Subcommittee Co-Chairs:

Hon. Audie Rowe
Cook County Commissioner

Hon. Jasper Watkins
Gwinnett County Commissioner

Objective: To identify the ways in which local law enforcement agencies, 9-1-1 Centers, and EMS providers can contribute to the de-escalation of mental health crisis situations.

Recommended Best Practices

Best Practice 1: Implement Crisis Intervention Team (CIT) Training

Crisis Intervention Training (CIT) programs provide specialized training to assist law enforcement officers with identifying mental health issues, de-escalation techniques, and appropriate responses. A study published in the Psychiatric Services Journal in 2015, found that law enforcement officers trained in CIT programs had improved knowledge, attitudes, and skills related to mental health crises. CIT-trained officers were also found to be less likely to arrest individuals in crisis and more likely to divert them to mental health services, reducing the likelihood of unnecessary incarceration.

Best Practice 2: Enhance Interagency Collaboration

There is a tremendous benefit in conducting joint training sessions and establishing clear communication protocols for information sharing. The Substance Abuse and Mental Health Services Administration (SAMHSA) has reported that coordinated and collaborative responses involving law enforcement, mental health agencies, and emergency services lead to reduced arrests, decreased hospitalization rates, and improved outcomes for individuals in crisis. Collaborative efforts facilitate more timely access to appropriate mental health services, reducing the strain on emergency departments and the criminal justice system.

Best Practice 3: Establish Mobile Crisis Teams

These mobile crisis teams can respond alongside or independently of law enforcement, providing on-site mental health assessments, crisis intervention, and referrals to appropriate services. Mobile crisis teams offer a more nuanced and compassionate approach to individuals in crisis, diverting them from the criminal justice system when appropriate.

A study conducted by the University of Memphis Crisis Intervention Team Center found that mobile crisis intervention teams significantly reduced the number of individuals with mental illness arrested and the number of emergency room visits. The presence of mental health professionals on these teams resulted in more appropriate and targeted interventions, reducing the burden on law enforcement and emergency services.

Best Practice 4: Promote Mental Health First Aid Training

Mental Health First Aid equips individuals with the skills to recognize signs of mental health issues, provide initial help, and guide the person toward appropriate professional support. This knowledge can be invaluable in de-escalating situations and connecting individuals with the right resources.

Studies have shown that Mental Health First Aid training programs enhance mental health literacy, reduce stigmatizing attitudes, and increase helping behaviors. A study in 2023 found that individuals trained in Mental Health First Aid demonstrated improved knowledge and confidence in assisting individuals with mental health problems.

Best Practice 5: Develop Clear Protocols for Mental Health Crisis Calls

Develop and disseminate clear protocols for handling mental health crisis calls within the 911 centers. Ensure that 911 operators have specific guidelines for assessing mental health calls, prioritizing them appropriately, and dispatching the most suitable response teams, whether they are CIT-trained officers, mobile crisis teams, or a combination of both.

Clear protocols and guidelines for handling mental health crisis calls have been associated with reduced response times and improved accuracy in dispatching appropriate resources. Research conducted by the Police Executive Research Forum (PERF) indicates that well-defined protocols enhance dispatcher confidence, leading to more effective communication with callers and responding officers. Timely and accurate information leads to better outcomes in mental health crisis situations.

Subcommittee Co-Chairs:

Sergeant Terry Hawkins
Forsyth County Sheriff’s Office

Mr. Michael Bellino
Forsyth County GIS Department

Objective: To identify the most effective means of collecting, analyzing, and sharing data on mental health patients in county jails and other county facilities. This subcommittee will also identify a process for counties to “map” all the mental health resources available in each county.

Recommended

Best Practices

Best Practice 1: Implement mental health screening tools within detention facilities to identify inmates who meet the criteria for further mental health assessment or monitoring.

The policies and procedures should clearly state who will administer the screening and when it will be done in the intake process. The policies and procedures should also include how the information will be collected and reported to the necessary staff in the jail to determine the next steps for those identified as having mental health needs.

Early identification can help determine opportunities for diversion, special needs, and expedited medical evaluation and medication compliance. This data may also serve communities as they evaluate the efficacy of diversion programs, as well as assist in framing programs that fit their particular needs.

Best Practice 2: Establish a framework with local public safety agencies for the capturing of relevant data related to calls for service.

Public safety agencies, such as police, fire, and EMS, should create mechanisms within their respective systems to capture relevant data related to their responses to mental health or substance abuse-related calls for service. Examples of desired data include: the frequency of these calls; duration of the call; geographical location of calls; chronological data for the day of the week and time of day calls are received; number of personnel required.

Best Practice 3: Analyze how individuals with mental health disorders intersect with public safety and criminal justice entities to improve cross-system and inter-agency collaboration to reduce involvement in the criminal justice system by persons with mental health disorders.

Those with mental health disorders often have a higher propensity to interact with the criminal justice system. Communities will benefit from using interagency collaborative efforts to divert consumers away from the criminal justice system by encouraging contact with mental health providers.

Best Practice 4: Compile a comprehensive list of known resources serving those with mental health and substance abuse disorders from your community.

As local governments focus on increasing their ability to serve their residents facing mental health disorders, they should begin to catalog a list of available resources. One solution could be to work with a local organization to create a comprehensive, web-based tool that lists all known resource providers in the area. The tool could separate providers into categories based on what they offer and provide contact information to aid citizens in contacting them.

Subcommittee Co-Chairs:

Hon. Kathy Cooper
Hall County Commissioner

Hon. Clinton Johnson
ACCG 1^st Vice President and Dougherty County Commissioner

Objective: To identify ways in which the Accountability Courts, Probate Courts, and Juvenile Courts can contribute to the diversion and rehabilitation of citizens with mental health and substance abuse disorders.

Recommended

Best Practices

Best Practice 1: Divisionary Methods to Help Populations Avoid Criminal Court Proceedings and Jail Facilities.

Counties would be well served by instituting Accountability Courts that operate programs that establish alternative sentencing options for certain non-violent crimes. Examples of accountability courts are Mental Health Courts; Felony Drug Courts; Driving Under the Influence (DUI) Courts; Family Treatment Courts; and Veteran Treatment Courts.

A joint report from the Council of Accountability Court Judges (CACJ), Criminal Justice Coordinating Council (CJCC), and the Carl Vinson Institute of Government found that Accountability Courts not only produced tremendous social benefits to communities, but they also produce a significant economic benefit to communities. The report discloses that Accountability Courts produce $41.27 million in estimated economic benefits to state and local governments.

Best Practice 2: Regulate a State-Wide Standard for the Accountability Courts.

Many Accountability Court jurisdictions operate independently, which can create disparate outcomes depending on which court system in the state is used by those facing mental health disorders. While organizations such as CACJ and CJCC perform great work, there is still a lack of state-wide resources for Mental Health and Accountability Courts. Creating more regulations or enforcing current regulations would help produce equitable outcomes for those facing mental health disorders. One solution may be to strengthen the CACJ peer review process and allocate funds to address any shortfalls identified by the experts in that peer review process.

Best Practice 3: Streamline and Add More Regulation to Forensic Evaluation for Mental Competency.

While it is essential that jail detainees facing mental health disorders are properly evaluated within the jail, there must also be tactful state and local regulations to ensure that these forensic evaluations do not produce backlogs in the court system due to delayed court proceedings. The goal of these regulations is to prevent overwhelming the courts and jails.

Subcommittee Co-Chairs:

Hon. Helen Stone
Chatham County Commissioner

Hon. Larry Johnson
DeKalb County Commissioner
(served from May 2023 – March 2024)

Objective: To identify the funding, workforce, and facility requirements needed to provide effective mental health services throughout counties.

Recommended

Best Practices

Best Practice 1: Access archive of information provided by the National Association of Counties (NACo).

NACo has the distinct advantage of being able to gather information and best practices from counties across the United States. They have channeled these efforts through their Mental Health and Wellness Commission. This commission—in which ACCG Mental Health Subcommittee Chair Helen Stone is a member—gathers county leaders from across the nation to take action to address the ever-growing mental health crisis from the county government perspective. Georgia counties should access the helpful resources that this commission provides, such as informative documents and webinars that provide key data points about the state of mental health in the U.S., as well as policy initiatives to address local, state, and federal mental health issue areas.

Best Practice 2: Seek funding opportunities through the state government for local projects.

By working with their legislative delegation and state agencies, counites may have success in procuring funding in the state budget. Chatham County worked with their legislative delegation, leadership from the Georgia House of Representatives and Senate, and the Georgia Department of Behavioral Health and Developmental Disabilities to receive funding for a capital project to address mental health. Through a partnership with their local Community Service Board, Chatham County secured about $7 million in state funding for the construction and operation of their new behavioral health crisis center (BHCC). As a part of their local obligation, Chatham contributes 10% of the operating cost annually to ensure the successful operation of the BHCC.

Furthermore, Chatham County used the same strategy to secure state funding for an adolescence behavior health crisis center. This project had a $23 million price tag. The state appropriated $15.5 million in its state budget to assist in establishing this center, which when completed will be a statewide resource. Additionally, Chatham partnered with the state to use federal recovery dollars to contribute another $5.5 million. Chatham County is working with their community service board to obtain the remaining $2 million.

Awareness is important. Use time outside of the legislative session to inform and educate your state delegates. Seek opportunities to use data or on-site educational tours to highlight accomplishments or share pervasive challenges with your state delegation. 

Best Practice 3: Seek funding opportunities through the federal government for local initiatives.

Counties should work with federal agencies to explore and secure the numerous grant opportunities that exist to help counties achieve their local initiatives. For instance, in 2018 Chatham County worked with the U.S. Department of Justice through its Justice and Mental Health Collaboration Program to secure a three-year grant to support Chatham’s “Breaking the Cycle” initiative. This initiative sought to reduce recidivism of those with mental illness through interagency collaboration with the county, public safety and criminal justice personnel, and behavior health specialist. Furthermore, the Breaking the Cycle initiative is run under NACo’s Stepping Up Initiative. Astonishingly, Chatham County was able to use this initiative to reduce the average length of stay of their jail detainees with mental illness from 600 days (about 1 and a half years) to 45 days (about 1 and a half months) in 2020 (prior to COVID).

Subcommittee Co-Chairs:

Hon. Chris Gaines
Dawson County Commissioner

Hon. Doreen Williams
Rockdale County Commissioner

Objective: To identify opportunities for partnership with relevant organizations and people who specialize in providing mental health services.

Recommended

Best Practices

Best Practice 1: Passing the “Stepping Up” Resolution

This program is a foundation for helping counties collaborate and support unique community-based services and programs that share the common goal of reducing and mitigating incarceration. The starting point is a resolution by the County and/or City Boards to publicly state the intent and desire to move towards implementing the NACo Stepping Up Initiative.

Best Practice 2: Become acquainted with local community partners.

Key local partners are Community Service Boards (CSB); the local National Alliance on Mental Illness (NAMI) chapter; the local United Way; Addiction Recovery Support Centers; Recovery Community Organizations; local non-profits, DBHDD Regional Service Administrator; and “Family Connections” contact.

Each of these organizations can and should work in harmony toward supporting the mental health needs of the community in which they thrive. County leaders must engage and learn more about each organization's resources and programs that are offered so that they can better support the critical efforts being provided to their community through the hard work of these organizations and their paid and volunteer staff. This network of organizations can be found in every single county or region in Georgia.

Best Practice 3: Create a resource map to determine what your county has and what they don’t have.

Many counties may not know which resources are available in their community, so creating a resource map to determine what resources your community harbors is a great starting point. Capturing this data can be a challenge, but the time invested in identifying these resources so that they can be effectively shared throughout your community is critical. Using the network of partnerships and assigning this task to a single contact point can help with the accuracy and regular updates required.

Best Practice 4: Identify local partners to assist in closing gaps after completing resource map.

Counties play a critical role in solving mental health issues within their communities. However, other local partners such as cities, businesses, and non-profits also can step in to help solve gaps in resources. Lean on these partners so that together you can build out your communities' mental health care resources and help solve challenges that impact every aspect of our communities.