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Madison County Fiscal Court talks mental health, drug recovery
Richmond Register - 5/25/2023
May 25—Sierra Marling
On May 23, the Madison County Fiscal Court recognized May as Mental Health Awareness Month to "highlight the critical role of behavioral health services and resources to all Madison County residents."
Madison County Judge Executive Reagan Taylor highlighted the necessity for mental health services in a proclamation speech.
In his speech, he highlighted the following mental health statistics for the court:
Nearly one-in-five adults and one-in-five adolescents in the United States live with a mental illness.
Mental health impacts a person's emotional, social, environmental, financial, and overall well-being with significant disparities among racially and ethnically diverse communities.
Suicide is now the second-leading cause of death for 15 to 24 year olds.
Teenagers are experiencing a 17.3% increase in the use of anxiety medication since 2010.
One-third of the United States's population lives in a county designated as a mental health professional shortage area.
An estimated 44% of residents detained in jails are suffering from mental illness, often with co-occurring substance use disorders.
However, while the beginning of the speech highlighted major systemic issues, Taylor circled back around to recognize the county's resources and efforts against mental health issues, including Madison County's local hospitals, rural health clinics, and outpatient centers that offer mental health services.
Taylor praised the Madison County Attorney's office for developing a diversion program that "helps individuals stay out of jail by offering mental health and substance use disorder treatment."
The judge executive also thanked members of the Madison County Fiscal Court for continuing "its commitment to partner with our community members to ensure all mental health services are accessible, valuable and culturally appropriate for all Madison County residents."
Baptist Health Richmond's Executive Director of Behavioral Health Services, Lora King, and Clinical Manager Kaitlyn Arvin came forward to accept the proclamation.
King thanked the fiscal court and added, "Behavioral Health has become a huge passion of ours. About five or six years ago when I was in the emergency department in Madison County, we just didn't have anything. Unfortunately, we would spend hours watching people just suffer from mental illness, behavioral health, and substance abuse. So we've come a long way."
Right after, Arvin approached the podium.
"Like Reagan Taylor had mentioned, one-in-five folks, if we all took turns to raise our hands in here, mental health and behavioral health is affecting all of us, if not personally, through a loved one or family member. As leaders in the healthcare space in this county, we want to provide quality and accessible healthcare, and I'm very happy to be a part of the team that's doing just that. Thank you all for the opportunity to offer that to our folks here in the county," she commented.
Taylor, who has been a vocal mental health advocate in the past, took a moment to speak on the issue of mental health further.
"It's very important that we continue to bring awareness to this scourge," he asserted. "It's in our community. When I started eight years ago, or eight and a half years ago, as county judge, I really thought we had a jail problem. Then that led to realizing we had a drug problem, and now it's led to the conclusion that we really have a mental health crisis in our community and it's affecting all ages. It does not discriminate."
His resolution has consistently been a public call for community unity surrounding mental health.
"I think the more that we can do as a governing body and leaders in the community that we can bring awareness and attention to this and help educate and take down the stigmas, the better off our community is going to be. We're only going to beat this thing if we work together as a community. I mean, it's citizens; it's elected officials; it's business leaders — it doesn't matter. We're all going to have to come together to combat this," Taylor said.
Next, Madison County Attorney Jennie Haymond approached the Madison County Fiscal Court to give updates on diversion Programs.
She told the court that her office utilizes Advent, a provider she says provides "science-education based online video treatments." Advent serves five other states and 70 other Kentucky counties.
"They have probably 27 programs for us to choose from," she noted, adding that those programs cover topics such as marijuana education, anger management, and "corrective thinking" to low-level misdemeanor offenders.
As of the meeting, Haymond said that, not counting traffic violations, they referred over 30,000 low-level misdemeanor offenders to their Advent diversion courses — making Madison County the first or second top referrer for misdemeanor referrals to Advent in the state since she began in 2019.
"We get them out of jail, put them through this programming, and give them a diversion, which is a dismissal in the end — that's kind of a chance not to ruin their record. Especially since we've got two colleges that are in the county. We don't want to hurt these kids and their ability to proceed with financial aid or obtaining a job after college," she explained.
As for felonies, Haymond said her office has been working in partnership with Baptist Health Richmond Behavioral Health and the chemical dependency intensive outpatient program (CDIOP) to expand recovery opportunities for offenders.
While she acknowledged she is not an expert, she said that in her 15 years as a prosecutor, she has noted that "short-term treatment is not as effective" and can be a "bit of a revolving door" for offenders.
This initiative began in early February 2022 when King and Arvin approached Haymond for suggestions on how to utilize grant money toward making a difference in the community.
Haymond said, "Without a blink, I said, 'Why don't y'all just come to court and sit with me every day?'"
There, they would have access to offenders who could potentially utilize their services. Hammond said the program began at the end of February, less than a month after the initial meeting.
She explained the county attorney's office helps process paperwork and tracks people for the program, but that "the heavy work" is done by Baptist Health Richmond.
"So, when we refer [offenders] out to Baptist Health, the experts do those evaluations and assessments and they make the determination of the level of need that individuals have," she explained.
While some of those individuals do end up needing inpatient assistance that is currently unavailable in Madison County, she said that Baptist Health Richmond's new Thrive Center will potentially provide those services and solve that issue.
Since the program's official kick-off in March 2022, her office has referred 181 people for Baptist Health Programs, with 73 of them being for mental health evaluations and 108 being for substance use evaluation, which she said can also coincide. They have had a 71% completion rate for the program.
Additionally, she reported that 76 of those cases qualified for the CDIOP through Baptist Health Richmond.
"When I give somebody the option of, 'I'm gonna let you go to jail today, or you can go to treatment, almost everybody says, 'I'll go to treatment if it gets me out of jail," Haymond said.
She noted that 31 of those 76 cases who were referred to the CDIOP were no-shows.
Those no-shows are given review dates and are given a second chance to comply with the program instead of being sent to jail. However, she said those noncompliant no-shows do not further burden the county court system or jail.
"The agreement is, if you don't comply with the programming and do what we asked you do, you've automatically waived your felony case to circuit court," explained Haymond. "So we bypass going back to jail, we send you straight up to circuit court, and it becomes a state indictment issue, so then it no longer becomes a county financial responsibility."
She reported that 49 individuals complied with CDIOP programming and that 49% of those offenders are still participating, plus 22% have completed treatment. Haymond also provided the fiscal court with additional numbers that demonstrated a savings of approximately $262,500 by reducing incarceration time for offenders who would be awaiting indictment instead of utilizing the programs.
"One of the reasons I really like it, is that it is truly an intensive outpatient program. It is three phases. It takes several months, and it provides full wraparound services," Haymond said.
The majority of those 181 referrals are Madison Countians, she said, but Baptist Health has also been connecting people with other necessary services.
"Baptist Health has been great for us, not only because of their programming, but they've agreed to take on the responsibility of helping us if they have to get programming outside of Baptist Health," she explained.
Haymond added that employees of Baptist Health Richmond go out of their way to connect offenders with veteran's services and out-of-county services.
Arvin explained to the court the program had taken measures to identify barriers to treatment — like lack of insurance or transportation — as well as inserting an employee at the Madison County Detention Center.
She said that, after a screening, the candidates for the program are then taken through nine hours of individual and group counseling every week.
"That's contributing to your sense of purpose and creating a network that is also going to give you accountability and that's so important when we're working on recovery and healing and treatment," Arvin explained.
Additionally, while clinically handling drug-related ailments and working to prevent relapse, she said their holistic approach gives participants access to different providers and focuses on the individual's needs. They also reintegrate these individuals into the community and work to connect them with employment, housing, and other essential resources.
"I truly believe, as a clinician and as a project director, the combination of all of those folks — it takes a village — and that is what makes the treatment team so successful," she asserted.
"As someone ebbs and flows — because healing is not linear — we can make sure we're right there to get them into any resource they need if they have to go inpatient or to a higher level of care. If we have to step them up or down, we're able to do that right within the walls of our facility with the continuity of the same providers to help make that a better experience," Arvin continued.
Arvin then proceeded to summarize a letter that a provider had received from a court-referred participant to further elaborate on the impact of the program.
"She says, 'Scott, I want to thank you for everything that you have taught me in IOP classes: the coping skills, my five senses, 12 Step programming, just caring in general, because when I first come to you, I was most definitely against the whole idea of any class. I thought I did not need any help and I had everything under control. But in all reality, I needed you, Crystal, and all of my awesome IOP classmates who are now my family, who are always in my prayers, and I love all of them and you so much, because without you all, I will not have come to a good understanding or healing point with the abuse by my family members, my mother and all of the things that I experienced in my life,'" Arvin read.
She continued, "'I had to become a mother of my siblings very quickly at 11 years old, and all of the abuse — verbal and physical — that I experienced pretty much got me out of my way. Then I was married to my husband of eight years who was very abusive in every way and controlling. and my children, I was not there for them. I didn't really want to live life. But now I have all I need to know that I need to love myself and I am a child of God. and I know that I am somebody who deserves to be happy, full of joy, and be loved in every way.' We can change lives like that. and so I can't word it any better than that."
Haymond said the letter reflected what the program was really about — people.
"It's not just about the numbers. It's not just about the money. It's about the people. If we can help one person, then we've saved that one life. That's enough for me," Haymond said.
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