YOUNGSTOWN — Mental health and criminal justice are far more intertwined than many in both fields would prefer. This week, Mahoning County judicial and law enforcement officials will participate in an online forum with the hope of finding some solutions.

The Stepping Up Initiative: The Ohio Project is a state branch of a national program that seeks to help county officials break the cycle of county jails functioning as de facto mental health hospitals.

The Ohio Project is led by retired Ohio Supreme Court Justice Evelyn Stratton, who will direct the Zoom call on Thursday. The three-hour-long meeting will see presentations from Mahoning County Mental Health and Recovery Board Executive Director Duane Piccirilli, several Mahoning County and Youngstown judges who oversee special dockets, representatives from Northeast Ohio Medical University, NAMI Ohio, Gov. Mike DeWine’s office, and Peg’s Foundation — the largest funder of mental health programs in Ohio, among others.

“I have to tell you Mahoning is one of my favorite counties to work with because you are all so inspired and so excited about the visit,” Stratton said via video call at last week’s Mahoning County Commissioners meeting. “We started stepping up 10 years ago to deal with the issue of criminal justice and mental illness in the jails, and Sheriff (Jerry) Greene has been just a wonderful leader and partner in dealing with this issue.”

When Ohio closed most of its state-run mental hospitals in the late 1980s and early 1990s, the county sheriffs association met with the county commissioners association and began to discuss the problem that immediately arose from those closures — jails functioning as mental health hospitals.

“If you had somebody like this in your facility in 1991, when I began, you just couldn’t wait to get them out. It just wasn’t a focus, and I’ll be honest, back then it wasn’t a focus because people didn’t care,” Greene said. “But you evolve within your career, you see the recidivism, from mental health and addiction, and you start to focus on the core problems within the facility.”

Piccirilli said he remembers very well his first conversation with Greene about the problem, when he first started at MHRB in 2014.

“When I first started, I said I wanted to go see the jail and they said ‘no, you don’t,'” he said. “And I met Sheriff Greene and he said ‘I can’t arrest my way out of this mess.'”

Stratton said Thursday’s meeting will be the third time Stepping Up has met with county and local officials here in the past 10 years, the first in February 2016 in person, and the other in February 2021 via Zoom.

Stratton left the bench in 2013 to put her efforts toward addressing the problem of mental health in the criminal justice system, working with Stepping Up and became the director of The Ohio Project two years later.

“We’ve done things very differently than every other state — most states have three, four, five counties that are members, and we just got Hocking County, so we have 66,” she said. That means the program is active in 75% of Ohio’s counties.

Stratton said the state has seen many positive changes in her decade at the helm of The Ohio Project, but it still has a lot of ground to cover.

“We’re one of the best states for collaboration, but one of the worst for data collection,” she said. “So, we measure systematic changes.”

Many jails released many inmates during the COVID-19 pandemic, and many of those inmates who needed mental health services stayed out of the system and did not receive the help they needed.

Access to services beyond jail is another challenge that has only recently been partially solved.

“When we started, jails were terminating Medicaid for inmates,” Stratton said.

That meant that inmates who were receiving mental health and addiction recovery services through Medicaid lost their means of access to those services and had to begin the enrollment process anew when they were released again.

The Ohio Project found that this was unnecessary because the federal government allows for a suspension of services without terminating the person’s eligibility. She said it still took many years for them to get Ohio jails to implement suspension as opposed to automatic termination of benefits, but now inmates who are released can resume their benefits and continue any treatment they were receiving in the jail. They also can enroll while incarcerated so that they transition seamlessly after release.

Stratton said Sequential Intercept Mapping is another process that is now being used to help county officials and mental health experts identify patterns, strengths, weaknesses and opportunities within the system to identify people in need and help them, if possible, before they become part of the criminal justice system. It also helps jails and courts function in a way that better serves both the system and those individuals with mental health needs.

Em Ribnik, director of NEOMED’s Criminal Justice Coordinating Center of Excellence, will present the results of the SIM study conducted in Mahoning County at Thursday’s Zoom conference.

Greene said at the commissioners meeting last week that he is looking forward to understanding how that process can help streamline the system and meet everyone’s needs better.

“Many of these people, they’re just committing crimes to survive, and they end up coming back into the jail,” he said. “It’s better to get them focused on their meds, reconnected with their families. We just do a lot of things differently with mental health and addiction now.”