Grant awarded to DAPO for ‘Reach and Respond’ approach
(Editor’s note: Grant funding will help CDCR clinical social workers and parole agents reach paroled individuals beyond the parole office.)
Tackling the growing mental health crisis will undoubtedly take a multi-disciplinary, multi-dimensional and cooperative approach focused on breaking down barriers that keep those who are most vulnerable from accessing needed resources where and when they need them.
Alexa Wasserman, Psy.D., Chief Psychologist with CDCR’s Division of Adult Parole Operations (DAPO) Behavioral Health Services, which oversee the Behavioral Health Reintegration (BHR) program, helped the department secure a $466,500 grant awarded by Behavioral Health Justice Intervention Services to do just that.
In California, approximately 35% of people under parole supervision have received mental health treatment while in prison, though an even greater number rely on such services while in the community. The BHR staff of licensed clinician social workers and psychologists provide behavioral health intervention services to approximately 13,000 high-risk/high-need formerly incarcerated persons to support their successful reintegration into the community.
These clients are often diagnosed with major mental illness, have histories of serious substance use, have been exposed to trauma, and have engaged in violence. As such, they are at high risk for recidivism, police contact, parole violations and overutilization of emergency psychiatric services. To help reduce negative contacts and experiences, clinical social workers assigned to parole offices throughout the state provide behavioral health support to anyone on parole who needs it at any time for the duration of their supervision.
Office-based treatment can be limited
BHR clinical social workers and DAPO parole agents work together to manage these cases, but are currently limited to only providing services in the parole office. This often poses a significant barrier to clients who need the treatment most.
Trauma histories, psychotic symptoms, homelessness, limited access to transportation, or active substance use can interfere with a client’s ability to continuously engage in treatment. This can result in untreated symptoms/needs and negative outcomes being met in the field by parole agents and missing the critical behavioral health intervention treatment that can help avoid even more vulnerability to jail, prisons, and psychiatric emergency rooms.
Wasserman’s vision is to take a “Reach and Respond” approach that will enable clients to be met in the community by both parole agents and BHR mental health clinicians who can provide clinical interventions and maintain a “whole person” approach.
“There are a great deal of co-responding efforts where first responders and behavioral health clinicians work together to manage crisis situations in the community,” Wasserman explained. “However, our research struggled to find models similar to Reach and Respond which focuses on non-urgent, pro-active therapeutic interventions via field-based services where the pre-existing collaboration between parole agent and BHR clinicians are maximized. Evidence exists that when you show up to the person and meet them where they are, it makes an impact that you care, and that can make a difference in someone’s willingness to engage positively in their own treatment success.”
Clinical social workers can reach clients where they are
In addition to meeting the client where they are in the community, the Reach and Respond approach allows for the BHR clinician to have increased insight into the client’s living situation. It also has the potential to involve a client’s support system in the rehabilitative process.
“Since (BHR) has such collaborative working relationships with parole agents, when we have a mutual client who isn’t engaging in their successful reentry we’ll now be able to coordinate a visit to the home and see what’s going on,” Wasserman said. “And one part of DAPO’s guiding principles is family-based systems, which will now allow us to meet the family/support system. (This empowers them to) be involved in their loved one’s behavioral health care plans.”
Crucial to the success of this approach is the training of all staff – parole agents and clinicians alike. Wasserman, who has served the department for 21 years, is bringing her expertise to this effort as Project Director to bring the training online by Feb. 2023.
Partnership expands efforts
Wasserman’s team, through the grant, has partnered with the National Organization of Forensic Social Workers (NOFSW). This allows them to tailor their existing evidence-based program in co-responding methods to meet the specific needs of DAPO/BHR’s efforts. NOFSW will establish a virtual statewide training for 1,300 qualifying DAPO parole agents, BHR clinicians and parole service associates. Also, it will provide an advanced training for 120 BHR clinicians, allowing them to continuously train staff as the need emerges.
Other changes happening in the way CDCR provides mental health treatment and reentry services to parolees include moving towards whole-person case management models.
“Due to shorter parole terms, we need to focus efforts on establishing community based linkages for our clients. (This will provide) sustainable support when their parole supervision ends. Where BHR used to be a clinical therapy-based service, we are shifting towards a case management-heavy program addressing all identified needs that go beyond just mental health. We are maximizing our efforts by taking a holistic approach to the client. (We’re) paying special attention to what their positive resources are but also their limitations so plans can be realistic and attainable for that individual,” Wasserman said.
Treating the individual
This includes creating individualized treatment plans for clients and using various assessment tools to make sure clients are set up with exactly what they need to succeed, which varies from person to person.
“The case management model also presents us with an opportunity to specifically identify where barriers to entry exist due to lack of services, which we can potentially use this information to advocate for more specific resources in a given area to greater meet the needs in the community.”
She’s been with CDCR since she was a forensic psychology student conducting her practicum at Central California Women’s Facility. Since then, Wasserman has seen dramatic changes in the way behavioral health services are provided by the department, inside and outside of prison.
“We’ve talked about doing this for so long and there are so many forces that are all aligning to make this shift happen, I believe it’s a valuable shift to be making,” Wasserman said. “DAPO has amazing staff who are crucial to this effort. It is exciting to be involved in moving these initiatives forward with this dedicated group.”
Expanding health initiative to staff
In addition to the work involved in the “Reach and Respond” grant project, Wasserman is spearheading a “Be Well” initiative dedicated to addressing the wellness of all DAPO staff. The concept involves monthly open forum town halls, educational outreach campaigns and more accessibility to pro-active resources.
By Dana Simas, Press Secretary
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