CHARG Resource Center Clinic and Offices 709 E. 12th Avenue Denver, CO 80203 303-830-8805 | CHARG Drop-In Center 920 Emerson Street Denver, CO 80218 303-830-2130

MENTAL HEALTH & PUBLIC SAFETY COALITION
CHARG Resource Center

MEETING MINUTES

7/17/15

In attendance:
Regina “Regi” Huerter, David Burgess, Tiffany Anderson, Karen Aakeberg, Josi Stewart, Nita Bradford (NAMI), Carolyn Hall, Diana Roca

Introductions,
then a report from Regi Huerter
HER CURRENT STATUS:
New chief : Denver Division of Behavioral Strategies, has replaced Don Mares.
and on the Mayor’s  Denver Crime Prevention & Control Commission.
DO NOT ADMIT lists are not allowed but providers find a way around them,
e.g. close cases or informally tag individuals.
There are liability concerns (MHCD has been sued).
Dr. Fox & Lisa Clements knew they existed but mhc’s denied it.
Advocates are helpful such as NAMI, MHCA &consumer groups.
If we know of someone who is being denied services, call or email Reggie.
-Consumer rights butt up against criminal justice limitation.
For example, jail detainees cannot be forced on meds even if they need them.
There is a daily average of 450 detainees with “severe & persistent mental illness” in Denver jails.
Largest providers of mental health services are #1 Dept. of Corrections & #2 Sheriff’s Dept.
DENVER NEWS
RECOVERY COURT
:
500 individuals identified as “most needy” have a special court which attempts to connect them w/ services.
PHASE: Day reporting centers funded by federal grant & run by DU Criminal Justice students.
Mornings are spent at Phoenix MultiSport, and afternoons at 303 W. Colfax.
Purpose: to provide trauma-related services to people “under supervision” (Probation or Parole)
in District 6 – downtown & Capitol Hill.
CO-RESPONDERS NETWORK:
Similar to models in LA, Seattle, Austin
Victims Assistance Unit & Sheriff’s Dept. receive CIT training
and engage offender with web of support “jail diversion”.
Now hiring 4 LCSWs & 1 supervisor to accompany police
on calls with behavioral health concerns.
The staff will follow up with the individuals
and re-engage them w/services.
BEHAVIORAL HEALTH COMMITTEE (City of Denver)
is looking for consumer participation.

COLORADO NEWS
FORMULARY: developed by Behavioral Health Transformation Council
(Governor’s Task Force on crisis centers).
Many state-wide organizations have agreed to improve inter-agency communication
by using a common Formulary.
Purpose: CONTINUITY OF CARE
1. Help keep meds consistent no matter where individuals end up (ER, jail, etc.).
2. Increase purchasing power  by volume pricing on medication.
3. Share info state-wide so each organization has clinical information when people are admitted.
Note:  3 avenues for legislation:
CCJJ ?
BEHAVIORAL HEALTH TRANSFORMATION COUNCIL
MACJS ?

General Discussion: Josi & Carolyn recommend WRAP (Wellness Recovery Action Plan)
be included in state-wide Formulary. It should  include consumer directives such as
who NOT to call when there is a crisis. Karen thought it should also include  doctors & hospitals to call.
Nita remembered a similar bill was not passed but it was more about Advanced Directives.
David recalled his recent discussion with Charlie Smith, SAMSHA regional administrator,
about workforce training to help staff with difficult clients.
“Safety and liability not the only issues – training is needed.”
Nita discussed her disappointment that the state rejected a model for crisis centers
because it was from out of state (Arizona). She said nothing will change in Colorado
until there is openness to programs from out of state that have proven effective.
Regi said Denver has a good track record of openness to effective models from other places.
Note: Doyle Forrestal has replaced George DelGrosso at the Colorado Behavioral Health Care Council.

NEXT MEETING: TBD

_________________________________________________________________________
4/30/15

In attendance:
Josi Stewart: CHARG Drop-in Center, Rocky Mountain Crisis Partners
Carolyn Hall: CHARG Drop-in Center, Rocky Mountain Crisis Partners
Don Mares: Office of Behavioral Health Strategies
Jeannie Ritter: Mental Health Ambassador of MHCD
Stephanie Frank: CHARG Resource Center Clinic
Dunia Dickey: Equitas Foundation
Lacey Berumen: St. Anthony’s ER, Federation of Families for Children’s Mental Health
David Burgess: CHARG Resource Center
Diana Roca: CHARG Resource Center
Michelle Neumann: CHARG Resource Center community intern

David started the meeting with discussing why the coalition was started:

  • Imminent danger standard
  • Triaging in emergency rooms for mental health clients
  • Statewide network of crisis centers
  • Potentially dangerous and ‘difficult’ people get turned away from treatment

Questions:

  • What else should the system be doing?
    • Funding?
    • How we are spending the $ we have?
    • Public education?
  • Not just a Colorado problem
    • What are people in other states doing?
      • Connecticut: high ER utilizer report, reduced ER visits by including consumers in deciding what care they want and need
    • What would help the individual (individual case example from CHARG) who shot someone?
    • What do we do for people who continually go off their medications?
      • Additional options aside from court-ordered meds?
    • What extent is this issue discomfort on mental health treatment providers to take potentially dangerous clients?
      • Mental health providers afraid to treat ‘sickest of sick’ for multiple reasons including liability?
    • What about intensive outpatient treatment?
    • Should we mandate ACT (Assertive Community Treatment) teams?
    • How much of this is caused by people with mental health issues feeling unheard and frustrated, leading to acting out violently?
    • Where are the windows?
    • Is court-ordered treatment effective?
    • Asking consumers, how do you want your treatment to look?
    • How did the system fail?
    • How did people get helped or not?
    • What are the different levels of threat?
    • What are the barriers to getting meds and staying on meds?

Possible solutions:

  • Referrals to housing
  • Psychiatrist availability
  • Medication availability
  • Not allowing guns
    • 80% of weapons on the street are bought on the street
    • Availability to buy gun parts to put together own gun
    • Many ways to responsibly get guns as well
  • Murphy bill
    • Great intentions (down-falls = society protected vs. person protected; non recovery-focused ways; court-ordered programs focus)
    • Increasing access
    • Increasing Medicaid services
    • Brought back to attention soon, hopefully in better place
  • Stigma piece needs to be addressed
    • Movie theater trial gives opportunities for public education
  • Look at processes that are client-centered and client-driven
  • Intensive outpatient treatment
    • Shown to reduce police calls and shootings
  • More peer support and peer specialists
    • Able to address people who are acting differently by asking what is going on, help people to see what it was like for them before they were on medications
  • Getting to know clients more personally/building rapport
  • Peer support system in jails (in progress)
  • Case managers helping on deeper level
  • Mental health courts
    • Successful but not located in every county
  • Analyze new resources (crisis centers) and what we are missing
  • ATU (acute treatment unit) as between ERs and Crisis Centers
  • Train staff
  • Community conversations (Diane Mulligan)
  • Psychiatric advance directives, WRAP (Wellness Recovery Action Plan) plus
  • Transformational Council
  • Client buy-in
  • Options vs. force
  • Public education, addressing fear of people with mental illness

Possible focus of coalition:

  • Peer-informed discussion
  • Awareness
  • Strategies vs. solutions
  • Community education
  • Risk-management vs. finger-pointing
  • Analyze subsets
    • Learn more about individuals’ experiences: how did they get there?
  • Understand the problem more
    • Informal case studies

Additional notes:

  • Agreement that the name of the coalition is not appropriate if we take information into public forums
  • Agreement that nothing should be off the table
  • *Agreement that focus is on people who have mental illness with the potential to be violent*
    • 4% nationally of people with mental illness become violent

For next time:

  • Gather more information
  • Educate ourselves on acronyms and documents mentioned today
  • Send acronyms and documents to David (dburgess@charg.org) to distribute
  • Meet at CHARG Resource Center Clinic (709 E. 12th Ave, Denver 80203) at noon on May 28th, 2015

____________________________________________________________________________________________
6/19/15

In attendance:
Mike McEachern, Weslea Primus, Tiffany Anderson, Karen Aakeberg, Dunia Dickey, Josi Stewart, Diana Roca

Introductions,
then a report from David Burgess:

– Meeting last week with Don Mares, who suggests we gather data about Dan F’s experience trying to get
mental health services.
– Meeting next week with Charlie Smith, SAMSHA regional administrator.
– Will approach Regina “Reggie” Huerter: Denver Crime Prevention & Control Commission
– Regrets received from:
Email from Valerie “Val” Corzine, Esq. of Orchid: Mental Health Legal Advocacy of Colorado
She’s “sorry she couldn’t attend mtg…has a lot to say on the subject…clinical assessment of risk is passé,
even to experts at CMHIP, and should be replaced with VRS (violence risk scale?) for objective,
evidence-based criteria”.
Email from Amy Smith, mental health advocate: She “cannot attend meeting but cited issues illustrated
by Dan F’s case: CMH industry does not want to work with anyone considered dangerous, non-compliant
or disruptive, and for the most part, they DO NOT….let’s talk about how to launch an investigation.”

General Discussion: A lot of the above names were recognized by Dunia,
who works for the Equitas Foundation, and who has great professional interest
in the subject of systemic changes at the policy level to advance fairness in
the criminal justice system for people with mental health challenges & brain trauma.
Concerns:
– Staff burn-out when dealing with difficult clients (Tiffany)
– The dangerous client/ gun owner (Diana),
– Violent people lacking awareness of their behavior (Karen)
– Suicide as violence (Mike)
– What are other counties doing? (Weslea)
– The effectiveness of peer services in the treatment of the potentially violent individual (Josi).

NEXT MEETING:
Friday, July 17, 2015
Noon-1 pm
at the HEARTLAND CLINIC, 709 E. 12th Avenue DENVER 80203
RSVP: David Burgess, 303-830-8805 or dburgess@charg.org

 

____________________________________________________________________________________
1/29/15

In attendance:
Jennifer Brown, Bonni Taylor, Diana Roca, David Burgess, Stephanie Frank, Michelle Neumann

David Burgess introduced all in attendance and welcomed everyone to the meeting. He explained his concerns and the topics for the basis of the meeting.

Concerns raised by those in attendance:

  • Lack of resources after someone goes through a crisis center
  • Issues with relaxing the standards of a mental health hold (making it easier to put people on holds)
  • Shutting disruptive people out of systems created to help people
  • How do we help the most violent people?
  • Problem isn’t only lack of resources/money
  • Not enough beds as resources
  • Holmes as a possible resource
  • Keeping certain amount of beds open in hospitals based on psychiatric need
  • People banned from 16th street mall parallels to banning people from services
  • When working individually with someone and knowing a crisis is going to come, what can you do? Hands are tied, what other steps?
  • Not having resources to work with someone with severe mental health issues vs. being fed up with the difficult person
  • Preventative measures/treatment
  • Finding an earlier solution, current focus is too late
  • Train people specifically to work with most difficult people
  • Public education
  • Reducing stigma

Other goals:

  • Name of coalition
  • Outlining who we are and what we are doing
  • Who do we want around the table?

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