Mental health program at Cape Girardeau County jail shows promise in cutting recidivism

A mental health program that started as a pilot in the Cape Girardeau County jail is being credited for a dramatic drop in local recidivism.

The Jail Navigator Program also has organically captured the attention of state mental health and law enforcement officials. Perry County has adopted its own form of the program, and the navigator concept is being rolled out in four other parts of the state. Officials say implementing mental health professionals inside the jail system could have much wider applications.

The Community Counseling Center, which oversees the Cape Girardeau County program, says the Jail Navigator Program at the county jail has helped reduce recidivism among those who interact with the navigator, from 35% to 17.4%, according to a news release issued by the CCC in October.

According to the Missouri Department of Corrections, the statewide recidivism rate is 43.9% for all releases and 37.2% for first-time releases.

“I wouldn’t say we’re shocked at all,” said Cape Girardeau County Sheriff's Office Lt. Ed Curtis during an interview with the Southeast Missourian. “Giving these folks some help so when they leave us they have some sort of support in place, and they’re not just released into the wild. Having a warm handoff to the mental health services that are out there, having their medications provided for them and available to them while they’re waiting to get back engaged with the services. We just knew that there was a whole group there that needed help. … We’re all fighting for the same thing. I think that’s where the magic happened, with the CCC agreeing to help us and having her here.”

Curtis was referring to Heather Ressel, the navigator who works as a CCC employee at the jail. She’s been in the position for two and a half years. Through intake forms, roughly 1,000 inmates a year are identified as needing mental health services. Of those, Ressel refers some 300 or more to outside services when they are released from jail. On top of connecting them with services, she can also provide counseling services to inmates, helping individuals deal with the trauma, anxiety and stress that comes with being incarcerated. The result of her presence provided an immediate “calming effect” in the jail, according to jail administrator Richard Rushin.

Heather ResselSubmitted

The Jail Navigator Program isn’t necessarily the only reason for the recidivism drop. Other jail programs have likely helped as well. Because the program is only two-plus years old, the data isn’t old enough to determine definitive trends. But Curtis and Rushin are adamant the Jail Navigator program is the biggest reason for the early reduction in returning inmates.

“I would say there's certainly going to be other factors that may affect it,” Curtis said. “Implementing the tablet program that provides some alternatives for some of these folks. It gives them an avenue to try to better themselves with GEDs. You know, it has some self-help programs and that sort of stuff on there. I think Richard and (Sheriff Ruth Ann Dickerson) have been really trying hard to work on that recidivism rate, but I would absolutely attribute Heather to being the largest reason for the reduction, at least in the folks that she's having contact with.”

Responsibilities

Ressel sees inmates three days a week, but does much more than provide counseling services. She serves like a head coach for mental health care at the institution. In her role, she coordinates communication between many institutional layers. She can relay information to the Department of Corrections, to attorneys, care providers and the courts. She’s a contact person for Cape Girardeau’s co-response unit. Many if not most offenders in jail are not legally guilty of their crimes, but rather charged and waiting for trial or waiting for the judge to decide conditions for release. Sometimes Ressel may only meet with an inmate once before he or she is released on bond. Ressel treats every interaction with inmates as if she will not see them again, meaning she makes sure the inmates understand what services are available to them upon release. That can mean housing resources, drug treatment, counseling or other types of services.

“I’m an advocate for the county as much as I am for the inmates that are in here,” Ressel said. “How can I help this person not come back? How can I help the county save money, right? … I help people get bed dates with our local treatment facilities for substance abuse and stuff. I can help people who have a disability. I can help them get into a residential care facility. I’ve worked with the judges to get people furloughed to those residential care facilities, having their caseworker being able to help take them back and forth to the court. So there’s a lot of different things that a jail navigator could do to advocate beyond just getting them into services. It’s, how can I get them other places that they would be able to get treatment that would be a better place for them, but still be able to get back and forth to their courts.”

Once inmates plead guilty or are sentenced, they’ll then enter the state’s Department of Corrections prison system. By having mental health professionals work through mental health care diagnoses and treatment plans at the jail, the DOC can get a head start on their evaluations, which can dramatically cut wait times for medication and services once prisoners enter the state system, Ressel said.

Perry County

A version of the Jail Navigator program was launched in Perry County in July, with two major differences. The first is that the program was funded by the Missouri Department of Public Safety rather than the Department of Mental Health. And the second is that the funding included a position called a certified peer specialist, which is coordinated with the Gibson Center for Behavioral Change in Cape Girardeau.

The “navigator” in Perry County is called a “re-entry coordinator”. The certified peer specialist is someone who experienced troubles with mental health or substance abuse problems in the past. The specialist visits inmates daily.

Perry County Sheriff Jason Klaus, as Missouri’s Crisis Intervention Training coordinator, has had a front seat to how mental health issues affect people who intersect with law enforcement and the criminal justice system. The idea of more in-house mental health professionals being involved inside the jail is one he embraces.

Like the one in Cape Girardeau County, the new justice center being constructed in Perryville was designed and planned with the idea of bringing more mental health and substance abuse programs, as well as education programs, into the jails.

“We’re still early in our data tracking,” Klaus said. “We’re hoping our (recidivism) is trending that way as well, but our county is smaller in size. We want to focus on recidivism for sure, but we want to give inmates a new outlook and a bit more hope job-wise and family-wise, working on mental health and substance-use treatment.”

Statewide

Word has spread of the navigator program throughout the Department of Mental Health during meetings DMH officials have had with officials throughout the criminal justice system. Components of the program, including the certified peer specialists, are being rolled out in Stoddard, Wynn, Adair and Dent counties.

Angie Plunkett, the statewide diversion coordinator for the Missouri Department of Mental Health, said jail inmates are often a forgotten population, “and a lot of them are not receiving services. Just because they’re in jail doesn’t mean that they don’t need services. So to get someone connected with the services and also get them connected to community resources before they’re released from jail has a big impact and hopefully reduces recidivism of people returning to jail.

“We’re very proud of what Heather and Cape Girardeau County Sheriff's Department and community counseling center have done. It’s very creative what they have done. They've kind of filled the gap that's been needed, and we're very interested how that's replicated around the other pilot sites.”

In some of the rural counties, Plunkett said, one navigator could support multiple small jails.

“We were aware of what they were doing in Cape County,” said Taryn LeGrand Tyson-Lovett, the clinical director at Bootheel Behavioral Health. “We invited Heather to one of our meetings with the work group in Stoddard County, and so she was really helpful in giving us a lot of information about how she is providing this kind of service in her area. And we are looking to provide this service in our Stoddard County jail, and that’s where we’ll start. But then our agency covers four counties, so we are also going to be having the jail navigator do some work in our other two county jails, too, which are Scott County and Mississippi County.”

Bootheel Behavioral Health is conducting interviews for the new navigator position. Ideally, a hire will be made and the program will begin before the end of the year.

“We do see there's a large portion of people in jail that have a history of trauma, a history of either mental health or substance abuse, or both issues going on,” said Angela Lutmer, a Community Behavioral Health liaison at Bootheel Behavioral Health. “And a lot of times, not always, but a lot of times, those issues lead to some of their legal problems as well. I think it also helps the staff, for them to have somebody on the mental health side to speak with clients and to help make sure they're on medications, because that also reduces the stress level and the behaviors in the jail setting when people can't get their mental health services or medication.”

Lutmer said the introduction of a jail navigator has a lot of support from Stoddard County law enforcement.

Word of the program’s success is spreading in several different circles.

“It’s very humbling that it’s growing to this point,” Ressel said. “It’s exciting.”

Editor's note: This story has been edited to reflect the correct name of the Gibson Center for Behavioral Change.