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LEADing the way: Jail diversion program aims to address opioid crisis

Between 1999 and 2016, more than 12,000 people in North Carolina died from opioid overdoses. 

Not only are families losing their loved ones to the opioid crisis, but addiction is also placing a heavy burden on limited local resources. Drug-related crime has led to overcrowded jails, a backlogged court system and a spike in the number of children placed in the foster care system.

Law enforcement budgets are stretched thin, the district attorney needs more prosecutors, Department of Social Services employees struggle to meet the increased demand for services and mental health and rehabilitation facilities have long waiting lists.

Realizing they can’t arrest their way out of the opioid epidemic, the Waynesville Police Department has partnered with other agencies to find new solutions to address these problems. Det. Paige Shell traveled to Seattle two years ago to learn about an innovative program called LEAD (Law Enforcement Assisted Diversion) that has been successfully implemented by law enforcement to address drug crime and recidivism.

“We were able to shadow their LEAD Program and learn all about their program, what worked and didn’t work, challenges, etc.,” Shell said about the experience. 

Now the program is being implemented in large urban cities like Baltimore, Albany, New York and Portland, Oregon. Thanks to $250,000 in state funding for two years though Vaya Health, a push from local law enforcement and cooperation from the DA’s office, Waynesville is now included on the short list of cities implementing the program.

“A lot of other counties have Drug Court. We however do not have anything like that here. We are a rural community with limited resources,” Shell said. “However, we are also a very strong and involved community. (LEAD) gives officers another way to help people in need, instead of dealing with the same people over and over and not being able to offer a way to help them.”

The program allows low-level offenders to be diverted into treatment instead of being incarcerated and prosecuted. Community members and law enforcement officers are able to refer someone to the program pre-arrest in hopes of getting them treatment for addiction and/or mental illness before they get entangled in the criminal justice system. 

“There are some restrictions, such as anyone who is on supervised probation or has a violent criminal history are disqualified. We review each case individually and if someone does not qualify for LEAD we still try to connect them to the services they need,” Shell said regarding eligibility. 

If someone completes the program, his or her charges are dropped, but if they don’t, prosecutors can proceed with the original charges. Seven people have been referred to the program since April — some from officers and some from people in the community.

Part of the grant funds the salary of a case manager through North Carolina Harm Reduction Coalition, a statewide grassroots nonprofit dedicated to justice reform.

Gariann Yochym has jumped head first into the new position as she begins to learn more about the community and meet with potential program participants. Yochym, is originally from West Virginia — a rural state that is no stranger to the impact of the opioid crisis. 

“My hometown had experienced decades of economic distress and unaddressed social issues. It was primed and ready for something to come in, take hold, and make people feel better,” she said. “I was 17 when OxyContin made its debut in my hometown, and within six months, I had lost my first friend to a fatal overdose. We had just graduated from high school, and his stepmother found him unresponsive in his bedroom. On Aug. 24, 2018, I lost the 20th friend to a fatal opioid overdose.”

Yochym can also share stories of many more who are still struggling with addiction, cycling in and out of the criminal justice system and losing their children to the foster system. Sometimes she doesn’t know how she escaped it as she also experienced quite a bit of trauma at a young age — losing her dad in a coal mining accident and losing her mother to breast cancer. It was those experiences that eventually led her to become involved in social justice issues and get her master’s degree in social work. 

Before taking the job with the LEAD program, Yochym provided re-entry case management services to people in custody at the Buncombe County Detention Center. 

“I witnessed the struggles they faced as they attempted to re-enter their communities, obtain gainful employment and rebuild their lives,” she said. “It became clear to me that pre-arrest work, prevention, is where I wanted to focus my energy.”

Yochym is all about meeting people where they are — physically, mentally and emotionally. She’s there to help people, not judge them or pressure them into something they might not be ready for yet. Rehabilitation is a commitment and recovery will only be successful if the person wants the help. 

When she receives a referral, she makes initial contact with the person to conduct an intake assessment to gauge what the person’s needs are — immediate and long term. It can be as simple as driving the person to the DMV to get a license, reaching out for a $30 fuel card donation to get someone to a new job or helping them fill out job applications. 

If the person is suffering from addiction or a mental health crisis, Yochym can direct them to services offered with Meridian Behavioral Health Services, Appalachian Community Services or inpatient rehabilitation services. 

Tabatha Brafford, director of consumer services with ACS, said the organization offers a full continuum of crisis services that are available 24 hours a day and seven days a week. In addition to a Mobile Crisis team and Adult Recovery Unit for crisis stabilization and/or detox, ACS opened a Behavioral Health Urgent Care (BHUC) in March, which allows individuals to come to the Balsam Center in Waynesville for immediate intervention. 

“We are actively taking LEAD referrals. With the opening of our BHUC, we are able to provide support, clinical intervention and medication care 24/7/365,” Brafford said. 

In addition to helping people with substance use disorders, LEAD aims at reducing recidivism rates in the Haywood County Detention Center, which will in turn help law enforcement keep the jail population down and will help relieve the county’s budget for the sheriff’s department and jail operations.

“There will be ways in which this work and the relationships I am building cannot be measured. Ultimately, I hope that through intensive case management, LEAD can provide folks with an opportunity to transcend survival mode and enter into a space where they are thriving,” Yochym said. “I hope it will reduce recidivism, save critical financial and human resources, enhance public safety, and strengthen community-police partnerships.”

While having the LEAD program is a great start, WNC still lacks some of the resources and funding needed to help those suffering from addiction or mental health crises. More funding is needed from the state level to allow agencies like ACS and Meridian to offer medication-assisted treatment for opioid addiction and other wrap-around services to indigent clients. 

In the meantime, Brafford said communities must all work together to begin solving this epidemic. 

“The LEAD program is an excellent example of how our community agencies can work together to break the cycle of incarceration for nonviolent drug offenders by connecting them to a wide rage of support services that often includes case management and addiction treatment,” she said.

There’s also an affordable housing shortage in the region and a lack of public transportation that are barriers to breaking the cycle of addiction and incarceration, but looking at the big picture, Shell thinks Haywood County is ahead of the curve when it comes to looking at new solutions. She said Police Chief Bill Hollingsed and Lt. Tyler Trantham have done a great job of spreading the word to the community about the challenges being faced. 

“We live in a very strong and united community and I think that helps a lot,” she said. 

If a community member knows someone who is at-risk of being arrested and/or desires an intervention to mitigate an individual’s current involvement, ideally they will make sure the person is open to the program before contacting the police department to make a referral. 

 

Who’s in the Haywood Co. Detention Center?

The Behavioral Health Evaluation Project for the Haywood County Detention Facility conducted a detailed behavioral health evaluation on a random sample of inmates during the calendar year of 2016. A total of 200 males and 83 females were evaluated using a structured diagnostic interview typically taking about 30 minutes per inmate.

Report developed by Alyssa L. Raggio, B.S., Albert M. Kopak, Ph.D., & Norman G. Hoffmann, Ph.D. Western Carolina University

Addiction

  • 85.5 percent had at least one substance use disorder based on current diagnostic criteria
  • 67.5 percent had at least one severe substance use disorder
  • 38.2 percent had a severe methamphetamine diagnosis
  • 30 percent had a severe opioid diagnosis
  • 24.4 percent had a severe alcohol diagnosis 
  • 40 percent of inmates had injected some drug in the last 12 months 
  • 33 percent reported regular injecting

Mental health

  • 48 percent had indications of possible PTSD
  • 34.6 percent reported a major depressive disorder in the past 2 months
  • 29.3 percent of inmates suffered from panic attacks
  • 18 percent have reported manic episodes and 11 percent had possible bipolar disorder
  • 35 percent met criteria for an antisocial personality disorder
  • 30 percent had indications of obsessive-compulsive personality disorder

Recidivism 

  • 66.8 percent had been booked at least once before in the last 12 months
  • 43 percent had been booked at least twice in the last 12 months
  • 61 percent of those with multiple serious substance use disorders had multiple bookings v. 35 percent for inmates without multiple diagnoses. 
  • 53 percent of repeated drug injectors had multiple prior bookings v. 38.4 percent who did not inject. 
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