- Judge Perez, I suspect that there are gonna be people who watch this town hall, who will go, "That's a courtroom that's happening in a courtroom."

Help us unpack the intersection among behavioral health, substance use, and criminal justice outcomes.

- Well, as Judge Despero said in that little video, they're so interconnected.

Folks who are suffering from significant mental health issues do self-medicate.

They turn to drugs and eventually, they end up in our criminal justice system, maybe more than one time.

This is the opportunity.

And Pitt County has a mental health recovery court as well.

An opportunity to get these people in a courtroom setting, but with you can tell people who care about them, who are enthusiastic to make these people understand that they can have a stake in this process.

And we're with them every step of the way, if they want us to be.

So, it's exciting to see now a move now in the judicial system to having these recovery courts, because I think statistically we're gonna find they're gonna work.

Are we gonna succeed in every case?

No.

But if we can succeed in one or two cases, I think we're making an impact.

- Have we been doing this long enough to have data on how successful these programs are?

- I don't think so yet, at least long-term statistics.

But I think for what I see in Pitt County and for what I see in traveling and talking to other districts, is that it is making an impact.

And we're getting people who traditionally have not had the treatment or had treatment and quit, who are now getting the treatment.

And more importantly, when they graduate, they're not alone.

The people who were providing resources to them when they were in that courtroom setting, when they're on probation, are still there to help, and that's important, 'cause as you know, this journey is not a journey of one day or one year of two months.

This is a life-long journey for them.

- I wanna go to you, Sheriff, because law enforcement is also changing the way it engages in these issues with mobile crisis units, for example, going out with law enforcement officers and first responders.

What are you seeing that gives you hope?

- I think law enforcement over the last several years, excuse me, has had to change.

The mobile crisis units has been unbelievably meeting people with those needs on scene.

I mean, they can meet at their homes, they can meet at schools, they can meet at churches, but having those mobile units to get ahead of the problem before we see it turn into the recidivism and inside our jails.

So, absolutely, we've gotta have 'em and we've gotta support 'em and they have to have the community buy-in to support those.

And we're seeing a lot of that.

- We're gonna come back and talk about community buy-in.

Latoya, one of the purposes of the program we saw here is to provide an alternative to incarceration, but I'm wondering if you could just talk to us a little bit about what role incarceration plays in exacerbating mental health issues.

So, let's start from the back.

- Sure, I think one role that it plays is that incarceration has really become the default option for people with mental illness who don't have access to mental health care.

At the beginning of the segment, you said that studies show that about 40% of people who are incarcerated have a mental health diagnosis is significantly higher than that for children.

So, I'm gonna speak from the Juvenile Justice perspective, because I serve as general counsel for the Division of Juvenile Justice.

So, that's my expertise.

And earlier this year we did a point-in-time study of confined youth in our population, those who are confined to a youth development center, or YDC, which is a long-term locked facility for a youth equivalent to a prison for an adult.

And what that study showed is that for youth in what YDCs, 99% have at least one mental health diagnosis.

- No, no, did you say 99%?

- 99, 99.

So, nearly every youth who is in a YDC in North Carolina has at least one mental health diagnosis.

But on average, a youth has four or more distinct mental health diagnosis, and 48% have co-occurring mental health and substance abuse.

30% have been diagnosed with PTSD.

So, that tells us that youth with mental health issues are disproportionately being placed in locked facilities.

But a prison or YDC is not an inpatient mental health treatment facility.

So, they're not getting the appropriate care that they need to resolve those issues.

And more importantly, incarceration can cause further harm by leading to more trauma, which perpetuates the mental illness.

Another issue that we're seeing in Juvenile Justice is that incarceration creates a barrier to mental health treatment, because once a child gets placed in a locked facility, they become ineligible for Medicaid-funded treatment and services.

Federal law prohibits Medicaid reimbursement for any services provided to an inmate, that includes children.

So, we are fighting a constant battle in Juvenile Justice, trying to get services for kids in our custody who very much need mental health treatment.

Oftentimes intensive residential mental health treatment.

But we can't find a resource to pay for it, because they're not eligible for Medicaid.

So, it's very counterproductive to place these kids in facilities when what they really need is mental health treatment.

- And it's interesting, because I've heard, Sheriff, many of your colleagues across the state say, "We're not a mental health institute.

We don't have the capacity to meet many of the needs that our inmates have."

What are the kinds of programs in jails that are available to support mental health challenges?

- And I will echo that, we are not.

In some counties, in a lot of counties, and I think law enforcement in general, and especially, the sheriffs or the sheriffs will tell you this, we have got to, it's become to where we're one of the biggest mental health providers in our detention facilities.

We partner, there's so many different partnerships that we work with, faith-based groups, professional groups, our local hospitals.

So, you know, we're doing everything that we can.

And not only that specialized training, 24-hour medical, detoxification protocols, policy changes, it could go down the list.

You know, the sheriffs have learned that's a new rule or role that we're playing, especially, over the last 10 years.

- [Anita] Yeah.

- Working great with the juveniles and the justice system itself is, we're in a tough position when it comes to mental health, especially, in our jails.

But we're also working with the General Assembly and we constantly, especially, as the association, work to try to fix those problems the best we can.

But going back, just you're right.

We have become one of the biggest providers of mental health in a lot of counties.

- Not just not what you're set up to do.

- It's not, we have evolved and we are doing it, but we're not the professionals.

- Judge, let's talk a little bit more about alternatives to incarceration so that these people don't end up in these facilities.

What are some other innovations that you're seeing you, Latoya, and any of you?

- Well, going back, I think what we're seeing now is the mental health recovery court, drug recovery court, veterans court.

We're developing these sub courts to address these issues.

And we're finding that there are people who are interested in coming to these courts.

The problem we have, the struggle we have, is resources.

Resources has been the big issue.

And so for me, I think it's important that we as stakeholders have to get into the community.

Look for resources in the community, 'cause there are many that are out there.

Faith-based is one of them.

And if we can connect with the community that deals with our people who live in our community, I think we need to start doing that more, because these recovery courts, again, they can make a difference, because you're offering some resources, maybe not all the resources they need, but some of these people have had no resources throughout their lives.

And so, we're offering that to them as an alternative to what they've been used to.

Going to jail, spending their time served, and then they get released, because they've been in more than they need to be for the crime they're charged with.

So, you let 'em out with nothing else.

So, what are they gonna do?

They're gonna re-offend, because they're not getting the help they need and they're gonna come right back.

And the sheriff has to deal with 'em.

We have to deal with 'em.

It's just a cycle.

- Yeah, yeah.

Judge, you actually served as a member of this ACEs informed Task Force that the Chief Justice put together, and that, of course, aspired the work highlighted in this story.

What have you learned about the specific links between ACEs, justice involvement, or other risks that make this work necessary?

- First, Latoya's also on Task Force.

- I was gonna give her some love too.

- And to answer your question, do we have three hours to talk about it?

Ben David, who is one of the co-chairman of Task Force, as is Judge Corpening is.

I mean, it is just awakened me.

It's been eye-opening.

Okay, that's right.

To learn the science, the data out there to realize what's out there as far, what are the studies have been done.

So, we know that there is an impact when children are traumatized and at an early age for a lot of reasons.

Usually, I see that in abuse and neglect Dependency Court.

Parents who can't parent, because of their substance abuse and mental health issues.

And so, the focus now is, okay, we have the science, we have the data, what can we do to make a change, to make an impact?

And the Task Force that was created by our Chief Justice Paul Newby, is the first year has been getting us the information so we can realize this is real.

This is real folks, and it's having an impact on our children.

If we can start making the changes when they're young to address their issues, to address their trauma, we can stop the cycle.

Those kids who we would see in Juvenile Court, in an adult court, perhaps will never get there, because we are doing something about it early on.

And one of the things we did at the Task Force, we're trying to get everybody informed.

And judges, we have a bench card for judges, 'cause judges deal with juveniles.

District Court judges deal with juveniles.

We deal with parents who are losing kids perhaps in that setting.

And this is a bench card that kind of puts together a lot of the philosophy, a lot of the things, that we need to be thinking about when we address people in our courtroom.

I think Judge Corpening would say, you know, not what did you do wrong, but what's wrong with you?

What has happened in your life?

What can we do to help?

And one of the most exciting things that's going to happen is we have early childhood courts.

So, zero to three, we're trying to get, there's four pilot counties in North Carolina modeled after the Florida system where you get children who are zero to three, who are having issues at home.

We bring 'em to the court.

We have a team that helps the parents out.

It's a team approach.

We meet regularly to make sure they're getting their needs met.

And hopefully, when it happens, they're unified and the parents have more skills to learn how to deal with the thing going on.

And that child will not be, have the trauma that most children have, zero to three and beyond.

So, it's exciting, but it's going to be a struggle.

But I think everyone agrees now that there is this issue.

We need to address it.

And I think we're working on trying to, hopefully, get these programs in place where at some point we can get the resources from the legislature to help us.

Because I think everyone agrees that the children are our most important resource.

We've gotta find a way to help them.

So, we don't have this recidivism.

We don't have them in the jails.

- Latoya, we've heard that these issues are broad based.

You also served on the commission.

Well, what is the role of agencies like school systems, social services, child welfare organizations in working to support these lifestream efforts?

- I think it's very simple.

Their role is to build resiliency.

That's what trauma-informed courts are about.

Making children and individuals who are engaged in the justice system more resilient.

And that can happen, if they get adequate support.

They won't end up in the Criminal Justice system.

Children won't end up in the Juvenile Justice system.

And so, what we see in Juvenile Court is that oftentimes the kids who are in Juvenile Court at the same time they're engaged in Child Welfare Court, they are in the special education system, they're involved with the mental health system and you know, among others.

But these different systems and agencies aren't working together to make sure that children don't fall through the cracks.

And so that's, you know, that results in them unnecessarily coming into the Juvenile Justice system for issues that could have been effectively addressed within the community.

And so, I think, again, building resiliency by working together more effectively.

One of the best examples that I've seen in recent years in North Carolina of effective multi-system stakeholder collaboration is the School Justice Partnership program, which I had the honor of talking with you about a couple years ago on this program.

But that is a great example of various stakeholders working together to support kids and help them avoid that unnecessary contact with the court system.

And so, about five years ago, the administrative office of the courts, in conjunction with the Raise The Age legislation, developed a program called the School Justice Partnership.

Where a local school district can partner with the courts and other local stakeholders, including law enforcement, the District Attorney's Office, Juvenile Justice and others, to keep kids in school and out of court by directly referring them to community-based resources.

Things like teen court, mediation, different types of restorative justice programs where their behavior can be addressed without the trauma of court involvement.

And it works, because we've seen about half of the counties in North Carolina now have a School Justice Partnership.

And in counties like New Hanover, where we just heard from Judge Corpening, in their first year, they were able to reduce school-based referrals to court by about 50%.

That's significant.

If we could do that throughout the entire state, we would have a lot more, much more resilient kids.

- And then maybe more resources within the judicial system to focus on the people who are there.

- Absolutely.

- I hear all this conversation and I'm wondering, Sheriff, you talked about community partners, how much of what law enforcement is doing in North Carolina is this kind of prevention or early intervention versus people who have gone through the system and now are gonna be incarcerated?

- I would say 90% has got to be the early intervention.

And I'll speak for myself, what we do locally and also a lot sheriffs across the state.

I hear we've got to get involved with our younger kids.

We do a teen academy.

We do an athletic league with over 300 girls every year.

I have mobile classrooms that we use.

Other sheriffs have all sorts of programs, because we understand if we would much rather prevent it than ever have to investigate something.

And we've gotta help them understand, you know, before they get into the system, you know, mental health is something we've got to see or we've got to work on, educate them and let 'em understand it.

I'll speak just for the last week ago, we had an 11-year-old commit suicide.

That's mental health.

So, law enforcement along with those things, everything from school resource officers in school, you know, we see that and we'll probably get to it shortly, but all those are the front lines of what we've got to solve the big problem.

- So, I wanna turn to the question of suicide, because we're all concerned about the breadth of mental health challenges, but we've seen a spike in suicide that really feels like a crisis in our nation.

And maybe more so, because we're thinking of an 11-year-old.

- [Darren] 11.

- What are resources to help people deal with suicides in jails in North Carolina?

- You know, it goes back to the policies, the training, the group sessions.

If it happened, obviously, we won't prevent it.

That comes through the education upfront.

Being able to recognize mental health disorders and other substance abuse disorders.

You know, when somebody's incarcerated, it is very traumatic.

I mean, it is.

So, our job is to do everything we can prevent it.

Not just on the front end, but on the back end as they leave.

- [Anita] Yeah.

- You know, we cannot just say, "Hey, they're here for the time."

Afterwards, we've got to worry about not in the jail we've got or worry about preventing, in my opinion, to start with it.

And then how to help 'em to, from coming back again.

- I'm gonna come back and talk to Latoya about re-entry, but while we're talking about suicide, law enforcement officers have a very high rates of suicide.

It's a tough job.

What are the supports for them?

- You know, we have something, and a lot of sheriffs across the state have family auxiliary support things.

Used to in the Fire Services called spousal support or the Women Ladies Auxiliary.

We have spousal supports where spouses can come together.

We do things like trunk or treatments for the kids, officer's kids for our communities.

You know, last week I've got, years ago we had a bad case involving kids with a father and a domestic.

The four initial deputies responded to that call three years ago.

None of 'em is still here.

It was a three and a four-year-old shot by their father.

Just this past week before I come down, we had a five-year-old get ahold of a gun and kill a three-year-old brother.

These young officers, two officers had less than a year on the job.

So, we have to have group sessions.

We met with them the next day.

We called 'em at night and talked to 'em on the phone.

These younger officers have to understand to lean on their older officers.

When I was coming up through, you didn't speak about this.

You didn't speak about being weak hearted or understanding or having strong emotion.

Now, we encourage it and it helps for the long term career of that officer to get it out and talk and have people understand it.

So, we put a big emphasis on that.

And also, prior to a lot of background mental health preparedness and things like that.

So, it is tough and we do see it.

And the suicide rates among officers, are some of the highest there is.

- And Anita, if I can also add with youth, one of the biggest thing that we do in the Juvenile Justice system is screening and assessment.

When anytime a child is referred to Juvenile Justice, they receive multiple assessments at intake to help identify mental health, substance abuse, or any sort of underlying issue.

And as they go through the system, as those issues are identified, they're then referred for more comprehensive clinical assessments with a mental health provider.

If they go to a facility, they're constantly being reassessed and seen almost every day by licensed mental health clinicians to help ensure that they are made, you know, that their mental health is being protected.

And so, identification is really key.

And so, we try very hard to make sure that we are effectively assessing youth who come into our care, who come in under Juvenile Court supervision so that we can identify it and then get them into the necessary treatment.

- And the judge in Juvenile Court, certainly, I was just thinking the same thing.

There are a lot of clinical assessments that are done on these juveniles.

And as a judge, my role is to determine what help are they gonna get?

What's been identified as issues, what are their risk factors, and can we address those?

And certainly that's the plan.

Unfortunately, it doesn't always work out.

We talked about that when they're in YDC, but we can identify, the question is getting them the resources.

Oftentimes, you know, I put 'em on probation with a court counselor and make sure, but the deal with juveniles is, if you don't have the parent or the guardian on board, it's difficult.

If you gotta get everybody on board.

And that's tough, because sometimes you have a juvenile who's had a tough time at it and parents who are no longer in the picture for whatever reasons, and it's tough.

But if you can get a young person into the system and start getting after they've been assessed getting the work, but getting their parents, the guardians on board, I think it makes a difference.

- [Latoya] Absolutely.

- What you gonna say?

- Well, no, I was gonna say when that, you know, I think now those that may look and see, hey, do we understand what the courts are doing?

Do we understand what Juvenile Justice is doing as far as a law enforcement perspective.

I think one message I would like the public to know, I think we are clicking now the best that it is clicking in a long time.

And I mean by that working together.

If we see an issue, or if the court see it, they're sending us, Latoya and her position where they're dealing with, we try to do as many referrals.

And I think it's been the best that I've seen in over 20 years of law enforcement.

Without dating myself.

- I think that's what we were seeing in that video.

When they said, this is the best, we've, I'm so excited.

- [Darren] Absolutely.

- Everybody's on board.

- And it has been a big effort to provide trauma-enforced training to not only judges, but to probation officers, law enforcement, public defenders.

So, we're trying to get the message out to all the judicial stakeholders that this is an issue that we need to address and if we work together, we can find solutions.

And that's what we're doing.

And that's the exciting part that I think we're all on board.

- You know, that's the tagline for this show, right?

If we work together, we can find solutions.

- No.

- Did you steal it from me?

- No, I did not.

I did not know.

Wow.

- I'm gonna turn to you all for some audience questions, but Latoya, given what you said at the beginning about some of the barriers for re-entry, particularly for young people needing services.

Just walk us through what the process looks like.

- Sure.

So, obviously, any individual leaving a correctional facility, child or adult, is especially vulnerable during that time period.

We talked about the significantly high rates of substance abuse and mental health for children who are in confined facilities.

And when they in the YDC setting, they are getting care from a team of professionals, including nurses, licensed mental health clinicians, social workers who are managing their care and treatment.

When they leave the facility, significant risk that their mental health will decline without those supports.

So, re-entry is a big part of our program at Juvenile Justice.

And some of the things that we're doing, we are very excited about a new grant-funded program that we have through a federal second chance grant called Re-entry to Resilience, or R2R for short.

This is a program operating in eight counties right now where a youth is paired with a youth success coach from the moment they enter a YDC up until 12 months post-release.

So, this person is with the youth, getting to know them, building a relationship of trust, understanding what their needs are, both while they're in the facility.

And then when they get released, they're helping that youth with all the support they need with getting re-enrolled in school, getting housing, getting a job, finding a way to get to the job, 'cause oftentimes they don't have transportation.

And so, with that type of support, we've seen an extremely reduced recidivism rate for those youth at only 4%.

The average recidivism rate for a child coming out of a YDC is 80%.

So, 80% of children leaving a YDC re-offend within two years.

Children who have been in an R2R is about two years old now.

We're only seeing about a 4% recidivism rate.

So again, resiliency with the right type of support these children can succeed.

- Yeah, but it goes to you've got to have a trusting relationship with someone who can guide you.

- And resources.

- [Anita] And resources, yeah.

- It's grant funded.

So, we're only in doing it in eight counties, but we're hoping to be able to expand it with more funding.

- It's amazing.

All right, we'll get the mic, we're ready for questions.

This is that moment where we just wait.

[Anita chuckling] - Hello everyone, I enjoyed hearing all your comments.

How do you get the different systems to share data?

- [Judge Perez] That's a good one.

- As far as the people that are being served, you can have the aggregate data, but I mean, when you talk about care data, thank you.

- We had in one of our Task Force meetings, a gentleman from Wilmington who talked about the data and was just starting and he was offering it.

I think you go online and look at things, but that is a very good question.

And I think that's one of the things we've got to work on is sharing the data so we can use that data to benefit these people who are at risk.

But there is an effort, and I think we have dashboards, which are people putting together the information, putting it online, and we can look at it.

For example, I was looking at one the other day at the number of children who are in our welfare courts, who, you know, are staying in the welfare system for how many months or days or where do they go to foster home often.

How many foster homes do they go to?

We get data, but it's certainly something we can continue to work on, but it's important to have the data.

- It's absolutely important.

A large part of what I do is help to develop policy and legislation for Juvenile Justice, and all of that is driven by data.

So, we share a lot of data, actually, with various stakeholders.

The challenge with Juvenile Justice is that our data is confidential, because we're serving children.

And so, most of the data that we're sharing is de-identified.

So, we're not necessarily sharing information about individual youth, because we don't want to stigmatize a child by, you know, disclosing to the public that a child is involved in Juvenile Justice that has all sorts of negative collateral consequences.

But we do share a lot of de-identified data with schools, with social services, with courts, with law enforcement, that helps to inform some of these policy decisions.

- And I'll just go ahead.

I agree wholeheartedly the information is, I guess we do share a lot, but it goes back to the old fashioned just sitting down, having your meetings.

If you see children and adults that's in the cross, I mean, I'm talking about the recidivism's up, we've seen 'em a couple times.

You still just have the means and that helping hand to reach out and say, "Hey, this is gonna be a problem."

Those types of communications I still think is very, it just pays huge dividends.

- Thank you, other questions?

Just come on up.

- Thank you all for your time today.

It's been really encouraging hearing about the interventions for young people.

And I understand why we've spent a lot of time on this and talking about how to kind of persuade people about the effectiveness and the need for those things.

I'm curious, as you're talking about people that have been involved in the justice system, maybe longer, maybe they're even older adults, how to make these arguments for stakeholders for still intervening for those people that are just as deserving of help?

- Great question.

- You know, first, I say that for me, I think we all agree that if we can get intervention early for these juveniles, I think we can make a big impact.

The issues that I see with the adults who I see coming back to me all the time is, again, no resources for them.

They don't have Medicaid, or if they do have Medicaid, they don't know how to get it.

They don't have anyone to help them out.

Oftentimes they're homeless.

They are just going from place to place and they just recommit an offense.

Sometimes it's a nonviolent offense, you know, it's trespassing, the larceny things.

But it's clear when I see them in my courtroom, oftentimes without even talking to them after one comment from them, I know there's a mental health issue there.

And so, what I think we need to do and I will talk to the attorney, the DA, if it's a public defender involved, normally it's a public defender, 'cause they can't hire a lawyer.

I bring 'em up, I say, "What can we do?"

Because me just saying, "Time served, bye."

Is not gonna make a difference.

And oftentimes I will put the person on probation and I'll order that they go to re-entry.

Contact a re-entry program, see if they can offer any resources.

I've been going to one of our churches sometimes.

See if they can get resources.

You've gotta get them to a place where they can get resources.

They're not gonna do it on their own, 'cause they haven't, after 30 years or 40 years, they need someone to help them, the resources.

And maybe that'll make the difference, because otherwise you will continue to see these people or they might move on to another jurisdiction and be in the same way.

- Right.

- So, those of you who represent or work for statewide organizations, when I hear resources, what is clear to me is that there's some places in the state that are better resourced than others.

- Absolutely.

- And that's particularly true when it comes to providers.

The data is here and clear about that.

So, what do you do in places where you just don't have providers?

- You beg, literally beg.

- Yeah.

- And you look and you ask, and sometimes you send 'em to other counties that might, you know, Pitt County, I know there's folks in Martin County that come to Pitt County, 'cause Martin County has no resources.

And so, you really, really are begging, looking, talking to other judges.

What do you have in your county that can help this situation?

So, it literally is you are at your wits end sometimes.

- That's a huge problem that we have in Juvenile Justice is in some of our more rural and underserved communities, they don't have sufficient resources.

Mental health care is one of the big areas where we see gaps.

And so, what happens for youth in those counties, they have to wait much longer to get access to treatment.

And oftentimes, unfortunately, they're sitting in a juvenile detention center waiting for a bed or a program to open up.

And so again, we see incarceration becoming the default option for kids who really need mental health treatment.

And so, unless they have the transportation to drive two or three counties away to get the treatment, they just have to wait.

And that's something that, you know, we're trying to fix by asking for more resources from the General Assembly.

But we have to work with what we have.

And I did wanna just address the young lady who had the question about, how do you lobby the General Assembly.

One of the things that I've seen that has been pretty effective for Juvenile Justice is that the legislature likes to save money.

If you can show them that a program is gonna save money and is economically efficient, then that typically goes a long way.

And so, something like the, right now we're doing a quality assessment of the R2R program, which is the re-entry program I talked about a few minutes ago.

We're working with RTI International and they're doing a quality assessment or effectiveness study.

But one thing that we've learned so far is that for children who are in a YDC, it costs about $110,000 per year for every child who is in a youth development center.

For a year on in the R2R program, it's about $5,000.

So, if you can show that type of.

- Like, yeah.

- That type of cost savings.

We invest about $5,000 into a child and that has a great potential to keep them from coming back to us.

You know, that can be pretty convincing.

- Yeah.

- And similarly with this early childhood courts are gonna be in the pilot program.

If you can get to the parents and get the resources they need when the child is zero to three years old, Florida has shown us that, that saves so much money.

'cause they're not gonna be, these parents no longer gonna be in the child welfare court system where you need to spend resource on them.

They're gonna be at a point where they're a lot better off and the state saves money.

And so, I think if you're gonna look at a cost benefit analysis, I think the data's gonna show that if you spend money now on this, it'll save you on the back end.

- So Sheriff, I want you to weigh in on the resource issue, because of course, you're representing sheriffs all over North Carolina.

Some of whom will readily say, "We just don't have what it takes."

What do those conversations look like?

What are the opportunities?

- Well, I think going back to the question.

One thing we've got to remember all of us here, we can forget anybody.

Everybody deserves, young or old, we've got to do everything we can to change somebody's life and help 'em be more conform with society.

As far as the resources, I think, you know, some counties and police departments, there's nothing for them to launch a program with $50,000.

They can do that outta the budget.

Other agencies are very small, they can't do that.

We have a lot of issues, just either private funding, working with faith-based groups, our athletic, our teen academies, things like that.

To have that early intervention and we've got to get it early.

But a lot of it is money and it does cost.

So, that is a constant thing I hear across the state.

And I'll tell you, a lot of small counties and the bigger counties work with them.

Hey, we have instructors.

We have people certified to teach these classes or our team or this working with state agencies also to bring those resources to your smaller county.

You know, we may help with the cost, but we have people trained.

And there again, you're reaching somebody else that may need the help.

And that's sort of the way we're coping with it.

And you know, grants and other monies and writing in budgets.

But a lot of times it seems like those things come sort of at the bottom of the budgets.

- I hear a lot of community assets and a lot of grant writing across the three of you.

More questions?

Yes.

- Mine is really quick.

Hi, everybody.

This is such a timely conversation.

This week Durham County got an update on our ACEs scores, our resiliency plan and where we updated.

And you know, if this was a stool, if I could throw another leg on this school stool, it would be education.

So, we launched a community resiliency model for my ACEs resiliency plan and it was a teacher collaborative.

So, we have like five newly-trained teachers.

I'm wondering, since you all are all over the state, you know, what are some best practices that you've seen?

Because I imagine a lot of the referrals that you get that have to go to him are coming from the schools.

And even though we have diversion, how could we better prepare our educators who already have enough on their plate?

I understand that.

To like be that first eye contacted.

You know what?

We don't need to call him.

We don't need to call you.

We need to call you.

So, what are just your thoughts on that?

- I'll say this, in Greenville, there's a resource that I use a group of educators from ECU and other therapists and they have a community-based trauma enforced therapy and they offer it to the public.

So, what I do in my custody cases, typically, when I see parents who are very toxic with each other.

I see young child or children who are in the middle of it, that's trauma, that's gonna create trauma, that's one of the trauma scores.

I will require them to attend the education part of the therapy where they go for an hour or two hours, learn about ACEs, what that means.

And then if I feel necessary, I'll have 'em do a parenting class that involves trauma therapy.

So, 'cause I wanna educate these parents who no longer live together.

What they're doing and what they can do better, if they realize that their relationship is going to forever change that child, for the good or the bad.

- We did a town hall that focused on older adults and talked a lot about screening that non-clinicians might be able to do.

Is there an opportunity for educators to do screening?

- I was just gonna, and I don't know if this would necessarily be considered screening, but one thing that we're doing for in Juvenile Justice is all of our staff is being trained in youth mental health first aid.

And that helps just, you know, an average citizen be able to identify a person who's in crisis.

And so, something that might look like for to a teacher as bad behavior is really a mental health crisis.

And instead of calling a school resource officer and filing a complaint, they need to be calling the managed care organization looking for to get a referral for an assessment.

And so something that, you know, that type of training, you know, we're in the process of having all 2,500 Juvenile Justice employees trained in that I think could be very helpful in an education setting.

- Thank you, and we have talked a little bit in the town hall on focused on youth about trauma informed schools and it does seem to be something that is gaining some steam as is true for trauma-informed courts.

All right, we'll take a couple more questions.

I knew you were waiting to ask, I could tell.

- Thank you for being here this afternoon.

Judge, I know that sometimes you and your colleagues on the bench have to, are required by state law to order certain criminal defendants to an inpatient treatment facility, if they meet a certain standard, which is really based on how serious their mental illness is.

And Sheriff, I know that you and your colleagues are the ones that required by law to carry out those orders.

But many times you're told by those inpatient facilities, "No, don't bring that criminal defendant here, because we don't take psychiatric patients that are criminal defendants."

Or if it's a state facility, they'll say, "No, you cannot come, you cannot carry out that order that, that judge issued according to law and required to issue according to law, because we have no room."

So, I know resource capacity has been a big topic of conversation and this applies to juvenile and adult offenders.

So, what's the answer?

Do we need more funding to expand the capacity of the state facilities?

Do we need to somehow incentivize private facilities or convince 'em that they can handle criminal defendants?

Sometimes they're no more dangerous than people who are, have a serious mental illness that are not a criminal defendant.

Or is it trying to provide some of those services in the jails?

I'm just curious to know what kind of state policy changes you would like to see.

Because I think there's no free lunch here, even though we might be saving money by not expanding capacity in the 24-hour inpatient facilities, you're probably incurring costs at the local level and detention facilities, thank you.

- As a lawyer and a judge, I will say, one of the issues that exactly on point with that scenario is the due process issues when someone who is not capable to understand what is going on in the legal system but is sitting in a detention center, because they cannot get to the inpatient facility they need to go to, which a judge has ordered and they're told they can't go for whatever reasons, capacity issues, or maybe there's a violent crime, or whatever the reason, that person is sitting in a facility, pre-trial facility, without due process for months, if not a year.

And that should raise an eyebrow when in our country, because of your mental health, you're gonna be punished in a facility, detention facility, because you cannot get your treatment.

You cannot get that therapy, that whatever you need.

And so, we need to address that.

And I think Pitt County, we're trying to figure that out too, but we need to address that whether it takes the legislature to get involved, because that's gonna be a crisis too when you have these inmates sitting in custody in jail, the only reason they're there is because of their mental health.

- And I said that earlier at the top.

You know, the jails have turned into some of the largest mental health facilities in their county And absolutely with what the judge is saying, it's so frustrating sometimes to do that.

And then, well, we can't house 'em.

We're bringing 'em back and they're sitting in jail.

Not only does that creates problems for them, for the detention officer, also, you look at your suicide rates, your death in jails, a lot of that or most of it's mental health.

One thing I'll say, and this is just years of doing it, I can remember the state did mental health good when they were doing it.

I think that worked well years ago, at least compared to what we have now.

You know, the private or the state funding is gonna have to be a decision for our General Assembly.

But I can tell you now that something has got to change and I think I'll speak on behalf of pretty much all sheriffs around that I hear.

You know, the jail is not the place for mental health.

We do the best we can.

We have went, you know, medical professionals on staff working with the court system, screening those juvenile same way we used to up to several years ago.

And all the partnerships we have with our communities trying to help this problem on our own, but it can't be, it's gotta be the standard.

We've got to fix this and we don't have, I mean, we see what the implications of it are by not fixing it.

- We will take one more question.

I see you holding your stuff come along, come.

We'll will take two.

[panelists laughing] - Thank you so much for being here.

As a social worker and addiction specialist in one of these inpatient facilities, we work with a lot of people with opioid use disorders and I think with the opioid pandemic we see a lot more involvement with the Justice Center.

I guess just to take on the temperature of either in the courtroom or even with the Juvenile Justice center or sheriffs with medicated assistive therapy.

So, either methadone or suboxone.

Is that something, I know some counties offer that as people are waiting for their hearings, other jails don't have it and so people are having to medically detox with no assistance.

And then we also see the rates of deaths increase when they're released because if they go out and use statistics show that they're might more likely to die from not having that resource, thank you.

- The Pitt County Detention Center does offer that recently and it was controversial, but they did.

I think Sheriff Dance who's kind of led the way in a lot of different things, but that's one of the things she did.

And because for that very reason.

I mean, you're detoxing and then if you make a bond, you get out, what are you gonna do?

You're gonna go back, and then obviously, you're gonna have issues perhaps with overdosing.

Sheriff.

- I think you hit on the head the times change.

We are gonna have to help.

We do it not in the full scope of every little standard there are, but we are trying to, it has been.

We've heard a lot of controversial issues about it, but when you're talking about people passing away in the jail, the civil liability from that.

Somebody coming in's addicted, continuing on with medical care.

That's the reason we consult with medical professionals that we have in our jail full time.

But going forward, I do see that becoming a lot more of the standard.

It's just, it's where we're at.

It's where we're gonna have to go to, to help help these people either.

I mean, you sit there and not do it and you're gonna have the deaths in the jail or ongoing or once you come out, you're repeating the process again.

So, you know, if it'll help, let's give it a shot.

- Yeah, we're not yet using any sort of medically-assisted detoxification in juvenile facilities.

If a child comes into our custody who is obviously detoxing, we take them to the hospital.

- Final question.

- Make her go.

- We wanna hear that.

We wanna hear.

All right.

All right, does anybody wanna take the final question?

All right.

So, Judge, Latoya, Sheriff, thank you for all that each of you is doing in North Carolina under what, obviously, are difficult circumstances, but you continue to innovate, to run around and get grants to do whatever it takes to make the work happen, and we are grateful to that.

To my live audience, thank you so much for being with us this afternoon.

Really appreciate you and your good questions.

And then, of course, we say thank you to the people who were featured in the stories.

We never want to overlook the expertise that they bring into the room.

And finally, to our audience, thank you for watching and engaging.

This is NC Impact.

We know there are solutions out there, if we work together.

[audience applauding]