COMMONWEALTH OF PENNSYLVANIA HOUSE OF REPRESENTATIVES

HUMAN SERVICES COMMITTEE HEARING

STATE CAPITOL HARRISBURG, PA

MAIN CAPITOL BUILDING ROOM 60, EAST WING

TUESDAY, OCTOBER 14, 2 014 10:00 A.M.

PRESENTATION ON MENTAL HEALTH COURTS

BEFORE: HONORABLE GENE DiGIROLAMO, MAJORITY CHAIRMAN HONORABLE HONORABLE JOSEPH HACKETT HONORABLE HONORABLE HONORABLE HONORABLE HONORABLE MICHELLE BROWNLEE HONORABLE PAMELA DeLISSIO HONORABLE MADELEINE DEAN HONORABLE HONORABLE

Pennsylvania House of Representatives Commonwealth of Pennsylvania 2

COMMITTEE STAFF PRESENT:

MELANIE BROWN MAJORITY EXECUTIVE DIRECTOR ELIZABETH YARNELL MAJORITY RESEARCH ANALYST PAMELA HUSS MAJORITY ADMINISTRATIVE ASSISTANT

ASHLEY McCAHAN DEMOCRATIC EXECUTIVE DIRECTOR 3

I N D E X

TESTIFIERS

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NAME PAGE

MARIE KEARNS MOVING AGENCIES TOWARD EXCELLENCE, and REGIONAL DIRECTOR, HORIZON HOUSE...... 5/44

PAM HOWARD PROGRAM DIRECTOR, ADULT MENTAL HEALTH, MONTGOMERY COUNTY DEPARTMENT OF BH/DD...... 7

STEPHANIE LANDES COORDINATOR, BEHAVIORAL HEALTH COURT, MONTGOMERY COUNTY ADULT PROBATION DEPT...... 13

MAUREEN FEENEY-BYRNES PEER SUPPORT SPECIALIST, MONTGOMERY COUNTY DEPARTMENT OF BH/DD...... 21

ROBERT MARTIN PEER SUPPORT SPECIALIST, MONTGOMERY COUNTY DEPARTMENT OF BH/DD...... 31

DIANE CONWAY CEO, MAX Association...... 51

SUBMITTED WRITTEN TESTIMONY

~k ~k ~k (See submitted written testimony and handouts online.) 4

1 P R O C E E D I N G S

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3 MAJORITY CHAIRMAN DiGIROLAMO: Good morning,

4 everyone. Welcome. I ’d like to call this meeting of the

5 Human Services Committee to order, and first order of

6 business I might ask everyone to rise for the Pledge of

7 Allegiance to the flag.

8

9 (The Pledge of Allegiance was recited.)

10

11 MAJORITY CHAIRMAN DiGIROLAMO: Okay. Thank you.

12 And I think first we'll give the Members an opportunity to

13 just say hello and let you know who they are, the Members

14 that are present. I know it's a busy morning so Members

15 are going to be coming in and out as we go. We've got the

16 room until 12 o'clock.

17 I just want to let everybody know a couple

18 things. The cameras are on. It is my understanding that

19 PCN is going to pick up the entire hearing so it'll

20 probably be on later on today. So we are being filmed.

21 And also I know many of you have come a long

22 distance so I would like to have everybody testify first,

23 and then at the end of the hearing if we have any time if

24 you're able to stay, I'd like to open it up then for

25 questions and answers. I think that's the right way to do 5

1 that.

2 I ’m going to start off. I ’m Gene DiGirolamo from

3 Bucks County and I ’m the Republican Chairman of the Human

4 Services Committee.

5 REPRESENTATIVE MURT: Representative Tom Murt,

6 Philadelphia and Montgomery County.

7 REPRESENTATIVE BROWNLEE: Representative Michelle

8 Brownlee, Philadelphia County.

9 MAJORITY CHAIRMAN DiGIROLAMO: Go ahead, Pam.

10 REPRESENTATIVE DeLISSIO: Pam DeLissio. Good

11 morning. I represent parts of Philadelphia and Montgomery

12 Counties, the 194th.

13 REPRESENTATIVE TOPPER: Jesse Topper, the 78th

14 District, Bedford, Fulton, and Huntington Counties.

15 REPRESENTATIVE MENTZER: Steve Mentzer, 97th

16 District, Lancaster County.

17 REPRESENTATIVE HACKETT: Good morning. Joe

18 Hackett, Delaware County.

19 REPRESENTATIVE ROAE: Representative Brad Roae,

20 Crawford County.

21 MAJORITY CHAIRMAN DiGIROLAMO: Okay. And again,

22 welcome to everybody.

23 And since Representative Tom Murt, who is the

24 Subcommittee Chairman, requested the hearing, I ’m going to

25 let Tom chair the hearing for today. So I ’m going to turn 6

1 the hearing over to Tom Murt and recognize Representative

2 Madeleine Dean also from Montgomery County. Welcome,

3 Madeleine.

4 REPRESENTATIVE MURT: Good morning, everyone.

5 Thank you for attending our hearing. I ’ll be brief because

6 we want our testifiers to begin.

7 But I just want to make reference to the fact

8 that we have made great -- there’s not too many families in

9 the Commonwealth or across our Nation that have not been

10 impacted in some way with challenges relative to mental

11 health, and we've made great progress but the challenge

12 remains and there's a lot of work that remains to be done.

13 We're very grateful to the professionals in the

14 field, the advocates, the Representatives from Montgomery

15 County, MAX, and so forth for the great work that you do

16 and you have done in this field caring for our

17 constituents. So thank you very much for being here today.

18 I also want to mention Mark Painter, who's here

19 from Montgomery County. Thank you very much.

20 We'll have our first testifier now, Marie Kearns

21 from MAX. Good morning, Marie.

22 MS. KEARNS: Good morning.

23 I'm here this morning representing MAX, which is

24 a provider organization, Moving Agencies Towards

25 Excellence, and it's an organization that has providers 7

1 from both behavioral health and intellectual and

2 developmental disabilities. One of the things that we have

3 been trying to do is to get the word out about programs

4 that are working. Many times we hear all of the things

5 that are needs that are unmet that aren't working

6 correctly, aren't working in the best way for people's

7 well-being. So we wanted to highlight some things that

8 actually are working well.

9 There's been discussion across the Nation of

10 jails becoming the new mental health institutions, and in

11 Montgomery County -- and this is replicated in other

12 counties but you're just going to hear the representation

13 from Montgomery County, but I think many of you will find

14 in different counties that Behavioral Health Courts are now

15 in place. It’s the marriage and the working together of a

16 variety of constituencies, so the courts, probation, the

17 jails, the mental health and behavioral health facilities

18 working together to support individuals who are coming

19 before the courts mainly because of behaviors related to

20 their illness and trying to work with them so that they do

21 not get stuck in a jail system, that we are able to provide

22 services to them in the community and help them to get well

23 and on track and be the productive citizens that they wish

24 to be.

25 So today we have with us Pam Howard, our first 8

1 person. She’s the Adult Mental Health Program Director for

2 Montgomery County Office of Behavioral Health and

3 Developmental Disabilities, and she’s going to speak a

4 little bit about why Montgomery County went for a

5 Behavioral Health Court and sort of the history behind

6 this. W e ’ll then hear from Steph Landes talking about the

7 actual Behavioral Health Court. She’s the coordinator of

8 the behavior health court. And then w e ’ll be talking with

9 two consumers in recovery who’ll be representing that

10 aspect of how peers work with peers to promote somebody’s

11 mental health well-being.

12 So our first speaker is Pam.

13 REPRESENTATIVE MURT: Good morning, Pam. Thank

14 you for being with us today.

15 MS. HOWARD: Good morning. Thank you very much

16 for having us here. It’s very exciting to be here to tell

17 you a little bit about Montgomery County’s Behavioral

18 Health Court and our experience in developing it.

19 I have sort of the easy job of just kind of

20 introducing this and really letting people who are much

21 more involved than I tell you about the structure and the

22 interactions of the court.

23 But I just wanted to have the chance to tell you

24 a little bit about the background, how we got involved in

25 the idea of setting up a Behavioral Health Court in 9

1 Montgomery County. And I think that one of the things that

2 really helped us to do so was that the area was sort of

3 fertile for a Behavioral Health Court to come about. There

4 was some very nice collaboration that went on between the

5 Department of Behavioral Health and the criminal justice

6 system. Our county’s Adult Probation Department had made a

7 commitment several years back to creating specialized

8 mental health probation officers and there were some

9 services in the prison that were paid for by the Department

10 of Behavioral Health.

11 But at the same time when Montgomery County

12 stopped and did some mapping about the time that people

13 spent in jail and people’s interaction with the criminal

14 justice system, what we came to learn was that on average

15 for a person who experienced a serious mental illness, the

16 average length of time that they would spend in our

17 correctional facility was 242 days, and that is not only a

18 human cost but there’s also a financial cost involved in

19 that, and a financial cost where those dollars are much

20 better spent on other services and supports for people. So

21 that cost is about $10,500 for the 242 days in jail versus

22 for a person in the general population who had that

23 experience of being incarcerated at the correctional

24 facility, the average was 74 days. And that represented a

25 cost of $3,250. 10

1 So when there was an opportunity that came out

2 from Pennsylvania's Crime Commission for a PCCD grant that

3 was for the planning of treatment courts, Montgomery County

4 thought, hmmm, let's kind of go and explore and see what

5 this is all about. One of the most sort of telling things

6 about this county where really good collaboration went on

7 was that people from the different departments came to

8 Harrisburg to come listen to information about treatment

9 courts and everybody from the different departments drove

10 separately. They all came in different cars. So probation

11 came and the behavioral health people came. So it was just

12 interesting to note that despite all this collaboration,

13 people were kind of separated out into their various

14 departments.

15 And so after people came to hear about the

16 treatment courts, everybody got very interested and they

17 thought, you know what, this is something that we could do.

18 So Montgomery County went after one of the planning grants

19 for the Behavioral Health Court and we received one, which

20 was great. And then after that grant, we also had received

21 later two further grants, one for the implementation then

22 of the court after the planning went on and then another

23 one for the continuation.

24 The thing that the Behavioral Health Court, the

25 first step in it was to develop a really strong team to 11

1 layout the planning for this, and I have to say that I ’m

2 sad that he couldn't be here today but our Honorable Judge

3 Smyth has just been such a tremendous asset to us, a very

4 key player in this establishment of the Behavioral Health

5 Court in Montgomery County and he really has taken such a

6 strong interest in having the court learn so much about the

7 factors that lead to people’s challenges with behavioral

8 health: trauma, addiction. He’s just been a fabulous

9 support and a great player in all of this.

10 But in the beginning when the planning team came

11 about, it really was the leadership of all the different

12 departments that came together just to the step-by-step

13 layout the plans for this. So the court administration was

14 involved, the Department of Behavioral Health, the

15 President Judge, our District Attorney’s Office, the Chief

16 Public Defender, and the Warden from the prison. And we

17 also had the benefit of having an already-established Drug

18 Court in Montgomery County and so we had the advantage of

19 learning some of the steps and the development and planning

20 from our own Drug Court.

21 A key factor in all of the development of this

22 that the PCCD grant enabled us to do was to get a lot of

23 training and consultation for everybody involved and that

24 was really helpful. So we had the National Association of

25 Drug Court Professionals come in, we had the GAINS Center 12

1 for Behavioral Health and Justice Transformation, and then

2 more locally, Drexel’s Center of Excellence helped to kind

3 of think through and really educate folks about all of the

4 components that would be helpful.

5 We also brought in through that PCCD grant a

6 behavioral health planning facilitator so there was a

7 designated person to help think through and do all of these

8 steps and planning, and that involved the policies and

9 procedures, the structure of the court, how people would

10 interact with the court.

11 I think one of the key factors that really led to

12 this success in Montgomery County of our Behavioral Health

13 Court was the fact that we didn’t then try to develop some

14 new services. What the county did was we took a look at

15 the existing resources and decided to really take a look at

16 how we could develop this new level of collaboration and

17 planning that would really impact people’s interaction with

18 the criminal justice system, and that’s exactly what

19 happened.

20 So the county spent some time and did a little

21 work on the reorganization of those specialized mental

22 health probation officers and then the Behavioral Health

23 Department really took a look at how they could bring the

24 behavioral health supports to the table to really be part

25 of helping the probation department and the criminal 13

1 justice folks understand how people's treatment could

2 impact on their lives, their challenges, their illnesses,

3 their behaviors to really help them get on a different

4 course. And it was bringing all this together and really

5 thinking through how you can develop this tight

6 coordination and planning and consultation together that

7 really set everything on a whole new course.

8 The PCCD grant has really helped also, too, to

9 establish some process for data collection but I think one

10 of the best things that came out of it was that we really,

11 in Montgomery County, made a commitment to the coordination

12 of the court and it also enabled our probation departments

13 really make the commitment to establishing a court

14 coordinator.

15 So I have the pleasure to introduce to you Steph

16 Landes, who is Montgomery County's Behavioral Health Court

17 Coordinator. And I will note to you that today, instead of

18 driving separately, the departments came together in the

19 same car so this really just shows a whole new level these

20 years later of coordination, relationship development, and

21 interaction between the different entities and departments.

22 REPRESENTATIVE MURT: Thank you, Pam.

23 Stephanie, before you testify, I just wanted to

24 mention that Representative Brad Roae is here and also

25 Representative Mindy Fee. 14

1 Stephanie, thank you for being with us today.

2 MS. LANDES: Good morning, everyone. Thank you

3 for having us.

4 So when I was hired by the Adult Probation and

5 Parole Department in 1996, I was hired for the Intensive

6 Mental Health Unit, and as we heard this presentation from

7 PCCD on Behavioral Health Courts, I think we were all a

8 little naive and thought we've got this; we're already

9 doing this in our county. We're already collaborating with

10 all of the other agencies. What we underestimated was the

11 significance of the judicial interaction and also peer

12 support. That was something that we had not incorporated

13 yet very strongly in our county and something that has been

14 highlighted through Behavioral Health Court.

15 What Behavioral Health Court does is it brings

16 all of the key players around the same table at the same

17 time where we can communicate and identify different gaps

18 in our system and work towards improving those gaps. So

19 the Judge is the leader of our team. Judge Smyth has been

20 part of our team since the beginning. We also have

21 representatives from the District Attorney's Office, the

22 Public Defender's Office, all the Adult Probation officers

23 are present, the Warden and Assistant Warden, and also a

24 Special Forensic Case Manager from our prison is present.

25 The Office of Behavioral Health, Justice-Related Services, 15

1 Certified Peer Specialists, and any other consultants that

2 we need to bring in to specialize whatever training we may

3 need at that time.

4 Our program is an 18- to 24-month program and

5 it's divided into three different phases. Phase I requires

6 weekly reporting in front of Judge Smyth. Our probation

7 officers and recovery coaches also meet with the

8 individuals on a weekly basis.

9 We have started a program called Pathways to

10 Recovery, which was identified because we were finding that

11 some of our participants were coming to court early and

12 there were not so many pro-social activities happening at

13 that point. They were kind of collaborating and seemed to

14 be some negative behaviors going on.

15 So in order to combat that, we kind of

16 brainstormed that we would like to use that time as more of

17 a therapy time, and what we have is a different peer come

18 and speak to our participants on their road to recovery,

19 and each week it's a different person that speaks on a

20 different topic. And in a little bit Robert will elaborate

21 on that in more detail. It's mandatory for all of our new

22 participants. It's a 10- to 12-week program. And what we

23 found is that some of our participants will stay even

24 beyond the mandatory time to listen to the stories because

25 they find them very inspiring. 16

1 Initially, what w e ’re looking for is to build the

2 trust with the participant and develop a relationship with

3 that participant in our court. Oftentimes, we have our

4 participants come in and they’re very jaded and they’re

5 really intimidated by the court system, and what w e ’re

6 trying to do is develop a system of honesty and a system

7 where we understand that all of your problems haven’t gone

8 away because you’re part of our Behavioral Health Court but

9 we ’re now willing to work with you and work through those

10 issues.

11 We also try to establish more accountability in

12 the participant and let them know that they themselves are

13 responsible for their behaviors. They may not be able to

14 fix them but we can’t help them unless they’re going to

15 speak to us about their problems.

16 We increase self-awareness about their treatment

17 and try to increase self-disclosure. We require consistent

18 treatment involvement. We help them identify their

19 triggers that involved their being part of the criminal

20 justice system. We like to have the participant start a

21 WRAP program or start thinking about a Wellness Recovery

22 Action Plan, which also Maureen and Rob will speak in more

23 detail about. And we like to expose people to more mutual

24 aid supports.

25 In Phase II we continue on what has been 17

1 developed in Phase I and w e ’re partnering with our

2 participant to develop relationships with the Court and

3 demonstrate growing and personal responsibility and trust.

4 At this point w e ’re hoping that they have completed

5 Pathways, that they’re maintaining their involvement in

6 treatment and mutual aid, and that they’re actively

7 developing a plan for change and what the next step is

8 going to look like for their life.

9 One of the key roles of Behavioral Health Court

10 is really developing meaningful activity in someone’s life,

11 so that could be going back to school, going back to work,

12 or really just being a more involved parent.

13 In Phase III w e ’re looking for our participant to

14 really model the way and show our newer participants what

15 someone who is actively engaged in treatment looks like and

16 what recovery looks like. We ask the person to take

17 responsibility for their behavior and to embrace the key

18 recovery principles and develop a plan for meaningful

19 activities and support.

20 We have two cardinal rules that we like to tell

21 our participants when they come into the program: one, that

22 you have to show up; you have to be everywhere that you’re

23 supposed to be. We can’t help you if you’re not where

24 you’re supposed to be. And you have to be honest. And

25 that sounds like a pretty basic concept, but for many of 18

1 our participants, their exposure to probation has been

2 quite the contrary. You lie about what you know that you

3 haven’t been exactly caught on and you try to get away with

4 what you’ve done for fear that you’re going to be

5 incarcerated.

6 We work through an incentive-and-sanction model

7 so we reward good behavior, and a reward could be anywhere

8 from praise from the Judge, which is really extremely

9 significant. What w e ’ve noticed is that our participants

10 really value the relationship with Judge Smyth and they

11 really want to please him. They want him to be proud of

12 them. It could be a round of applause from their peers, it

13 could be a gift card, it could be a movement in phases

14 where they’re reporting less often.

15 And then we also have sanctions where w e ’re

16 holding people accountable. If someone is honest and

17 they’ve told us that they’ve relapsed, then the sanction is

18 going to be a more therapeutic sanction where w e ’re going

19 to be looking to increase services or increase treatment

20 and look at why the treatment plan isn’t working and how we

21 can improve that plan. If they’re not honest, then w e ’re

22 looking at more of a punitive sanction where they may be

23 doing community service or they may be incarcerated.

24 I remember very early on in the process being a

25 probation officer for quite some time and our first 19

1 sanction that we handed out was an essay and I remember

2 feeling so frustrated because this person who had been in

3 this system for quite some time was given an essay for

4 relapsing on heroin and I thought this is so silly. He has

5 done so much time in jail and now he’s going to write an

6 essay. And he came back the following week and this essay

7 was so insightful and it identified his triggers, it

8 identified where he could have made a different choice, it

9 identified his relapse prevention plan for his future, and

10 it also identified what he intended to do to prevent a

11 further relapse. And I was really glad that I didn’t speak

12 up in that meeting because I would have been very

13 embarrassed because his insight into that essay was so much

14 more profound than what he would have done if he had done

15 24 or 48 hours in jail on a sanction.

16 And then our graduation we really try to focus on

17 and celebrate the person’s recovery and their

18 accomplishments. For so long our participants have been

19 just defeated by the criminal justice system and just been

20 a number, and for them to hear that the Judge is proud of

21 them and the Judge knows their children’s names and knows

22 what they’ve done and what is specific to their plan, it

23 really goes a long way for our participants.

24 Through Behavioral Health Court, our probation

25 department became even more specialized with even a greater 20

1 knowledge of the Behavioral Health Court systems and

2 interventions. Our department was committed to continuing

3 Behavioral Health Court even beyond the PCCD grant that we

4 had, so what we did was we incorporated our Behavioral

5 Health Court into our Intensive Mental Health Unit so that

6 we have the same officers who are specialized supervising

7 two different populations but with all of the same issues.

8 Our Behavioral Health Court is the Judge approves

9 their admission and the DA accepts their admission into the

10 court. For those with serious mental illness who the

11 District Attorney may be uncomfortable with them coming to

12 a Behavioral Health Court and having the chance of

13 diversion or for those who aren't accepting of their mental

14 illness and aren't willing to come into the program, we

15 have a mental health unit track.

16 The Behavioral Health Court is a voluntary

17 participation. There is no requirement for a person to

18 come into the court. The person makes that decision on

19 their own with the advice of their attorney. But we can't

20 force or sentence anyone into the Behavioral Health Court

21 unit.

22 We've had 352 individuals actively participating

23 in Behavioral Health Court and the Intensive Supervision

24 program since 2010. In 2011 we had seven successful

25 completions; in 2012, 38; and in 2013, we had 23. 21

1 Montgomery County estimated to have saved 160,000 jail days

2 through the behavioral health and mental health programs.

3 I think the lessons that we learned are that

4 Behavioral Health Court, through the inception of this,

5 really training and consultation in co-occurring disorders

6 are number one. I feel that the court is almost like

7 parenting. I feel like w e ’re constantly learning and

8 constantly evolving and we’re constantly changing to the

9 needs of our participants.

10 We also have found that ourselves, w e ’ve become

11 very inspired by the resilience and the success of our

12 participants as they move forward in their program and in

13 their recovery. They’ve returned to the workforce, they’ve

14 become more involved parents, and they mentor one another.

15 We ’ve learned that it’s not only cost-effective but it just

16 feels like the right thing to do and it feels like w e ’re in

17 the right place.

18 I think the other part that we really

19 underestimated when we started our court was the

20 involvement and the necessity of peer support and how

21 important that is for our people to develop positive

22 relationships with other people who have walked in their

23 shoes and who have lived experience.

24 So with that, I ’d like to introduce you to

25 Maureen Feeney-Byrnes. 22

1 REPRESENTATIVE MURT: Thank you, Stephanie, for

2 your testimony.

3 I also wanted to mention Representative Steve

4 Kinsey is here from Philadelphia.

5 Good morning, Maureen. Thank you for being with

6 us.

7 MS. FEENEY-BYRNES: Hi. Thanks for having us.

8 This is very exciting to be here. I like this room much

9 better. Last time I was up here we were in a different

10 room and it was like a graduated kind of thing. I felt

11 like I was back in school.

12 So anyway, I am Maureen Feeney-Byrnes and I want

13 to tell you that my recovery date is December 27th, 1980,

14 and I tell you that because it is truly a miracle. And it

15 is through God’s grace that I am sitting here today. And I

16 want to tell you a little bit about myself because it very

17 much impacts what is happening today in Montgomery County.

18 My experience started as a young child -- of

19 course I was a young child -- who never fit in anywhere. I

20 never felt like I belonged to my family, to school, to any

21 organization that I was involved in, just about everything.

22 And I wasn’t able to tell anybody this because I felt like

23 it was normal, that other people were experiencing the same

24 thing and I just felt that that was very sad.

25 It was pretty overwhelming at times, the sadness, 23

1 and my family would tell me just to snap out of it, to stop

2 feeling sorry for myself, and I wanted to but I couldn't do

3 that.

4 When I was in 7th grade, I found cigarettes and

5 alcohol and it was the elixir that I had been looking for.

6 I can still remember getting drunk on that 16-ounce bottle

7 of Schlitz beer that I had stolen from my father's

8 refrigerator, and the cycle continued. I was 12 years old

9 at that time and that cycle continued until I was 27 when I

10 came into recovery. I know I look very young for my age.

11 I actually was two years old when I came into recovery.

12 So this worked. I mean this, you know,

13 cigarettes, alcohol, it worked for a while but then a while

14 could have been a month because what I realized, not at the

15 time but in retrospect, was I was treating my depression

16 with a depressant, so no longer did I just have a

17 depression, I now had an addiction to alcohol.

18 When I was 15 years old, I was a junior in high

19 school and I was introduced to crystal meth, which took me

20 to places that I have never experienced, that I never

21 thought were possible. This took the depression away.

22 This worked for a very long time. So from 15 to I guess 27

23 I continued shooting meth -- well, I don't want to say I

24 continued shooting it because I didn't shoot it for all

25 that time. 24

1 When I was around 21 years old, my younger sister

2 was 16 at the time and she was involved with Children's

3 Hospital and she was having her third surgery and she was

4 being given last rites because they didn't think that she

5 was going to make it through this surgery. So I went to

6 see her and we were allowed to see her like for an hour on

7 Sundays, and when I went to see her she asked me why I was

8 trying to kill myself when she was fighting for her life.

9 That made a big impact on me, not big enough to stop using

10 drugs because it doesn't work like that, but I stopped

11 shooting drugs. I continued to drink and to snort it, you

12 know, any way that I could get it into my body, but I did

13 stop shooting drugs.

14 During this time there were many visits to

15 psychologists, psychiatrists, hospitalizations. My parents

16 were so involved with my younger sister that I was kind of

17 like an afterthought a lot of times. And believe me, I'm

18 not blaming them. It's just the way it was. They did what

19 they knew. That's the way it was.

20 I have a brother that's a year older than me and

21 him and I kind of took our own path. He's also in recovery

22 today.

23 One of my last hospitalizations was Norristown

24 State Hospital, my alma mater. Yes, I'm smiling. I have a

25 wonderful story that happened to me there many years later 25

1 that I ’ll share with you, but that’s where I ended up,

2 Norristown State Hospital. And I hated my father because I

3 remember seeing him sign the papers for me to go in there

4 and I blamed him. I blamed him for that.

5 Well, I guess I was maybe 15 years in recovery

6 when I found out that I had tried to jump out of the third-

7 floor window of the hospital that I was in and they had no

8 option but to commit me to this State hospital, but I

9 didn’t know that at the time. I just hated him. He didn’t

10 come and visit me. It was all left up to my mother. So I

11 had a lot of anger about him.

12 But when I got out of the State hospital I did

13 not stop using the chemicals, any of the chemicals that I

14 was using, and now I was also on a lot of prescribed

15 medications, too, so I ’m taking a lot of like Valium and

16 all these opiates and I ’m also still continuing to use the

17 meth and to drink, so my body didn’t know if it was coming

18 or going. I was literally bouncing off the walls.

19 In the late ’70s I decided to take my life, that

20 this time I was going to do it, but I could not do it in

21 Philadelphia. I had to move out of the State. So I moved

22 to Florida, you know, got in the car, drove down there, got

23 a place, lasted about a year, decided that I was going to

24 take my life, had everything planned. But then God

25 intervened because he wasn’t done with me yet and I ended 26

1 up going into a detox and into a 28-day program. They had

2 them back then. And I also went into a halfway house for a

3 couple years after that, which I know I would not be

4 sitting here today if I did not have that opportunity.

5 Norristown State Hospital also had a program. It

6 was called Independence House. And I have friends today

7 who are in their early 40 years of recovery who went

8 through that house who are still clean and sober today. We

9 don’t have treatment like that anymore, but that’s not what

10 this is about but I just wanted to get that out there

11 because I think it’s something that is desperately needed.

12 My recovery is all about my serious mental illness and my

13 drug addiction and they go hand-in-hand. I can’t separate

14 them out. Stephanie mentioned the co-occurring disorders.

15 We really do not have a handle on that. And to be a person

16 using chemicals, it’s just so -- like you can’t figure it

17 out. You can’t figure out why it’s not working.

18 So anyway, I got into this halfway house and I

19 started being surrounded by people who were in recovery and

20 my behaviors slowly started to change. Eventually, my mind

21 started to follow. And that’s what I needed. I needed to

22 be away from the people, places, and things. I need to be

23 surrounded by people who were about the same thing I was

24 about. I didn’t know that’s what I was about but I knew

25 they weren’t using and I knew that’s what I needed. 27

1 So over the next 15 or 20 years my life was

2 pretty full. I ended up moving back to Philadelphia when I

3 was four years in recovery. I ended up going to college.

4 I got a master's degree in psychology. I used my family

5 for show-and-tell through the whole experience. I

6 purchased a home. I bought a home. That like blew me

7 away. I got married, which again real funny story about -­

8 it's not funny; to me it was funny. When I did get

9 married, I had just been diagnosed with another chronic

10 illness and the doctor told me that I had a year to live.

11 So I was like, well, this is like completely unacceptable

12 because I'm 12 years sober, I bought a house, I'm getting

13 married. Like what you're telling me is unacceptable. He

14 said, well, there's a 5 percent chance that you'll make it.

15 And it's like, okay, I'll take it. Here I am. God's got a

16 plan for me.

17 So chemical intervention was no longer a part of

18 my life because the depression was abated. I was in

19 recovery now. Life was wonderful. I adopted two children,

20 which is truly a miracle, and through this whole time peer

21 support was wrapped around me, absolutely wrapped around

22 me. It wasn't my family, it wasn't my church; it was peer

23 support, so I knew that this worked.

24 So in the year 2000 my walls caved in on me

25 because the depression came back with a vengeance and I 28

1 found myself planning to drive my car into a wall and I

2 knew that I needed to see somebody about this, that it’s

3 back. It’s back. And I was very confused like I had been

4 working a program for 20 years, my program was telling me

5 if you just work the steps, it’ll work for you and it’s

6 like it’s not working.

7 So I did end up going back to a psychologist.

8 For the next four years we tried many different kinds of

9 interventions, chemical interventions, and I got introduced

10 to some people in the mental health arena because I had not

11 focused on that part of my illness because it was not

12 primary in my life. And I knew from having 20 years of AA

13 and NA behind me that peer support works, so I wanted that

14 in mental health also.

15 And what ended up happening is that I got the

16 opportunity to bring it to the mental health arena. My

17 mother passed in the year 2005 and after she passed it was

18 time for me to go back to work and I went to the mental

19 health arena because I had worked 25 years in the drug and

20 alcohol field and now I wanted to focus on the mental

21 health arena and bring all that good stuff into the mental

22 health arena.

23 So I got introduced to some people and God in his

24 way had it all planned out for me, and in 2007 I had the

25 opportunity to take this training to become a certified 29

1 peer specialist. And one of the requirements to be a

2 certified peer specialist is that you have to be in

3 recovery from a mental illness, a serious mental illness.

4 And I certainly fit that category. And I had the education

5 that you needed. You need to have a high school diploma;

6 you need to have some work experience, so I had all that.

7 It was a very exciting time because I thought, you know

8 what, this is it. It’s going to work for me. It’s going

9 to happen. I had that glimmer of hope because I had

10 received that 20 years prior and it was happening all over

11 again.

12 So I got this job at Montgomery County Office of

13 Mental Health, and in this position I utilize every single

14 strength that I have. I cannot believe the job that I have

15 today. Besides being a mother, it’s like the best thing

16 that ever happened to me.

17 And the other thing I got, like Montgomery

18 County, those of you that are from Montgomery County, I

19 have the newsletter that I passed out because we just

20 celebrated 10 years of peer support, certified peer

21 specialists. We were the first ones to offer this training

22 in Montgomery County, so w e ’re there and w e ’re doing like

23 really, really neat things in Montgomery County and I got

24 the opportunity to help push this initiative forward. It’s

25 almost like I can’t sit still in my seat because it’s 30

1 constant, you know, like let's do this, let's do this. My

2 boss can attest to that.

3 So a huge piece of this initiative was the

4 Behavioral Health Court and Pam's predecessor Nancy asked

5 me to be involved, to sit on the team at the Behavioral

6 Health Court as the voice of recovery and to offer the

7 perspective of a person in recovery to the team, not just

8 to the person sitting in the room, not just to the

9 participant but also to the team.

10 A lot of times our system is so embedded in the

11 way things are that they can't see where they could be and

12 what works and we know that this works. And it has been an

13 interesting -- it's been about three or four years now that

14 I've been on the team and I can sit back now on the team

15 and listen to the rest of the team talking about

16 recommending meetings for the people to go to, peer support

17 for the person. This was not happening. And Stephanie

18 made reference to that. This was not happening before.

19 So this journey that I'm on now has definitely

20 taken me to places that I could never have imagined. I

21 have the opportunity today to walk with my peers who have

22 also decided to transform their lives. I'm connected and

23 grounded in my journey knowing that there is invaluable

24 worth in a single act of faith. My journey continues to

25 take me towards endless possibilities. 31

1 So what is peer support? Peer support is the

2 system of giving and receiving help founded on key

3 principles of respect, shared responsibility, and mutual

4 agreement of what is helpful. It's no longer me telling

5 somebody; it's us working together. That's how it works.

6 Who provides the peer support? I told you about

7 the certified peer specialist training, high school

8 diploma, last three years maintain 12 months of employment,

9 and has completed the certification.

10 I feel really blessed to be part of this team,

11 part of this Behavioral Health Court team. I do feel

12 respected. I do feel like they want to make a difference

13 in people's lives. And I do get the opportunity to -- I've

14 been around for quite a while now into the 12-step program,

15 like I know how it works. It just works. It works, I

16 work, you work it. That's all there is to it.

17 So the other piece of it, I get to talk with the

18 recovery coaches, the probation officers to ask them about

19 connecting their peers with peer support in the community

20 because there's a whole lot more to recovery than just

21 going to court once a week or going to your therapist or

22 going to groups. Life happens and sometimes people in

23 recovery, especially with co-occurring disorders, need

24 someone to help introduce them, connect them with these

25 supports out in their community of choice. That's a very 32

1 important piece because if nothing changes, nothing

2 changes, so we have got to get out there and we have got to

3 make this work, especially like with our -- now I ’m going

4 off on another tangent. I have my two adopted children and

5 they’re the next generation. W e ’ve got to lay the

6 groundwork for them. It’s got to be there. It’s got to be

7 there. Thank you very much.

8 Oh, I ’m sorry. I have to introduce our next

9 person. I ’m sorry, Robert. I almost forgot. My coworker,

10 who is like everything, Wellness Recovery Action Plan, this

11 man is truly amazing and you’re going to enjoy listening to

12 him. Thank you. This is Robert Martin.

13 REPRESENTATIVE MURT: Thank you, Maureen, for

14 your testimony.

15 Good morning, Mr. Martin.

16 MR. MARTIN: Good morning.

17 REPRESENTATIVE MURT: Thank you for being with us

18 today.

19 MR. MARTIN: Thank you for having me.

20 First, let me just thank all of you for listening

21 to us and believing in a person like myself. Why do I say

22 that? First of all, my name is Robert Martin. I ’m a

23 person in recovery and I ’m recovering from many things.

24 I’m recovering from substance abuse, I ’m recovering from

25 mental health challenges, I ’m recovering from financial 33

1 issues, I ’m recovering from relationship challenges, I ’m

2 recovering, oh Lord, from myself.

3 Most importantly what brings me to the table

4 again to advocate for our continued services is I ’m

5 recovering from a forensic background, and being a person

6 who walks around with a State number on their back can be

7 more devastating than anything you could ever recover from

8 because my belief is a lot of times once you go to prison,

9 people stop believing in you. So when you don’t have the

10 supports to be able to walk out of prison and have

11 opportunities, you genuinely wind up doing the same things

12 you normally would do, which took me back and forth into

13 prisons.

14 Let me just tell you a little about my background

15 and then I ’ll go into the behavioral health peer services

16 that I coordinate under WRAP. Once again, I am a person in

17 recovery and I ’m 48 years old. I thank my Higher Power for

18 letting me see 48. A lot of people I grew up with aren’t

19 here anymore.

20 I do come by way of New Jersey. I can’t say I

21 grew up deprived. My family owns a funeral home. They’ve

22 had it for 75 years. So actually I grew up under wealth,

23 and I say that only to say that substance abuse and mental

24 health challenges and all the other things I ’m recovering

25 from, they don’t have a name on them. These challenges can 34

1 hit anybody anywhere, whether you're wealthy, whether

2 you're poor, whether you're mid-level. It's really a war

3 out there, and I'm actually glad that I'm on this side of

4 the war now.

5 But for me I grew up in New Jersey. I have one

6 sibling sister and love her. She's in California. I'm

7 actually about to go visit her so I'm very excited. But

8 growing up my life was very good, but at the same time,

9 having mental health challenges, I made my life rough. For

10 many, many years I wasn't diagnosed properly, I wasn't

11 taking my medications; I wasn't doing the proper things in

12 order to take care of Robert.

13 But also at the same time I need to honestly say

14 back when I first started recovery, the system, which is

15 why we're here talking together collaboratively, the system

16 was much more in silos back when I was recovering. The

17 behavioral health system wasn't talking to the mental

18 health system. They weren't talking to any of the prison

19 systems.

20 So a lot of times a person like myself, I got put

21 in places that I didn't necessarily belong because I wasn't

22 diagnosed properly. A lot of times I was sent to the

23 county jail and I was doing something on the street because

24 I was suffering from my mental health challenges. So

25 instead of them taking me to a psych unit, they took me to 35

1 the prison so I didn’t get the proper help. Or vice versa.

2 A lot of times they might take me to the psych unit and

3 maybe I did do a crime, stole something from a store, but

4 I ’m in the psych unit.

5 And I say all that to say today I ’m very proud to

6 be part of this system because w e ’re really starting to

7 figure out how to get people like myself to the proper

8 entities to get the proper service.

9 Recovery has been real good to me these last 12

10 years. I ’ve been really, really blessed. I know I ’ve sat

11 in front of a few of you all. I come by way of

12 Philadelphia under the tutelage of Dr. Evans. Now, I ’m in

13 Montgomery County under the tutelage of this great team.

14 So I am really, really blessed. A lot of people don’t get

15 this opportunity, especially coming from the prison, county

16 jails like I ’ve been in and out of.

17 So this is why I sit before you today advocating

18 for other people because I really believe they deserve the

19 same chances that I ’ve been blessed with. So I need to

20 keep shouting and speaking and talking to you

21 Representatives, and once again, I ’m very grateful that

22 you’re taking the opportunity to listen to us because I

23 know at the end of the day if we can make a small dent

24 together, w e ’ve done something with our lives, and that’s

25 just for me. 36

1 But at this time I really want to connect my

2 recovery into what I do and kind of how I wound up doing

3 what I ’m doing. I have to really just thank my Director

4 Betsy Gorski, who is the Director of Creating Increased

5 Connections. When she actually hired me almost two years

6 ago, the first thing she saw in me was I had a yearning to

7 help people in the criminal justice system, period, and I ’m

8 very grateful for that because at first I have to be

9 honest; when I got hired, I was scared to death of the

10 criminal justice system because I didn’t want to go back.

11 So for me it really was a personal though.

12 But when somebody else can see something in you

13 that you don’t necessarily see in yourself and then they

14 support you to become very good at it, I ’m grateful for

15 that because the people that I ’m allowed to work with and

16 that I’m honored to work with mirror me. When we look at

17 each other, it’s really like looking in a mirror. I feel

18 their pain, I understand the trials and tribulations

19 they’re trying to get through, whether it’s getting through

20 the system, coming out of the system, or even going into

21 the system. And being a person who has done that several

22 times, I ’m able to sit here today and have a job that can

23 afford them some options and understanding of how to use

24 those options.

25 On the average, 90 percent come out with positive 37

1 outcomes. I don't say I fix everything, cure anything,

2 nothing of that nature, but we do offer options now for

3 people to actually be more successful when they're making

4 the transitions throughout the court system.

5 And what do I mean when I say that? When I was

6 going through the system, we did not have any type of

7 system that offered groups, supports, CPSs like myself and

8 Maureen Feeney-Byrnes who can genuinely reach out to them

9 and say here's the options you have; let's go see about

10 some of these options. Most of the time when we get out of

11 the system or get intertwined with the system, once they're

12 done with you, it's just straight to the probation office,

13 and once you do that, if you mess up, you're straight back.

14 We lock you back up and forget all about you.

15 So I'm glad this day and age we have the first

16 entity, which Stephanie Landes talked about and I'm so

17 grateful to be able to collaborate with her. Pathways to

18 Recovery, as she talked to you all about, this was really

19 brought about because they wanted to fill some time, but in

20 all honesty, I'm glad they were thinking about filling

21 time.

22 But for me being the coordinator of this specific

23 project, it does more than fill time. And how I can attest

24 to that is I have people who come in now who come even

25 earlier for the group because we actually have a group 38

1 prior to the group where we'll sit and converse and they'll

2 tell me their highs and lows and I'll tell them my highs

3 and lows so that they can understand, one, they're not

4 alone, and at the same time they can understand that they

5 still can talk to their probation officers because I

6 support them with that. When you're put in the system,

7 authoritative figures can be very scary and you really

8 don't usually trust them. So I like to think of myself as

9 the link between the probation officers and them and help

10 support that fusion.

11 But at the same time, we use the group. We have

12 10 topics in the group and the individuals have to -- well,

13 let me not say "have to.” We support them in coming to the

14 group to do the 10 topics, and the topics, some of them

15 consist of healthy relationships, what does recovery mean

16 to me, we talk about financial issues. So there's specific

17 topics. There's 10 of them.

18 Once they do the 10 topics and they complete that

19 successfully, then they no longer have to come to Pathways

20 to Recovery but it becomes a choice if they want to come

21 because they'll show their Certificate of Completion to the

22 Judge, to Stephanie, or the POs, whoever they are involved

23 with, and then it becomes a choice. And they pretty much

24 become I call them alumni of Pathways. But for the most

25 part they still continue to come and I truly believe it's 39

1 because once they go through the topics and they share and

2 start talking about some strategies that they actually can

3 build to help not only get them through the program, the 18

4 months, but also how they can build upon making their lives

5 stronger in the community.

6 One of the things I ’m the coordinator of is

7 Wellness Recovery Action Plan. I know you heard me say

8 WRAP. Wellness Recovery Action Plan, this is a living,

9 breathing document that was built by Mary Ellen Copeland

10 and a team of hers, and this is an evidence-based practice,

11 document, or model that they put together that helps people

12 -- if you go to the next page and then I ’ll flip back -- it

13 helps people to build strategies in their lives, to build a

14 better quality of life. And this is something that

15 definitely, definitely works. I ’ve been using WRAP since

16 2006.

17 And as you can see here, there are several things

18 in the WRAP. They have a wellness toolbox, daily

19 maintenance list, triggers and action plans, early warning

20 signs and action plans, things are breaking down and action

21 plans, then a crisis plan, and a post-crisis plan.

22 Let me tell you more in simple terms what a WRAP

23 is and what it does. Most of us in life or all of us in

24 life have a WRAP, have a Wellness Recovery Action Plan.

25 I ’ll give you mine as an example. I wake up in the 40

1 mornings, under my wellness toolbox, the first thing I do

2 is say a prayer for myself. Then, some of the other things

3 that are in my wellness toolbox, I go in the bathroom,

4 brush my teeth, wash my face, take my medications. All of

5 these are in my wellness toolbox. These are simple things

6 that we used as tools to keep us well and healthy.

7 On my daily maintenance list, this is just simply

8 a list that I have of things that I need to do on a daily

9 basis to stay well. One is talk to my supporters like

10 Maureen. Another, go to work, make some money. Simple

11 stuff. Some of my other daily maintenance things, talk to

12 my wife. That’s a must, communication daily.

13 But you normally don’t think of a WRAP. It

14 something you just do. And I ’m very honored that Mary

15 Ellen Copeland had the foresight to put it on paper because

16 I looked at it and I was like, wow, this is stuff I do, but

17 being able to write it down and make it tangible helps the

18 person build structure for themselves such as myself, to be

19 able to see my list on a daily basis and then go to it and

20 say, okay, your clock is not tick-tocking right. Okay. So

21 what do you need to do to fix that? Let me go on my daily

22 maintenance plan and see if there’s something that I didn’t

23 do during the course of the day that I do that’ll help

24 rebalance me. It might be something as simple as have a

25 cup of coffee because I know on a daily basis I need that 41

1 cup of Joe early in the morning. That will smooth me out

2 and get my day started right.

3 Then some other simple things, Stephanie

4 mentioned something about triggers and triggers of course

5 we know are just external things outside of us that can

6 trigger us. Like I know for me I'm from Philadelphia,

7 there's a whole bunch of bars on every other corner. For

8 me that's a trigger. So I need to say like when I go

9 through certain parts of Philadelphia I drive kind of fast.

10 I keep the blinders on. I go straight through, make no

11 stops. If it gets a little rough, some of my action plans

12 are I get on the phone, call my wife. Listen, I'm driving

13 through Philadelphia, North Philly specifically, so talk to

14 me on the phone for about 10 minutes until I get to another

15 area of the city. And so it's simple things.

16 So let me just say this about WRAP. You all

17 understand it. It's a plan. It's a living, breathing

18 document that becomes embedded inside of us and it's

19 something we walk around with. But at the same time, it's

20 also something we build together in trainings and we also

21 talk about it in support groups.

22 One of the things that I just wanted to touch on

23 before I wind up were two things is I've been afforded -- I

24 spoke to you all about having a State number on my back.

25 One of the blessings was that Stephanie Landes and Pam 42

1 Howard and my Director Betsy Gorski and the Warden and

2 former Administrator Nancy Wieman, they all got together

3 collaboratively and they actually supported getting a

4 person like me approved to be able to go behind the walls.

5 Because they saw Pathways working so well, we had a

6 conversation about, okay, if w e ’re helping the people when

7 they’re out and they’re part of the court system, let’s

8 start helping them and supporting them prior to them

9 getting out, which made a whole lot of sense because if I

10 work with people, which I do now, and support people in the

11 prisons, right, some of them are coming out, some of them

12 are waiting for trial, some of them know their date and

13 know what’s going on.

14 But at the end of the day, if they were to tap

15 into them prior to them leaving, they leave actually prison

16 with some kind of WRAP plan. So they have some type of

17 structure, because in the WRAP groups we talk about, so,

18 what’s going to be some of your options and what are going

19 to be some of the things you want to set up prior to

20 leaving so that you won’t be triggered, so that you won’t

21 break back down and go back to criminal activities? And

22 with a person like myself and them knowing that I ’ve been

23 to prison, we receive each other very well when I go in

24 that prison. I ’m not saying people who haven’t been to

25 prison can’t reach the people in prison, but there’s just a 43

1 connection. I ’m sure you all understand that w e ’re able to

2 talk at a very real level. Let me just put it that way.

3 And the real reality is even when I do the groups

4 with them behind the walls, they really help me as well.

5 They help me understand how important it is for me to stay

6 out here and stay connected with these services to help

7 them get out, but it also helps keep me out just as much.

8 I have to be honest. Because when I go in the prisons or

9 in the jails and I speak with them and we do WRAP, it’s

10 wonderful when I walk back out. And I come back and

11 collaborate with them, what’s going on, things of that

12 nature.

13 Last but not least, the Adult Probation

14 Department, this was done very differently. Stephanie

15 Landes had the foresight -- well, this happened prior to

16 getting into the prisons. Once we actually got Pathways

17 started up, Stephanie is definitely a go-getter because as

18 soon as we started that up, she was like, hey, Rob, I have

19 an idea. Let’s have a meeting and talk. And the first

20 thing she said was I ’d like WRAP trainings within the

21 probation department. So that’s also a different level of

22 us collaborating.

23 So WRAP is now in the actual court systems with

24 Pathways. We talk about strategies there but we also have

25 the speakers come in. We have WRAP now in the adult 44

1 probation so once people are free and they're actually

2 dealing with their probation officers, when they come take

3 their yarns, they actually come do an hour group with

4 myself. And we also have WRAP in the prisons behind the

5 walls. So we're actually supporting people at three

6 different levels, and we do both sides, men and women. And

7 the probation of course it's coed, but in the prisons we go

8 on the women's side and we go on the men's side the next

9 day.

10 So in closing, this journey for me has been so

11 wonderful and I feel not only collaboratively that we're

12 helping the people out there, but as a system, we're

13 helping ourselves because we know with this war that's

14 going on, this war is becoming new and improved. But I

15 think the system is becoming new and improved, too, to be

16 able to keep up with the war. So for me I'm very grateful

17 for that. I'm very, very grateful for you all and thank

18 you for helping us.

19 REPRESENTATIVE MURT: Thank you, Robert, for your

20 testimony.

21 Maureen, before I ask you to come up, I just

22 wanted to mention that Diane Conway is here from MAX.

23 Diane, do you want to offer any testimony today since you

24 were very active in organizing today's hearing?

25 MS. CONWAY: I think I'm good. We have the 45

1 panelists; I think they really covered a lot of points. I

2 just wanted to thank the Committee for letting us get this

3 very important topic to them.

4 REPRESENTATIVE MURT: You're welcome. Thank you

5 for being so persistent in bringing this hearing to

6 fruition.

7 Marie.

8 MS. KEARNS: I introduced myself earlier as

9 representing MAX, which is the provider organization.

10 However, I'm also a Regional Director for a nonprofit

11 organization called Horizon House. And in Montgomery

12 County we operate what's called an Assertive Community

13 Treatment Team. That's an evidence-based practice for

14 individuals who in many ways are treatment-resistant. It

15 came out of Wisconsin in the '70s at the start of

16 deinstitutionalization, and the idea was to take people out

17 of institutions and all the interdisciplinary services that

18 were in the institution to wrap around them in the

19 community so that they could be successful in that

20 transition.

21 In my role in operating this team I actually was

22 able to meet Stephanie Landes when she was in the intensive

23 adult probation specializing in working with individuals

24 with mental health conditions.

25 And to be served on an Assertive Community 46

1 Treatment Team you need to be someone who has a serious

2 mental illness, who is what we call a high-utilizer of

3 services, so people in and out of the hospital frequently

4 or in and out of our criminal justice system, as well as

5 not being successful in lower levels of care.

6 The traditional levels of care is I make an

7 appointment at an outpatient clinic and I go to the

8 appointment and I meet with the therapist or a meet with a

9 psychiatrist and then they give me another appointment the

10 next time. Many people with serious mental illness cannot

11 get that structure yet in their life to be successful in

12 doing that. They’re struggling with hearing voices;

13 they’re struggling with all kinds of hallucinations and

14 paranoia. So to go to appointments and keep them regularly

15 is a challenge. So the Assertive Community Treatment Team

16 is able to wrap the services around that individual until

17 they’re well enough to be able to utilize traditional

18 services.

19 Given that population, it was frequent that we

20 encountered the criminal justice system because these are

21 individuals that, if you think about it, as you’re walking

22 down the street and you see somebody who’s talking to

23 themselves or is cursing or yelling because the voices are

24 bothering them, it frightens people. You don’t know what’s

25 going on. You don’t know what they might do. 47

1 And so many times the police are contacted and

2 sometimes the police bring the person, as Robert was

3 alluding to, they bring them to the psychiatric hospital to

4 be evaluated and hopefully helped there, but sometimes the

5 person may get aggressive, they’re afraid of the police,

6 they don’t know what’s happening. We don’t know what’s

7 happening in terms of their hallucinations, and so

8 sometimes they also land in the criminal justice system and

9 not in the hospital psychiatric system.

10 The intensive adult probation for individuals

11 with mental health issues allowed us to work with treatment

12 and probation together so that people who were only

13 involved in the system due to symptoms of their illness not

14 being treated, we were able to encourage them to stick with

15 treatment, we were able to use the support of probation

16 when the person was like, well, I don’t know if I want to

17 take this medication, and it helped to help that person

18 move forward.

19 But there was only a couple of probation officers

20 and they couldn’t serve all the people. So we also had

21 people who were assigned to general adult probation. And

22 in those circumstances some of our people would miss their

23 probation appointments or they weren’t taking their

24 medication or they relapsed on substances because they had

25 co-occurring and they would give violated and put back into 48

1 the jail.

2 Since we've now had Behavioral Health Court, we

3 now have individuals that if I'm working with an individual

4 and they end up getting involved in the criminal justice

5 system, the treatment providers can say, look, this person

6 is someone who needs treatment, not punishment. We can do

7 an application for Behavioral Health Court explaining why

8 that person would benefit from a treatment approach and get

9 that person served. And we truly are at the table. Our

10 program is there every single Monday to discuss with

11 probation, the Judge, everybody involved how things are

12 going with the individuals that we're serving, as well as

13 other mental health providers working with this population.

14 So you heard people talking about recovery coach

15 and no one actually said what that meant. In the old days

16 we called them case managers. We don't use that language

17 anymore. They're called recovery coaches. These are

18 people who assist individuals with serious mental illness

19 to navigate the system and to help them get the treatment

20 and the services that they need to be successful. So all

21 of us are at that table with that goal of helping an

22 individual manage the symptoms of their mental health but

23 also on the criminal justice side to keep them out of the

24 jail. It's much more cost-effective to treatment dollars

25 than it is to keep that extra 200 days in jail that a 49

1 person with mental illness sits in jail for.

2 My most frustrating example when before

3 Behavioral Health Court existed was I was working with an

4 individual who barged into his neighbor’s home because he

5 wanted cheesy fries and he wouldn’t leave. And the

6 neighbor was frightened. They had children. They were

7 terrified of this man in their living room who wouldn’t

8 leave and they called the police, naturally. We all would.

9 And he was arrested. He gave the police a hard time and

10 they arrested him. He was put in the county jail and every

11 time they tried to bring him into the court, he was not

12 able to participate in his defense but he was refusing

13 treatment in the jail.

14 Finally able to move him to the forensic hospital

15 unit but that man sat in some form of incarceration either

16 in the forensic psychiatric unit or just the jail for

17 almost a year for an offense that if he was found guilty,

18 he would have been out in 30 days.

19 That’s why we need Behavioral Health Court.

20 Those are the people who don’t belong in the system. But

21 we also need the treatment side to be available. W e ’re all

22 at the table but if there’s not treatment available to

23 somebody, it doesn’t work, and if there’s not an approach

24 that says within the court system let’s think of a

25 different way to process people who are not there because I 50

1 just robbed a bank, they’re there because of actions due to

2 their symptoms. And jail itself is not going to fix it.

3 Treatment is going to fix it. Getting control of the

4 person’s symptoms is going to fix it. So now w e ’re able to

5 work together so that someone does not have to have the

6 experience that that gentlemen had, that somebody like that

7 we can say there’s a different approach to use.

8 So our hope is to be able to continue to provide

9 services that we know work, and in the days of difficult

10 budget, w e ’re all challenged. W e ’re all challenged to

11 continue to provide the services, but everybody who’s at

12 the table needs to be able to stay at the table. And this

13 is an effort that w e ’re able to demonstrate truly saves the

14 system dollars, but more importantly, saves people’s lives,

15 saves people’s dignity.

16 It’s traumatic to be in jail, as Robert was

17 talking about, to have that number on your back. If you

18 come out with a criminal record, it’s very hard to get

19 certain housing, it’s very hard to go to school, it’s very

20 hard to get certain jobs. So if we can divert people that

21 really are not there because of criminal mindsets or

22 whatever we want to call it but are there because of

23 symptoms of an illness that can be treated and therefore

24 then prevent this behavior in the future, we really want to

25 be able to do that. 51

1 So from a provider's perspective I look and say

2 can I continue to do this? Do we have the services

3 available? So we always hope, as you move into the budget

4 season, that you think about that it's not just mental

5 health, it's not just drug and alcohol, it's not just

6 criminal justice, but there is a large group that

7 intersects. And so if any of us can't be at the table,

8 we're not going to be as successful as we can be when we're

9 all at the table.

10 But I never want to be able to see a person

11 incarcerated for cheesy fries for an extended period of

12 time. That's not what the system is for. That's not what

13 the jail is for. The jail gets frustrated because that's

14 not what they're there for. We get frustrated because we

15 can't get people out. But we have something like

16 Behavioral Health Court, we now have a way to be able to

17 say please get that man out, and we provide services, and

18 guess what? When that happens, people get well, they start

19 to take their medication, they start to get productive in

20 their lives, they're with their families, they have their

21 children, they get jobs, and they become certified peer

22 specialists and give back to society versus costing

23 society.

24 So I hope that we were able to give you some

25 information about an excellent practice that's serving well 52

1 the citizens of this Commonwealth, and w e ’re available to

2 answer any questions that you may have from any of us.

3 REPRESENTATIVE MURT: We do have some questions.

4 Diane, did you want to add something?

5 Thank you for coming to the microphone.

6 MS. CONWAY: I don’t have any formal testimony

7 today. I thought that the panel really deserves--

8 REPRESENTATIVE MURT: Diane, I ’m sorry. Could

9 you just introduce yourself?

10 MS. CONWAY: I don’t have any formal---

11 REPRESENTATIVE MURT: Could you introduce

12 yourself---

13 MS. CONWAY: Oh, I ’m sorry.

14 REPRESENTATIVE MURT: -- formally tell us who you

15 work with.

16 MS. CONWAY: I ’m Diane Conway. I ’m the CEO of

17 MAX Association. W e ’re an association of human service

18 providers in southeast Pennsylvania covering Bucks,

19 Chester, Delaware, and Montgomery Counties. We have as

20 membership human service organizations that have behavioral

21 health services, services for people with autism and

22 intellectual disabilities. So we kind of cover the gamut.

23 And I don’t have any formal testimony but what I

24 did have is kind of a concluding comment to the presenters

25 before the questions and answers. And I want to start off 53

1 by saying this is the second hearing that w e ’ve helped

2 organize with behavioral health issues, and we wanted to

3 thank the Committee for allowing us this time.

4 Our purpose really was because we see in the

5 media a lot of negative things and those negative things

6 like the school shootings get associated automatically with

7 people with mental health issues, and that may or may not

8 be the case. The media really likes to sell things in a

9 very sexy way.

10 But what we do know is that there are things -­

11 and we didn’t want to come to you also with we need money,

12 we need money, there’s not enough services, and that

13 certainly is true, too, but what we did want to come to you

14 with is that there are things that are working. There are

15 pockets of excellence. There is really a lot of hope out

16 there and that we wanted to spotlight those areas that you

17 may not know about, the Suicide Prevention, the first aid

18 mental health training that’s going on, and now Behavioral

19 Health Court. We do have a lot of other things that we

20 would like to come before you and talk about, too.

21 So I just wanted to thank you for this time,

22 thank Representative Murt, and actually congratulate you

23 also in your recent challenge and victory in changing the

24 Department of Public Welfare to the Department of Human

25 Services. The name of that department is really important 54

1 because it does serve humans and has human services and it

2 will change our conversation in the future. So thank you

3 very much.

4 REPRESENTATIVE MURT: Thank you, Diane. I was

5 going to mention that at the end, but yes, the Department

6 of Public Welfare will soon be Human Services, and I

7 appreciate that.

8 However, it was not just through my efforts.

9 Representative DeLissio was extremely active--

10 MS. CONWAY: I'm sure.

11 REPRESENTATIVE MURT: -- and energetic in that

12 effort and I thank her for that.

13 REPRESENTATIVE DeLISSIO: Thank you.

14 REPRESENTATIVE MURT: Okay. We do have some

15 questions and we would ask that any of our testifiers who

16 would feel qualified to answer any of the queries, if you

17 could please sit at the table and talk into the microphone

18 since we are on PCN.

19 Ashley has some questions from Representative

20 Michelle Brownlee. I'm going to let Ashley ask those

21 questions.

22 MS. McCAHAN: First of all, Representative

23 Brownlee wanted to thank you all for your testimony today.

24 And she had a twofold question, which is how many of these

25 courts do we have in Pennsylvania, and do they interact 55

1 with each other?

2 MS. LANDES: We do. I believe we have 98 active

3 problem-solving courts in Pennsylvania. The AOPC can give

4 an exact statistic on that, but I just came from State

5 College this past week and I am almost positive that was

6 the stat, and they were hopeful to have 100 by the end of

7 2014. There are two courts that are in application. The

8 problem-solving courts consist of Drug Treatment Courts,

9 Veterans 'Treatment Courts, Mental Health or Behavioral

10 Health Courts and there are some other kind of specialty

11 courts in there that might be specific to juveniles that

12 have different names, but the Commonwealth has

13 approximately 98 courts.

14 REPRESENTATIVE MURT: Excuse me for a minute.

15 Are these special courts organized by county?

16 MS. LANDES: They are organized by county and

17 then the AOPC supervises that and is there to answer any

18 questions and help us start up our courts as well. They

19 also train us and give us an overview as to best practices

20 and model different ways for our courts to be effective.

21 REPRESENTATIVE MURT: Thank you.

22 Pam, Representative DeLissio.

23 REPRESENTATIVE DeLISSIO: Thank you. I think the

24 one thing I was struck by, not in this hearing but

25 previously, is that a lot of counties in Pennsylvania don't 56

1 have any type of specialty court and that is a decision by

2 the county and often predicated on resources and

3 priorities. That was my first kind of startling piece of

4 information that the State in no way compels counties to

5 look at these specialty courts. So it would be interesting

6 to see, Representative Murt, of these 98 active courts

7 which counties they’re in and which counties have no such

8 specialty courts at this point and to try to understand why

9 that is. So that’s one comment.

10 The average days for persons with severe mental

11 illness are a little better than three times that for the

12 general population. Is that because as a result of their

13 disease they have committed crimes that get them longer

14 sentences or are they in there getting treatment as well as

15 serving time? What accounts for that longer time frame?

16 MS. LANDES: Yes, m a ’am. Actually, the

17 difference was not due to the nature of the offense. In

18 comparison studies they were very comparable offenses.

19 What we were finding was it was more difficult to plan for

20 the release of a person with serious maternal illness. It

21 was more difficult to set up services, housing is always an

22 issue, and also we found a population of people with

23 serious mental illness that were very quiet in the jail and

24 weren’t necessarily bringing attention to themselves so

25 they kind of just were there and no one was really 57

1 identifying them. The prison would know who they were but

2 it was very difficult. They weren't bringing any attention

3 to themselves so they weren't really advocating for

4 themselves. They were just kind of blending in.

5 So additionally, it costs more to house a person

6 with serious mental illness than it costs on average to

7 house a person that is just in general population not only

8 because they're there longer but because the cost of their

9 care is increased due to medication, due to different

10 services that they may need medical-wise and also

11 psychiatric.

12 REPRESENTATIVE DeLISSIO: So I come out of long­

13 term care; we're responsible to do discharge planning if

14 somebody's being discharged from a skilled nursing

15 facility. So you're saying this same concept of discharge

16 planning applies to our citizens who are about to reenter?

17 MS. LANDES: Yes.

18 REPRESENTATIVE DeLISSIO: So that discharge

19 planning becomes more complex and complicated because the

20 resources aren't necessarily there to readily meet their

21 needs?

22 MS. LANDES: Right. And what the problem-solving

23 courts are able to do is bring everyone together so you

24 have a multifaceted approach to getting that person out of

25 the jail. And different agencies are working in 58

1 collaboration.

2 REPRESENTATIVE DeLISSIO: One more question,

3 Mr. Chair.

4 There were 352 folks who were identified as

5 having actively participated and then it cites some

6 statistics about who successfully completed it. And those

7 numbers are greatly below 352. I think when you add them

8 up quickly, it’s roughly 70 out of 352. What happened to

9 the other folks?

10 MS. LANDES: Well, the program is 18 to 24 months

11 so some people are still in the program; they’re still

12 participating. We have had a few people who have dropped

13 out of the program and went to sentencing. W e ’ve had very

14 few but we have had a few deaths in the program. But most

15 of the people are actively in the court.

16 REPRESENTATIVE DeLISSIO: So just not enough time

17 has elapsed yet for those to be---

18 MS. LANDES: Yes, m a ’am.

19 REPRESENTATIVE DeLISSIO: -- counted as

20 successfully completing that?

21 MS. LANDES: Yes.

22 REPRESENTATIVE DeLISSIO: Okay. And when you

23 talk about jail days, that’s county jail time, not State

24 prison time---

25 MS. LANDES: Correct. 59

1 REPRESENTATIVE DeLISSIO: -- is that correct?

2 MS. LANDES: Yes.

3 REPRESENTATIVE DeLISSIO: Thank you,

4 Mr. Chairman.

5 REPRESENTATIVE MURT: Representative Kinsey.

6 REPRESENTATIVE KINSEY: Thank you, Mr. Chairman.

7 Robert, I have a question for you. You shared a

8 story about driving through Philadelphia. I actually

9 represent Philadelphia, but not the section you mentioned,

10 okay, but you actually mentioned, I guess as a support,

11 calling your wife sometimes.

12 MR. MARTIN: Yes.

13 REPRESENTATIVE KINSEY: So as I was reviewing

14 this document here and it talked about the team members, it

15 says "others as needed,” would your wife be considered part

16 of the team and do you as the individual choose who’s on

17 your team aside from maybe the Judge and the DA? Like do

18 you get to choose the supports or the members of the

19 support team that you believe could best serve in your

20 interest and support you?

21 MR. MARTIN: Well, when I speak to my team,

22 that’s something I set up personally. When you’re

23 developing or doing a WRAP, it’s done by the individual and

24 only by the individual. There’s no team. Now, you’re

25 speaking about the team-- 60

1 REPRESENTATIVE KINSEY: Right, for Intensive

2 Coordination it lists here---

3 MR. MARTIN: Oh, okay.

4 REPRESENTATIVE KINSEY: -- the Judge, a

5 representative from the District Attorney’s Office,

6 probation, mental health offices, certified peer

7 specialists. It says, "others as needed,” so I guess what

8 I ’m trying to allude to who decides the team members? Like

9 if this was an ISP, the individual would sort of pick who

10 he wants on his team that can best support that individual.

11 Is that the same idea with the Intensive Coordination Team?

12 MS. LANDES: Yes, sir. The probation officer or

13 the recovery coach would know the significant people in our

14 participants’ lives. We may know from the participants.

15 We may know because that person has made application to our

16 court.

17 REPRESENTATIVE KINSEY: Okay.

18 MS. LANDES: So the probation officer and the

19 recovery coach would have the family members’

20 perspective---

21 REPRESENTATIVE KINSEY: Okay.

22 MS. LANDES: -- and bring that to the court.

23 That person would not be part of our judicial review---

24 REPRESENTATIVE KINSEY: Okay.

25 MS. LANDES: ---where we meet with the Judge and 61

1 the District Attorney, but the family members are part of

2 our treatment planning and part of our case review as far

3 as the treatment team getting together. They would

4 participate in those meetings.

5 REPRESENTATIVE KINSEY: Great. So when you have

6 the weekly BHC team planning and the weekly court

7 appearance, is that a coordinated effort where the whole

8 team meets or goes with the individual for the court

9 appearance or is that just selective members? Like that

10 coordination I guess is what I'm trying to understand.

11 MS. LANDES: Okay. So we meet every Monday at 12

12 o'clock and that's with the Judge, the District Attorney,

13 the Public Defender, the Office of Behavioral Health--

14 REPRESENTATIVE KINSEY: Okay.

15 MS. LANDES: ---case management, and the

16 probation officers. We review all of our cases that the

17 Judge is going to see that Monday.

18 REPRESENTATIVE KINSEY: Right.

19 MS. LANDES: Then at two o'clock we go into the

20 courtroom and that's where the participants are, as well as

21 the entire Behavioral Health Court team comes in and we all

22 meet together, and each participant individually goes up to

23 meet with the Judge and fill the Judge in on their week and

24 how everything has gone.

25 REPRESENTATIVE KINSEY: Okay. 62

1 MS. LANDES: Their family members can be present

2 in court; they're not required to be---

3 REPRESENTATIVE KINSEY: Great.

4 MS. LANDES: -- but they can be.

5 REPRESENTATIVE KINSEY: Okay, great.

6 Just two more questions, Mr. Chairman?

7 REPRESENTATIVE MURT: Sure.

8 REPRESENTATIVE KINSEY: All right. The length of

9 training for the peer specialist certification, what's the

10 length of training that an individual needs to complete

11 that?

12 MS. FEENEY-BYRNES: Thank you for bringing that

13 up because as I sat down I realized I didn't tell you what

14 that was.

15 REPRESENTATIVE KINSEY: Okay.

16 MS. FEENEY-BYRNES: It is a two-week training.

17 REPRESENTATIVE KINSEY: Two-week training.

18 MS. FEENEY-BYRNES: It's a 75-hour training.

19 It's comparable to a three-credit college course.

20 REPRESENTATIVE KINSEY: Seventy-five hours.

21 Great. Okay. Good. Thank you very much for that.

22 UNIDENTIFIED SPEAKER: [inaudible] ongoing

23 training?

24 MS. FEENEY-BYRNES: Oh, yes, I'm sorry. There

25 are ongoing training requirements also, 18 hours of 63

1 education. If you’re working, you need to have 18 hours of

2 education.

3 REPRESENTATIVE KINSEY: Annually?

4 MS. FEENEY-BYRNES: Annually, yes, 12 of them

5 being in recovery.

6 REPRESENTATIVE KINSEY: Great. Okay. The last

7 question I have and I ’m not sure if you can answer this but

8 I ’m thinking -- 302, we know that that’s a hospitalization

9 when an individual is a danger to themselves or others.

10 How do you differentiate between a 302 and I guess -­

11 otherwise like I ’m thinking 302 is a hospitalization, but

12 again, if I ’m committing a crime or an assault toward an

13 individual, how do you determine do I go to jail or do I go

14 to a facility, a hospital, to get treatment? Do you see

15 that often in the counties?

16 MS. LANDES: We see that a lot.

17 REPRESENTATIVE KINSEY: Okay.

18 MS. LANDES: And that’s definitely a concern.

19 It’s something that w e ’re trying to kind of give some

20 thought around how we plan around that. Often what we see

21 in our county is we see both. We see someone committed on

22 a 302 and then charged for the same behavior. And our hope

23 is that eventually we can get our police officers and our

24 Board of Judges more comfortable with our civil

25 commitments--- 64

1 REPRESENTATIVE KINSEY: Okay.

2 MS. LANDES: ---so that someone can go from a 302

3 on an outpatient civil commitment for treatment and then

4 not necessarily have the same charges that have gotten---

5 REPRESENTATIVE KINSEY: Right. Yes.

6 MS. LANDES: -- them involuntarily committed.

7 But that is a big population of what we see in Behavioral

8 Health Court as well.

9 REPRESENTATIVE KINSEY: Okay.

10 MS. HOWARD: And I think that, like I said, the

11 really good relationships established in Montgomery County

12 with the criminal justice system and the behavioral health

13 system, I think that there are roads that we could continue

14 down because really we don’t want to see anybody enter into

15 the criminal justice system because of behavioral health

16 issues.

17 So one of our providers, Montgomery County

18 Emergency Service, does do training for some of the police

19 forces and we really do try to divert people and a lot of

20 the police really do try to divert people from ever hitting

21 the jail. And a lot of times people are brought for

22 evaluations and treatment as opposed to jail and having

23 charges filed.

24 But I would have to say that I think there’s more

25 to do. There’s definitely more training, education, and 65

1 more prevention that could be happening before people would

2 ever get into the criminal justice system.

3 REPRESENTATIVE KINSEY: Great. Great. Thank

4 you. Thank you all.

5 Thank you, Mr. Chairman.

6 REPRESENTATIVE MURT: Does anyone else have any

7 questions?

8 Representative DeLissio, sure.

9 REPRESENTATIVE DeLISSIO: Do you know if how

10 Montgomery County approaches this is unique, how any other

11 county does it? Do you have---

12 MS. LANDES: I think we're starting to see it in

13 more counties. I think Montgomery County's peer support is

14 very strong and very active and I'm not sure that other

15 counties have that much of a coordinated effort among peer

16 support. But I do know that there are many counties that

17 are developing Behavioral Health Courts and have a lot of

18 collaboration between the different departments and

19 agencies.

20 REPRESENTATIVE DeLISSIO: Thank you.

21 Representing part of Montgomery County, I'm very

22 proud of the effort. Thank you.

23 MR. MARTIN: If I can say---

24 MS. HOWARD: Again, I have to give a lot of

25 credit to Judge Smyth, too, because I think he really has 66

1 put his heart into this and I think his willingness to

2 really learn so much about behavioral health needs and

3 issues, and trauma is a huge piece of what impacts people’s

4 behavioral health challenges. And Judge Smyth has really

5 made a commitment to learning more and more. And he’ll be

6 out, he’ll go to conferences. He was just at a Hearing

7 Voices training recently. So I really have to just honor

8 him and express our gratitude to his willingness to

9 continue to learn about these needs that people have.

10 REPRESENTATIVE DeLISSIO: I had actually

11 contacted the Judge to testify at a policy hearing in

12 January on Medicaid expansion interestingly enough because

13 at this Committee a year or so ago we had a Judge from

14 Lackawanna or Luzerne County testify that Medicaid

15 expansion under the Affordable Care Act would provide much-

16 needed monetary resources and he could see that aiding

17 these mental health courts in a great way. And that was a

18 testimony that certainly I had never heard before and

19 certainly it caught the attention of any number of

20 colleagues how here was law enforcement, of all categories,

21 weighing in for Medicaid expansion.

22 So I ’m not sure how our current waiver plan that

23 was recently approved will support this effort, but boy,

24 that was a very attractive opportunity that I hope is

25 somehow included in the waiver plan and we haven’t missed 67

1 out on because we see how necessary these courts are and

2 this support is because the other side of it is it’s

3 costing us a lot of money without a lot of return on that

4 investment.

5 REPRESENTATIVE MURT: Stephanie, are there many

6 veterans that are involved in Behavioral Health Court?

7 MS. LANDES: We have a separate court for

8 veterans and we have about 35 veterans in Montgomery

9 County’s Veterans’ Treatment Court.

10 REPRESENTATIVE MURT: Is there any reason that a

11 person would not want to participate in a Behavioral Health

12 Court if they’ve offered the opportunity to do so?

13 MS. LANDES: Yes. It’s much more intensive; it’s

14 much more structured. So depending on the severity of the

15 charges that they’re facing, oftentimes they may have a

16 two-year probation, which means they would work with their

17 probation officer on a monthly basis as opposed to coming

18 to court on a weekly basis, meeting with a probation

19 officer weekly, having random urinalysis where you’re

20 called on average four times a week, it’s much more

21 intensive and it’s much more structured.

22 Also, there are some defendants with severe

23 mental illness that don’t recognize that they have a mental

24 illness and are very paranoid and suspicious of the

25 criminal justice system. So they would not be willing to 68

1 enter into our court.

2 REPRESENTATIVE MURT: I have another question.

3 In Montgomery County has the experience with the Behavioral

4 Health Court met your expectations or your hopes? Has it

5 been as successful as you hoped it would be?

6 MS. LANDES: I can say so. I mean I think we

7 were very naive going into it. I think we thought that

8 this was something that we were already doing in Montgomery

9 County, and I think it's really opened our eyes. This

10 increased collaboration I think has been extremely

11 successful. It's amazing to us that we have graduates that

12 continue to come back because they want to see the Judge,

13 they want to see the staff, and they want to see the

14 participants in the court. To me this is the most

15 rewarding work I've ever done. I've very happy to be part

16 of this court.

17 REPRESENTATIVE MURT: One last question, I think,

18 Marie, maybe you used this expression and it's the first

19 time I ever heard it, "treatment-resistant." What kind of

20 individuals are we referring to when we use that expression

21 "treatment-resistant"?

22 MS. KEARNS: Well, I think there's two

23 categories. One is that the individual themselves says I

24 don't have a mental illness so I don't want anything to do

25 with this mental health system. But there's a group of 69

1 people that they're going to continue to struggle with

2 mental health symptoms because there's not the right

3 medicine. We don't have the perfect package to help them.

4 And so they do struggle and they end up bouncing both in

5 systems because nothing fits them perfectly. So it's the

6 double-edged sword. The group of people who all the

7 treatment is not successful with them because we don't have

8 the right drugs or things, but then there's that group of

9 people who, because of their illness, they're saying, no, I

10 don't want anything to do with this system.

11 MS. FEENEY-BYRNES: I would also just like to

12 interject there also that peer support has had tremendous

13 success in--

14 UNIDENTIFIED SPEAKER: Both those areas.

15 MS. FEENEY-BYRNES: -- walking with people,

16 engaging people that have been labeled treatment-resistant.

17 REPRESENTATIVE MURT: Well, thank you very much

18 for your testimony. Thank you to my colleagues for

19 participating.

20 I did want to mention that there were two written

21 testimonies that were submitted that were excellent and we

22 appreciate those two individuals that wrote to us. The one

23 testimony has some really good suggestions and that's what

24 we like to see, people telling us what to do. So that was

25 very good testimony. 70

1 I also want to thank Liz Yarnell, Melanie Brown,

2 and Pam for helping organize the hearing today.

3 I hope everyone here knows that we care about

4 this issue and we appreciate your passion. And as I

5 mentioned in the beginning, there’s not too many families

6 in Pennsylvania that are not touched in some way either

7 directly or indirectly with the behavioral health, the

8 mental health, or an addiction-related issue, and so these

9 issues that w e ’re discussing touch all of us whether w e ’re

10 elected officials or not. So thank you very much for your

11 professionalism and your passion.

12 And the last thing I wanted to mention is that

13 we ’re always looking for ideas, proposals for legislation,

14 and if you have any ideas, if you have a legislative

15 agenda, please get it to us, okay, and we can talk to our

16 research people about it, maybe have some legislation

17 proposed or introduced for next session.

18 UNIDENTIFIED SPEAKER: Thank you very much.

19 Does anyone else have anything else before we

20 close?

21 Okay. That’ll conclude our hearing. Thank you

22 very much.

23 MS. KEARNS: Thank you.

24 MS. LANDES: Thank you.

25 MR. MARTIN: Thank you. 1

2 72

1 I hereby certify that the foregoing proceedings

2 are a true and accurate transcription produced from audio

3 on the said proceedings and that this is a correct

4 transcript of the same.

5

6

7 Christy Snyder

8 Transcriptionist

9 Diaz Data Services, Inc.