Governor Mike DeWine’s Work Group on Competency Restoration and Diversion has released a recommendations report detailing how the State of Ohio can improve behavioral health treatment and diversion opportunities. Interim Executive Director Alicia D. Smith, MHA, represented Clear Pathways in the Work Group. Rick Kellar, MBA, President and CEO of Peg’s Foundation, Robin Lindquist-Grantz, Director of Measurement & Evaluation, and Matthew Goldman, MD, MS, Senior Consultant for Research and Evaluation, provided additional expertise.
The Governor’s Work Group on Competency Restoration and Diversion developed actionable solutions to address the strain on Ohio’s regional psychiatric hospitals and improve access to care for all Ohioans. The Work Group met frequently over several months and held regional community listening sessions, studied best practices from experts in other states, and analyzed data.
Through our Work Group participation, Clear Pathways and Peg’s Foundation highlighted our work and shared fundamentals for developing, funding, implementing, and evaluating systems of change. We are pleased to see crisis services listed as a top recommendation.
The Work Group’s final 15 recommendations span the following 6 domains:
Broader system needs
- Scale universal, indicated, and targeted prevention services statewide, to support at-risk families and children as early as possible.
- Establish new and support existing statewide crisis services, including 988, to ensure that all Ohioans have someone to call, someone to respond, and somewhere to go when experiencing a behavioral health crisis.
- Continue to build Ohio’s continuum of housing supports for individuals with mental illness and criminal justice involvement, as these individuals are more often than others to encounter barriers to securing housing.
- Expand strategies to recruit and retain behavioral health and criminal justice workforce.
- Increase inpatient psychiatric treatment capacity.
Pre-trial diversion
- Create local processes to assess behavioral health needs and risk concerns early in the criminal justice process and communicate these findings to inform decision-making at different intercepts.
- Develop local programming to proactively respond to and plan for individuals who interact repeatedly with criminal justice and behavioral health systems, through multisystem stakeholder meetings and data sharing.
- Pilot pre-trial, behavioral health diversion facilities as a place to receive treatment while charges are held in abeyance.
The judicial system
- Explore streamlining motions for a competency evaluation through screening tools to ensure the right individuals are evaluated and access care.
- Expand Assisted Outpatient Treatment to more counties in Ohio as an alternative pathway to competency restoration.
Systems navigation
- Expand training opportunities for professionals at the intersection of behavioral health and criminal justice on topics including voluntary and involuntary treatment, competency restoration, medications to treat mental illness, medication-assisted treatment, and others.
- Develop multi-disciplinary navigation teams to engage individuals with mental health and/or substance use disorders throughout the criminal justice system through assessments and linkages to care.
Jail-based services
- Expand jail-based competency restoration pilots in higher-volume jails with access to needed behavioral health resources.
- Expand access to jail-based behavioral healthcare, including increased access to medications for mental illness and opioid and alcohol use disorders; uniform formularies for these medications in jails and prisons, where possible; and the availability of prescribers and providers to administer medications.
Access to residential treatment
- Continue to expand the availability of community residential treatment facilities as avenues to step individuals out of inpatient care, continue needed treatment, sustain recovery, and safely maintain individuals in the community.
