Proper training to improve outcomes for individuals with mental health and substance use challenges is especially important when law enforcement personnel become involved.
Intercept 1 – Law Enforcement
Intercept 1 begins when law enforcement typically first becomes involved when responding to a crisis or nuisance call or encountering people with mental health or substance use challenges and is over when the individual is either arrested or sent to or chooses to engage in treatment. Given that Intercept 1 is a critical step with multiple potential resolutions via branching pathways, it is crucial that law enforcement officials receive training on the core competencies to help them make the best decisions possible or collaborate with the appropriate community partner regarding most appropriate next steps and level of care for the individual in crisis to best create positive and least-restrictive outcomes.
Intercept 0 often naturally flows into Intercept 1 with law enforcement being involved as part of a response team for most 911 calls and many crisis response calls, although some teams are moving away from this co-response model and bringing in clinical staff and peer workers instead, further highlighting the overlap between 0 and 1 and how the intercepts flow. Because of this, there is a great deal of overlap in the competencies relevant to Intercept 0 and Intercept 1. It is recommended that law enforcement officials and providers at Intercept 1 become familiar with the competencies relevant to Intercept 0 and the nuances between the competencies as they pertain to both intercepts.
Intercept 1 CCBHC Integration Opportunities
- Dispatcher training
- Specialized police responses
- Intervening with high-need persons and providing follow-up post crisis
The CCBHC funding model supports clinics in working with 911 and law enforcement when MH/SU-related calls are made, with 72% of CCBHCs providing training to law enforcement or corrections officers in Mental Health First Aid (MHFA), CIT or related trainings that support officers in responding to individuals with MH/SU needs. Many CCBHCs (20%) provide officers with electronic tablets to deliver telehealth support when interacting with an individual with an MH/SU need and 13% partner with 911 to have relevant calls rerouted to an MH/SU response team. CCBHCs are required to develop a crisis plan with each consumer and to have an established protocol specifying their role with law enforcement in the provision of crisis services.
Intercept 1 Core Competencies
Collaboration and Teamwork
- Adopt a single system-wide county definition of key terms consistently used by local behavioral health systems, jails, courts and community corrections, including but not limited to:
- Substance use disorders
- Serious mental illness
- Recidivism
- Conduct a Sequential Intercept Model mapping workshop.
- Identify service capacity/interventions/gaps.
- Understand respective roles and responsibilities.
- Obtain leadership commitment (criminal justice council or task force).
- Develop collaborative criminal justice and behavioral task force if one does not already exist.
Workforce Development
- Provide cross-systems training on:
- Substance Use Disorder and MAT
- Implicit bias
- Data and evaluation
- Trauma-informed Care
- MHFA for public safety
- Motivational Interviewing
- Screening, Brief Intervention and Referral to Treatment (SBIRT)
- Peer Navigators/Recovery Coaches
- Integrated mental health treatment for co-occurring substance use disorders
Screening and Assessment
- Share assessment information with partners to streamline workflow and coordinate care.
Care Planning and Care Coordination
- Develop process for linking to services (warm handoffs).
Cultural Humility
- Implement/enhance anti-racist training and education.
- Adapt services to language, gender and pronoun preferences and cultural norms of population served.
- Promote diversity among staff teams, executive leadership, boards.
- Develop task force that is inclusive of individuals with lived experience to spearhead the implementation/assessment of anti-racist policies and procedures, training and education.
Racial and Ethnic Disparities
- Identify and address racial disparities within criminal justice system involvement and in health care access and quality for populations served.
- Develop task force for racial and ethnic disparities to help achieve the following goals:
- Set qualitative process and outcome goals for racial and ethnic disparity reduction.
- Set a numerical target for reducing justice system involvement and/or improving outcomes for Black, Indigenous and people of color (BIPOC).
- Set a numerical target for reducing the relative likelihood of justice system involvement for BIPOC compared to White adults.
Evaluation and Quality Improvement
- Develop a city/county-level training plan that includes quality assurance to ensure fidelity.
- Develop a city/county-level plan for information/data sharing.
- Data Collection Across the Sequential Intercept Model (SIM): Essential Measures
- Agree on how to measure recidivism and other health outcomes. For example:
- Recidivism outcomes:
- Reduction in police contact, arrest and reincarceration.
- Health outcomes:
- Reduction in wait time for accessing services.
- Access to and engagement in treatment and services.
- Track medication refills.
- Rate of homelessness/access to housing.
- Reduction in hospitalization/ER rates.
- Increase access to care coordination.
- Reduction in wait time for Medicaid reinstatement.
- Recidivism outcomes:
Funding and Sustainability
- Prioritize policy, practice and funding improvements.
- Understand Medicaid/SSA coverage.
- Routinely communicate with the people responsible for the county budget.
- Utilize data to justify funding.
- Explore federal and state funding opportunities.
National Council Resources
- 2021 CCBHC and Justice Systems Report
- 2022 CCBHC Impact Report
- Deflection and Pre-arrest Diversion to Prevent Opioid Overdose
- Addressing Health Equity and Racial Justice Resource Directory
- Health Equity Resource Directory
- Trauma-informed, Recovery-oriented Systems of Care Toolkit
- The Intersection of Criminal Justice, Race and Addiction: The Case of Harold Easter
- 988 and Mobile Crisis Response with the CCBHC Model
- Roadmap to the Ideal Crisis System
- Training Public Safety to Prevent Overdose in BIPOC Communities
- Addressing Opioid Use Disorder in Emergency Departments: Expert Panel Findings
Want to Learn More?
- Transform 911: Blueprint for Transformation Chapter 7
- Justice Community Opioid Innovation Network (JCOIN) and National Council for Mental Wellbeing: First Responder Deflection e-course