Judicial Branch Debuts Plan To Improve Outcomes for People With Mental Illness, Drug Issues

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Elaine Michaud of the Manchester Health Department, helped facilitate program at Elliot Hospital.

Manchester, NH – The New Hampshire Judicial Branch has launched a series of statewide Sequential Intercept Mapping or SIM workshops with a goal of improving outcomes for individuals currently or potentially involved in the criminal justice system due to mental illness or substance use disorder. 

 The first SIM workshop as part of a county-by-county statewide effort took place recently (January 17-18) at Elliot Hospital in Manchester and was focused on organizations and populations in the Hillsborough County north area.

SIM workshops are a national model that take a science and evidence-based approach to bring together various law enforcement agencies such as prosecutors, police and corrections officials with nonprofit organizations and community-based human service and healthcare providers and persons with lived experience. With everyone in one room, the participants – with the help of facilitators – brainstorm all the different intercepts or incidents of interactivity between those with mental illness or substance use disorder and the criminal justice system, from arrest to incarceration and re-entry. Anne Zinkin, the Mental Health and Wellness Coordinator for the NH Judicial Branch, will facilitate each of the workshops with co-facilitators from partner agencies. 

“We gather between 30-60 stakeholders who are involved with either criminal justice or the behavioral health system or related services to look at the criminal justice system as a series of places where you can intercept somebody with a serious mental illness or a co-occurring substance use disorder – to either prevent them either getting into the system at all, or once in the system, to divert them elsewhere,” said Zinkin. “The workshops are strategic planning initiatives. The stakeholders will map out what resources are available in that county for these individuals who are already justice involved or at risk of becoming justice involved. Through a series of questions, we identify where are there gaps in services, and then the stakeholders participating in the workshop identify which gaps they want to fill. The first day of the workshop is all about mapping out the resources, the second day is all about creating action plans. The focus of the workshop is really on short-term, attainable, measurable, relevant goals.”

The Manchester SIM workshop was conducted in partnership with Elliot Hospital, which is leading a grant from the federal Department of Health and Human Services to expand access to medication-assisted treatment for substance use disorder, reduce substance misuse and overdose, and help individuals involved with the justice system.  This important initiative, now called the Center for Recovery Management at Manchester, will provide enhanced case management and discharge planning to inmates at Hillsborough County Department of Corrections before release.  Among Elliot Hospital’s partners for this initiative is Makin It Happen, a Manchester-based nonprofit.

Stakeholders participating in the first SIM Workshop in Manchester hosted by Elliot Hospital include:

Manchester Police DepartmentManchester Department of HealthHillsborough County Attorney’s OfficeNAMI NH
Hillsborough County House of CorrectionsRevive RecoveryHillsborough County Superior Court NorthManchester District Court
NH Public Defenders OfficeNH Department of CorrectionsElliot Health SystemsMental Health Center of Greater Manchester
UNH Institute for Health Policy and PracticeMonadnock HospitalNH Coalition of Recovery ResidencesManchester Veterans Administration Hospital
NH HospitalFoundation for Healthy CommunitiesCatholic Medical CenterMakin’ It Happen

In attendance for the beginning of the Manchester SIM workshop were Hillsborough County Commissioner Toni PappasDr. Greg Baxter, President and CEO of Elliot Health System; and Manchester Mayor Jay Ruais.  Commissioner Pappas conveyed the enthusiastic support of the Hillsborough County Board of Commissioners for the SIM workshop effort.  Dr. Baxter thanked participants for their time and dedication. 

“Your work to find solutions to care for, and lift up, our community are a testament to your commitment to the wellbeing of families and individuals in our region,” said Dr. Baxter

Mayor Ruais has spoken publicly about his own personal battle with addiction as a young man, and his work at the community level helping to provide services to those in need. 

“Gatherings like this are essential because they identify where amazing work is going on, but we could potentially be in silos,” said Mayor Ruais. “If we’re not communicating across the justice system, the healthcare system, the city system, the county system, if we’re not having those collaborative conversations about where we may be duplicating efforts or where we could better serve a population, then ultimately we’re not going to have the end result that we all want, which is to break the cycle that individuals are in and get them into a sustainable path. My life is a testament to that. I was very fortunate to find recovery when I was 24 years old. It was the result of these kinds of collaborative efforts to try to get me off the path that I was on into a more sustainable life. My message today is one of hope and gratitude that we are continuing to build and strengthen these partnerships at the local and county and state level.”

The participants at the SIM workshop identified four areas where gaps exist in treatment or services available to those experiencing mental Illness or substance use disorder.  They divided themselves into four working groups to devise action plans for filling those gaps.  The gaps concerned housing, pretrial diversion, restoration services for those deemed not competent to stand trial, and recovery and sober houses equipped to house individuals with serious mental illness.  The working groups plan to continue meeting. A comprehensive report from the Hillsborough County North SIM workshop identifying these gaps and action plans will be published by the NH Judicial Branch in the future. The NH Judicial Branch has partnered with UNH’s Institute for Health Policy & Practice to evaluate the progress made on the action plans. 

Hillsborough County North Superior Court Judge Amy Messer, who oversees drug court dockets, also attended the SIM workshop and spoke to the attendees.

“At the Judicial Branch, making our communities safer really does matter to us. We are very open to hearing ways we can improve the system and improve the quality of life for people that come into our system – whether they are defendants or victims of crime,” said Judge Messer. “We still have a way to go, there is no question about that. But seeing everybody here in this room collaborating and bringing to the forefront these issues of pre-trial services, pre-trial diversion. Restoration is an issue that we see on a regular basis at the court. It is a challenge for us, but we’re talking about it. We are thinking about these reentry issues. The advances that are being made at the jail right now are something we have not seen for a very long time. They are really working hard to address the issues, to give access to community mental health to be able to be there and help move the ball forward for people. It is incredible.”

SIM workshops are being coordinated for the rest of 2024 in all counties in New Hampshire as part of a broader Mental Health Initiative launched in 2023 under the direction and leadership of Supreme Court Chief Justice Gordon J. MacDonald and Dianne Martin, Director of the Administrative Office of the Courts.

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