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					     FORward MOMentum




Los Angeles County MIOCR-II
                                  MIOCR II GRANT
                               LOS ANGELES COUNTY
        Reducing Criminal Recidivism in Dually
          Diagnosed Incarcerated Mothers


   Funding Agency/Award: State of California Board of Corrections $5,000,000.00
                         DMH County of Los Angeles (In Kind) $3,000,048.00

   Funding Period:          July 1, 2001 – October 1, 2004

   Staff:                   Department of Mental Health         Clinical     17
                                                                Support    3
                            Sheriff’s Department                Deputies   2
                                                                Sergeant   1
                            Probation Department                Officer    1
   General Description:
         True experimental design incorporating detailed Informed Consent and random
          assignment to one of four treatment conditions: 1) Intensive Jail Treatment; 2)
          Intensive Community Treatment; 3) Combined Intensive Jail and Community
          Treatment; 4) Treatment as Usual – Jail and Community.
        LOS ANGELES COUNTY ANNUAL
                BOOKINGS

   180,000

   Annual Female Bookings: 28,080

   Annual Female Dually Diagnosed: 5,953

   76% of a Recent Sampling of Females had Children

   21% of Females Booked were Homeless at Time of Arrest

   20% of Females Booked were at Risk of being Homeless at
    Time of Arrest
    TWIN TOWERS CORRECTIONAL FACILITY

                      MIOCR II - PILOT STUDIES

   Pilot # 1 – N = 80 (January, 2001)
      66% Dual Diagnosis

   Pilot # 2 – N = 50 (February, 2001)
      76% Had Children
      48% Had Minor Children
      Average Number of Children = 2.6

   Pilot # 3 – N 60 (March, 2001)
        48% Dually Diagnosed with Minor Children
        50% History of Homelessness
        Total Number of Arrests = 211
        Average Number of Arrests = 7.3
        Experimental Design
        Group Comparisons
Combined MIOCR         MIOCR
Treatment              Community
N=100                  Treatment Only
                       N=100
MIOCR Jail Treatment   Comparison Group
Only                   No MIOCR Treatment
N=100                  N=100
                Initial Screening
   A. PRE SCREEN
    - based on law enforcement computer databases
    - joint effort of Mental Health staff and Sheriff Dept. staff

    CRITERIA:
    - Age: 18-50 y.o.
    - Legal Hx: at least 1 prior arrest
    - Estimated Length of Incarceration: release date >4 weeks
    - Possible/likely Release to the Community
    - Violence Hx considered
    - Not enrolled in other specialized offender programs
   B. BRIEF SCREEN
    - based on 20-30 minute face-to-face interview
    - conducted by Mental Health staff

    CRITERIA:
    - Biological mother, currently pregnant, or primary caregiver of
      minor child(ren)
    - Axis I Serious & Persistent Mental Illness
         -   Schizophrenia, Bipolar Disorder, Recurrent Major Depression
    –   Substance Use Problem: current or significant risk for relapse
    –   Homelessness or significant risk for homelessness
    -   Estimated Length of Incarceration: release date > 4 weeks
    –   Language: English proficiency
    –   No LPS Conservatorship
   C. INFORMED CONSENT
    - 5-page document is read to client
    - 20-item Capacity to Consent Assessment
    - 20-30 minutes
    - conducted by Mental Health staff

    KEY CONCEPTS:
    - Voluntary
    - Does not reduce or increase sentence length
    - Random assignment to 1 of 4 groups
    - May involve movement to another jail housing location
    - Limits of confidentiality
    - Collaboration among Mental Health, Sheriff Dept. &
      Probation Dept.
                      ASSESSMENT
   Mental Illness Diagnosis
    -Prior history - Management Information System (MIS)
    -Screening for mental health housing or GP receiving
         psychiatric medications
    -Clinical interview
    -M.I.N.I Plus - Modified - Mini International Neuropsychiatric Interview
    -Brief Psychiatric Rating Scale (BPRS)
   Substance Abuse & Dependence
    Assessment
    – Begin with open ended questions related to use/negative
      consequences, and later more focused questions related to exact
      quantity/frequency etc.
   Standardized Tests
    – AUDIT - Alcohol Use Disorders Identification Test
    – DALI - Dartmouth Assessment of Lifestyle Inventory
    – CASAD - Comprehensive Assessment of Substance Abuse &
       Dependence (“homemade” based on ASI, SCID for Substance
       Abuse)
   Aptitude & Achievement Tests
   WASI - Wechsler Abbreviated Scale of Intelligence
    – Mean IQ 84, range 60-105
   WIAT - Wechsler Individual Achievement Test- Reading
    Comprehension
    – Mean Grade Level - 6.9, range 1.5 - 12.9

   Personality Test
   Personality Assessment Inventory (PAI)
Intervention Model
 Life Domains      Interventions
                Individualized Treatment
 PSYCHIATRIC       Assertive Outreach


   MEDICAL         Medication Education
                   Psychotherapy
                   Drug Abuse Counseling
   HOUSING         Housing Placement
                   Living Skills Groups
                   Home Visits
                   Budgeting
 FINANCIAL         Entitlement Assistance
                   Transportation Assistance
                   School Referral & Support
RELATIONSHIPS      Job Coaching & Placement
                   Social Skills Groups
EMPLOYMENT
& EDUCATION
       Intensive Jail Treatment

 Group Counseling
 Individual Counseling
 Medication Evaluation/Management
 Substance Abuse Counseling
              Intensive Jail Classes
   Anger Management
   Problem Solving
   Crime Prevention
   Medication Management for Co-Occurring Disorders
   Parenting Skills
   Social Support and Communication Skills
   Domestic Violence/Rape/Child Abuse Trauma Recovery
   Independent Living Skills/Community Resources
   Health and Wellness
   12 Step Focus Group
   Cognitive Behavioral Therapy
   Relapse Prevention
COMMUNITY OUTREACH
COMMUNITY COMPOSITION

       CLINICIANS      PROBATION




    FINANCIAL WORKER   CUSTODY
    COMMUNITY TREATMENT
         GROUPS
 COMBINED
    -discharge planning
 COMMUNITY ONLY
    -discharge planning
        SERVICE LINKAGES
   Housing
   Mental
    Health/Substance
    Abuse Treatment
   Medical
   Financial Resources
   Other Needs
   Group Activity
          KEY INTERVENTIO N
               Resources

   Social Security Card      Housing
   Photo Identification      Obtain financial
    Card                       benefits
   Birth Certificate         Obtain Services at a
                               MH clinic
                              SSI Benefits
                              Resume custody/care
                               of children
                  CHALLENGES
   Environmental Changes
    -early release dates


   Court Ordered Treatment

   MIA Tracking System
    -various data base systems
    (e.g. MIS, Cheers)
    -custody

				
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posted:2/23/2012
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