Requirements for Civil Commitment

1. The person is above the age of 18. 

2. The person has diagnosed mental illness or substance abuse disorders.  

3. The person is showing obvious signs of instability to the point that forced treatment is the only way they will show improvement, which will be assessed by a mental health professional. 

Outpatient Centers

• These will be devoted to the recovery of patients, so they can reenter the community.

• Specially trained mental health professionals will make a treatment plan for each patient which will include medication regimens.

• Those who have met the criteria for grave disability are also able to live within the outpatient centers, since they are unable to provide the basic needs for themselves.

  • They will be within the long-term stations, equipped with constant mental health services.

  • In order to live within this place, a doctor must diagnose them with grave disability and this would be a last resort option.

Preventative Commitment

• County X will also provide preventative commitment, as a first step.

• This means that if someone with mental illness is acting dangerously, we will require them to meet with one of our mental health professionals to suggest a specific treatment plan that will work best for them and their situation.

• They will still be living within the community instead of being involuntarily committed to live within our outpatient center.

Red Flag Laws

• Red flag laws will be used within County X, because it is important to confiscate guns if they are going to be used in a dangerous way.

• It is also important to not let guns get into the wrong hands, meaning those who will use them to commit violent crimes.

  • This will help prevent gun violence within the county. According to Delafave (2021), red flag laws reduce firearm related suicides by 6.4% and overall suicides by 3.7%, meaning it makes a positive difference for the mentally ill.

Client Rights

• Those with severe mental illness will meet with a mental health care professional to determine if they will be forced to engage in behavioral health treatment.

• If someone is deemed to be too dangerous to themselves or others, and treatment is the only way in which that individual will get better, they will be forced to use their treatment plan.

  • This only happens in severe cases where the individual is in obvious need of treatment but has anosognosia or does not want to cooperate.

  • However, these people can only stay within the treatment centers for no more than three months, where they will then be reevaluated again to determine if they still need to be involuntarily committed.

• Those who have a diagnosis of severe mental illness and have been involuntarily committed in the past or currently will be unable to own a gun.

  • These prohibitions will be reevaluated within 1 year to see if the person has shown improvement.

• According to Stuart (2012), negative media coverage on mentally ill individuals negatively affects their self-esteem, help-seeking behaviors, medication adherence, and recovery, which is something that County X wants to avoid.

Severe Mental Illness Services 

These services will provide extensive treatment for those who are diagnosed with severe mental illness and want to engage in treatment.

• This will include:

  • Medicine and therapy plans.

  • Psychotherapy

    • work to explore the patients’ thoughts and behaviors in order to improve their well-being.

    • work best when paired with medication.

  • Those with severe mental illness may also need to be hospitalized if they do not seem to be getting better (Mental Health Treatments, 2022).

  
  

• The criteria for those who will get these services include having a severe mental illness diagnosis.  

Juvenile Delinquency Services 

• Juveniles who committed violent crimes.

  • They will be secured in a juvenile detention center where they will be given treatment.

  • These treatments include mental health treatment depending on their mental state, which will be screened by a mental health professional.

  • There will also be programs that include

    • literacy and communication skills

    • self-respect training

    • drug-rehabilitation

    • life skills training.

  • This will be based on Criminion rehabilitation program (Criminon Courses and Services, n.d.).  

• Re-entry programs

  • These will help them become ready to go into the community.

  • This will focus on getting them back to school, finding jobs, and staying away from a path that will bring them back to crime.  

    
    

• Juveniles who committed misdemeanors

  • Diversion programs

    • educational services

    • victim awareness training

    • substance abuse education (if needed)

    • career path counseling

    • mental health treatment

    • family-related counseling

    • peer support groups (Diversion Programs, 2019).

    • This will be done as they live at home, while being on probation, instead of in a juvenile delinquency center.  

• Those available for these services are individuals under the age of 18 and have committed a crime.  

Substance Abuse Services 

• These services will assist those struggling with addiction with detox and medication-assisted treatments.  

• There will be impatient programs which assist individuals with substance abuse and mental health problems.  

• There will be outpatient rehabilitation treatment centers available for individuals who need it.

  • These will include mental health assessments, group therapy, medication assessments, and childcare services.  

• County X will also include substance use intervention programs for individuals concerned about substance abuse problems of a loved one.

• There will be clinical and peer recovery options which help guide patients through a treatment plan (Addiction Services and Programs Pittsburgh | UPMC, n.d.).

    

• Those who are able to get this treatment are those who are addicted to a substance and are reported.

Preventative Services 

• Preventative services will be a large focus within County X as there will be classes, such as D.A.R.E. to help the younger generation understand the dangers of drugs and alcohol abuse through the guidance of a local officer.

  • D.A.R.E teaches students from kindergarten to twelfth grade about the risks and dangers facing their generation, such as drugs, suicide, social media, and vaping (D.A.R.E, 2017).  

• Everyone that goes through the school system will be able to achieve these services.  

• There will also be intensive prevention services (IPS) available for individuals aged 10 to 19, who are having trouble at home or in school.

  • The goal of this program is to teach them strategies to stay away from the juvenile justice system.

  • They are taught healthy behaviors which strengthen their self-worth, life skills, academic performance, and relationships at school and within the community.

    • This will be based on the IPS program within Philadelphia (DHS Intensive Prevention Services (IPS) | Programs and Initiatives, n.d.).  

• Anyone who is referred to this program has to be 10-19 and having troubles in school, home, or the community.  

Grief Services 

• County X will provide peer support programs to assist children, teens, and families specifically with grief.

• These services include peer support groups, referral services, educational programs, and support for adults.

  • This is based off Highmark Caring Place located in Pittsburgh, Pennsylvania (Highmark Caring Place, n.d.).  

• Those available for these services are families who have gone through a death and are struggling to cope and will be given to victims and their families. 

Services for Sexual Offenders 

• There will also be services for sexual offenders within prisons and jails.

• In order to be placed within the treatment program, one must complete psychosexual evaluation testing.

• Services for sexual offenders will include an outpatient treatment center which will provide:

  • sex offender group therapy, conducted by a licensed professional.

  • individual sex offender therapy sessions

  • family therapy

  • relationship counseling

  • victim-based therapy (Wagner Behavioral Health Services, LLC, n.d.).  

• Those who have committed a sexual crime will be available for these services.  

Homeless Services 

• Homelessness is a large issue within America, making it an issue within County X, meaning it is important to provide care for the homeless.

• County X, with part of the $300 million, will provide temporary housing for homeless people, as well as free mental health services within this housing.

• Anyone who is homeless will be able to get these services, however there are limited spaces, meaning those who are in the most need of mental health services will be held as a priority.

   

• There will also be street outreach services which will assist people experiencing homelessness with medical care and their basic needs.

  • This will be based on the street outreach program in Pittsburgh (Pittsburgh Mercy, n.d.).  

All of these services are extremely beneficial to our community. However equal resources are not available for every service, so those who are most important are severe mental illness treatment, substance abuse treatment, and homeless services because they require the most amount of money and attention

• severe mental illness

• juvenile delinquency

• substance abuse

• sexual offender treatment

  • all outsourced by private agencies

It will be County X's priority to work together with the police to prevent incarceration of mental illness.

• All police officers will become specially trained in handling and de-escalating mentally ill individuals and situations, which will be a three month extensive training program.

  • This will be a controversial change, but it is important for cops to deeply understand how to handle mentally ill offenders from constantly being incarcerated instead of getting treatment.

• There will also be a large Crisis Intervention Team (CIT) program for those interested in working solely with the mentally ill.

Solitary Confinement

• Solitary confinement will be used for the most extreme cases only and will follow the United Nations Maximum Rules for the Treatment of Prisoners (United Nations Office on Drugs and Crime, 2016).

• Long-term uses of solitary confinement affects health and well-being for inmates

  • More specifically, physiological damages include gastrointestinal and genitourinary problems, insomnia, migraines, poor appetite, back pain and much more.

  • Psychological problems include anxiety, depression, anger, cognitive disturbances, paranoia, psychosis, self-harm and suicidal thoughts (Haney, 2018).

• Due to these obvious problems with solitary confinement, County X will only use it for a maximum of 15 consecutive days (United Nations Office on Drugs and Crime, 2016).

• Also, those with mental and physical disabilities will not be subject to solitary confinement because it will make their conditions worse (United Nations Office on Drugs and Crime, 2016).

COVID-19:

• County X will provide COVID-19 vaccinations within prisons and jails but it will not be required for the incarcerated individuals to get.

• County X will provide a continuum of both independent and sheltered care.

  • Those who will be recommended for independent care are those who are deemed competent enough to take care of their own basic needs, which will be decided by a mental health care professional (Independent Living vs. Sheltered Housing: Choosing the Right Housing Option for Older People | Information and Advice, n.d.).

  • Those who will be recommended for sheltered care are those who have grave disability.

Case Management

• Case management training will be given to all employees that are involved within this mental health treatment plan to understand and identify resources to better assist their patients.

  • This program will be based off of Pennsylvania's department of drug and alcohol programs case management training (New Training Opportunity! Case Management Overview and Skills Training, n.d.).

ACT

• Assertive Community Treatment will be available for those with severe mental illness.

• services include but are not limited to:

  • 24 hour crisis assessment and intervention

  • substance abuse services

  • employment help

  • peer support

  • education services

    • This will be based off of the Pennsylvania ACT program (Assertive Community Treatment, n.d.).

• In addition to SSI and SSDI County X will provide Federally Qualified Health Centers (FQHC), which will be able to provide mentally ill patients will services based on the patients' abilities to pay.

  • These will receive government funding to operate (Fay, n.d.).

• The universities within County X will also provide free mental health counselling to their students.

• Also with the given $300 million we will be able to set up free health centers equipped with interns who are overseen licensed mental health professionals.

• County X will implement OSHA practices for workplace safety.

  • There will be a website given to all employees to report safety and health concerns.

  • On this website will be a link to the form as shown above (Worker Participation Encourage Workers to Report Safety and Health Concerns, n.d.).

  • This will ensure that each employee has access to resources to identify a concern of safety to upper management.

Workplace Violence Prevention

• Workplace violence prevention includes training employees to recognize warning signs, such as excessive use of substances, behavioral changes, depression signs, complaints, violation of policies, mood swings, overreaction, and paranoia (Bleich, 2018).

  • There will be a zero-tolerance policy for violence as well to ensure that everyone will be held accountable for their actions.

Emergency Evacuation Training

• Employees will take training lessons on emergency evacuation procedures, which includes an understanding of all emergency exits and assembly areas.

• This will also include setting up areas in which the employees will always have access to an escape route.

  • For example, the patient will be set up against the far sided wall and our employees will be set up near the door.

  • This is because the people we are working with can sometimes be dangerous and it is important to ensure the safety of our staff.

Anti-Bias Training

• There will be anti-bias training that focuses on recognizing biases and learning how to minimize it to enhance employee workplace culture.

Security

• There will also be a number of full-time security guards on site to further ensure the safety of our employees.

• These guards will be trained in de-escalating situations involving mentally ill individuals to ensure the safety of our patients and our employees.

Assertive Community Treatment. (n.d.). Department of Human Services. https://www.dhs.pa.gov/Services/Mental-Health-In-PA/Pages/ACT.aspx 

Bleich, C. (2018, February 28). How To Prevent Workplace Violence: 7 Steps To Take Right Now. EdgePoint Learning; EdgePoint Learning.

https://www.edgepointlearning.com/blog/workplace-violence-prevention/ 

Criminon Courses and Services. (n.d.). Criminon International. https://www.criminon.org/what-we-do/ 

D.A.R.E. (2017). D.A.R.E. America | Teaching Students Decision-Making for Safe & Healthy Living. Dare.org. https://dare.org/ 

Delafave, R. (2021). Article 6 Delafave, An Empirical Assessment of Homicide and Suicide Outcomes with Red Flag Laws. An Empirical Assessment of Homicide and Suicide Outcomes with Red Flag Laws, 52(3), 52. https://loyola-chicago-law-journal.scholasticahq.com/article/77228.pdf 

DHS Intensive Prevention Services (IPS) | Programs and initiatives. (n.d.). City of Philadelphia. https://www.phila.gov/programs/intensive-prevention-services-ips/ 

Diversion Programs. (2019). Youth.gov. https://youth.gov/youth-topics/juvenile-justice/diversion-programs

Fay, M. (n.d.). Financial Help for Mental Health: Treatment, Employment & Housing. Debt.org. https://www.debt.org/advice/financial-help-for-mental-health/ 

Guzman, G., & Kollar, M. (2023, September 12). Income in the United States: 2022. Census.gov. https://www.census.gov/library/publications/2023/demo/p60-279.html 

Haney, C. (2018). The Psychological Effects of Solitary Confinement: A Systematic Critique. Crime and Justice, 47(1), 365–416. https://doi.org/10.1086/696041 

Highmark Caring Place. (n.d.). Www.highmarkcaringplace.com. https://www.highmarkcaringplace.com/cp2/index.shtml 

Independent Living vs. Sheltered Housing: Choosing the Right Housing Option for Older People | Information and Advice. (n.d.). AbbeyField. https://www.abbeyfield.com/independent-living-vs-sheltered-

housing/#:~:text=Sheltered%20housing%20offers%20a%20higher 

Masters, J. (2022, June 10). U.S. Gun Policy: Global Comparisons. Council on Foreign Relations; Council on Foreign Relations. https://www.cfr.org/backgrounder/us-gun-policy-global-comparisons 

Mental Health Treatments. (2022). Mental Health America. https://mhanational.org/mental-health-treatments 

New Training Opportunity! Case Management Overview and Skills Training. (n.d.). https://www.ddap.pa.gov/Documents/Training/CaseManagement_NewCurriculumAnnoucement.pdf 

Pittsburgh Mercy. (n.d.). Street Outreach. Pittsburgh Mercy. https://www.pittsburghmercy.org/homeless-services/pittsburgh-mercys-operation-safety-net/street-outreach/ 

Stuart, H. (2012). Media portrayal of mental illness and its treatments. CNS Drugs, 20(2), 99–106. https://doi.org/10.2165/00023210-200620020-00002

Testa, M., & West, S. G. (2010). Civil commitment in the United States. Psychiatry (Edgmont (Pa. : Township)), 7(10), 30–40.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3392176/

United Nations Office on Drugs and Crime. (2016). United Nations Standard Minimum Rules for the Treatment of Prisoners (Nelson Mandela Rules). International Legal Materials, 55(6), 1180–1205. https://doi.org/10.1017/s0020782900030898 

Wagner Behavioral Health Services, LLC. (n.d.). Wagner Behavioral Health Services, LLC - Adult Outpatient Sexual Offender Treatment. https://www.wbhservices.com/sop-treatment-program/adult-outpatient-sexual-offender-treatment/ 

Worker Participation Encourage Workers to Report Safety and Health Concerns. (n.d.). https://www.osha.gov/sites/default/files/2_Reporting_Safety_And_Health_Concerns.pdf