s Behavioral Health Advisory Committee (BHAC) discuss:

The definition of procedural justice, which is also known as procedural fairness;

The importance of slowing down and using plain language, listening, and involving people in the court process;

How this folds into trauma informed processes;

The importance of the judicial system being aware of and suppressing their personal biases and values;

Cultural Competency;

Mindfully incorporating procedural fairness into the courtroom and throughout the courthouse;

Reaching out on a human level; and

Vicarious trauma in the courtroom.

Judge Suzanne Chanti & Judge Nan Waller, Circuit Courts Judges and Co-chairs of the Chief Justice’s Behavioral Health Advisory Committee (BHAC) discuss:

Stigma, lack of resources, and the impact on procedural justice;
The role of a compassionate community in changing the system;
Building in flexibility to meet people where they are with the acknowledgement of the barriers they face;
Engaging treatment courts (speciality courts) participants in their vision of a meaningful life and building hope to support behavior change; and
The momentum for change within Oregon and OJD’s Behavioral Health Advisory Committee (BHAC) work.

Kevin Fitts, Executive Director of the Oregon Mental Health Consumers Association discusses:

The focus of the Oregon Mental Health Consumers Association;
The importance of the voices of people with lived experience at the table;
The need for a tiered system to meet people where they are when they seek help before they are in crisis;
Peer respite to help bolster hope and meaning, support wellness, and build community; and
The recent passage of a bill at the legislature for four regional peer respite centers in Oregon. One of which will specialize in working with an underserved BIPOC community.

Kevin Fitts, Executive Director of the Oregon Mental Health Consumers Association discusses:

What peer respite centers provide to consumers;
Filling gaps by providing services that aren’t covered by Medicaid;
Redefining workloads in the system to include more peers;
The importance of peer voices within policy groups;
Building community and long term supports to bolster hope and support wellness;and
The need for damp and wet housing in Oregon

Dr. Ericia Leeper and Dr. Andrea Avila, Psychologists and Certified Forensic Evaluators, discuss:

How Psychiatric Advanced Directives, or as they are known in Oregon, Declarations of Mental Health Treatment (DMHTs) can direct treatment when a person is within a crisis;

DMHTs communicate in writing what treatment works or doesn't work for a consumer;

Consumers can appoint a trusted representative to carry out decisions outlined in the DMHT while the person is in crisis, but it ends when the crisis ends;

Anyone can talk about DMHTs with a consumer, but there are restrictions around who can be witnesses or representatives;

Dissemination of the DHMT is up to the consumer;

Supports continuity of care with the consumer's voice;

The research around DHMTs;

DMHTs as tools for supporting diversion from the criminal justice system; and

How to find the paperwork on the web.

Chris Bouneff, Executive Director of the Oregon Chapter of the National Alliance on Mental Illness (NAMI), discusses:

What does NAMI do?;

Examples of the education NAMI provides free of charge;

NAMI’s current proposal for a bill in the 2022 short session focusing on addressing wage gaps for those working in the behavioral health field;

Why we need to focus on closing the wage gap and providing more services concurrently – at the same time – instead of consecutively;

How guidelines and standardization can be incorporated into the behavioral health field to support service availability throughout Oregon for consumers;

NAMI’s partnership with Crisis Intervention Team (CIT) trainings; and

How to contact NAMI:
Phone: 503-230-8009 or 800-343-6264 (not a crisis line).
Website: https://namior.org

Edward Jones, retired Judge and former Interim Executive Director of Oregon Public Defense Services (OPDS) discusses:

What OPDS does;
Long-term consequences of felonies and misdemeanors;
How misdemeanors can snowball into more serious consequences;
Asking ourselves: is this the right approach for this problem? Is it a criminal justice issue? A public health issue?;
Just sending someone to jail doesn’t address the root issues of the behavior resulting in them to going to jail;
What we can do differently;
Disparities in treatment within the system; and
Thoughtful analysis regarding enforcement and behavior change versus habitual behavior.

Terry Schroeder, OHA Operation and Policy Analyst for the Certification and Licensure Department, and Jeffrey Gray, PhD, licensed psychologist, discuss:

An overview of the role of the mental health examiner as a friend of the court who provides clarification around clinical aspects of a civil commitment hearing;
Their role as a clarifier and a questioner – not just as an expert witness;
How this role is helpful to the judge;
Changes in the law regarding inability to care; and
The role of intent, impulsivity, and the person’s relationship to their symptoms when determining dangerousness.

Rod Harwood, Older Adult Coordinator for Greater Oregon Behavioral Health, Inc., discusses:

The growing aging population in the U.S.;
How Dementia impacts the senses and the brain;
Practical tips on how to provide accommodations when communicating with someone with Dementia;
The suicide rate among older adults;
What you can do to mitigate the impact of Dementia; and
The need to maintain connection and meaning throughout the lifespan.

Michelle Brandsma MS CADC III QMHP-C, Greater Oregon Behavioral Health, Inc. Substance Use Disorder/Trauma Informed Care Manager discusses:

Naloxone distribution program and how it saves lives by reversing narcotic overdoses (e.g., fentanyl or heroin)
Reducing the stigma of addiction
Medication Assisted Treatment as a medical intervention supporting the therapeutic intervention
Using peers to enhance engagement, build hope, and meet people where they are; and
The need for holistic treatment.

OCBHJI wanted to turn the usual approach to privacy law training (i.e., HIPAA and CFR 42, part 2) on its head - we didn’t find the typical training centered on jargon and what you can’t say very helpful and figured neither did you. The result is this privacy laws radio play presented via our podcast. The radio play focuses on scenarios to demonstrate what you can say, not just what you can’t say.

The Center collaborated with GOBHI employees while drafting the script and during production. We are excited to provide a tool that helps make privacy laws understandable, accessible, and, hopefully, somewhat entertaining.

Please note that these situations concern potentially sensitive topics in mental health crisis response. None of the characters in our narrative vignettes are based on real people or events—any similarity to actual people, living or dead, or actual events, is purely by chance.

To view a full transcript of this episode, visit https://www.ocbhji.org/privacy-laws

Contents:
3:54 Observable Behaviors
5:32 Information Outside the Clinical Setting
6:08 Law Enforcement is Not Constrained by HIPAA or Part 2
7:22 Minimum necessary information disclosure in a crisis situation
9:37 Disclosures with HIPAA vs CFR
12:41 Gunshot wounds, stabbings, and certain other physical injuries - 45 CFR 164.512 (f)(1)(i)
16:11 Identification and location purposes - 45 CFR 164.512 (f)(2)
18:43 Averting Harm - 45 CFR 164.512 (j)(1)(i)
24:14 Victim of a Crime - 45 CFR 164.512(f)(3)
26:36 Crime occurs on the premises - 45 CFR 164.512 (f)(5)
29:03 Crime away from the premises - 45CFR 164.512 (f)(6)
29:50 A Court order or court-ordered warrant - 45 CFR 164.512(f)(1)(ii)(A)-(B)
33:18 Administrative request or an administrative subpoena or investigative demand or other written request from a law enforcement official - 45 CFR 164.512(f)(1)(ii)(C)
35:30 Healthcare Facility Notification of Blood Alcohol Level or Presence of Cannabis or Controlled Substance in Blood - ORS 676.260
36:45 Mobile Crisis Call

Captain Lee Eby, Clackamas County Jail Commander; Cierra Brown, owner of the Metro Law Group and Member of the CIDC Consortium; and Dr. Alexander Millkey PsyD, Northwest Forensic Institute, discuss Clackamas County’s Rapid Process for “in-house” fitness evaluations:

This collaborative venture was born out of necessity after recognizing a 1,000% increase in individuals with SPMI being seen in the jail with a need for forensic evaluations to determine fitness to proceed.
Previous processes proved to be entirely too lengthy, and resulted in mental health decompensation because of the individual sitting in jail for too long, often on a low level violation, or misdemeanor crime.
The communication process between jail staff, defense, and medical/forensic creates a “frictionless environment.”
The collaborative nature of this process highlights the “inefficiencies in business as usual.” (Capt. Eby) It’s easy to find the inefficiencies once people start working together, and can solve those visible problems - like reaching low-hanging fruit.
The model includes giving Cierra Brown a jail access card after going through training. Having unfettered access to the jail continues the open-door policy and makes the flow of communication more efficient.
The judge is appointing Cierra Brown to cases with a mental health component from the bench. She can go to the jail to see clients, which removes transportation barriers, and she can request referrals for evaluation in the jail.
This process has cut down the time from arrest to evaluation from 37 days to 6.35.
It decreases the risk from transporting a person with significant mental health conditions from the jail to be evaluated and back again, saving costs for transportation and staff time.

Alton Harvey, Jr., CADC-I, Mentor, Public Defense Services Commissioner, and man in recovery discusses:

His story and what was helpful in his recovery; One man’s journey from addiction to inspiration. Alton’s personal journey and insights into the perspectives that helped him realize he was ready for recovery.
The important role of mentors, and how they can show a person a new way to live based on lived experiences. Supporting clients during their own personal process, and applying the evidence-based approach of harm reduction when needed.
Recognition of how meeting people where they’re at allows engagement at any point, and can help to motivate change prior to criminal justice involvement. This engagement approach can help to build trust with “the system”
Fostering connections based on shared or similar lived experiences, and recognizing how that knowledge differs from “book learning.”
A compassionate approach from treatment providers can help to “put the pieces of the puzzle together” for a person’s recovery.

Quinn Berry, MS, LPC, CACD-I, owner of Wallowa Health Services and Brandon Miller, CSWA, CADC-I, Wallowa Valley Center for Wellness Mental Health Therapist, Crisis Coordinator, and CIT Coordinator discuss:

Establishing a CIT program in a small community presents unique challenges, but also better opportunities for connections and trusting relationships between community partners. Building those relationships outside of the crisis situations pays dividends when the next crisis occurs.
Interactions with community members in a small community are different, as there will be ongoing interactions with the same individuals. Every call is somebody you know.
The CIT program is working to change the culture of first responders, moving away from the underlying belief that the expectation is to “toughen up and keep going.” Part of the local culture shift has involved the Fire Department. They have had regular debriefing sessions at the Fire Hall with a culturally competent counselor in order to process events and improve overall wellness. How having a background as law enforcement officers helps to make them more culturally competent mental health providers for first responders.
Promoting education such as Law Enforcement 101 for mental health clinicians helps to build relationships within CIT programs, as it broadens understanding of different perspectives.
Recognizing that Law Enforcement is part of the public health apparatus, as most community policing responses are service-related.
Experiencing a different order of magnitude of events makes it difficult to relate to others outside the profession, which impacts resiliency. Defining what resilience is and what it means for first responders.

Dr. John Gotchall, Pulmonary and Critical Care Doctor, The Arc of Benton County Justice Advocate, and The Arc of Benton County Board Member; Diane Scottaline, Executive Director of The Arc of Benton County; and Cody Gotchall, Self-Advocate and The Arc of Benton County Board member, discuss:

How a person receives services through the community Intellectual and Developmental Disability (IDD) services program, and how accommodations are accessed if a person doesn’t meet services criteria.
Accommodations are independent of county services, and the onus is typically on the individual who needs the accommodations to ask for them.
Accommodations are typically very low-cost, and “should be applied as generously and liberally as possible.”
Approximately 18% of Americans experience IDD, but only about 1.5-2% receive services.
Co-occurrence of mental health disorders along with IDD are very common, and if accommodations aren’t provided, mental health symptoms may be exacerbated.
How CommCards can identify communication impairments, express personalized accommodations, and can improve interactions between individuals with IDD and the justice system.
Distinctions between “soft” and “hard” accommodations, and how both are in-line with the ADA’s goals for nondiscrimination.
People with IDD tend to be victims more frequently as they are a vulnerable population. This should be considered during the adjudication process for people with disabilities in order to avoid disability bias and unconstitutional procedures.

Lane County Jail Captain Clint Riley and Sergeant Chuck Hardy, discuss:
Programming in jail started due to a desire to improve behavior of the Adults In Custody (AIC) through teaching new skill sets to address their behavioral health conditions, and thus providing a better environment for AIC’s and staff.
Multi-disciplinary team meets weekly to discuss the needs of the AIC’s and staff. The team can be assembled as needed for interventions.
Wellness and socialization program provides people with privileges before they’ve earned it. They have something to look forward to, but also something to lose. “People will rise to the level of expectation you set for them.”
There is no requirement for length of time in jail in order to participate in the program.
Working with AIC’s in a trauma-informed capacity is a mindset, not necessarily related to credentialing.
Providing SUD treatment and medication assisted treatment helps to make the community safer.
Peers teaching trauma-informed pro-social cognitive skills, like how to spend time sober, conveys the power of hope to AIC’s.
The jail levy makes the programming possible. It also increases the available jail beds, so AIC’s can be housed for the entire duration of their sentence, and can engage in the programming. The goal is a safer community, accountability, and for AIC’s to leave the jail better than how they arrived.

Kailee Evans, Oregon Department of Corrections Lead Correctional Counselor, Team Lead for the Peer Support Team, and CIT Coordinator for High Desert CIT, discusses:
History of the Memphis Model CIT curriculum development, and how she altered the format to fit within the corrections environment.
How the Oregon Way was developed through a partnership with the Norway prison system, and involved staff from the prison in Oregon traveling to Norway to learn about the different cultural approach.
The Oregon accountability process utilizes staff wellness to model prosocial behavior to the AIC’s in order to teach them how to react and behave by example.
99% of people in prison get released, so the more focus spent on rehabilitation, the better neighbors we will all have.
The Oregon Department of Corrections puts emphasis on staff wellness, and has added CIT and peer support to policy.
The 40-hour CIT training incorporates different methods, including utilizing real-life scenarios for role-plays in order to practice the skills learned.

Sue Goldberg, Senior Director Decision Support for Umpqua Health Alliance Coordinated Care Organization and Cheryl McDonald, Licensed Clinical Social Worker, Crisis Program Director for ADAPT Integrated Health Care discuss:

IMPACTS Grant can uniquely meet people’s previously unmet needs.
Grant covers 3 full-time outreach navigators, 1 part-time therapist housed in the E.D., 23-hour crisis resolution room, and a sobering center.
Doesn’t require cohort members to engage in treatment to receive program support.
Allow the cohort member to be the expert in their lived experience, and allow them to identify what they need to be stable.
Reducing recidivism by providing Law Enforcement options for diverting people to where they need to be, rather than incarcerating them due to lack of an appropriate treatment environment.
IMPACTS can fund services that aren't traditionally covered by insurances, such as peer support, phone calls, showers, clothing needs, food, etc.
Timely and thorough data is allowing better outreach and getting the correct people into the cohort.
Outcomes indicate a cost reduction in healthcare and jail costs for the individuals in the cohort (approximately 333).
Community support: It’s not all about the money - people’s lives have been changed.

Dr. Andrew Orf, partner of Lithia Forensic and Consulting LCC and a certified forensic evaluator, discusses:
Oregon began the certification for forensic evaluators in 2012 for fitness to proceed evaluations, and the courts now prefer Certified Forensic Evaluators for pre-adjudication services.
The level of nuance between evaluations, as it is combining the clinical perspective with the legal perspective.
The many clinical components to consider, such as neurocognitive conditions, personality disorders, or substance use.
Legal considerations for statutory evaluations are related to an individual’s intent. Evaluations are also conducted in order to determine if a person’s qualifying mental health disorder impacted their capacity to form intent.
The pressing need for more Certified Forensic Evaluators, as a lot of people are in correctional settings, and end up waiting for evaluations.
When people are acutely ill, there are few, if any places to send them for help, as the bar for civil commitment in Oregon is very high.
Rapid evaluations increase access, and timeliness in more rural areas, as the majority of certified evaluators are in the Portland, Eugene, and Salem areas. There is a collaborative effort between community mental health programs, district attorney, courts and the defense attorney to identify who needs a rapid evaluation.
Regular consultation with other evaluators is important for maintaining wellness as a clinician doing the evaluations day in and day out.
Certified Forensic Evaluators can conduct several different types of evaluations based on the requests from the court, such as: guilty except for insanity, juvenile waiver evaluations, risk assessments, mental health evaluations for qualification, neuropsychological evaluations, and civil evaluations.
People assume that evaluators are advocates, but they strive to be independent and ethical.
There are layers of complexity within human beings. People can have multiple underlying conditions that make it difficult to know a conclusive answer as to what drives behavior. Two well-trained, experienced evaluators can disagree on a diagnosis, and neither are necessarily wrong.
Nuanced and well thought-out evaluations are crucial due to the real world implications and ripple effects for people.
There is a vested interest from the general public because once the process is initiated, costs pile up. One day at the Oregon State Hospital for a person is over $1000.
Oregon is in a transitional phase with mental health conversations and legislature. It’s easy for everyone involved to point out the problems, but very hard to come up with solutions.

Holly Harris, LPC, Deschutes County Behavioral Health Director, and Sheriff L. Shane Nelson, Deschutes County Sheriff discuss:

The benefits of having a 24 hour walk-in crisis stabilization center with therapists on staff.
The stabilization center takes anyone unless there is a safety concern, and law enforcement can voluntarily drop people off in lieu of taking them to jail. The attitude is, “Coming from a place of yes.”
The staff can de-escalate situations early for people by providing basic needs - food, rest, shower, etc - so the crisis doesn’t escalate, and the person can stabilize.
Diverting people to services rather than taking them to jail makes the community and the jails safer.
The center opened during COVID, and staff wellness has been a focus through safety implementation, debriefing, the betterment committee, and being mission-driven. It creates psychological safety for both staff and clients.
The staff was provided with situational awareness and tactical training from law enforcement, and they rarely need to call police for back-up and initiate the involuntary process.
The stabilization center staff also provided training to law enforcement, but it's not just training - it's about the partnership, and creating the trust to be able to provide the best services for the clients.
The initial funding came through the sheriff’s department to start the project. The stabilization center later applied for, and received, funding from the IMPACTS grant.
Approximately 400 people were diverted from jail in one year, with an average of 1500 mental health calls. Having behavioral health taking the non-law enforcement response calls straight from dispatch to respond to behavioral health crisis situations has helped to save an estimated $75,000 in officer time.
Substance use goes hand-in-hand with the behavioral health problems, and won’t exclude a person from receiving services from the stabilization center.

We have reached the end of Season 3 on the Center Collaborative. Closing out this year, we’re bringing you a fascinating discussion about how professional peers are making a difference in first responder culture in Eastern Oregon.

Peer Coordinator Sergeant Tyler Reddington, Retired Firefighter and Department Chaplain Kevin Coleman, and Dr. Lindsay Tice PsyD, Clinical Psychologist, discuss:

Fire and police often experience the same traumatic events, which is why it made sense to collaborate on the peer program.
Undoing the old thought-process that traumatic events don’t affect all aspects of a first responders well-being.
After a series of traumatic events in the community had a clearly negative impact on the first responders, the need for more support was recognized.
First responders need a place to unload traumatic stress that doesn’t feel like they’re placing an undue burden on family and friends.
Trauma isn’t always a big event - it can be a result of the accumulation of traumatic stress from any area of a person’s life over time.
Peers are a sounding board, encouraging ongoing communication about stresses whether they’re related to the job or not.
If a person feels they would like more skills or help with processing trauma, they can be referred to Dr. Tice, who is culturally competent with first responder culture.
The Eastern Oregon Peer Team is adding peers to the team who have first-hand knowledge of an array of life experiences, for example, divorce.
They are also adding peers from additional agencies in the area to continue building cross-agency relationships.
The beginning shift in the resistance of the first responder culture to seeking support, as there is a level of understanding from peers. Seeking help and talking about stresses has been normalized during the culture shift.
Peers are required to complete a 3 day training to be certified, and also must sign a confidentiality agreement.
The peer team is working on relationship building with partner agencies by doing presentations, and hosting department breakfasts.
They are working to implement a call-tree to be dispatched out to trauma scenes in order to have a timely response to critical incidents to provide support to first-responders.
After experiencing a significant trauma incident, first responders should be treated as though they’ve been injured, and be allowed time to process the incident before going out on more calls. Not being allowed time to process critical incidents can result in reduced job performance, increased stress, and potentially, the development of PTSD.
A peer is a person who has had a similar experience who you can talk to about your experiences. Peers also have access to other resources, such as Dr. Tice, if a person needs them.