Reimagining Law: Addressing Behavioral Health in the Illinois Justice System

In this episode of Reimagining Law, we talk to Scott Block, the Illinois Supreme Court’s first Statewide Behavioral Health Administrator. Scott defines behavioral health and how it intersects with the justice system, shares statistics that highlight the behavioral health crisis in Illinois, and discusses the Court’s goals for addressing behavioral health in the court system.

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Timestamps

00:55: What does the term “behavioral health” mean, and what is its relationship to mental health and co-occurring disorders?
01:49: As a general proposition, why is behavioral health important to the Illinois Supreme Court?
04:10: As you look to improve behavioral health resources, what communities will you focus on (i.e., judges, lawyers, court users, etc.)?
06:36: How has COVID affected these behavioral health challenges?
08:14: The Court recently partnered with the National Center for State Courts on a summit and a report on how people can better respond to these challenges. What were some of the takeaways and next steps?

Related Resources

About Scott Block

Scott Block is the Statewide Behavioral Health Administrator of the Illinois Supreme Court. In his role, Block serves as a mental health voice and resource for the Illinois Judicial Branch, furthering local, state, and national behavioral health and justice initiatives that impact the courts. This includes providing guidance to the Illinois Courts on the intersection of behavioral health and justice and serving as project director for the Illinois Supreme Court Mental Health Task Force.

Before joining the Illinois Judicial Branch, Block was the Executive Director of the McHenry County Mental Health Board and Director of Special Projects at the 22nd Judicial Circuit Court, where he developed and led its Problem-Solving Court. The 22nd Judicial Circuit’s Adult Drug Court was recognized as a Mentor Court by the National Drug Court Institute.

About Reimagining Law

The Reimagining Law video series explores how legal and judicial professionals are adapting the delivery of services to meet the unique needs of today’s consumers. Reimagining Law is produced by the Illinois Supreme Court Commission on Professionalism.

This interview was recorded on January 12, 2022.

Transcript

Jayne Reardon 0:07

Hi, I’m Jayne Reardon and welcome to Reimagining Law. Today I have with me Scott Block. He is the State Behavioral Health Administrator for the Illinois Supreme Court. Welcome, Scott, and thanks for joining me.

Scott Block 0:24

Jayne, it’s a pleasure to be here. Thank you for the invitation.

Jayne Reardon 0:27

I would just like to remind our viewers before I jump in, please like and share this video, and to stay updated on new episodes subscribe to our channel. So last year, the Illinois Supreme Court hired Scott Block to serve as its first Statewide Behavioral Health Administrator. In this role, he focuses on the intersection between the justice system and behavioral health. And before we get into it too much, Scott, for our viewers, what does behavioral health refer to? And what is its relationship, if any, to mental health and co-occurring disorders?

Scott Block 1:09

Great question, Jayne. And we certainly both work within systems that have languages and acronyms all their own. So, I appreciate setting the tone with that specific question about terminology. So behavioral health, which you mentioned is also included in my title, is somewhat of a catch-all term that encompasses both mental health and co-occurring substance use disorders. So, within the field, you’ll hear behavioral health and mental health and co-occurring substance use disorders used interchangeably.

Jayne Reardon 1:43

Okay, so we’ll go with behavioral health, and I’m so glad to set the terminology straight. As a general proposition, Scott, why is behavioral health important to the Illinois Supreme Court?

Scott Block 1:56

Well, over the years, we’ve heard jails and prisons in reference to our country’s largest mental health institutions. And right here in Illinois, Cook County Jail is often completely included in that reference, along with LA County Jail, Rikers Island in New York. But certainly, local jails are overwhelmed and under-resourced when it comes to treating and managing behavioral health disorders. As a result, we’ve seen courts throughout the country elevate the development of new strategies and responses to behavioral health as a primary priority. Some of the statistics that are commonly cited to reinforce the court’s involvement in behavioral health discussions are that approximately 60% of local jail inmates struggle or are diagnosed with a mental health disorder. When looking at substance use, approximately 70% of all incarcerated persons are experiencing a substance use disorder. So, this really is an issue that impacts the greater system in its entirety. Certainly not to be overlooked in that discussion is also the fact that marginalized populations, such as racial and ethnic minorities, are disproportionately impacted by the negative effects of mental health and co-occurring disorder. So notably, Black and white Americans use illicit drugs at similar rates, yet Black and brown users are six times more likely to be incarcerated on drug-related charges than their white counterparts. So again, because the justice system plays such a major part in responding to behavioral health disorders, the court is also obligated to play a role in leading change. I’d like to recognize in that discussion that we’re currently not looking to implement change at the detriment of public safety or any other institution. But the sheer prevalence of these issues within our institutional walls makes it necessary to reevaluate what we’re doing and look for new opportunities to do that better.

Jayne Reardon 4:10

So, as you look for new opportunities to do that better, are you focused on lawyers and judges, others in the system, court users? What communities will your office interact with?

Scott Block 4:23

All of the above. So, we are currently engaging all of our justice partners from judges, trial court administrators, Assistant State’s Attorneys, public defenders, private counsel, probation, and law enforcement professionals, as well as our peripheral partners in the behavioral health community. Since again, court and criminal justice professionals frequently interact with individuals who would likely not be involved with the courts if it weren’t for under- or untreated behavioral health disorders, and conversely, behavioral health providers frequently interact with individuals who would likely not be engaged in treatment if it weren’t for court mandates and conditions. The criminal justice system as a whole and behavioral health systems are synergistic partners, with a shared responsibility to strive for the best outcomes for court users. To illustrate this multidisciplinary approach and the nature of my role here with the Administrative Office of the Illinois Courts, I’m currently working with the Judicial College and Education Divisions, as well as several of our key justice partners and stakeholders, such as the Division of Mental Health, the Guardianship and Advocacy Commission, the Illinois State Bar Association, and a number of health and hospital systems to develop some specific trainings not only for judges, but also practitioners, and will be seeking to address these topics such as involuntary commitment, mental health, advanced directives, and proclamations. We’ll also be seeking to address the unfit to stand trial and competency statutes, all of which intersect with both our practitioners within the criminal justice system, as well as our behavioral health community.

Jayne Reardon 6:20

Wow, there’s a lot of educating that you’re going to need to do. To the extent that it’s appropriate, the Commission on Professionalism stands at the ready to assist. This is a serious issue and lawyers need to be educated about it. I’m wondering, Scott, if you could address how COVID has affected these behavioral health challenges?

Scott Block 6:46

Prior to the COVID-19 pandemic, behavioral health was often referenced as the public health challenge of our times in many circles. And that is because of, again, the sheer volume and prevalence of behavioral health, being mental health and or substance use disorders, within our general population. Again, often cited, 1-in-4 individuals will experience a mental health disorder at any point in time, and approximately 1-in-12 Americans will experience a substance use disorder. Unfortunately, COVID-19 has only exacerbated that challenge. And we’ve seen an increase in the percentage of the population that struggles with mental health symptoms, as well as substance use disorder. Unfortunately, in the year 2020, we in Illinois had a record-breaking year in a negative way, in that we had the record for overdose deaths in Illinois, which accounted for almost 3,000 lives or eight individuals per day who lost their lives to opioids and or heroin overdose. So, we see that just the general nature and prevalence of mental health and substance use disorders in our community intersect with our criminal justice systems.

Jayne Reardon 8:08

Wow. Yeah, those figures are staggering. I read, Scott, that the Court recently partnered with the National Center for State Courts on a summit and a report on how people can better respond to these challenges. What were some of the takeaways and next steps, if you could share that at a high level with our viewers?

Scott Block 8:34

Sure. And if I may, just backing up slightly about the summit and report, I think it’s important to provide some context around that, in that this is not just an Illinois concern or issue. This is something that’s being addressed at the national level. In 2019, the State Justice Institute funded a three-year project called the National Initiative to Improve the Justice System Response to Mental Illness and Co-occurring Disorders. That national initiative was then elevated to a National Judicial Task Force, supported by the Conference of Chief Justices and state court administrators. And that group is made up of about 40 individuals who are judges and behavioral health practitioners from around the country focused on developing resources to help state courts respond and start to manage how we deal with such a large part of the population within our court system. So, through that effort, Chief Justice Burke developed an Illinois-specific task force made up of a multidisciplinary group of individuals, and that is the group that planned our 2020 Illinois Mental Health Summit and led the initial development of the summit report. Some of the takeaways we saw in that report were specific to the need to engage some of our external stakeholders for insight and input into how we strengthen our systems and responses. And we’re actually engaged in some of that work right now. Just earlier today, I hosted and facilitated one of our task force’s regional councils and resource mapping workshops, in which we are using the sequential intercept model as a framework. I’m not certain if some of your viewers would be familiar with that model, but it is a model that was created by the SAMSA National Game Center to take a look at how individuals encounter the criminal justice system. And at what points do we have opportunities to intercept those individuals and stop them from penetrating further into that system. So, we’re engaging a, again, multidisciplinary, cross-sector group of individuals throughout the state to look at what happens when an individual first comes into contact with a law enforcement officer. What happens when someone calls 911 and asks for help? And then we build on that, to what happens at the initial arraignment or initial hearings? What happens when somebody is booked into jail? How do we help re-enter individuals back into our community and supervise them in the community? So, we are taking a comprehensive look at that here in Illinois.

Jayne Reardon 11:34

I’m really impressed that the mapping is getting really quite deep into what the community resources are and who are the people in the communities who these folks interact with. Whether it’s social workers or you know, just people who may not have any connection at first blush with the justice system, I think that is a really laudable approach to really have a holistic grasp of, of where are these touchpoints are that can be levered to help people not go deeper into the system. So, I will be very curious to see what comes from that mapping and workshop process. So, Scott, thank you so much for joining me today. I really appreciate it.

Scott Block 12:28

Thank you, Jayne, for the invitation to be here.

Jayne Reardon 12:31

Let’s stay in touch. And viewers, thank you for watching. Please like and share this video and stay subscribed to our channels to be updated on new episodes. In the meantime, be well.