 the what as well as the why for partnering with SAMHSA for this bear cares grant specifically for the youngest of our population and so we are the city of San Antonio and the Head Start program of which I work in within the city have children from ages six weeks through five years of age in our program and we have over 3200 children and their families and we target although that's probably not the way I should use just now we select how's that we select children who are of greatest need we truly look for and plan for having at least 10% of the children we serve to be children identified with disabilities and we look for families that are at a right very close to the federal poverty guideline so we're truly looking for the children and greatest and their families of greatest need so when one does that there are multiplicity of connected issues and problems with the families and with the children and with the institution 100% of our children ages three to five are within public schools our young children the infants and toddlers are in six inner city child care centers so you have some system pieces you have some family pieces you have some children needs and what we've done differently with our SAMHSA partnership grant monies well the partnerships actually with CHCS Center for Health Care Services is we've created an opportunity to address young children's mental wellness issues in the constellation of their family now previously and it will give those of y'all who know little kids well and especially those in pre-k classrooms realize that at a three-year-old level it's pretty hard to tell whether you're dealing with a behavior problem that's a function of the classroom or you're dealing with a behavior problem that's a function of perhaps some other kinds of issues because they look exactly the same when you're three so with our opportunity here we've been able to truly institute a three tiered program of mental wellness for our children now this concept the triangular concept of three levels exists many many places that's that's really for us not the innovation itself it's the ability to actually execute it has been the innovation previously we really had no mechanism at a level three child a child who is in desperate need of more than that which can be handled in a classroom we had no way to provide services for that child as well as the family at the same point in time and y'all know as well as I do that you can't take a three-year-old or a four-year-old and treat them in their area of mental illness perhaps without the family I mean we're talking we're talking a system issue here within the family and so this has allowed us to provide funds for the level one children in the public school classrooms for the level two children by being able to take funds and provide behavior specialists who truly work with the teacher to make sure that the environment in which an acting out or a child with a behavior issue we can make sure that the environmental factors for that behavior have been taken care of and teach the teacher show the environmental constructs that can be changed within the classroom but then when that doesn't really address or solve or give an environment where the child behavior can be improved because of our ability now to level three issues with our partnership through the SAMHSA grant and CHCS we can actually offer the family and the child the types of ongoing services that we've never been able to do before within the public school system so it's been a bit of a rough start for the first year in all honesty when you're dealing with so many different sets of rules and so many different expectations head start for those of you who may or may not know it is a highly structured highly governed standards driven program the public schools which is 100% what our children are are highly designed highly governed highly standard set of issues and then we want to go outside of those two and provide mental wellness services to the infant our family constellation because of a behavior issue or set of issues of a three-year-old or a four-year-old so you have three distinctively different systems that the challenge is how do we make that work easily quickly and readily available for families who may or may not have had successful experiences with any one of those three systems or all of them at one point in time so the innovation for us and I don't want to belabor this point but is that ability to get the services together as quickly as we can provide them to the family constellation if that's what's necessary and provide that type of service to the child whose behavioral issues are of such magnitude that they cannot be addressed with changes in the public school classroom environment or what those issues that are under the control of the teacher him or herself we have referred about eight the SAMHSA grant let me go step back a minute the SAMHSA grant is designed to receive 250 referrals a year that's a lot of young children in need of intervention of that 250 referrals which we did have this past year about 18% of them come from the Head Start population in the inner city the city of San Antonio Department of Human Services Head Start program serve children only in SAISD and Edgewood ISD so we're truly just serving the young pop excuse me we're serving the population only in those two school districts so that that's the population that I'm talking about right now so when we look at this intervention even though it's only 18% of the 250 we refer what we're going to be able to do is look long term and see if this truly does become the ability of young children being more likely to be successful when they get into Kinder 1 and 2 that's the whole reason Head Start does what it does is we want to prevent by early intervention with the child and the family those kinds of behaviors that can dictate unsuccessful experience in public school we don't want that to happen for our children so we now we think we have a model and a partnership because of the SAMHSA funds and putting young children directly into that system of care it isn't that it wasn't available before but it was not a focus the younger the child the greater the probability that the intervention will make a significant difference in how they are able to be successful in a public school arena it becomes the least restrictive environment for our children it becomes a pathway to their learning it's and in all honesty it's just a lot more fun to be in a classroom when you when you can comport yourself in a way that that you are able to learn and to be there not be pulled out of class because your behaviors are unacceptable or for whatever reason and so this is going to take a while you know this is not a silver bullet we're not going to fix every problem for every young child who has an issue that requires level two or three or level three intervention but I think if we as a community begin to look at these kinds of partnerships across time we will begin to see the difference in our two school districts where we concentrate our efforts and you know what can I say in closing is that's our goal we want our 3,236 kids to land in kindergarten in first grade in the two school districts ready to rock and roll ready for their parents to know what the expectations are and that they have received the kinds of support that they needed to get that five year old or that six year old where they need to be so they can experience school in a very good way it's a truism that success breeds success in public school little kids who are successful in elementary school become more likely middle schoolers who are successful and if you're successful if you get through middle school successfully you're going to be fine in high school okay so that's the that's our whole idea behind our SAMHSA grant and our partnership with CHCS so now it's my pleasure to ask a parent and she is I believe I get this correct she's the chairman of the governing committee for our SAMHSA grant and for the systems of care and it comes at this for a parent's perspective so here you go thanks Barbara so my name is Shana Wheeler I got involved because I'm a mom I'm not a professional teacher I'm not a professional anything except for a professional mom I think at this point I got involved because I have ten children I have adopted eight children through the foster care system and have been a foster parent for the last 13 years so I've been around a little bit and we fostered over 45 children in that time all of my children that I currently have in my home that are adopted the eight children all have mental health issues ranging from schizophrenia to ADHD to autism to all different kinds of fun adventures we have in our home and so through that process I kind of learned different things in the system maybe that were wonderful or things that I really didn't have access to and and couldn't find and so in in experiencing all these things for myself decided that I really needed to start advocating for things that I saw as I became more involved in foster parenting I became a behavior management trainer and started training other foster families and different kinship families that were having some mental health challenges with their children and started going into those homes so through that process and kind of meeting all the families and working with them I've been able to see the the system from all different kinds from all different sides from all different perspectives with all the different abilities and challenges that we have in our home that being said I am really really excited and looking forward to the wonderful things that I think that the bear cares grant or the SAMHSA grant and the bear cares foundation has that's going to be available in our community and is and is available now Barbara mentioned that she is one of the partners that CHCS has in the city of San Antonio has on the grant currently right now and the grant has been around for a little while the first year was a little bit slow I'm fairly new to the council and just came on in last May so it's been kind of a new thing in the the CHCS and bear cares is moving kind of in a new direction right now and we're really looking forward to all the possibilities right now bear cares is really looking for partners it's a community effort Head Start is one of those partners and through that Head Start program Barbara's talked a little bit about how now that bear cares is able to CHCS is able to send partners into those homes to work specifically with families. SAMHSA is a family driven grant it's supposed to be very family involved and as you all know as much work as we do in the schools as much work as we do at providers offices if those needs aren't being met in the home then we're not going to be a successful and so that is a huge part of the SAMHSA grant is to be very family driven that being said right now on our board and who we're currently working with is the Department of Family and Protective Services there's we're also working with different joint collaborations with the military bringing kinship partners with voices for children that many different agencies are a part of this this program I think what what our potential and what we would really like to see happen with bear cares is bear cares becomes the one stop shop for children ages three through eight who have a mental health diagnosis or think that there might be some mental health care challenges where there need there needs to be some intervention either that intervention happens in the school system and we provide training to the schools that intervention can happen with providers that intervention can happen with families at every aspect in every level so that there's help for families just to kind of give you a little background with our little guys I have a four-year-old son who well he's not four now what we got him when he was four years old he was found living feral at the age of four here in a local county and had been living on his own since he was one years old in the woods and as you can imagine with our little guy we've had a few challenges and he is learning how to live among people is really our big thing and as we've tried to navigate the system for him we've we've navigated through school systems and trying to train and help schools come along and learn how to help him in school we've worked with providers he's been through the mental health core system and court committed he's been through different hospitals and different residential treatments and and he's now back home and in doing really really well we've gone through that process and we've had so much help with him but what's amazing to me is it's been a community effort he's had occupational therapists and a teacher who came and helped us move what teacher does that you know we we have had some wonderful wonderful doctors and therapists and professionals that have helped us so so much along the way that is our goal here at Bear Cares is to provide families and these children specifically with resources in our very rich community to be able to have that one-stop shop so families aren't having to go to 10 different locations to try to get help when you have a child in crisis or maybe not in crisis but you're just desperate for help it's really hard to shop around it's really hard when you're having financial problems for some of our low-income families maybe it's a cultural challenge where we don't speak the language and we're not able to get access to services but to have that one place that we can go to look for that will be the help that we need to navigate a system that is the goal of Bear Cares that is what we are looking for partners for we we have many plans in the work to work with many different families and to also not have the entry point the only entry point being a head start but having entry points within the school system in different school districts we have several different school districts that they're we're currently working with to work with the military effort to also look at the Department of Family Services we're also looking with Post Adoption Services all those different programs and resources that any child in our community who is suffering from a mental health challenge or the family is suffering from challenges where they need access to those services that will be able to be that and provide that and I'm really hopeful and looking forward to the many things that I think that are to come with Bear Cares. Hello everyone I'm Judge Daphne Pravity Austin and I'm here with Jeanne Yvonne Stoltz we work with juveniles which are kids between the ages of 10 and 16 that have committed a crime and we're working real hard to try and get those kids out of the criminal system and into the mental health system because a lot of kids have you know they'll have some kind of an outburst or some kind of a situation where it's their mental illness that might be contributing to the reason that they committed their crime and those kids really don't need to be in the criminal system with the other criminals it would be great if we could get them diverted get them into treatment and have them learn the triggers and things that might set them off and be able to learn what they need to do as they grow for the whole rest of their lives if they have something that's triggering an issue that they can get the treatment they need and not just be in the mental health system so I commend Michael and Shana for working with the really babies and the younger ones from I guess up till five and up till eight and then once they get to be ten we find for example there might be a child who's having a lot of issues at a school and the school's really exhausted all their resources and they can't wait until the child turns ten because then when they push another child in class or they you know are having an episode they're being restrained and they flail and they hit the teacher they can be sent to court and for those of you that don't know if you hit your teacher that's a felony and so it's really a big deal for a ten-year-old to be struggling with the mental illness but then also be in the criminal system and be facing a felony and possibly a conviction that can stay with them for the whole rest of their lives we've had some situations over the years our juvenile court systems have been here for many years we have one great judge Parker Laura Parker who's our more senior juvenile judge and she has now a girl's mental health court that's probably been around for close to eight years before I was a I'm a new judge I'm the low judge on the totem pole so before I was a judge I was a prosecutor for more than ten years here in Bear County I had my own defense law firm for about eight years and so I would see kids that would really need a special situation and they would be a boy we just didn't have anything and so we've had the girls court and one of the things I really wanted to implement during my term was to get something going for the boys so I'm very pleased to announce that we got a grant okay thanks we got a grant from well the very first grant we applied for we received and so I feel like we're blessed to have gotten it and so our girls court is called the crossroads court and the court grant that we applied for really wasn't meant for a boys mental health court nationally there's this idea and we've been seeing it recently even this week in the news sometimes there's somebody that's having a mental health episode and may get shot by a police officer because the police officers don't have the proper training to know how to de escalate those situations there they may be fearful and sometimes they shoot to protect themselves first when maybe that could have been de escalated so the focus of all this grant money really was for that kind of training there was they saw that there's a need for that nationally and so you know whenever you apply for a grant the people that apply are the ones that have the opportunity to get the money and so I think we really just got very lucky that our proposal was met we're being supervised by the council state governments and we received the grant I took the bench on January 1st of 2015 and we received the grant toward the end of last summer we applied for it early on and the grant itself started thanks the grant itself started October 1st of last year so this is the last day of our first year which was supposed to be a planning year and then we have two years of implementation I've been very aggressive and trying to get it started sooner so we've actually already had some court meetings and staffings and identified the children for the program so we have one in September that we've gotten in and we're going to be staffing three or four more at our staffing next week and hopefully trying to get it up the maximum amount of children that we can serve at one time is going to be 12 and we're hoping that within a period of about six months we can get them stabilized learn what kind of community partners we can get them in touch with and that we can move them out of the program and into they'll get their record sealed but they'll just be in a perpetual maintenance type of system where they know what they need to do it should they need something so studies show that one in five children suffer from some form of mental illness but of those only one of those five would receive treatment there's a lot of children that are undiagnosed I've been doing some work with the clarity mental health hospital and learn things from them and one of those is that a lot of the children don't even realize that they have a mental illness until they're arrested for the first time we do some intake screens at the detention center that will help them determine usually the first thing really is is this a child that might be suicidal or some really high risk type of behavior that we need to know about right away and get them in treatment but then based on those screens we figure out which children might be best diverted into either the crossroads or the voice court which is called mind it stands for males in need of direction and then the National Conference of State Legislatures have determined that 60 to 70 percent of the children that are arrested each year have some form of mental health disorder and 25 percent of those can suffer from a severe mental illness the grant this is a talked a little bit about this already the grant that we received there were 16 communities awarded that totaled four million dollars our grant was just a few dollars short of about 250 thousand dollars and the partners for this are donating a lot of their time so for example I'm a full-time judge I've tried to make my docket super efficient to be able to carve out a few hours a week to donate my time to the grant so the grant's not paying part of my sorry the probation officers have a set number of probation officers and they've also retooled their team to be able to dedicate a probation officer to this court and so the reason there's only 12 at a time is that one probation officer needs to be the one that handles all 12 of those cases and if you can imagine how severe the needs might be and the amount of time contacts that they would need it's really helpful to have that one person handling it and so we actually just selected that person in the past few weeks he's a young man probation officer so we're hoping that he'll have a dual purpose of being also maybe a mentor to some of these boys and then our grant we were one of only two grants of the whole country that applied to juveniles the other one was in I don't know the correct term Native American Indian grant so hopefully that definition didn't offend anybody so in the planning process we really had a lot of help from a lot of different partners we created a community task force we met once a month the third Wednesday of each month for probably about an hour and a half to two hours trying to just hash out we're the also were the first mental health boys court in the country so the all the community partners were trying to figure out what would be really helpful to these kids what would be unique characteristics we didn't want to just be the same exact program that we have for the girls but put boys in we wanted to try and develop it so that whatever the boys needs were we might be able to meet those so some of the partners I think are on a future slide let's see okay so there's people from the court also the DA's office is donating the time of their assistant district attorney that's going to be working with the court we have the consulting psychologist there's a defense attorney that is working with the court the local mental health authority the Center for Health Care Services went with us to the training last year in December we went up to Washington DC child protective services was involved some of the children's mental health agencies we had a representative from Jewish family services from the clarity children's Center some educational agencies we had people from communities and schools and of course juvenile probation and then we had one gentleman Dr. Tom Stone for those of you that may know him that kind of was our overseer to try to keep everybody together you know in focus so that we could have achieve a lot during these hour and a half meetings each month so we wanted to define or refine the target population and the grant applies to all the kids in the in the jurisdiction of the court which right now are 10 to 16 years old we might try and focus it down to the 11 to 14 year olds to get started just so that if we have a 10 year old and a 16 or 17 year old in the same outing they might have more in common if they're closer in age we're going to see how that works out we've identified a lot of evidence-based services and supports we've done a lot of research on what types of programs and training are out there for boys and then we did a request for proposal and the group that got word of the grant from so most of the $250,000 is going to the treatment provider and it's going to be a group called Southwest Key and so they are going to provide three staff people a clinician a caseworker and then a family liaison to work with the families the family is on position is only a half-time position but they're up they're hired they're started and they're going forward and so we're all real excited about it and so then of course since the program only has two years to really live and breathe under the grant we need to get it towards self-sustainable and that's what the sustainability is so our mission statement one of our meetings we spent to finding that is to end involvement in the juvenile justice system for boys with mental health needs through a comprehensive family and community response and basically one thing I saw for many years as a prosecutor was there'd be people suffering with a mental illness and you might see them panhandling at the Valero and then you see or the bus stop and then you see them get arrested for a criminal trespass or panhandling and they'd go to the jail and they might sit there for three weeks or four weeks until their case came up on a docket and they get released from jail time served but would never get any treatment and so it's just this endless cycle of those unfortunate souls not getting the help that they need and so one of our goals is to stop that revolving door of the continual arrest okay the criteria for being in this court we have several different specialty courts we have like I mentioned the girls mental health court we have each there's three full-time district courts and they'll have a full-time associate judge so we all have all the courts have a pre-adjudication drug court for kids who are kind of dobbling in drugs for the first time trying to get them these are diversion programs so they have not actually been adjudicated or can that's that's a word that would be considered a conviction in adult court they haven't actually been found to have committed their offense it's kind of like a if you do this program it's a get out of jail free type of deal you do the work and you work real hard and you get stable and you get the opportunity to not go to court if you don't do well in the program you get referred back to court and you're you would be a regular type of case that gets supervised by the community supervision department so to be in this court I'm sorry we also have a couple other courts we have a court for family violence and then we have another court for girls or and boys but there are mostly girl participants involved in it that are victims of human trafficking we call that restore to restore the dignity to these young girls that really are involved in the trafficking so for the mental health most of the offenses need to be nonviolent but like I mentioned you know there's these hitting the teacher hitting a sibling cases we'll take those but they can't be aggravated violent cases the risk levels we have so many different programs available through probation we're trying to really reach the moderate risk levels we think we could do the most good if we have the kids that are low level they might just do well with extra services at home in the community you know not being supervised by the case worker the counselor and the probation officer they might be able to just go to the probation officer once a month for three months and kind of get back on track if there's academic issues we want there to be an involved family member because these are intensive they have to have maybe as many as four contacts with the team a week at the beginning then you know it will taper down they come to court at least once every two weeks I'm meeting the first and third Thursdays of each month in the afternoon and so they need to come and they need to tell me like what they've done to improve things from the last time they were there so we're giving them a little sheet where they can make three goals for this week and when they come up to the bench and I kind of check in with them and visit with them in a progress report type of style I want to know like whatever their goals were did you meet them do we need to work on one of these again next two weeks so we we decided to take up for sure all the first-time offenders they have to be eligible for the deferred prosecution program because the DA's office has involved as one of the partners we're also considering first-time failures there might be a kid who's come through the court system before but we didn't know that time because they had such a casual interaction we didn't recognize that they had a mental health issue so those are ones that were also still taking we're excluding the ones that have psychosis intellectual and developmental disabilities solely a conduct or disorder or opposite CODD oppositional defiant disorder or severe substance abuse and we have another specialty court for the kids that are using hardcore drugs it's the post adjudication drug court and they're the ones that are using a lot of drugs a lot of heavy drugs and you know we're trying to get them stabilized as well so we have these smaller work groups that did the proposed programming components the task force identified some of it and then after Southwest Key was identified we've been having a lot of really intensive meetings since July with that specific team to try and get everything going it's still in the very early stages we had only a couple of staffing so far the first one with a child that's actually coming through the court is going to be next Thursday so let's see oh each time when we meet we'll have a staffing meeting right before court all the kids that have been identified as being potential candidates who want to make sure that the family is really interested in being involved sometimes a kid might be a great candidate but there's not an interested family member that's willing to put in the work and get them here there and everywhere to make sure that they can succeed and sometimes the additional issue we find is that the parent may also have a mental health issue and that makes it hard for them to comprehend how great of a program this could be for their child so as we identify them they agree to do it then we have our psychologists do some a battery of tests to make sure that they really are the appropriate candidate and help us put together the treatment plan before they come to the staffing so we get all those reports at the staffing meeting and then the team would decide if we were going to go ahead and admit them or not and then if we do they sign a contract and they would start coming in every couple of weeks so they have a lot of contacts again each week they'd be meeting with their counselor their caseworker their treatment provider we have many people don't know this we have a lot of probation officers assigned to various schools and the ones that don't have a probation officer at the school we have contacts where we can get a lot of the records we keep track of their school records and their attendance and things as well so and we're also we're going to be making contacts with them at their homes to help with the transportation issues so there's gonna be the home base the case management they'll be individual and family therapy we have separate parent training courses and then group therapy and life skills training and there'll be a lot of outings and things with the kids too and then we have some incentives that will give them when they're doing well or they move up into the next system and as they're doing really well we'll taper off the contacts we'll start real intensive at the beginning and then we'll taper things off as they're doing well so I thank you all for your time I'm glad that all of you take an interest in the kids and I thank everyone here for the work that you do thank you judge okay so while I'm switching over the PowerPoints everyone I want you to take your hands and rub them together and maybe we can heat up this room or at least ourselves what do you think the other work is it working for anybody besides I need a warm I'm not feeling the breeze over here is anyone else cold besides me okay now it's not their fault okay so I get to talk to you about the big sister of the mind court which is the girls mental health court and that's a court that's been in effect since 2009 and I guess it was the precursor to the mind court and so just a little bit about specialty courts in general the idea behind a specialty court is that it's a different way of approaching those that are struggling in either the criminal juvenile justice system instead of an offender going before the judge only when they're in trouble right when they've made a mistake the idea behind a specialty court is that the court gets to develop a relationship with the offender which I'm going to switch now to calling a child because that's what we're working with so the child gets to develop a relationship with you know basically authority where the child regularly goes before the judge and the family does but the the focus is not on what mistakes have you made but how are you doing in addressing whatever specialty issue is going on how are you doing in addressing your mental health issues how's it going in addressing like we say we have girls that are involved in trafficking and what can the court do what can we as a community do to support you so it's really about like you were talking about bringing very different communities and agencies together to support that child and that family and so what we see a lot is it means so much I mean I as a psychologist or even as a probation officer can talk to a kid and family and go you know you guys have been making so much progress we're so proud of you but to have a judge do that to have a judge checking in with someone and saying how's it going you know wow that's great that you're doing that you know how are you struggling this way well you know here I want you to think about this I want you to work on that it takes it to a whole another level in regards to the intervention it makes that child and that family feel the support that is really there I mean it because I mean it just helps them kind of understand that does that make sense to everybody and so some of you may go and well why do we do this you know and what we the judge had mentioned it briefly is what we are seeing in our system now is about 30 to 50 percent of our kids walk in our door with mental health issues even though it's one in five in the general community it's 30 to 50 percent and that number ranges I mean in regards to the more deeply involved kids we see higher rates of mental illness and what I'm concerned about what we're all concerned about is that the criminal and juvenile justice systems are turning into the mental health providers of this jurisdiction in the country right and that's the last thing we want we do not want to be the mental health provider I do not want a child who has mental illness to be with an around a child who we call a high-risk child who's at high risk for criminal behavior I don't want a mental health child to learn those types of behaviors it never goes the other way right it never goes where the gangster learns how to you know have you know ADHD it's always the ADHD the kid learns how to have kind of you know gangster or drug related behavior so that's what we're trying to kind of do what we also see in our system is that we see children with incredibly high rates of trauma and you guys are probably all familiar with ACEs study I mean our kids on average and I think what you're doing is really trying to focus on addressing those with the child and the family early on our kids on average have at least four to five instances of trauma and so they have high rates of trauma which not only affects mental health issues but it affects their physical health it affects rate really their longevity their lifespan in regards to how long they're going to live so we're kind of working with those factors okay so why did we have a girls mental health court way back when so this is in 2008 2009 and what we were seeing is when we're looking at our data which is always a valuable thing to do we were seeing that we had a lot of girls being ordered into residential placement disproportionately even though at that time our girls are maybe one quarter of our juvenile justice system they were half and even more than half of the kids going to placement right and then we dug down a little bit deeper not only were these girls taking up you know going to placement a lot but they were also like really low-risk offenders I mean they were going when they had their when they committed their first crime or maybe even the second crime where we tend to do everything we can in the community for a child and so by the time they get removed from the home they've you know committed not crimes but they've been back before the judge four to five times oftentimes when a kid goes back it's not because they've stolen again but because now they fail to follow the rules of the court they fail to follow the conditions of probation like curfew or getting you know doing good in school so but anyway these girls like first timers and they were going and we're like well what's going on with that then so what we also found is that okay so we're taking these girls at at high rates that are very low-time offenders and when they come back they were recidivating recidivating or reoffending at a much higher rates than the boys were so we were taking out the home and we weren't doing any good right they were still getting in trouble and so we kind of dug a little bit deeper and we started kind of having focus groups and the funny part is that our probation officers would literally say I will take ten boys if you just take this one girl off my caseload I mean they did not want to work with these girls they said they drove us crazy there's too much drama we don't know what to do you know that it's just it's constant all the time ten to one I mean that's a huge trade I mean if you've ever met our juvenile justice boys a ten to one trade I don't know if there's ever but they were willing to do it so so we kind of dug down and kind of figure out well what can we do with these girls and what we found is that a lot of these girls struggle with significant mental health issues you know bipolar disorder was a typical diagnosis PTSD was a typical diagnosis and really high rates of trauma so our target population is similar 12 to 17 years of age ideally we'd wanted it to be 12 to 15 but everyone kept saying you know well what about this one what about that one and so it's really kind of broadened over time they have obviously like I said the mental health issues in the trauma what we began doing like so with the mental health court model was the way that it works just so that you know is a child is identified typically through some formal psychological assessment the team reviews the case to see is this child appropriate and when we talk about things like psychosis or oppositional not being included it's if either like for psychotic if the child is severely psychotic if they're actively floridly psychotic they need kind of more inpatient care and then we look at transitioning them into the mental health court afterwards if they're solely oppositional defiant that's more of a criminogenic issue so we don't want them around our kids that are truly mental illness so that's what we're talking about in regards to exclusionary criteria so but we review those cases they say yes this child's appropriate for court and then the idea is to really drive the services around kind of the child's and family's needs oftentimes you'll see that these courts are often really intensive on the front end to engage the child in the family they meet with them frequently the providers will often be in the home two two times a week the probation officer will be there equally as often these programs require 24 7 availability by both the clinicians and the probation officer because the families often don't know how to respond in a crisis and what they've been doing is when they have an issue you're nodding and the home the first thing they do is they call the police because the police becomes kind of the de facto parent in a way and so it's really kind of training them what's you know what's a parenting issue what's a physical crisis what's a criminal crisis you know kind of helping them kind of figure out what to go depending on the crisis so they learn kind of these skills and then as the court progresses the child progresses through treatment stages then the intensity decreases and so the idea is to jump in stabilize the child and family and then really get them connected to those long-term informal and formal supports because the idea is not for the court to be involved more than six months maybe a year depending on the issue but for them to have the services that they need and not have to rely on the juvenile justice system to get those for the rest of their life so again the services obviously tend to be home-based we try to eliminate all barriers right all obstacles to obtaining treatment oftentimes if the family has been trying to address the child's mental health issues they haven't been able to get to the treatment provider consistently transportation you know availability in regards to where it's located in town hours of operation all of those things have created a challenge so it's really home-based services at first a lot of parent training involved with our girls what we tend to see is kind of more family relational issues lots of challenges between mom and daughter and with the boys we're probably going to see a very different kind of mental health presentation it's probably going to be more externalizing type behaviors and then the appeal for all these courts is that at the end it's automatic sealing the child doesn't have to hire an attorney and know all the political or legal steps to take to close a record but and it's not they don't even have to initiate it we do that you know we give them a few months to make sure that they're doing okay if they don't reoffend then we seal the records automatically and so then they can move on with their lives and not have to worry about it so what we realized as we began working with the girls is oh wait we need more than mental health services right guess what the number one service that we needed was it's at the top of the list so we start this court and I don't know about three weeks in the court our 12-year-old is pregnant right so we're like okay here's another so so now that's almost takes priority over the mental health issue in regards to you know when we're doing the psychological evaluation really quickly exploring okay are you sexually active you know are you taking birth control and then really working with our community partners to kind of help them get connected to true health clinics not just family planning clinics but health clinics for the child to address kind of their entire reproductive and physical health okay we also learned that we kind of really needed to add a lot of school-based crisis intervention which is where we got partnered with communities and schools because having communities in schools or having a relationship with that school counselor or whoever wants to be the identified support because not every campus is a communities in schools campus if there is just someone on that campus that wants to be that voice for that child on that campus we've seen coaches we've seen band directors we've seen ROTC directors everybody doesn't have to be your traditional school administrator whoever wants to be that liaison and the eyes on that child is so beneficial just for that child to know that they're always supported you know they'll joke and say always watched at some points but they they they complain about it but then they also miss it at the same time right so it's just like you know your own kids you know why are you always checking on me and the first time you don't then they're like where were you you know so it's this kind of same thing we also stress the importance of recreational activities we get these girls and we will do the same with these boys get them connected to activities they've never seen before you know and activities that they love you know we go to things like movies but we also go on college tours we go on museum tours they've gone to you know those painting ceramic classes they've done equine therapy they've done the experiential learning the ropes courses just to kind of expose them and we've had girls you know this is something I really want to do we've even hooked up a girl to a boxing class and have mixed feelings about that given that I'm a psychologist and all the brain stuff that I think about but for her that was really powerful it helped give her kind of strength and courage in a way and she felt like she could accomplish things you know and it really also was a great way to kind of relieve stress for her so we try to kind of involve all of that the biggest challenge for probably any of you that were working with someone who's got mental health issues is how to connect them to psychiatric treatment the access to a psychiatrist and a lot of that requires just you know pre-planning and having backup plans all along in regards to okay we she does need to see a psychiatrist let's get her an appointment that appointment is what two and a half three months away if we're lucky so what do we do until then you know and know that we have good relationships with the psychiatric inpatient facilities in town if it really reaches a crisis level but we don't want to hospitalize her just to get a psychiatric assessment right so trying to walk that and navigate that but that kind of knowledge requires a group I mean this is a district attorney going okay you know we know she's acting up in school but we're not going to immediately pull her and yank her and lock her back up because we know we're working on it and we see progress this is the defense attorney saying you know I don't I you know having a child watch 24-7 is not always great because everyone's going to screw up at times excuse my language but you know everyone's going to mess up at times but I trust that you're not going to immediately file on her just because she's messing up so you know what can we do to all support this child and get you know get along as different agencies and entities this is the partners for our program similar to Judge Poverty Austin we have Judge Laura Parker as a 386 district court judge she leads it defense attorneys treatment providers district attorneys we have someone doing psychological assessments and as I mentioned we have in our internal mentoring program our internal chats program all kind of dedicating time to this program the key is the three or four that work with them frequently the probation officer you know you have to have kind of a special personality I mean I know it's only 12 kids at a time but it's 12 I mean and these are people that are calling you at 3 a.m. you know sometimes the parents are calling at 3 a.m. because he didn't wash the dishes today you know and helping them work through okay is that a crisis what can we do how can we not escalate it to where he takes off or bashes the hole in the wall but use he still gets an adequate consequence for that kind of helping them balance that so I thought you know we've highlighted kind of specialty courts I did want you to see outcomes for programs like this I think that's really important so understand that these numbers aren't huge right and this is relatively inexpensive program but it's nothing compared to how much it costs to send a girl to residential treatment and the loss in the separation when she's taking out of her home so today then this is since 2009 really we've worked with only 108 girls but it's 108 girls and I'm gonna say 63% successfully completed but I want you to kind of notice something because we have really high expectations in regards to graduation from a court but what we have seen is that even for those that didn't graduate there was benefits that they gained from the program so of the 63 that successfully completed only two two kids wound up going to residential placement no of the 63 of the 63 but out of the 108 82 percent didn't reoffend within three years so out of the 108 even those that did not graduate we had over an 80% non reoffend rate and for us I mean that's kind of what a criminal justice system I mean we definitely want good outcomes we want them to be happy positive productive citizens but you know really we don't want them to break the law right that's kind of what we're funded for and over 80% of these girls did not break the law after completing even if they didn't complete the program successfully but what sustains this program is that we keep preventing girls from getting sent to residential please even placement even though this is an expensive program it is still much cheaper than locking so 63% would be 60 68 of those girls wow you and you don't even have a pen and a pencil oh okay is that really a calculator is that the hidden thing that gets you to those apps that we don't want you to know about okay so so 68 percent out of the 68 girls that completed only two wound up in residential placement which earlier those all 68 would have gone to residential placement so that's what we call a huge savings and we expect to see the same with the boys in regards to lower recidivism less use of kind of county funds in regards to those high-end kind of placements and none were committed to TJ JD I don't know if you guys know what TJ JD is for those that don't it's the teen prison system so there's a teen juvenile justice or juvenile probation system and then even a higher level the teen prison system and so for this this is since the inception of the program so there are some girls that have been in through the program and done since you know 2009 and this is still the numbers as today okay so we have time for questions for any of the panel members is that correct the EU sign-ins are sort of being passed around so if you need a formal CEU be sure to do that before you leave the session they're back there with Amy she's raising it up it's got a red cover thanks and oh boy now I just totally forgot the other thing I was going to say and that's alright anyway yes we can talk for a little bit have some questions and I'll try to help watch and see who has a question yes right back there talk loud if we can't hear you all run back there I just wanted to consider that and if you would that those behaviors mask lots of things but that's a very prevalent issue in this population and I'm talking to people I know that our experience in screening and I think that would be probably really critical for the important piece of what you're doing at trial spot I would mention that see what your response would be genie has a better understanding of all the psychological background things I have the more criminal experience but I I don't want to say that we would exclude anything but it's my layperson's understanding that they generally have a lower IQ is that correct or no so yes anybody that has an identifiable mental health disorder and I believe that would fall within that because it's in the DSM right that we would consider taking them as long as they met all the other criteria with the involved parent I wouldn't want to have somebody that had such a low IQ that they wouldn't be able to be successful in the program we want them to have the ability to learn and go forward thank you for bringing up to our attention because we do do a formal psychological assessment at the time of considering whether they're appropriate and that's something that I can ask the forensic assessment I mean they're more forensically trained in regards to but they do the full it's all screenings right this is not you know so they do an IQ screening and academic screening they obviously do a pretty extensive psycho social history oftentimes what we see in those cases is that that those that detail in regards to what happens prenatally in regards exposure we don't get that information until there's been a strong relationship developed with the family you know three months in and then they start talking so then we would try to identify if there are additional services needed or additional evaluations but our experience has been when someone walks into a juvenile justice door they're pretty cautious about all the information that they share especially the families do which is totally understandable I mean because you know this is a court and a judge and you know probation but I do think you're right that that's something we need to be more sensitive not just fetal alcohol but also and we have kids that are exposed to other substances prenatally that are of concern not they don't have as clear symptom mythology that's kind of been outlined for FAS but I think we should be more careful that and I'll talk to our assessor about that that's a good idea any other questions for any of the programs the other one the other one whoa there we go let's try that again the other referrals can come from other school districts within the county it's not impossible that they could come from other childcare centers so wherever the young child can be served would be possible for a referral to come from them referrals can be made by family members by parents by physicians fortunately not by the criminal justice system yet at our whole goal is to keep put you all out of business so the referrals can come from many different people that are involved with the child and from other school districts or childcare centers within within Bear County you also well this is kind of where Bear Cures is kind of in that we're working on that I guess is the best thing to say really right now those ML users are being developed and we're reaching out to a lot of different agencies right now to really start working on that and and just to kind of add work we want to serve a community you know it's we don't want to target just one specific where we're getting referral from we want any provider to know that if they have a child that comes into the doctor's office just to see the pediatrician and mom and dad are saying I think my kid has ADHD I think maybe there's autism going on here that that they can be referred to Bear Cures and Bear Cures becomes that one-stop shop for our community that then therefore they can come there we have the resources then that can send them out that's the goal we're not there yet but that's what we're working towards Well it just really depends we have the initial screening in the staffings the head of our intensive clinical services department of our probation unit kind of reviews all the cases on a daily basis of who got arrested last night what was there there's a test we call use called the mazy that they evaluate what their criminogenic need is if it's a moderate level of care that they'll need and so we kind of pick from that list that hits those points probably every week there might be three or four names that meet those and then we'll check and see some of those kids may have already committed a heavier crime that they're not eligible because we don't want to mix the more criminogenic kids with the kids that are just have mental health the kids that don't have a real involved family member we can't take them either so I was really surprised because that list over the course of a month has probably 30 some names on it so early on this year in April and May I was getting listed I thought oh my gosh we have so many kids that we're going to be able to help and then it got to be August and we're trying to figure out which ones on the list but none of them fit for the first month because maybe they had assaulted their family so they got diverted into the family enrichment court or maybe they have a history of labor or sexual trafficking so they got diverted to the Restore Court because we thank goodness we have as many programs as we do that really can help everybody so they weren't considered the best fit for the first time boys mental health court does that help answer your question okay very good I always have mixed feelings about bringing up stuff that we do in juvenile justice if they're in our system we will work and I'm not being I'm not trying to be mean but that's the last thing we want is for someone to go well you know what if you press a charge that I hear there's really good services in juvenile probation that we don't I mean because they're you know we if you have any questions if there's a kid that you're struggling with contact us and we can try to get you connected to certain agencies that we know in the community we do not want a kid in our system who doesn't need to be in our system let me let me add to that just a minute although we were talking about the newness of this current piece of Bear Cares targeting the youngest children in our community reach out to Bear Cares if you have older children that you believe need assistance in mental health issues or families before they get to the courts I mean it's not impossible for a 7 year old or an 8 year old or a 9 year old or a 12 year old not to have yet gotten into trouble but reach reach out you know go ahead and make a referral to Bear Cares make a referral to CHCS go to your school and ask for a referral if all else fails call Head Start I mean granted we only serve little kids but we'd be very happy to share resources and guide you in a direction if you know of people that have elementary age middle school age even high school age children prior to their getting into the juvenile justice system that we can provide them the mental health services and support that they and their family needs. So I see Liam back there so just so that everyone here knows if a child first commits an offense at the age of 17 that's an adult in the state of Texas so they go straight to the adult system sit in the adult jail with all that stuff although we try to help the jail and hold them in our system but they're technically in the adult system but so that is this really tough age right now and it's in it's a really difficult age because they're in if they commit a crime they're considered an adult but yet they still need a perperinal consent for treatment there is a new do you want to mention it a bit ma'am about the psychosis program or is it not at announcement stage yet did I just blow it not over we're set to have I think the training will be the 12th, 13th and 14th for the specific curriculum that they'll be using but they're focused on individuals who are age 14 to age 30 that have a psychotic disorder or some type of diagnosis within the last two years and so it has to be so we're looking at that early onset psychosis and so we'll be taking referrals for that program in the next probably two to three weeks and so if you have kids that recently got diagnosed or getting diagnosed with that some kind of psychotic disorder or bipolar or major depression with psychosis then they will be qualified for possibly that program it's a pretty intensive program for itself it will be a small the state of Texas has eight sites around the state where we house it and so the Fair County is always a great place to sit and talk about earlier about how to do the program so if you look forward to that if you have kids that you're working with that have a normal need you can always reach out to CHCS and they can do a screening and a assessment for meetings and so any other questions thank you so much this is a large thank you we really appreciate that because we know the other seminar