CHART Showing Success In Everett

In late November, a man identified by the Chronic-Utilizer Alternative Response Team (CHART) walked out of the Snohomish County Jail and directly into housing and services. James had been living on the streets for years, struggling to get housing and maintain mental health services.

Living in the woods and wandering the streets, it became easier to find drugs, like meth, than his mental health medication. This downward spiral landed him repeatedly in the emergency room or jail, and then back out on the street.

“It is unfortunate that you have to cycle through the jail repeatedly to rise to the top of a program like this,” said Snohomish County Jail Bureau Chief Tony Aston. “But cases like this show that successful release planning can break the cycle.”

After 14 arrests for criminal trespassing in just over a year, James ended up in the Snohomish County Jail this September. James had acquired two trespass charges for refusing to leave locations where he had sought treatment, one at the emergency room and one at a local treatment provider.

Because of his repeated use of emergency services and the jail, he was already on the CHART list and was flagged for attention the moment he entered the jail. CHART is a collaborative effort among Everett Police and prosecutors, Snohomish County Jail, Snohomish County Human Services, Everett Fire and EMS, the Providence Regional Medical Center-Everett, and many social service providers, to find long-term solutions that address chronic use of emergency response systems such as jail and emergency rooms.

“CHART challenges our systems to work together and to find a better way to get individuals into the services they need,” said Anji Jorstad, community mental health supervisor for Snohomish County Human Services. “We had to make some changes to our process to help James, but now those who come after will be able to take advantage of a more streamlined process.”

It took more than a month of work by Jail and Human Services staff to arrange for housing and treatment in the community, Jorstad explained.

“There is a need in our community that is greater than current capacity” Jorstad said, “But we are moving in the right direction. Our goal should be to give people options other than jail and emergency rooms that are better for them and for those systems.”

In this case, James chose to connect with Sunrise Services for treatment and housing.

“We became involved in CHART because we provide services for those with chronic mental health and chemical dependency issues,” says Jamie Hanken, program manager for Sunrise Community Mental Health Intensive Outpatient and Dual Diagnosis Programs. “By working with the jail and CHART, we are better able to get to those in the criminal justice system who could benefit from our services.”

The CHART program goals include not shifting costs from one system to another, but instead looking for long-term solutions that address an individual’s repeated use of the emergency response system to address health or social issues. The team recommended that James should stay in jail until such time as a release plan was in place.

“Without an adequate release plan, we believed James would very quickly find his way back into the jail,” said Nikki Behner, Snohomish County Jail Health Services director.

That does not mean his time in jail was wasted. Behner has worked to establish numerous changes over the past years to better respond to individuals with mental illness in jail, specifically, those who are chronic utilizers.

“Because we recognize that without proper release planning, we would be sending people back to homelessness, we have dedicated resources to working with individuals like James,” Behner said.

Now, when an identified CHART individual is in the jail, that person is visited daily by mental health professionals, and a team of service providers begin exploring release options the moment that person enters the jail.

“At first James wanted me to do whatever I could to get him released,” said Xandy Evans, James’ attorney, “But when he found out all of these people were working to help him get housing and treatment, he was so happy and wanted to make some changes himself.”

It was a few days after meeting with his attorney and learning he was part of the CHART program that James made a simple request to Behner: he wanted a haircut.

“I have known James for a while, and he always had unkempt long hair and beard, but he was so excited to get a haircut and do his part to make his release a success,” said Behner.

Release planning for inmates such as James requires a new level of coordination between law enforcement, jail, courts and service providers. CHART is helping all of those groups communicate better and identify ways to get individuals into appropriate services.

“We are making huge improvements in our release planning, but we cannot do it without cooperation from those who provide treatment and housing services in the community,” said Aston.

The CHART program will continue to track James’s case. Individuals remain on the CHART list and are discussed at bi-weekly meetings until 60 days pass without contacts with the emergency response systems.