The Stepping Up initiative is a joint effort supported by NACO (the National Association of Counties) and the American Psychiatric Association, to combat the epidemic of persons with mental illness in the prison system.

The number of people with mental illness in U.S. jails has reached crisis levels. In counties across the nation, jails now have more people with mental illnesses than in their psychiatric hospitals.

The human toll of this problem—and its cost to taxpayers—is staggering. Jails spend two to three times more money on adults with mental illnesses that require intervention than on those without those needs, yet often do not see improvements to public safety or these individuals’ health.

In Warren County’s case, with the reduction in beds at the State Hospital due to the Olmstead Act, as well as the closing of the Forensic Unit at the State Hospital, the County has seen an increase in severe mental health cases in our jail and criminal justice system in general.

Warren County also has an issue with drug and alcohol cases in our prison system, which it is estimated that over 80% of our inmates have charges related to drugs and alcohol.

In response to these issues, the County Commissioners have brought a resolution proclaiming the County’s support for the Stepping Up initiative. Similar resolutions have been passed by over 375 counties across the country and by passing on here, Warren County has become just the 17th County in Pennsylvania to adopt such a resolution.

Stepping Up asks communities to come together to develop an action plan that can be used to achieve a measurable impact in local criminal justice systems of all sizes across the country. This resolution is non-binding, and is simply a statement that we intend to make this effort a focus of the County’s administration

During initial meetings with local law enforcement, prison administration, criminal justice officials, and mental health providers we will be addressing the following questions which are the foundation of the Stepping Up initiative:

  1. Is our leadership committed?
  2. Do we conduct timely screening and assessments?
  3. Do we have baseline data?
  4. Have we conducted a comprehensive process analysis and inventory of services?
  5. Have we prioritized policy, practice, and funding improvements?
  6. Do we track progress?

In continuing this effort, a list of resources for thought leaders and interested individuals is below, separated by category.

To address questions and concerns, please contact Commissioner Jeff Eggleston via email (jeff.eggleston@warren-county.net) or via phone (814-728-3403).

Organization/Collaboration/Public Relations

SAMHSA – Community Conversations About Mental Health (PDF)

Pennsylvania Commission on Crime and Delinquency (PCCD)
CJAB Minimum Operating Standards (PDF)

National Institute of Corrections (NIC)
Guidelines for Staffing a Local Criminal Justice Coordinating Committee (PDF)

National Institute of Corrections (NIC)
Developing a Criminal Justice Coordinating Committee (PDF)

Justice Management Institute (JMI)
Managing a Criminal Justice Coordinating Councils (CJCCs) in a Small Jurisdiction (PDF)

Stepping Up
Ten Ways to Engage People Affected by Mental Illness in Your Community (PDF)

National Institute of Corrections (NIC)
Getting IT Right – Collaborative Problem Solving for Criminal Justice (PDF)

Howard County, Maryland
Behavioral Health Taskforce (LINK)

Johnson County, Kansas
Criminal Justice Advisory Council (LINK)

Stepping Up
Introduction to the “Six Questions County Leaders Need to Ask” (PDF) (PDF)

Stepping Up
Reducing the Number of People with Mental Illnesses in Jail – Six Questions County Leaders Need to Ask (PDF)

Substance Abuse and Mental Health Services Administration (SAMHSA)
Definitions and Terms Relating to Co-Occurring Disorders: Overview Paper 1 (PDF)

Information Sharing / Coordination

Council of State Governments (CSG) Justice Center
Sharing Information between Behavioral Health and Criminal Justice Systems (Webinar)

United States Department of Health and Human Services, Office for Civil Rights (OCR)
Information Sharing in Criminal Justice-Mental Health Collaboration: Working with HIPAA and Other Privacy Laws (PDF)

United States Department of Health and Human Services, Office for Civil Rights (OCR)
Data-Driven Justice and the Health Insurance Portability Accountability Act (HIPAA): Frequently Asked Questions (PDF)

United States Department of Health and Human Services, Office for Civil Rights (OCR)
Summary of the HIPAA Privacy Rule (LINK)

Council of State Governments (CSG) Justice Center
Health, Mental Health, Substance Use Disorders FAQs (LINK)

Police-Mental Health Collaboration (PMHC)
Police-Mental Health Collaboration Toolkit (LINK)

Police-Mental Health Collaboration (PMHC)
Example MOU between law enforcement agencies and behavioral health agencies (PDF)

National Association of Counties (NACo)
The Data-Driven Justice initiative offers guidance on Using and Sharing Data (LINK)

United States Department of Health and Human Services (HHS)
HHS lists an overview and examples in Business Associate Contracts (LINK)

Pre-Trial / Assessments

Stepping Up Webinars
“Conducting Timely Mental Health Screening and Assessment in Jails”
Video 1 – https://www.youtube.com/watch?v=mYzEMVgnbcQ
Video 2 – https://www.youtube.com/watch?v=f7BDUi_BwXk

The Council of State Governments (CSG) Justice Center
Screening and Assessment of Co-Occurring Disorders in the Criminal Justice System (Webinar)

National Institute of Corrections (NIC)
Mental Health Screens for Corrections (PDF)

Substance Abuse and Mental Health Services Administration (SAMHSA)
Screening and Assessment of Co-Occurring Disorders in the Justice System (PDF)

Stepping Up
Technical Assistance Module 2 Planning Guide (PDF)
Collect and Review Data on the Prevalence of People with Mental Illnesses in Jails and Assess Their Treatment Needs

National Criminal Justice Reference Service (NCJRS)
Uniform Recidivism and Revocation Rate Calculation: Recommended Methodologies for State Criminal Justice Agencies. (PDF)

The Council of State Governments (CSG) Justice Center
Risk Assessment Instruments Validated and Implemented in Correctional Settings in the United States: An Empirical Guide (PDF)

Pretrial Justice Institute Website (a great resource)

The Council of State Governments (CSG) Justice Center
Improving Responses to People with Mental Illnesses at the Pretrial Stage – Essential Elements (PDF)

National Association of Counties (NACo)
County Roles and Opportunities in Pretrial Justice (PDF)

National Association of Counties (NACo)
Using Pretrial Risk Assessment to Guide Release and Detention Decision-Making (Webinar)

The Council of State Governments (CSG) Justice Center
Adults with Behavioral Health Needs Under Correctional Supervision: A Shared Framework for Reducing Recidivism and Promoting Recovery (PDF)

The Council of State Governments (CSG) Justice Center
Risk Assessment: What You Need to Know (LINK)

PEW Center on the States
Risk/Needs Assessment 101: Science Reveals New Tools to Manage Offenders (PDF)