University of North Carolina at Chapel Hill School of Social Work Course: SOWO 769, Social Work at the Interface of the Mental Health and Criminal Justice Systems: Practice, Policy, and Research Professor: Gary S. Cuddeback, Ph.D., M.S.W., M.P.H. Assistant Professor, School of Social Work Faculty Research Fellow, Cecil G. Sheps Center for Health Services Research University of North Carolina at Chapel Hill CB#3550, 325 Pittsboro Street, 324-H Chapel Hill, NC 27599-7590 Phone: Social Work (919) 962-4363, Sheps Center (919) 966-0995 cuddeback@mail.schsr.unc.edu Brief Course Description: Social workers are often the front-line service providers for mentally ill offenders. This course explores social work practice, policy, and research at the interface of criminal justice and behavioral health. Expanded Course Description and Objectives: Persons with severe and persistent mental illness are one of the most vulnerable populations served by social workers today. Unfortunately, the criminal justice system now plays a significant role in the care and treatment of persons with severe mental illness and the welfare of these individuals is closely intertwined with criminal justice practice and policy. Given the significant overlap between behavioral health and criminal justice caseloads, it is important that professional schools of social work equip our graduates with the knowledge and skills necessary to serve justice-involved persons with severe mental illness and successfully work with and within the criminal justice system. This course is designed to explore social work practice, policy, and research at the interface of the public mental health and criminal justice systems and to provide instruction in the following topics: (1) evidence-based practices for justice-involved persons with severe mental illness; (2) jails, prisons, and community supervision and persons with severe mental illness; (3) criminal and specialty courts for persons with severe mental illness; (4) mental health and criminal justice policies and persons with severe mental illness; and (5) social work research at the interface of the behavioral health and criminal justice. Upon completion of this course, students will be able to: 1. Discuss the overlap between criminal justice and behavioral health caseloads; 2. Discuss the public health and public safety implications of the large and growing numbers of persons with severe mental illness in the criminal justice system; 3. Identify evidence-based practices for justice-involved persons with severe mental illness; 4. Understand and discuss the structure and functions of criminal and specialty courts, jails, prisons, and community supervision and their service points used by social workers who are providing services to justice-involved persons with severe mental illness; 5. Understand the independent and synergistic effects of criminal justice and behavioral health policies on the well-being of persons with severe mental illness served by social workers; 6. Discuss issues of stigma, race/ethnicity, diversity, and disparities for justice-involved persons with severe mental illness. 7. Identify and discuss ethical issues for social work practice, policy and research at the 1 SOWO 769 – Short Course - Cuddeback interface of the criminal justice and behavioral health systems; and 8. Enumerate and discuss important social work research issues and gaps at the interface of the criminal justice and behavioral health systems. Policy on Incomplete or Late Assignments: Students must notify the instructor at least 24 hours before an assignment is due if an assignment is going to be turned in late. Extensions may be given at the instructor’s discretion. Students will lose five points for each 24-hour period beyond the due date and time (including weekends) for unexcused late assignments. Assignments that are more than 5 days late will not be accepted. A grade of “Incomplete” will be given only in extenuating circumstances and in accordance with School of Social Work and University policy. Policy on Academic Dishonesty: Academic dishonesty is contrary to the ethics of the social work profession, is unfair to other students and will not be tolerated in any form. Please refer to the APA Style Guide, The SSW Manual, and the SSW Writing Guide for information on attribution of quotes, plagiarism and appropriate use of assistance in preparing assignments. All written assignments should contain a signed pledge from you stating that, "I have not given or received unauthorized aid in preparing this written work.” In keeping with the UNC Honor Code, if reason exists to believe that academic dishonesty has occurred, a referral will be made to the Office of the Student Attorney General for investigation and further action as required. Format for Written Work: APA format should be used for all written assignments. Students should refer to the Publication Manual of the American Psychological Association (6th ed.) for information on APA format. A self-paced APA tutorial can be found at http://www.lib.unc.edu/instruct/citations/apa/index.html. Policy on Accommodations for Students with Disabilities: Students with disabilities that affect their participation in the course and who wish to have special accommodations should contact the University’s Disabilities Services (Voice/TDD 962-8300, 966-4041). Students must have a formal letter from the University’s Department of Disabilities Services to receive disability-based accommodations. Students should discuss the need for specific accommodations with their instructor at the beginning of the semester. Course Requirements Short Essays: There will be three short essay assignments during the course of the semester. These assignments are structured to reinforce classroom learning and help students develop and further critical thinking and policy analysis skills. These assignments will be due each week. Short essay assignments will count for 33% of the course grade. Final Paper: The final paper will be worth 66%. The paper will consist of 2 to 3 pages and will represent the student’s understanding of the practice, policy and research issues at the interface of the mental health and criminal justice systems and will conclude with practice, policy or research recommendations to address a critical issue that was discussed during the semester. More details will be provided. 2 SOWO 769 – Short Course - Cuddeback Evaluation and Grading: Short Essay Average Final Exam 33.33% 33.33% 100% Points 94 – 100 80 – 93 70 – 79 < 69 Grade H P L F Course Outline and Readings Class 1 Introductions Course overview and syllabus Overview of severe and persistent mental illness Overview of the public mental health system Overview of the interface of the mental health and criminal justice systems Suggested readings: Goldman, H. H., Gattozzi, A. A., & Taube, C. A. (1981). Defining and counting the chronically mentally ill. Hospital and Community Psychiatry, 32, 21–27. New Freedom Commission on Mental Health, 2003. Achieving the Promise: Transforming Mental Health Care in America. Final Report. DHHS Pub. No. SMA-03-3832. Rockville, MD. Videos, documentaries and web resources: Psychiatric bed shortage: http://energycommerce.house.gov/hearing/wherehave-all-patients-gone-examining-psychiatric-bed-shortage FRONTLINE series: Locked up in America – April 2014 http://www.pbs.org/wgbh/pages/frontline/locked-up-in-america/#prison-state Local News – inmate with mental illness dies in prison http://www.9news.com/longform/news/investigations/2014/06/19/mentally-illdeath-lawsuit/10882089/ CNN – taking on America’s mental health crisis https://www.youtube.com/watch?v=gsUd8hMBAbA Mental Health in Jails – CBS local news http://chicago.cbslocal.com/2013/02/13/sheriffs-office-releases-shockingvideo-of-mentally-ill-inmates/ Mental illness teaching videos: Mania: https://www.youtube.com/watch?v=zA-fqvC02oM Psychosis: https://www.youtube.com/watch?v=ZB28gfSmz1Y 3 SOWO 769 – Short Course - Cuddeback Schizophrenia: https://www.youtube.com/watch?v=bWaFqw8XnpA Class 2 Reflection paper 1 due Evaluating the evidence for evidence-based practices Evidence-based practices for persons with severe mental illnesses Assertive Community Treatment (ACT team) Housing First Medication management Suggested readings: Bond, G. R., Drake, R. E., Mueser, K. T., & Latimer, E. (2001). Assertive Community Treatment: critical ingredients and impact on patients. Disease Management and Health Outcomes, 9(3), 141-159. Dixon, L. (2000). Assertive community treatment: Twenty-five years of gold. Psychiatric Services, 51(6), 759-765. Tsemberis, S., Gulcur, L., & Nakae, M. (2004). Housing First, consumer choice, and harm reduction for homeless individuals with dual diagnosis. American Journal of Public Health, 94(4), 651-656. Vidoes, documentaries and web resources: NPR – Effort To Force Treatment On Severely Mentally Ill Meets Resistance http://www.npr.org/2014/05/01/308692285/effort-to-force-treatment-onseverely-mentally-ill-meets-resistance Persons with schizophrenia before and after medication https://www.youtube.com/watch?v=n7kSwG3sPQY https://www.youtube.com/watch?v=XhbfZAhOxrI https://www.youtube.com/watch?v=01aNbS3EVfE https://www.youtube.com/watch?v=z7LsV82a-3A Class 3 Reflection paper 2 due Evidence-based practices for persons with severe mental illnesses (cont’d) Integrated Dual Disorder Treatment Family Psychoeducation Supported Employment Illness Management Recovery Suggested readings: 4 SOWO 769 – Short Course - Cuddeback Drake, R. E., Mercer-McFadden, C., Mueser, K. T., McHugo, G. J., & Bond, G. R. (1998). Review of integrated mental health and substance abuse treatment for patients with dual disorders. Schizophrenia Bulletin, 24(4), 589608. Cook, J. A., Lehman, A. F., Drake, R., McFarlane, W. R., Gold, P. B., Leff, H. S., Blyler, C., Toprac, M. G., Razzano, L. A., Burke-Miller, J. K. Blankertz, L., Shafer, M., Pickett-Schenk, S. A., & Grey, D. D. (2005). Integration of psychiatric and vocational services: A multisite, randomized, controlled trial of supported employment. American Journal of Psychiatry, 162(10), 1948-1956. Videos, documentaries and web resources: Supported employment https://www.youtube.com/watch?v=DoLO_p04uKY Class 4 Reflection paper 3 due Evidence-based and emerging practices at the interface of the criminal justice and mental health systems Sequential intercept model Mental Health Courts Crisis Intervention Training Cognitive behavioral therapies Suggested readings: Barrowclough, C., Haddock, G., Beardmore, R, Conrod, P, Craig, T., Davies, L. et al. (2009). Evaluating integrated MI and CBT for people with psychosis and substance misuse: recruitment, retention and sample characteristics of the MIDAS trial. Addictive Behaviors, 34, 859-866. Compton, M. T., Bahora, M., Watson, A. C. et al., (2008). A comprehensive review of extant research on Crisis Intervention Team (CIT) programs. Journal of the American Academy of Psychiatry and Law, 36, 47-55. Drymalski, W. M., & Campbell, T. C. (2009). A review of motivational interviewing to enhance adherence to antipsychotic medication in patients with schizophrenia: evidence and recommendations. Journal of Mental Health, 18(1), 6-15. Munetz, M. D., Mark, & Griffin, P. D., Patricia. (2006). Use of the Sequential Intercept Model as an approach to decriminalization of people with serious mental illness. Psychiatric Services, 57(4), 544–549. doi:10.1176/appi.ps.57.4.544 Steadman, H. J., Davidson, S., & Brown, C. (2001). Mental health courts: Their promise and unanswered questions. Psychiatric Services, 52(4), 457458. 5 SOWO 769 – Short Course - Cuddeback Videos, documentaries and web resources: What to Expect in Court: http://www.tsc.state.tn.us/programs/self-help-center/what-should-i-expectcourt-video https://www.youtube.com/watch?v=S6tuCBeRn6o What to Expect in Juvenile Delinquency Court: http://www.saccourt.ca.gov/juvenile/delinquency/what-to-expect.aspx Mental Health Court Videos: http://www.pbs.org/wgbh/pages/frontline/released/inside/ http://www.ksl.com/?sid=17993037 https://www.youtube.com/watch?v=_bTjP8cAaj4 https://www.youtube.com/watch?v=DFIDmuevXQQ https://www.youtube.com/watch?v=DFIDmuevXQQ Officers respond to person with mental illness – National Geographic http://channel.nationalgeographic.com/channel/videos/mentally-ill-inmate/ Officers respond to inmate with mental illness – CBS local news http://sacramento.cbslocal.com/2013/11/01/video-shows-guards-pepperspraying-mentally-ill-inmates-in-california-prisons/ “The Sequential Intercept Model as an Approach to Decriminalize Persons with Serious Mental Illness/Substance Use Disorders” https://www.youtube.com/watch?v=GkFG-dZPFsM Sequential Intercept Model: http://gainscenter.samhsa.gov/cmsassets/documents/145789-100379.bh-sim-brochure.pdf Class 5 Reflection paper 4 due Evidence-based and emerging practices at the interface of the criminal justice and mental health systems (cont’d) Critical Time Intervention Mental health probation caseloads Forensic assertive community treatment Suggested readings: 6 SOWO 769 – Short Course - Cuddeback Cuddeback, G. S., Morrissey, J. P., Cusack, K. .J., et al. (2009). Challenges to developing Forensic Assertive Community Treatment teams. American Journal of Psychiatric Rehabilitation, 22, 225-246. Herman, D., Opler, L., Felix, A., Valencia, E., Wyatt, R. J., & Susser, E. (2000). A Critical Time Intervention with mentally ill homeless men: impact on psychiatric symptoms. Journal of Nervous & Mental Disease, 188(3), 135140. Lamberti, J. S., Weisman, R., & Faden, D. (2004). Forensic assertive community treatment: preventing incarceration of adults with severe mental illness. Psychiatric Services, 55, 1285-1293. Morrissey, J. P., Meyer, P. S., & Cuddeback, G. S. (2007). Extending ACT to criminal justice settings: Origins, current evidence, and future directions. Community Mental Health Journal, 43(5), 527-544. Skeem, J. L, En candela, J., & Louden, J. E. (2003). Perspectives on probation and mandated mental health treatment in specialized and traditional probation departments. Behavioral Science & Law, 21(4), 429-58. Class 6 Reflection paper 5 due Policy issues at the interface of criminal justice and mental health Housing Benefits and entitlement programs Community reentry and services Suggested readings: Dennis, D., Lassiter, M., Connelly, W. H., & Lupfer, K. S. (2011). Helping adults who are homeless gain disability benefits: The SSI/SSDI Outreach, Access, and Recovery (SOAR) program. Psychiatric Services, 62(11), 1373– 1376. doi:10.1176/appi.ps.62.11.1373 Dennis, D., & Abreu, D. J. (2010). SOAR: Access to benefits enables successful reentry. Corrections Today, 72(2), 82–85. Videos, documentaries and web resources: FRONTLINE: The Released http://www.pbs.org/wgbh/pages/frontline/released/view/ Housing http://vimeo.com/53883990 SOAR: https://www.youtube.com/watch?v=re81Hsml6EA 7 SOWO 769 – Short Course - Cuddeback Class 7 Reflection paper 6 due Research and evaluation at the interface of the mental health and criminal justice systems Ethical issues Diversity and research and evaluation Stigma Disparities Recovery Suggested readings: Clark, R. E., Ricketts, S. K., & McHugo, G. J. (1999). Legal system involvement and costs for persons in treatment for severe mental illness and substance abuse disorders. Psychiatric Services 50(5): 641-648. Taxman, F., & Thanner, M. (2006). Risk, Need, and Responsivity (RNR) : It all Depends. Crime & Delinquency, 52, 28-51. Videos, documentaries and web resources : Stories of recovery http://www.nytimes.com/interactive/science/lives-restored-series.html?_r=0 8