TTI Through the Years

TTI 2021 Information Page

In FY 2020-2021, CMHS awarded 40 TTI grants, all in the amount of $150,000, to the following 28 states and territories:

• Alabama: ADMH will develop a crisis communication system that includes new crisis diversion centers, rural crisis care projects, and the Alabama Stepping Up Initiative, that will provide access to care in addition to advocacy for passage of state funding for 988 crisis line. 
• Colorado: CDHS will enhance the existing Jail-Based Behavioral Health Services (JBBS) Program and provide targeted technical assistance and peer-to-peer learning for rural jails with a focus on  the SMI population by linking community resources and providers, connecting individuals with their Peer Recovery Network. The University of Colorado will create and facilitate an integrated peer-to-peer community to foster successful implementation of best practices and the sharing of team successes, barriers, lessons learned, and problem solving amongst the participating jails.
• Connecticut: DMHAS will enhance Communicare mobile crisis services by including peer navigators to provide postvention follow-up services in order to divert adults from jails, increase collaboration with local police departments, and strengthen clinical staffing on the mobile crisis teams. DMHAS will employ peer navigators, replicating the success of the CARES Project, to support individuals with SMI in local jails and re-entering the community. 
• Delaware: DSMAH, through the Delaware Treatment and Referral Network (DTRAN), will integrate Certified Peer Support Specialists (CPS) to serve clients with SMI and co-occurring disorders and provide additional service options through the Pre-Arrest Police Diversion Program (PDP). DSMAH will enhance the  their Mobile Bridge program, which is a joint venture with the Department of Corrections, that provides recently released individuals with a myriad of services, including behavioral health screening, referral to treatment, and enrollment into State services by expanding hours, reach and public awareness of the program.  
• District of Columbia: DBH will expand their existing service registry, EMResource, by engaging DC hospitals, crisis stabilization beds, inpatient and residential SUD services, and the Access HelpLine (AHL) to increase capacity of tracking the full range of acute inpatient psychiatric services and reduce unnecessary wait times.
• Florida: DCF, through culturally appropriate, evidenced-based, and best practices, will employ Forensic Peer Specialists to the new Community Forensic Liaison (CFL) Team to reduce the health and social disparities for justice-involved individuals with mental illnesses, thereby improving service access and outcomes, and strengthen collaboration between the mental health and law enforcement/criminal justice systems. DCF, using the Sequential Intercept Model, will employ Forensic Peer Specialists to colloaborate with jails to assess and coordinate treatment for individuals within the jails and upon reentry in their efforts to reduce the health and social disparities for justice-involved individuals with mental illnesses.
• Hawaii: AMHD will develop a provider and public-facing service registry and dashboard integrated with their EMR by upgrading their system to increase efficiency and include crisis, inpatient psychiatric, residential mental health, and substance abuse facilities. Data collection will enhance cross-system collaboration and identification of needs. AMHD will increase the number of Certified Forensic Peer Specialists and offer additional training to increase state capacity at pre-arraignment, arraignment, and for Hawaii State Hospital forensic patients.
• Kansas: KDADS will expand their mobile crisis competency restoration services to reduce pretrial detention times, create a best practice toolkit and guidance for judges and court officers regarding community-based competency evaluation and restoration services, and facilitate a statewide judicial training and awareness campaign. 
• Kentucky: DBHDID, through the Louisville Behavioral Health Jail Diversion Initiative, will work to revolutionize and expand the crisis healthcare system in Louisville by implementing non-police jail diversion models that are trauma-informed and racially equitable for individuals in crisis, and reducing incarceration rates recidivism.
• Louisiana: OBH will research and develop a model for a crisis services registry of a triage, dispatch, and data collection/reporting to strengthen  mobile crisis and crisis stabilization systems.
• Massachusetts: DMH will expand and enhance their Behavioral Health Network peer support program to assist with diversion via co-response and Community Clinical Response Team (CCRT) Clinicians, increase capacity through telehealth, and collaborate with law enforcement.  
• Minnesota: MMHCF will expand and enhance FastTracker, Minnesota’s public website with two portals to track availability of mental health and substance use disorder treatment services, completing a state-level, real-time, comprehensive service registry for mental health treatment services across the continuum of care. 
• Mississippi: MDMH will enhance their Crisis Intervention Team (CIT) program by employing Forensic Peer Support Specialists and establishing a Crisis Services Center (CSC)  that will act as a Single Point of Entry (SPI) for the CIT program and will be accessible to any individuals experiencing psychiatric or substance abuse challenges. MDMH will promote a trauma-informed approach in the justice system by partnering with a local Community Mental Health Center to train a team of Forensic Certified Peer Support Specialists (CPSS) to work in the jail system, and train corrections officers, jail staff, and/or justice system in trauma-informed care.
• Missouri: DMH will replicate an expansion of the successful Forensic Mobile Team, a community behavioral health program, to provide services in county jails that have no medical, psychiatric, or other services available. 
• Montana: AMDD will increase access to crisis and diversion services by researching and developing a Behavioral Health Crisis System Strategic Plan to inform the most relevant services in rural and frontier communities.
• New Jersey: DMHAS will support and champion peer specialists in crisis programs in two counties of the state with a focus on facilitating the diversion of legally involved individuals from involuntary hospitalization or incarceration, and expanding support for local police departments. DMHAS will strengthen services in the state by recruiting, training, and deploying forensic peer specialists (FPSs) who will work in justice-involved services (JIS) to engage individuals with a mental illness who are in county jails and local courts and support their re-entry into the community.
• New Mexico: NM BHRN will develop a Learning Collaborative to bring together and strengthen existing Crisis Triage Centers (CTCs) by bringing together service providers, their state Office of Peer Recovery and Engagement (OPRE), and law enforcement.
• New York: OMH will combine two successful peer-run county emergency programs; the 911 Diversion Program which trains 911 dispatch and emergency service personnel to screen for mental health or co-occurring issues and the Mobile Crisis Stabilization Team which is a forensic-focused mobile team that works directly with law enforcement and courts seeking diversion through alternatives to incarceration (ATI) to provide immediate crisis response and/or transitional care services to people at risk of entering the criminal justice system.
• Ohio: OMHAS will expand and enhance treatment services within jails and increase reentry coordination for treatment and recovery supports for individuals with SMI to transition into the community through crisis prevention and training staff on trauma-informed care, access to psychiatric services, and access to supportive housing and transportation.
• Oklahoma: DMHSAS, expanding upon the Sequential Intercept (SIM) Model to provide services at every level of diversion, will partner with a county jail to implement reentry support to community providers including behavioral health treatment services and other community social support such as housing, education, employment, and legal resources. They will identify a community partner network to educate about the reentry planning process and develop collaborations to make referrals and service connections. DMHSAS will work to expand reach of their County Service Engagement Project via Certified Peer Support Recovery Specialists to better screen individuals, connect them to community services, and improve jail-based behavioral health services. Multiple  models  of  telehealth  intervention  are  in  use  throughout  the  state  and  will  serve  as a blueprint for this project.   Projects which provide tablets directly to individuals receiving services have  demonstrated  the  success  of  immediate  access  to  care  and  proven  the  effectiveness  of proprietary  software  which  protects  the  devices  from  unauthorized  use. Tablets  have  been distributed  to  law  enforcement  to  connect  individuals  they  interact  with  in  the  public  with emergency crisis care in the field have also proven successful interfaces with the criminal justice system.
• Palau: PBHAC will train providers and law enforcement on Behavioral Care and Diversion. The long-term outcome is to reduce recidivism and incarceration rates, lower the costs associated with arresting, sentencing, and jailing those with mental health issues, and more importantly, provide those experiencing a behavioral health crisis with the care and services they need.
• Pennsylvania: DHS/OMHSAS will develop a community-based forensic pilot bed registry program in the southeast region of the state building upon their Stepping Up Initiative implementation. The registry will focus on diverting individuals with mental illness involved in the criminal justice system from incarceration to community-based treatment. DHS/OMHSAS will provide specialized response training through Crisis Intervention Training (CIT) and Mental Health First Aid for law enforcement when interacting with individuals with behavioral health challenges such as mental illness and will promote collaboration at the local level. They aim to increase officer and public safety during crisis situations and enhance diversion/treatment opportunities to improve outcomes for individual with behavioral health challenges.
• Puerto Rico: ASSMCA will expand services of the Crisis Peer Support Specialists to the Integrated Crisis Intervention program of the Linea PAS Hotline by assigning Certified Peer Support Specialists to provide services to crisis programs through the ASSMCA Mutual Support Center (MSC). ASSMCA will integrate Crisis Peer Support Specialists, Recovery-Oriented Services, and their Offender Re-Entry Program to strengthen mental health treatment interventions at correctional facilities and in Forensic Psychiatric Hospitals by engaging individuals in peer-based recovery services, MH treatment, and development of personal skills.
• South Carolina: DMH will strengthen their statewide mobile crisis program to increase jail diversion practices through a  Criminal Justice Coordinating Council and engagement with leaders in the local justice system to utilize data-driven, evidence-based practices to inform decision making, providing effective treatment for individuals and families, and implementing jail diversion practices. DMH will engage Certified Peer Support Specialists to increase access to mental health and substance use services for individuals released from a detention center through coordinated care and will employ mental health professionals to improve coordination of care for individuals returning to the community.
• South Dakota: DBH will create a real-time, community-based, forensic service registry of comprehensive services including but not limited to residential crisis services, mobile crisis services, outpatient mental health and substance use disorder services, residential mental health and substance use disorder services, and supported and recovery housing. They will focus on diverting individuals with mental illness involved in the criminal justice system from incarceration to community-based treatment.
• Texas: HHSC, through trainings, educational resources, and planning activities, will develop, publish, and implement a research-informed and evidence-based training and technical assistance (TTA) strategy to accelerate the implementation of successful diversion programs throughout the state. This project will include data collection from law enforcement, peer service providers, people with lived experience of justice involvement, including people of color, and local mental health service providers.
• Utah: DSAMH, through Forensic Peer Support Specialists (FPSS), will create a new initiative to expand diversion from incarceration into the existing crisis system. They will establish a specialized FPSS enhancement and practicum program and create a peer workforce to focus on individuals being diverted from incarceration due to behavioral health issues.
• Washington: DBHR will develop a statewide service registry by upgrading their system to increase efficiency, converting existing state hospital capacity into Forensic Centers of Excellence, and  including smaller treatment facilities dispersed throughout the state to better serve individuals within or nearer their home communities and reduce institutionalization. DBHR will create a continuing education, trauma-informed curriculum for certified peer counselors to work in crisis service environments. The curriculum, created by CPCs and crisis service providers will serve the needs of behavioral health providers, and build upon the lived experience of those uniquely qualified to provide peer services. DBHR will create a specialized online curriculum focusing on Trauma Informed Approaches for jail personnel, law enforcement, and possibly forensic hospital personnel which will be delivered by co-trainers, presenters and panelists who are local tribal members, representatives of under-represented groups, youth, family, and adult content experts with lived experience.