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In this first of two segments focusing on the Boone County Sheriff’s Office (BCSO) and its partnerships with Aspire Indiana Health and Integrative Wellness (InWell), we look at how these entities are three of Boone County’s strongest advocates for mental and behavioral health for not only county residents but for their clients as well.
In a subsequent article, we feature Aspire Indiana Health’s programs and its role as Boone County’s Community Mental Health Center (CMHC). According to Boone County Commissioner Tom Santelli, the commissioners have recently renewed the county’s contracts for services with both Aspire Indiana Health and InWell going into 2022.
With rehabilitation being the core focus of BCSO, Sheriff Michael Nielsen and InWell’s Director Lynette Clark spoke about their respective programs and services and on how the two entities collaborate to provide the best practices of care and an array of services to help get people and inmates back on their feet and living their best lives.
What Is the Difference Between Mental Health and Behavioral Health?
First, let us define the difference between mental health and behavioral health. Mental health focuses on an individual’s ability to manage regular life stressors, work in a productive manner and contribute to their society. Behavioral health revolves around the impact that one’s habits have on their physical and mental health. InWell and BSCO focus on both the mental and behavioral health of their clients, as made evident in their list of services provided.
What Does InWell Offer in Terms of Programs and Services?
InWell is a client-centered practice providing outpatient and school-based services throughout Boone, Clinton, and Montgomery counties. Through client-centered practice and a diverse group of therapists, InWell offers the following: individual therapy, family therapy, couples therapy, life skills coaching, recovery and addiction services, and school-based therapy. InWell also partners with other organizations within its communities to coordinate care and connect its clients with a host of social, medical, and other related services.
- Outpatient Therapy
- School-Based Therapy
- Recovery and Addiction Services
- Psychiatry Services
What Programs Does Boone County Sheriff’s Office Provide Its Clients in Its Facility?
- Matrix (male and female)
- JCAP (male and female)
- Chaplains (male and female)
- HSE (male and female)
- Parenting (male and female)
- Individual counseling sessions
- MAT program (male and female)
- Anger management (male and female)
- AA (male and female)
- NA (male and female)
- Pretrial assessments
- Attorney visits
- QCC mental health sessions
In conjunction with some of the programs listed above, InWell offers the following services as part of its partnership with BCSO:
- Initial Assessment: InWell completes a biopsychosocial assessment for clients interested in any services it offers inside the jail.
- Individual Therapy: A licensed therapist meets one-on-one with clients to work on goals to improve their mental health and addiction symptoms.
- Matrix Group: The Matrix Model program has been specifically adapted to meet the unique needs of law-involved clients and allows for a focus on substance abuse and criminal thinking. There are five different components to this programming. Within the jail, participants receive 16 weeks of early recovery skills and eight weeks of relapse prevention.
- JCAP for Men: This model teaches inmates how to problem solve, communicate for conflict resolution, mentoring and skills for community living. The development of three phases of treatment allows for more inmates to participate and still receive quality care. Continuing care upon release has been expanded to six months. This program is part of Community Corrections as they contract InWell to provide this specific service for men at the BCJ.
- Peer Support Services: Individuals in recovery certified as Peer Support Specialists meet with clients one-on-one to help navigate the recovery process and provide support to them along the way.
- Medication-Assisted Treatment: Clients who meet criteria and who are interested in MAT services are able to receive Buprenorphine or Naltrexone to help reduce cravings and feelings of euphoria. Clients meet with InWell’s prescribers or RN daily if they are on Buprenorphine.
Successes and Challenges Related to Rehabilitation versus Incarceration
“We’ve got to focus on rehabilitation,” Nielsen emphasized. “I’ve been very vocal about that. We’ve done a really good job in our jail, especially with the Medication-Assisted Treatment (MAT) program. We’re seeing successes from that program, and when you can go from a 44% recidivism rate down to 17%, that’s pretty darn good. From a rehabilitation standpoint, we’re doing the right things, but we have run out of room to do them now.”
Nielsen continued, “Once we hit the 240 [detained] mark, we have to ship our clients [inmates] to other counties,” Nielsen stated. “As we are 100% responsible for the welfare and mental/physical care for our clients, once they are shipped out of our county, we can no longer provide them with our services and programs. We want to build a facility [on-site] where we could offer vocational services to our clients so that they could go out and be productive members of society. Our mission and our goals are to rehabilitate these inmates and not to build a bigger jail just to house more inmates.”
According to Nielsen, 79% of Boone County Jail’s clients (inmates) are suffering from some type of mental health, trauma, emotional and/or addiction issues.
“Unfortunately, across the state and the country, jails have become the pseudo mental health facilities, and we deal with mental health issues every single day,” Nielsen stated. “We have to look at mental health and addiction and what we are offering for both of those as we know that they are intertwined.”
When Nielsen was first elected sheriff in 2014, he explained that there were no mental health services or programs inside the Boone County Jail facility.
“When I became sheriff, we had zero mental health services inside this facility—none,” Nielsen emphasized. “I sat down with the Community Mental Health Center [CMHC] people, and I complained about it. They would send a doctor once a month for two hours for 250 inmates. There’s no way you can physically treat a person who’s going through emotional and/or addiction issues with that type of treatment. So, I reached out to Lynette and asked what InWell could do for us and how could we partner. I am proud to say that we have 152 hours a week from InWell alone, and they are providing mental health and addiction services in our facility.”
The sheriff also mentioned that in addition to the mental and behavioral health programs the jail offers its clients, it also provides services such as high school equivalency and job placement programs. But as it is being discussed and reported, the jail is out of space, and in order for Nielsen and his staff to expand on its current services and programs, it will need the space that the proposed justice center would provide BCSO and organizations such as InWell.
“I’d like to bring in folks to teach trades like welding and auto mechanics,” Nielsen said. “We are limited on space and on what we can provide as far as those additional services like the ones we’re talking about.”
When asked if he thinks the partnership between BCSO and InWell has been beneficial to all concerned, Nielsen said,
“We went from having zero mental health services to having 152 hours a week of counseling services inside this jail, which is pretty amazing. This partnership has been absolutely awesome. When I became sheriff, I’ve always said we have to focus on rehabilitation. That is our business, not incarceration. As soon as our folks walk out the door, that’s when we fail them. We have to make sure that continuity of care is there on the outside when they walk out the door.”
Boone County Sheriff Mike Nielsen
Clark added, “We started out through a pilot program with Public Works, and initially we were only able to see just a small population of the jail that was within 60 days of their release. We do a biopsychosocial assessment and get them ready to go and start them with peer support services—a peer who has lived experiences. It was a great starting point, and we were able to start improving on the continuity of care, which the sheriff has always been focused on. He’s able to do a lot here [in the jail] with a captive audience; however, once they leave the facility, sometimes they need some help staying connected.”
Additionally, Clark mentioned that they have a Quick Response Team at the sheriff’s office.
“I’m hoping that we will be able to add mental health to that because we’ve been going out for addictions, and for the individuals on the outside, we offer them resources and wraparounds to help them and their families because these diseases [mental health and addiction] impact the whole family, whether it’s mental health issues, addictions or both.”
Nielsen concluded, “Mental health and addiction are diseases. Most people don’t see it that way—they see it as a choice. Neither is a choice—they are diseases. We are making an impact in this community in so many ways and are helping those who are struggling with addiction and mental health. We could do so much more, given the space and the opportunity to do so.”
Look for the continuation of this discussion in next month’s segment found on livinginboonecounty.com. For more information on InWell’s services and organization, please visit inwell.org.