After nearly a decade of wheel spinning, the launch of a facility to divert mentally ill and addicted offenders from jail to treatment has finally gained traction. County Commission and City Council have committed a combined $1 million a year and Gov. Bill Haslam has pledged $1.5 million from the state for operation of what will be known as the Behavioral Health Urgent Care Center.
The center will provide up to 72 hours of treatment for those arrested for nonviolent behavioral offenses whom law enforcement officials have long insisted don’t belong in jail. Helen Ross McNabb will manage the 15-bed facility as an extension of its pervasive community wide mental illness and substance-abuse treatment programs.
The center’s prime proponents, Sheriff Jimmy “J.J.” Jones and former District Attorney General Randy Nichols, contend that treatment can break the cycle of “revolving door” incarcerations that fill as much as 20 percent of Knox County jail space at great expense. But skeptics have doubted whether 72 hours, which is all the law allows an individual to be detained without being charged with a criminal offense, begins to be enough to make a lasting dent in deep-seated mental and addiction problems that are frequently co-occurring.
In its latest incarnation, the Behavioral Health Urgent Care Center puts more emphasis than earlier versions on laying a foundation for ongoing care and treatment. “The aftercare is what’s really important,” Helen Ross McNabb’s president, Jerry Vagnier, told County Commission.
In its proposal to Knox County, McNabb stated that, along with assessments and interventions during a stay, “a fundamental key to success is a strong and obtainable discharge plan … which is essential to reduce recidivism and meet the needs of the individual.” It goes on to say that, “One of the main responsibilities for the discharge planning staff will include expert community knowledge of agencies and services to work directly with the participant to devise a plan to increase the likelihood of follow through once they leave the BHUCC…. Each discharge plan will include a follow-up appointment and a support plan….”
In an effort to get a better understanding of what this means, I met with the two longtime McNabb administrators who will oversee the center, Leann Human-Hilliard and Candace Allen. For starters, they sought to disabuse me of the notion that a 72-hour stay wouldn’t be meaningful per se.
“It’s amazing what can be accomplished in three days,” Allen asserted. “You are giving people who have been in and out of jail repeatedly an alternative. You work with them and give them help that translates into a solid discharge plan.”
For those who present with mental illnesses, this will include scheduling an appointment with an outpatient provider and prescribing medications. A case manager will follow up with each of them to make sure appointments are kept and medications obtained. For the indigent, a Behavioral Health Safety Net program that former Gov. Phil Bredesen established more than a decade ago may be a source of funding.
The program has been patterned to some extent after ones in San Antonio, Phoenix, and Miami that have purportedly been successful in reducing recidivism. At the same time, Memphis has been a model for a program, also conducted by McNabb, that has trained more than 300 local law enforcement officers on how to recognize and deal with people who are exhibiting symptoms of mental illness. Sheriff’s deputies will transport them both to and from the center.
Human-Hilliard acknowledges that successes won’t be uniform. “Can some people not get it right and need to come back. Perhaps. But if they keep coming back, then we won’t take them any more,” she said. All admissions are voluntary. But for those who don’t want to come or stay, the alternative destination is jail.
The center will be located just off Western Avenue near its intersection with Ball Camp Pike. Knox County is also investing $1.2 million and the City of Knoxville $200,000 in the renovation of a former church now owned by McNabb that will house it. The initial contract for its operation runs for three years, and the state is also expected to make a three-year financial commitment to it.
What’s needed before commitments are extended is a set of measures of the program’s success or lack of same. This should start with keeping track of many of the several thousand individuals who are expected to be treated by the center annually and who are the subject of subsequent arrests.
As much as I hope the program can make a difference in their lives, I will be pleasantly surprised if very many of them realize lasting benefits.
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