Portland Courant

The Multnomah County Department of Community Justice’s Mental Health Unit recently launched a pilot program designed to improve access to treatment and other services for people involved in the justice system who struggle with behavioral health challenges. 

The new program, called Treatment Readiness, focuses on first providing stability, then encouraging participants to engage in treatment and services. At the same time, participants learn the skills that will help them achieve success as they access those services. The pilot program can serve up to 40 participants at a time —  staffed by parole and probation officers, case managers, community health specialists among other county partners. 

With limited capacity in Oregon for substance use and behavioral health resources, the County’s pilot program has the potential to serve not only as a path for people in the legal system to access community-based treatment and services, but also as a way to decrease the odds they’ll have future involvement in the criminal justice system, utilize hospitals or experience unemployment. 

Multnomah County’s Mental Health Unit MHU, provides supervision for people on parole, probation and post-prison supervision who also struggle with behavioral health issues. The team works to preserve public safety while also reducing the reoccurrence of crime and helping people avoid having to return to clinical and therapeutic services.   

John McVay, a sworn Community Justice Manager with the Mental Health Unit (MHU), noted that Treatment Readiness meets a need amid a statewide lack of substance use treatment options, including residential-level care and substance use treatment for people whose mental health needs are acute.  

“We started the Treatment Readiness Program because in the Mental Health Unit we were seeing a lot of folks who could not get into treatment because they weren’t ready for treatment or treatment was not available. And one thing we realized we needed was a way to stabilize folks,” said McVay. 

The Mental Health Unit can supervise as many as 300 people at any given time, many of whom have long wait times to access treatment. Ambivalence about entering and engaging with treatment is not uncommon either, said McVay. But Treatment Readiness — offered out of Multnomah County parole and probation offices — provides a one-stop shop for basic needs, skill building and training.  

“What we try to do is to focus on the basic needs for folks, such as food, shelter, clothing, hygiene, etc.,” said McVay. “Because without those things, it’s really difficult to do any kind of programming."

“We’re working to build as much of a one-stop center as we can, where we’re able to meet or help folks navigate their needs in one place. So, for example, we have community health specialists who will take people to appointments or take people to resources.”

Participants might receive food, clothing and hygiene supplies, or simply a place to sleep. Treatment Readiness staff can help with tasks like getting an ID, or more complex ones like helping the participant find housing. The program offers many other services and benefits, including skills training through individual and group activities and longer-term case management. Showing participants that the program is there to meet those needs helps to develop trusting, stable relationships with parole and probation officers, case managers, treatment providers, community health specialists and others who are genuinely invested in their success. 

“A lot of this is about building relationships with folks,” McVay said. “One thing we found in our outreach work through the Mental Health Unit was that having a steady relationship — or someone they could count on who would always be there who could walk them through everything — is really important.” 

Treatment Readiness strives to make participation as accessible as possible by foregoing stringent requirements for participation. Participants are referred through the Mental Health Unit or through Multnomah County’s Mental Health Court. 

“We develop goals with them and then work on them to reach those goals and break it down into steps and skill development,” said McVay. 

“But it’s also a low-barrier program. For example, we have folks who all they want to do is sleep, and a lot of that is because they’re experiencing homelessness and it’s the only safe place they have to sleep. So we’ll start where people are at and work toward developing skills and the things they need to be successful in programming.”

“Having something like this makes it a lot easier,” said Cornejo.

“It’s really going a step further and saying we really want to help our community. We really want to make sure they have access to care, that we meet their basic needs. As probation and parole officers, we’re trained to provide specific skill sets to clients, but because of a high caseload, it could be challenging to be able to meet that.” 

Cornejo described one client who recently had nowhere to go. He wasn’t absconding or out of compliance with the conditions of his supervision, but he was not as engaged in services as he could have been. 

“The program really allowed him to have a place to just come in every day, in my opinion, where he is turning a corner. He’s starting to share some goals where, for so long, he was unmotivated,” Cornejo said. “So the idea is that he’s like, ‘OK, I have a place where people will listen to me, where I can share some goals..’ He’s been showing up every day. Right now we’re working on housing.”

McVay mentioned another client who had very complex medical needs but refused medical care, and also had untreated mental health needs.

Treatment Readiness served as a touchpoint where medical providers, the parole office and corrections health staff have been able to come together and actually collaborate on working with the client, McVay said.

“Because it was the one place he would regularly show up to get his needs met,” said McVay. “That’s an important example of having a place that’s relatively low barrier where individuals can kind of come to get their needs met.”

It’s an iterative process, said McVay. The program will be sculpted and shaped as it grows over time. For example, cooking and basic nutrition classes being considered for participants who live on their own in single-room units. Portland Street Medicine has also joined the roster of providers who offer guidance to participants. 

“It can take some time,” McVay said, but “usually what we're finding is that we're able to really engage most people.”

Original source can be found here.