13MARCH - Forensic Mental Health Association of California

11 13MARCH

4010 FOOTHILLS BLVD., STE. #103-196

(916) 540-7460 tel (916) 560-5989 fax

www.fmhac.org

4 5 t h A N N U A L

11 13MARCH

FMHAC 4 5 t h A N N U A L

C O N F E R E N C E

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C O N F E R E N C E

HYATT REGENCY MEETING ROOMS

45th ANNUAL T O T H E

C O N F E R E N C E

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WELCOME LETTER FROM THE EXECUTIVE DIRECTOR On behalf of the entire FMHAC Board, Staff , Planning Committee , and Volunteers, it is with great pleasure that I welcome you to the 45th FMHAC Annual Conference. We have worked extremely hard to put together a program with education and networking events we are sure you will enjoy. Our three-day conference kicks off on Wednesday, March 11th with a full slate of educational sessions including an Opening Session on Understanding Mass Shootings: Pathways to Prevention, followed by a Keynote Presentation on Social Justice & Historical Repair: Race, Culture, Diversity, and the Lives of Healers in Forensic Mental Health. Don ’t forget to join us at the Welcome Reception and network with your peers. Our second day of educational sessions begin at 9:00 am. Lunch will be provided on this day from

12:15—1:15 pm. Afternoon sessions will be held from 1:15—4:30 pm. I would like to personally invite you to join me and the FMHAC Board of Directors at our FMHAC Business Meeting at 4:45 pm. Finally, on Friday, March 13th, we will close out the conference with two presentations. Social Justice and Mental Health, and Co-Occurring Disorders and the Opioid Crisis. I wish you an excellent and memorable conference experience. Welcome to the Hyatt Regency Resort & Spa in beautiful Monterey, California.

Catherina Isidro FMHAC Executive Director

I’m so pleased to welcome you to our annual conference at the start of a new decade! I look forward to meeting and interacting with you during our time together, and I hope that by attending this conference you are able to learn something new and reinvigorate your desire to do great work. That’s the mission of FMHAC - to increase your knowledge of forensic mental health and to keep you excited about the work you're doing. Many people have worked hard to create opportunities for you this week and we hope you make the most of your time here - learn, participate, and take time to find others who want to make significant improvements in our field. Recently I spoke to a gentleman who was pitching a new business idea. He confessed that in his previous mbusiness he had done well financially, but he was dissatisfied because he never felt his work made any real difference to anyone. He wanted to have a positive impact on society, and was trying to remedy that with his new

venture. At the same time, I’ve been dealing with issues around rising malpractice costs that are associated with the business of providing services to people who can be dangerous and litigious. While I've been focused on risk and mitigation of risk, I’ve felt the need to specifically discuss the important contributions to our society that these programs provide. I’ve realized that knowing the impact of our work in keeping communities safe and healthy is crucial to understanding how to support it. I feel fortunate to know we provide important services to our families, friends and communities throughout California. As we strengthen and improve our agencies, our communities will be strengthened. While I know this work is often underappreciated, I personally want to thank you for all the great work you do. I'm convinced that as we continue to improve, we will continue to make positive changes in our world.

Ken Carabello, MSW FMHAC Board President

WELCOME LETTER FROM THE PRESIDENT

C O N F E R E N C E

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C O N F E R E N C E

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C O N F E R E N C E

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SECOND FLOOR

BOARD OF DIRECTORS

President

Ken Carabello, MSW

President-Elect Kevin Rice, LCSW, CCHP-MH

Vice President Sam Knudsen, JD

Secretary

Cynthia Lermond, PsyD

Treasurer Ramsey Khouri, PsyD

Director of Conference Tom Granucci, LCSW

Director of Education

Anna Kafka, PsyD

CONFERENCE PLANNING COMMITTEE Chair

Tom Granucci, LCSW

Kara Chien, JD

Dick Conklin, LCSW

Anna Kafka, PsyD

Sam Knudsen, JD

Norbert Ralph, PhD, MPH

James Rokop, PhD

Danny Sciacqua, MA, LPT, CADCII

FMHAC STAFF Executive Director

Catherina (Trina) Isidro

Events and Communications Director

Morgan Grabau

Administrative Coordinator and Words to Deeds Liaison

Stephanie Waldron

THANK YOU! 2020 FMHAC SUSTAINING MEMBERS

Patricia Butler Sam Knudsen

Kenneth Carabello Cynthia Lermond

Richard Conklin Raymond Murphy

Jessica Funk Kevin Rice

Mark Grabau Armando Sandoval

Tom Granucci Munir Sewani

Robert Hart Luis Velosa

Anna Kafka Lindsay Weston

Ramsey Khouri

As ongoing supporters of the Association, Sustaining Members get special

treatment at the conference including upgraded hotel rooms and personal thank you notes from FMHAC!

WEDNESDAY, March 11

THURSDAY, March 12

FRIDAY, March 13

10:00 am Registration Opens

12:30—1:00 pm (Regency I/II/III/Main)

President’s Remarks • Ken Carabello, MSW; FMHAC President

Opening Presentation Understanding Mass Shootings: Pathways to Prevention • James Densley, PhD

2:30—2:45 pm BREAK

Keynote Presentation Social Justice & Historical Repair: Race, Culture, Diversity & the Lives of Healers in Forensic Mental Health • Mathew Mock, PhD

4:15—4:30 pm BREAK

6:00—7:00 pm (Regency IV/V/IV/Lobby)

Welcome Reception & Poster Presentations

9:00—10:30 am Breakout Presentation 1

10:30—10:45 am BREAK

10:45 am—12:15 pm Breakout Presentation 2

12:15—1:15 pm LUNCH

1:15—2:45 pm Breakout Presentation 3

2:45—3:00 pm BREAK

4:45—5:45 pm FMHAC Business Meeting

9:00 am—10:30 am (Regency I/II/III/Main)

Closing Presentation 1 Social Justice and Mental Health • Ruth Shim, MD, MPH

10:30—10:45 am BREAK

10:45 am—12:15 pm (Regency I/II/III/Main)

Closing Presentation 2 Co-Occurring Disorders and the Opioid Crisis • Thomas Freese, PhD

SCHEDULE AT A GLANCE

BOARD OF DIRECTORS

President

Ken Carabello, MSW

President-Elect Kevin Rice, LCSW, CCHP-MH

Vice President Sam Knudsen, JD

Secretary

Cynthia Lermond, PsyD

Treasurer Ramsey Khouri, PsyD

Director of Conference Tom Granucci, LCSW

Director of Education

Anna Kafka, PsyD

CONFERENCE PLANNING COMMITTEE Chair

Tom Granucci, LCSW

Kara Chien, JD

Dick Conklin, LCSW

Anna Kafka, PsyD

Sam Knudsen, JD

Norbert Ralph, PhD, MPH

James Rokop, PhD

Danny Sciacqua, MA, LPT, CADCII

FMHAC STAFF Executive Director

Catherina (Trina) Isidro

Events and Communications Director

Morgan Grabau

Administrative Coordinator and Words to Deeds Liaison

Stephanie Waldron

THANK YOU! 2020 FMHAC SUSTAINING MEMBERS

Patricia Butler Sam Knudsen

Kenneth Carabello Cynthia Lermond

Richard Conklin Raymond Murphy

Jessica Funk Kevin Rice

Mark Grabau Armando Sandoval

Tom Granucci Munir Sewani

Robert Hart Luis Velosa

Anna Kafka Lindsay Weston

Ramsey Khouri

As ongoing supporters of the Association, Sustaining Members get special

treatment at the conference including upgraded hotel rooms and personal thank you notes from FMHAC!

WEDNESDAY, March 11

THURSDAY, March 12

FRIDAY, March 13

President’s Remarks • Ken Carabello, MSW; FMHAC President

Opening Presentation Understanding Mass Shootings: Pathways to Prevention • James Densley, PhD

2:30—2:45 pm BREAK

Keynote Presentation Social Justice & Historical Repair: Race, Culture, Diversity & the Lives of Healers in Forensic Mental Health • Mathew Mock, PhD

4:15—4:30 pm BREAK

6:00—7:00 pm (Regency IV/V/IV/Lobby)

Welcome Reception & Poster Presentations

9:00—10:30 am Breakout Presentation 1

10:30—10:45 am BREAK

10:45 am—12:15 pm Breakout Presentation 2

12:15—1:15 pm LUNCH

2:45—3:00 pm BREAK

4:45—5:45 pm FMHAC Business Meeting

9:00 am—10:30 am (Regency I/II/III/Main)

Closing Presentation 1 Social Justice and Mental Health • Ruth Shim, MD, MPH

10:30—10:45 am BREAK

10:45 am—12:15 pm (Regency I/II/III/Main)

Closing Presentation 2 Co-Occurring Disorders and the Opioid Crisis • Thomas Freese, PhD

SCHEDULE AT A GLANCE

CONFERENCE INFORMATION EXHIBITOR COMPANY LISTINGS

COLLEGE REGISTRATION FORM Please fill out the college registration form that was given to you when you checked in. These are submitted to the State of California which then provides funding for FMHAC, aiding us in providing the conference each year. It doesn’t commit you to anything and it’s an easy way for you to support FMHAC!

NOTICE BOARD A notice board is located in the foyer - use it for such things as job announcements, group dinner invitations, upcoming events, or general networking!

CERTIFICATES OF ATTENDANCE Certificates of attendance are included in your packet. Please review the requirements for CEs on page 25.

ELECTRONIC EVALUATION SURVEY The conference evaluation is electronic and will be emailed to you on the last day of the conference. Thank you for filling it out!

COMPLIMENTARY RESORT BENEFITS Receive these benefits when you stay at the Hyatt as an FMHAC Conference Attendee:

NAME BADGES FMHAC requires that you wear your name badge at all times throughout the conference. This will be your entrance pass to all workshops and social events. Lost badges can be replaced at the FMHAC registration table.

CHECK-OUT Hotel check-out at the Hyatt is 12:00 noon.

Wifi in guest rooms Complimentary tennis court time

Self & Valet Parking Wine sample at the onsite tasting room

10% discount at several shops as well as $20 credit toward the coastal/nature hike at Hyatt Carmel Highlands

Resort & Indoor Games

Shoe shine

Favorite Overall Poster

Most Potential Impact in Forensic Mental Health

Reception & Poster Presentations Wednesday, March 11 at 6:00 pm

Ballroom IV/V/VI

Winners will be announced at lunch on Thursday, March 12.

VOTE Best

Posters!

Alkermes Mental Health Association of San Francisco

California Correctional Health Care Services Netsmart

Department of State Hospitals Atascadero Otsuka

Department of State Hospitals Sacramento Palo Alto University Continuing & Professional Studies

Kern Behavioral Health & Recovery Services Psychological Assessment, Inc.

Johnson & Johnson Sunovion Pharmaceuticals

CONFERENCE INFORMATION EXHIBITOR COMPANY LISTINGS

COLLEGE REGISTRATION FORM Please fill out the college registration form that was given to you when you checked in. These are submitted to the State of California which then provides funding for FMHAC, aiding us in providing the conference each year. It doesn’t commit you to anything and it’s an easy way for you to support FMHAC!

NOTICE BOARD A notice board is located in the foyer - use it for such things as job announcements, group dinner invitations, upcoming events, or general networking!

CERTIFICATES OF ATTENDANCE Certificates of attendance are included in your packet. Please review the requirements for CEs on page 25.

ELECTRONIC EVALUATION SURVEY The conference evaluation is electronic and will be emailed to you on the last day of the conference. Thank you for filling it out!

COMPLIMENTARY RESORT BENEFITS Receive these benefits when you stay at the Hyatt as an FMHAC Conference Attendee:

NAME BADGES FMHAC requires that you wear your name badge at all times throughout the conference. This will be your entrance pass to all workshops and social events. Lost badges can be replaced at the FMHAC registration table.

CHECK-OUT Hotel check-out at the Hyatt is 12:00 noon.

Wifi in guest rooms Complimentary tennis court time

Self & Valet Parking Wine sample at the onsite tasting room

10% discount at several shops as well as $20 credit toward the coastal/nature hike at Hyatt Carmel Highlands

Resort & Indoor Games

Shoe shine

Favorite Overall Poster

Most Potential Impact in Forensic Mental Health

Reception & Poster Presentations Wednesday, March 11 at 6:00 pm

Ballroom IV/V/VI

Winners will be announced at lunch on Thursday, March 12.

VOTE Best

Posters!

Alkermes Mental Health Association of San Francisco

California Correctional Health Care Services Netsmart

Department of State Hospitals Atascadero Otsuka

Department of State Hospitals Sacramento Palo Alto University Continuing & Professional Studies

Kern Behavioral Health & Recovery Services Psychological Assessment, Inc.

Johnson & Johnson Sunovion Pharmaceuticals

CONFERENCE AWARDS

2020 AWARD RECIPIENTS

WILLIAM T. ROSSITER

CHRISTINE M. WEST AWARD

The Christine M. West Award recognizes significant contributions by dedicated individuals working in the field of Forensic Mental Health. This year, FMHAC honors Neil Besse.

Neil Besse, JD

Neil Besse has been a Deputy Public Defender for 20 years. He is a graduate of Old Dominion University (B.A. ’91) and the University of Georgia (J.D. ’96). He currently supervises the Public Defender’s Defense Transition Unit, which he formed in 2016. The DTU consists of four licensed mental health clinicians and two housing navigators. With paralegal support, the DTU accepts ‘mental health management’ referrals directly from assigned Public Defenders. DTU clinicians assess clients’ diagnoses and treatment needs within 5 working days, linking them to mental health services with timely and appropriate treatment plans which may be used as conditions of probation and which improve the lives of our most vulnerable clients.

WILLIAM T. ROSSITER AWARD

The William T. Rossiter Award honors an individual who has made, over a period of time, an exceptional global contribution to the field of Forensic Mental Health. This year, the award goes to Terri McDonald.

Terri McDonald

Terri McDonald has over 36 years of public service in mental health treatment facilities, state and local corrections. She began her professional career in 1981, serving as a mental health worker and supervisor in a variety of community based mental health and drug treatment facilities. In 1988, she began an extensive and broad-based career in law enforcement, beginning with the California Department of Corrections and Rehabilitation (CDCR), serving in various capacities, and ultimately, as the Undersecretary of Operations. In this capacity, she was responsible for providing executive direction and operational oversight of the State’s correction system.

Terri has had the unique honor of having been responsible for providing executive oversight of the State of California’s parole/prison/juvenile justice system, the County of Los Angeles jail system, and most recently, the County of Los Angeles probation system, with over 7,000 employees supervising over 38,000 adult and 7,000 juvenile probationers on any given day. Each of these systems are the largest of their kind in the nation, and she led them during fundamentally transformative periods.

Terri possesses a Bachelor of Science Degree in Leadership in Law Enforcement from the University of San Francisco. She is an active member of several criminal justice associations and has served on a variety of non-profit boards. Terri is married and resides in the County of Los Angeles. She enjoys the outdoors and spending time with her family in Northern California.

CONFERENCE AWARDS

2020 AWARD RECIPIENTS

WILLIAM T. ROSSITER

CHRISTINE M. WEST AWARD

The Christine M. West Award recognizes significant contributions by dedicated individuals working in the field of Forensic Mental Health. This year, FMHAC honors Neil Besse.

Neil Besse, JD

Neil Besse has been a Deputy Public Defender for 20 years. He is a graduate of Old Dominion University (B.A. ’91) and the University of Georgia (J.D. ’96). He currently supervises the Public Defender’s Defense Transition Unit, which he formed in 2016. The DTU consists of four licensed mental health clinicians and two housing navigators. With paralegal support, the DTU accepts ‘mental health management’ referrals directly from assigned Public Defenders. DTU clinicians assess clients’ diagnoses and treatment needs within 5 working days, linking them to mental health services with timely and appropriate treatment plans which may be used as conditions of probation and which improve the lives of our most vulnerable clients.

WILLIAM T. ROSSITER AWARD

The William T. Rossiter Award honors an individual who has made, over a period of time, an exceptional global contribution to the field of Forensic Mental Health. This year, the award goes to Terri McDonald.

Terri McDonald

Terri McDonald has over 36 years of public service in mental health treatment facilities, state and local corrections. She began her professional career in 1981, serving as a mental health worker and supervisor in a variety of community based mental health and drug treatment facilities. In 1988, she began an extensive and broad-based career in law enforcement, beginning with the California Department of Corrections and Rehabilitation (CDCR), serving in various capacities, and ultimately, as the Undersecretary of Operations. In this capacity, she was responsible for providing executive direction and operational oversight of the State’s correction system.

Terri has had the unique honor of having been responsible for providing executive oversight of the State of California’s parole/prison/juvenile justice system, the County of Los Angeles jail system, and most recently, the County of Los Angeles probation system, with over 7,000 employees supervising over 38,000 adult and 7,000 juvenile probationers on any given day. Each of these systems are the largest of their kind in the nation, and she led them during fundamentally transformative periods.

Terri possesses a Bachelor of Science Degree in Leadership in Law Enforcement from the University of San Francisco. She is an active member of several criminal justice associations and has served on a variety of non-profit boards. Terri is married and resides in the County of Los Angeles. She enjoys the outdoors and spending time with her family in Northern California.

POSTER PRESENTATIONS

6:00—7:00 pm (Ballroom IV/V/VI)

Wednesday, March 11

CONREP EFFECTIVENESS—PRELIMINARY RESULTS Melinda DiCiro, PsyD, ABPP Shiva Amin, PhD This poster will present preliminary results of California Conditional Release Program (CONREP) Effectiveness study, the first of its kind since 2002. The poster will include a five-year subset of adult forensic patients discharged from California State Hospitals between 2002 and 2017. CONREP is tasked with safety reintegrating Forensically committed patents into the community upon discharge from the secure state hospital settings. One of the ways to evaluate the program’s effectiveness is by comparing the CONREP patient recidivism rate to that of directly discharged patients. We therefore compare the re-arrest rates for CONREP-treated. active CONREP, and directly discharged patients. We linked DSH discharge data to arrest data from the California Department of Justice (DOJ) for this purpose. We examine general, violent, and sex offense recidivism and examine the effects of commitment type, diagnosis, and duration of psychiatric treatment on recidivisms rates. NEEDS ASSESSMENT RESULTS: PROVIDING LGBTQ+ AFFIRMING TREATMENT WITHIN FORENSIC MENTAL HEALTH SETTINGS David Muchin, LCSW Danielle Bryce, PsyD Lesbian, gay, bisexual, transgender, queer, and intersex (LGBTQI+) patients face unique challenges because of stigmatization linked to their gender identities and/or sexual orientation. This presentation will share the various steps taken at the grassroots level within one DSH location to promote organizational evidence-based care, education, research, advocacy, and culturally competent treatment for the LGBTQ+ community members mandated to treatment. This presentation will highlight a needs assessment results from Oct 2nd, 2019 Annual Forensic Multicultural Conference at Department of State Hospitals and research from academic, community, and systemic points of view and recommend specific steps and interventions that other forensic inpatient psychiatric settings can Incorporate to nurture an LGBTQ+ focused and gender-affirming care model. MYTHS, COMPETENCY, AND TREATMENT FOR DEVELOPMENTALLY DELAYED SEXUAL OFFENDERS Amber Stewart, MS Venus Klinger, PsyD Briana Rodriguez, MA This presentation will aim to raise awareness about common myths about intellectually disabled and developmentally disabled individuals and provide concrete techniques in providing sex offender treatment with them. In addition, many treatment providers wonder how their clients were able to stand trial. Therefore, the PC1370 evaluation and training process will be reviewed. By the end of today’s presentation participants will be able to describe the competency evaluation process for DD/ID clients, list at least three myths about DD/ID Sex Offenders, and describe at least three techniques in working with DD/ID sex offending clients. A MODEL FOR FACILITATING EFFECTIVE PSYCHOLOGICAL ASSESSMENTS FOR THE JUVENILE AND DEPENDENCY COURTS Norbert Ralph, PhD, MPH Briana Loomis, PhD This presentation is designed to assist those who supervise these court ordered evaluations with specific methods to provide more effective assessments. The presentation is also designed to provide psychologist doing those evaluations with practical and usable "best practices" methods and criteria to develop more forensically defensible assessments.

The Department of Public Health in San Francisco administers and coordinates psychological testing for the dependency and juvenile courts through the Psychological Assessment Services (PAS) Program. The goal of the PAS Program is to provide competent psychological evaluations for the courts through establishing administrative procedures, best practices criteria for evaluations, training in those criteria, and importantly quality assurance and quality improvement methods for evaluations. It is assumed that psychological assessments which can more effectively identify treatable factors will promote better outcomes in both delinquency and dependency settings and inform the courts in decision making. The PAS program has developed guidelines to promote effective psychological evaluations including expectations regarding records review, contacts with collateral sources, the clinical interview of children and adolescents, and parents, and what types of psychological instruments are best choices based on current research. The guidelines also suggest formulating treatment recommendations which are practical and evidence-based. The assessment model promoted emphasizes multimethod-multi-informant methodologies which are also developmentally, culturally, and trauma informed. Also, a methodology for quality assurance, and providing feedback to improve practice is discussed. The presentation discusses the relevant research on which this model is based and the checklist that has been developed. For example, the best practices literature has identified that ongoing fidelity to well-designed practices is strongly associated with better outcomes. The presentation also addresses the challenges oF administering such a system using psychologists who are independent contractors, working with families and youth in multicultural contexts, with probation and child welfare systems, and the courts and attorneys. Best practices criteria and methods for special evaluations such as neuropsycho-logical, juvenile competency, and parenting capacity are discussed.

THE ROAD TO FREEDOM: A COMPRESHIVE COMPETENCY-BASED WORKBOOK FOR

SEXUAL OFFENDERS IN TREATMENT

Jill Levenson, PhD, LCSW

THE GIFT OF FEAR: SURVIVAL SIGNALS THAT PROTECT US FROM VIOLENCE Gavin De Becker

COLUMBINE Dave Cullen

MINDHUNTER: INSIDE THE FBI’S ELITE SERIAL CRIME UNIT John E. Douglas Mark Olshaker

MINDFULNESS-BASED SUBSTANCE ABUSE TREATMENT

FOR ADOLESCENTS Sam Himelstein Stephen Saul

MURDER BY FAMILY Kent Whitaker

BOOK LIST

POSTER PRESENTATIONS

6:00—7:00 pm (Ballroom IV/V/VI)

Wednesday, March 11

CONREP EFFECTIVENESS—PRELIMINARY RESULTS Melinda DiCiro, PsyD, ABPP Shiva Amin, PhD This poster will present preliminary results of California Conditional Release Program (CONREP) Effectiveness study, the first of its kind since 2002. The poster will include a five-year subset of adult forensic patients discharged from California State Hospitals between 2002 and 2017. CONREP is tasked with safety reintegrating Forensically committed patents into the community upon discharge from the secure state hospital settings. One of the ways to evaluate the program’s effectiveness is by comparing the CONREP patient recidivism rate to that of directly discharged patients. We therefore compare the re-arrest rates for CONREP-treated. active CONREP, and directly discharged patients. We linked DSH discharge data to arrest data from the California Department of Justice (DOJ) for this purpose. We examine general, violent, and sex offense recidivism and examine the effects of commitment type, diagnosis, and duration of psychiatric treatment on recidivisms rates. NEEDS ASSESSMENT RESULTS: PROVIDING LGBTQ+ AFFIRMING TREATMENT WITHIN FORENSIC MENTAL HEALTH SETTINGS David Muchin, LCSW Danielle Bryce, PsyD Lesbian, gay, bisexual, transgender, queer, and intersex (LGBTQI+) patients face unique challenges because of stigmatization linked to their gender identities and/or sexual orientation. This presentation will share the various steps taken at the grassroots level within one DSH location to promote organizational evidence-based care, education, research, advocacy, and culturally competent treatment for the LGBTQ+ community members mandated to treatment. This presentation will highlight a needs assessment results from Oct 2nd, 2019 Annual Forensic Multicultural Conference at Department of State Hospitals and research from academic, community, and systemic points of view and recommend specific steps and interventions that other forensic inpatient psychiatric settings can Incorporate to nurture an LGBTQ+ focused and gender-affirming care model. MYTHS, COMPETENCY, AND TREATMENT FOR DEVELOPMENTALLY DELAYED SEXUAL OFFENDERS Amber Stewart, MS Venus Klinger, PsyD Briana Rodriguez, MA This presentation will aim to raise awareness about common myths about intellectually disabled and developmentally disabled individuals and provide concrete techniques in providing sex offender treatment with them. In addition, many treatment providers wonder how their clients were able to stand trial. Therefore, the PC1370 evaluation and training process will be reviewed. By the end of today’s presentation participants will be able to describe the competency evaluation process for DD/ID clients, list at least three myths about DD/ID Sex Offenders, and describe at least three techniques in working with DD/ID sex offending clients. A MODEL FOR FACILITATING EFFECTIVE PSYCHOLOGICAL ASSESSMENTS FOR THE JUVENILE AND DEPENDENCY COURTS Norbert Ralph, PhD, MPH Briana Loomis, PhD This presentation is designed to assist those who supervise these court ordered evaluations with specific methods to provide more effective assessments. The presentation is also designed to provide psychologist doing those evaluations with practical and usable "best practices" methods and criteria to develop more forensically defensible assessments.

The Department of Public Health in San Francisco administers and coordinates psychological testing for the dependency and juvenile courts through the Psychological Assessment Services (PAS) Program. The goal of the PAS Program is to provide competent psychological evaluations for the courts through establishing administrative procedures, best practices criteria for evaluations, training in those criteria, and importantly quality assurance and quality improvement methods for evaluations. It is assumed that psychological assessments which can more effectively identify treatable factors will promote better outcomes in both delinquency and dependency settings and inform the courts in decision making. The PAS program has developed guidelines to promote effective psychological evaluations including expectations regarding records review, contacts with collateral sources, the clinical interview of children and adolescents, and parents, and what types of psychological instruments are best choices based on current research. The guidelines also suggest formulating treatment recommendations which are practical and evidence-based. The assessment model promoted emphasizes multimethod-multi-informant methodologies which are also developmentally, culturally, and trauma informed. Also, a methodology for quality assurance, and providing feedback to improve practice is discussed. The presentation discusses the relevant research on which this model is based and the checklist that has been developed. For example, the best practices literature has identified that ongoing fidelity to well-designed practices is strongly associated with better outcomes. The presentation also addresses the challenges oF administering such a system using psychologists who are independent contractors, working with families and youth in multicultural contexts, with probation and child welfare systems, and the courts and attorneys. Best practices criteria and methods for special evaluations such as neuropsycho-logical, juvenile competency, and parenting capacity are discussed.

THE ROAD TO FREEDOM: A COMPRESHIVE COMPETENCY-BASED WORKBOOK FOR

SEXUAL OFFENDERS IN TREATMENT

Jill Levenson, PhD, LCSW

THE GIFT OF FEAR: SURVIVAL SIGNALS THAT PROTECT US FROM VIOLENCE Gavin De Becker

COLUMBINE Dave Cullen

MINDHUNTER: INSIDE THE FBI’S ELITE SERIAL CRIME UNIT John E. Douglas Mark Olshaker

MINDFULNESS-BASED SUBSTANCE ABUSE TREATMENT

FOR ADOLESCENTS Sam Himelstein Stephen Saul

MURDER BY FAMILY Kent Whitaker

BOOK LIST

WEDNESDAY, MARCH 11

10:00 am—2:00 pm REGISTRATION

President’s Remarks • Ken Carabello, MSW - FMHAC President

1:00—2:30 pm (Regency I/II/III/Main) CE: CPA/BBS/BRN/POST 1.5 CE hrs

UNDERSTANDING MASS SHOOTINGS: PATHWAYS TO PREVENTION James Densley, PhD For over two years, James Densley (with his colleague Jillian Peterson) has studied the life histories of mass shooters in the United States for a project funded by the National Institute of Justice, the research arm of the U.S. Department of Justice. He’s built a database dating back to 1966 of every shooter who killed four or more people in a public place and has interviewed incarcerated mass shooters and their families and friends; people who planned a shooting but changed their minds; shooting survivors and first responders. The goal has been to find new, data-driven pathways for preventing mass shootings. The study shows that mass shooters typically have four things in common. They suffered early-childhood trauma and exposure to violence at a young age. They were angry or despondent over a recent event, resulting in feelings of suicidality. They studied other mass shootings, often online, and found inspiration. Finally, they possessed the means to carry out an attack. By understanding the traits that mass shooters share, we can do more than just upgrade security or lockdown an entire generation: we can instead plan to prevent the violence.

2:30—2:45 pm BREAK

2:45—6:00 pm (Regency I/II/III/Main) CE: CPA/BBS/BRN/ POST/MCLE 3.0 CE hrs

SOCIAL JUSTICE & HISTORICAL REPAIR: RACE, CULTURE, DIVERSITY & THE LIVES OF HEALERS IN FORENSIC MENTAL HEALTH Mathew Mock, PhD Forensic psychologists and mental health staff consider race, culture, ethnicity as well as the dynamics of power differentials in assessment; diagnoses; performing evaluations; treatment and dispositioning; forming effective working relationships and short and long term outcomes. Performing our work with deeper meaning, insight and awareness often means appreciating our own backgrounds including trauma exposure, loss, challenges and triumphs, and relational ruptures as well as repair. Services at all levels such as those in forensic mental health continue to strive for cultural humility, and cultural competency and responsiveness with a vision for optimal mental health practices. Our work is not only knowing those we serve but also being aware of self, professionally as well as personally, relationally. Awareness of our own backgrounds related to what we do is inextricably tied to being cognizant in our work. This presentation will acknowledge commitments as well as future challenges with research, policy, practice as well as system recommendations.

4:15—4:30 pm BREAK

6:00—7:00 pm (Regency IV/V/VI/Lobby)

WELCOME RECEPTION & POSTER PRESENTATIONS

TRACKS LEGEND

Sex Offender Clinical Juvenile Legal Words to Deeds

THURSDAY, MARCH 12

8:00—9:00 am REGISTRATION

9:00—10:30 am BREAKOUT PRESENTATION 1

(Regency IV/V/VI) CE: CPA/BBS/BRN/POST 1.5 CE hrs

CONTROVERSIES IN FORENSIC MENTAL HEALTH: HISTORICAL AND FUTURE PERSPECTIVES Ariana Nesbit-Bartsch, MD, MBE David Naimark, MD The field of forensic psychiatry has evolved over the years. This panel will allow audience members to consider the evolution of several issues in forensic mental health, including the right to access treatment, the evolution of psychiatrists as “jailers,” mental illness and guns, the Incompetent to stand trial crisis, and emerging genetic and neuroimaging technologies with their potential impact in the courtroom.

(Regency I/II/III/) CE: CPA/BBS/BRN/POST/MCLE 1.5 CE hrs

THE DIAGNOSIS DEBATE: ITS USE IN NGI, IST, MDO AND SVP EVALUATION – PART 1 Melinda DiCiro, PsyD, ABPP Susan Napolitano, PhD Brandon Yakush, PsyD Mental disorder is a threshold condition for meeting the statutory elements of incompetency to stand trial (IST) status, not guilty by reason of insanity findings (NGRI), or mentally disordered offender (MDO) and sexually violent predator (SVP) commitment. What constitutes a mental disorder in forensic contexts varies both by the statutory definition and the impact of the disorder on specifically defined functions or capacities. No psychiatric diagnosis alone, no matter its nature, is sufficient for a person to be deemed IST or NGRI or to meet the definitions of severe mental disorder under the mentally disordered offender law or diagnosed mental disorder per the sexually violent predator law. Each of these determinations has its definitions, exclusions and controversies. This presentation will demonstrate the application of legal criteria to determining whether a mental disorder exists as a threshold condition in these forensic evaluations, common in California. The presentation will first explore the relevance of diagnosis, particularly DSM diagnoses, to forensic evaluations in general. It will then define mental disorder and exclusions for each of the four statutory schemes. Arguments for and against use of diagnoses in each scheme will be reviewed. The specific application of statutory and other legal elements for determining the presence or absence of a qualifying mental disorder will be demonstrated with case examples.

(Spyglass) CE: CPA/BBS/BRN/POST 1.5 CE hrs

PRACTICAL EVIDENCE-BASED INTERVENTIONS FOR JUVENILES ON PROBATION: DIALECTICAL BEHAVIOR THERAPY AND PROSOCIAL INTERVENTIONS Norbert Ralph, PhD, MPH Cory Adams, LMFT The goal of the presentation will be to give participants well researched, effective models for probation youth, which can be readily implemented, are user- and client friendly, and cost-effective. Two types of practical evidence-based interventions for juveniles on probation will be presented: Dialectical Behavior Therapy (DBT) and also interventions to promote prosocial reasoning and development. The research and theoretical basis for both for working with juveniles will be discussed. Both sets of interventions are currently being used for juveniles on probation in California. The models target modifiable criminogenic risk factors for these youth. Both sets of intervention have been implemented consistent with "best practices" associated with better outcomes. These principles include competency-based training in the model, specific description of the treatment in manualized or work book format, quality assurance measures to ensure that the model is being implemented with fidelity, and "built in" outcome measures to assess effectiveness. The DBT model discussed has been modified to be developmentally, culturally, and trauma sensitive. The prosocial models discussed include Aggression Replacement Training and Being a Pro, which target deficits in prosocial reasoning. The use of both models is associated with positive outcomes for probation youth.

WEDNESDAY, MARCH 11

10:00 am—2:00 pm REGISTRATION

President’s Remarks • Ken Carabello, MSW - FMHAC President

1:00—2:30 pm (Regency I/II/III/Main) CE: CPA/BBS/BRN/POST 1.5 CE hrs

UNDERSTANDING MASS SHOOTINGS: PATHWAYS TO PREVENTION James Densley, PhD For over two years, James Densley (with his colleague Jillian Peterson) has studied the life histories of mass shooters in the United States for a project funded by the National Institute of Justice, the research arm of the U.S. Department of Justice. He’s built a database dating back to 1966 of every shooter who killed four or more people in a public place and has interviewed incarcerated mass shooters and their families and friends; people who planned a shooting but changed their minds; shooting survivors and first responders. The goal has been to find new, data-driven pathways for preventing mass shootings. The study shows that mass shooters typically have four things in common. They suffered early-childhood trauma and exposure to violence at a young age. They were angry or despondent over a recent event, resulting in feelings of suicidality. They studied other mass shootings, often online, and found inspiration. Finally, they possessed the means to carry out an attack. By understanding the traits that mass shooters share, we can do more than just upgrade security or lockdown an entire generation: we can instead plan to prevent the violence.

2:30—2:45 pm BREAK

2:45—6:00 pm (Regency I/II/III/Main) CE: CPA/BBS/BRN/ POST/MCLE 3.0 CE hrs

SOCIAL JUSTICE & HISTORICAL REPAIR: RACE, CULTURE, DIVERSITY & THE LIVES OF HEALERS IN FORENSIC MENTAL HEALTH Mathew Mock, PhD Forensic psychologists and mental health staff consider race, culture, ethnicity as well as the dynamics of power differentials in assessment; diagnoses; performing evaluations; treatment and dispositioning; forming effective working relationships and short and long term outcomes. Performing our work with deeper meaning, insight and awareness often means appreciating our own backgrounds including trauma exposure, loss, challenges and triumphs, and relational ruptures as well as repair. Services at all levels such as those in forensic mental health continue to strive for cultural humility, and cultural competency and responsiveness with a vision for optimal mental health practices. Our work is not only knowing those we serve but also being aware of self, professionally as well as personally, relationally. Awareness of our own backgrounds related to what we do is inextricably tied to being cognizant in our work. This presentation will acknowledge commitments as well as future challenges with research, policy, practice as well as system recommendations.

4:15—4:30 pm BREAK

6:00—7:00 pm (Regency IV/V/VI/Lobby)

WELCOME RECEPTION & POSTER PRESENTATIONS

TRACKS LEGEND

Sex Offender Clinical Juvenile Legal Words to Deeds

THURSDAY, MARCH 12

8:00—9:00 am REGISTRATION

9:00—10:30 am BREAKOUT PRESENTATION 1

CONTROVERSIES IN FORENSIC MENTAL HEALTH: HISTORICAL AND FUTURE PERSPECTIVES Ariana Nesbit-Bartsch, MD, MBE David Naimark, MD The field of forensic psychiatry has evolved over the years. This panel will allow audience members to consider the evolution of several issues in forensic mental health, including the right to access treatment, the evolution of psychiatrists as “jailers,” mental illness and guns, the Incompetent to stand trial crisis, and emerging genetic and neuroimaging technologies with their potential impact in the courtroom.

(Regency I/II/III/) CE: CPA/BBS/BRN/POST/MCLE 1.5 CE hrs

THE DIAGNOSIS DEBATE: ITS USE IN NGI, IST, MDO AND SVP EVALUATION – PART 1 Melinda DiCiro, PsyD, ABPP Susan Napolitano, PhD Brandon Yakush, PsyD Mental disorder is a threshold condition for meeting the statutory elements of incompetency to stand trial (IST) status, not guilty by reason of insanity findings (NGRI), or mentally disordered offender (MDO) and sexually violent predator (SVP) commitment. What constitutes a mental disorder in forensic contexts varies both by the statutory definition and the impact of the disorder on specifically defined functions or capacities. No psychiatric diagnosis alone, no matter its nature, is sufficient for a person to be deemed IST or NGRI or to meet the definitions of severe mental disorder under the mentally disordered offender law or diagnosed mental disorder per the sexually violent predator law. Each of these determinations has its definitions, exclusions and controversies. This presentation will demonstrate the application of legal criteria to determining whether a mental disorder exists as a threshold condition in these forensic evaluations, common in California. The presentation will first explore the relevance of diagnosis, particularly DSM diagnoses, to forensic evaluations in general. It will then define mental disorder and exclusions for each of the four statutory schemes. Arguments for and against use of diagnoses in each scheme will be reviewed. The specific application of statutory and other legal elements for determining the presence or absence of a qualifying mental disorder will be demonstrated with case examples.

PRACTICAL EVIDENCE-BASED INTERVENTIONS FOR JUVENILES ON PROBATION: DIALECTICAL BEHAVIOR THERAPY AND PROSOCIAL INTERVENTIONS Norbert Ralph, PhD, MPH Cory Adams, LMFT The goal of the presentation will be to give participants well researched, effective models for probation youth, which can be readily implemented, are user- and client friendly, and cost-effective. Two types of practical evidence-based interventions for juveniles on probation will be presented: Dialectical Behavior Therapy (DBT) and also interventions to promote prosocial reasoning and development. The research and theoretical basis for both for working with juveniles will be discussed. Both sets of interventions are currently being used for juveniles on probation in California. The models target modifiable criminogenic risk factors for these youth. Both sets of intervention have been implemented consistent with "best practices" associated with better outcomes. These principles include competency-based training in the model, specific description of the treatment in manualized or work book format, quality assurance measures to ensure that the model is being implemented with fidelity, and "built in" outcome measures to assess effectiveness. The DBT model discussed has been modified to be developmentally, culturally, and trauma sensitive. The prosocial models discussed include Aggression Replacement Training and Being a Pro, which target deficits in prosocial reasoning. The use of both models is associated with positive outcomes for probation youth.

(Regency I/II/III) CE: CPA/BBS/BRN/MCLE/POST 1.5 CE hrs

THE DIAGNOSIS DEBATE: ITS USE IN NGI, IST, MDO, AND SVP EVALUATION (PART 2) Melinda DiCiro, PsyD, ABPP Susan Napolitano, PhD Brandon Yakush, PsyD Mental disorder is a threshold condition for meeting the statutory elements of incompetency to stand trial (IST) status, not guilty by reason of insanity findings (NGRI), or mentally disordered offender (MDO) and sexually violent predator (SVP) commitment. What constitutes a mental disorder in forensic contexts varies both by the statutory definition and the impact of the disorder on specifically defined functions or capacities. No psychiatric diagnosis alone, no matter its nature, is sufficient for a person to be deemed IST or NGRI or to meet the definitions of severe mental disorder under the mentally disordered offender law or diagnosed mental disorder per the sexually violent predator law. Each of these determinations has its definitions, exclusions and controversies. This presentation will demonstrate the application of legal criteria to determining whether a mental disorder exists as a threshold condition in these forensic evaluations, common in California. The presentation will first explore the relevance of diagnosis, particularly DSM diagnoses, to forensic evaluations in general. It will then define mental disorder and exclusions for each of the four statutory schemes. Arguments for and against use of diagnoses in each scheme will be reviewed. The specific application of statutory and other legal elements for determining the presence or absence of a qualifying mental disorder will be demonstrated with case examples.

AN OVERVIEW OF THE SEXUAL BEHAVIOR TREATMENT PROGRAM: A COURT ORDERED SEX OFFENDER TREATMENT FOR JUVENILES IN A CORRECTIONAL SETTING Kirsten Mason, PsyD This presentation will be an overview of the Sexual Behavior Treatment Program (SBTP) which is provided to court mandated youth who are sentenced to CDCR-Division of Juvenile Justice. Research on juveniles who sexually offend as well as the research used to guide the creation and implementation of this treatment will be provided. A closer look at the population of youth we serve and the recidivism rates after treatment and re-entry back into the community will also be discussed. This presentation will be done by two SBTP clinical psychologists who are actively working within this program and can provide a first-hand narrative of the implementation and success of this treatment approach.

(Windjammer) CE: CPA/BBS/BRN/POST 1.5 CE hrs

EVIDENCE-BASED UNDERSTANDING OF EMPATHY AND SEXUAL OFFENDING Elijah Morrow, PsyD Adam Yerke, PsyD Sexual offenders are commonly assumed to lack, or have limited empathy – otherwise, how could they commit such horrendous acts? Likewise, many sexual offender treatment programs maintain that development of “victim empathy” is imperative for rehabilitation. However, researchers have continually found this intervention to have limited impact on reducing sexual recidivism. This presentation provides evidence-based information about the relationship between empathy and sexual offending. Presenters describe the history of this topic, giving an overview of theories, research, and practices. Most notably, results from a meta-analysis completed by the presenters in 2018 are delineated, including significant differences found between sexual offenders and the general population for general and cognitive empathy, but not affective empathy. In light of these findings, implications for effective management of sexual offenders are explored, including evidence-based treatment.

(Regency IV/V/VI) CE: CPA/BBS/BRN/MCLE/POST 1.5 CE hrs

THE TURNAROUND: SANTA BARBARA COUNTY’S APPROACH TO IST TREATMENT AND DIVERSION John Lewis, PhD Many California jurisdictions have experienced increased rates of individuals adjudicated to be Incompetent to Stand Trial on misdemeanant charges, which often strains limited treatment resources and results in delayed access to treatment. This presentation will describe how Santa Barbara County has sought to address the matter through collaboration among partner agencies and the expansion of outpatient competency restoration procedures. The speaker will also describe plans to increase opportunities for diversion and conclude with a list of lessons gleaned from this experience.

THE GOOD NEWS ABOUT BURNOUT Melissa Piasecki, MD This interactive workshop looks at the "good news" about burnout: that there are evidence-based tools and strategies that we can apply to increase resilience and decrease the impact of chronic stress. Participants will have a hands-on experience with brief interventions and will be invited to craft a change plan to promote individual and institutional wellness.

(Big Sur) CE: CPA/BBS/BRN/POST 1.5 CE hrs

UNDERSTANDING SUICIDE AND SUICIDE RISK IN SPECIFIC INMATE GROUPS: LIFERS, FEMALES, AND THE SEVERELY MENTALLY ILL Robert Horon, PhD Justine Schmollinger, JD, PhD Amber Carda, PsyD This presentation will feature three integrated talks regarding risks for suicide that are specific to certain groups of inmates. First, one panel member will discuss the unique vulnerabilities to suicide of inmates with major mental illness, incorporating findings from a large study of patients in a correctional inpatient hospital. Next, a second panel member will present research on male inmates with life crimes, noting the distinguishing suicide risk factors in the group from both a research and clinical perspective. Third, a panelist will discuss differences in suicidal behaviors in female inmates based on interviews and analyses of suicide attempts in women’s prisons. The presentation will conclude with a discussion of implications in working with each group and a question and answer session.

(Cypress) CE: CPA/BBS/BRN/POST 1.5 CE hrs

WORDS TO DEEDS – THE CASE FOR DIVERSION Katherine Warburton, DO State and national expert, Dr. Katherine Warburton will provide a review of the historical, national and research trends that support the case for mental health diversion with specific emphasis on diversion of individuals found incompetent to stand trial (IST). The session will enhance audience understanding of the national IST problem and provide insight as to why more and more individuals with serious mental health disorders are ending up in jail; and why we must look to community-based solutions to help solve the problem. Attendees are encouraged to ask questions to improve their own professional effectiveness.

10:30—10:45 am COFFEE BREAK 10:45 am—12:15 pm BREAKOUT PRESENTATION 2

WHAT DOES CHANGE MANAGEMENT HAVE TO DO WITH FORENSIC MENTAL HEALTH? PART 1 Will Cash Tom Granucci, LCSW If you have been recently tasked with starting the implementation of evidence-based practices (EBPs) in your agency or you are in the middle of an EBP implementation effort, then this workshop is for you. The workshop will begin with a brief review of the Risk-Need-Responsivity (RNR) model. The focus will be to use implementation science as a framework for successful implementation of EBPs. The workshop will assist attendees to practically integrate the RNR model into their day-to-day mental health practice. The presenters will facilitate a series of small group discussions which will cover organizational development areas of: 1. becoming an evidence-based organization vs. training in an EBP; 2. implementation stages; 3. paradigm shift; 4.. change management leadership, including technical & adaptive leadership; 5. selection, training, and coaching; and 6. data driven decision making. Participants will have time to interact around implementation science ideas and their application to forensic mental health work. This workshop is designed to be highly interactive and to provide attendees with networking opportunities. Within the workshop, attendees will choose their small groups based on their desire to network with colleagues who are geographically local or to expand connections across California.

THE DIAGNOSIS DEBATE: ITS USE IN NGI, IST, MDO, AND SVP EVALUATION (PART 2) Melinda DiCiro, PsyD, ABPP Susan Napolitano, PhD Brandon Yakush, PsyD Mental disorder is a threshold condition for meeting the statutory elements of incompetency to stand trial (IST) status, not guilty by reason of insanity findings (NGRI), or mentally disordered offender (MDO) and sexually violent predator (SVP) commitment. What constitutes a mental disorder in forensic contexts varies both by the statutory definition and the impact of the disorder on specifically defined functions or capacities. No psychiatric diagnosis alone, no matter its nature, is sufficient for a person to be deemed IST or NGRI or to meet the definitions of severe mental disorder under the mentally disordered offender law or diagnosed mental disorder per the sexually violent predator law. Each of these determinations has its definitions, exclusions and controversies. This presentation will demonstrate the application of legal criteria to determining whether a mental disorder exists as a threshold condition in these forensic evaluations, common in California. The presentation will first explore the relevance of diagnosis, particularly DSM diagnoses, to forensic evaluations in general. It will then define mental disorder and exclusions for each of the four statutory schemes. Arguments for and against use of diagnoses in each scheme will be reviewed. The specific application of statutory and other legal elements for determining the presence or absence of a qualifying mental disorder will be demonstrated with case examples.

AN OVERVIEW OF THE SEXUAL BEHAVIOR TREATMENT PROGRAM: A COURT ORDERED SEX OFFENDER TREATMENT FOR JUVENILES IN A CORRECTIONAL SETTING Kirsten Mason, PsyD This presentation will be an overview of the Sexual Behavior Treatment Program (SBTP) which is provided to court mandated youth who are sentenced to CDCR-Division of Juvenile Justice. Research on juveniles who sexually offend as well as the research used to guide the creation and implementation of this treatment will be provided. A closer look at the population of youth we serve and the recidivism rates after treatment and re-entry back into the community will also be discussed. This presentation will be done by two SBTP clinical psychologists who are actively working within this program and can provide a first-hand narrative of the implementation and success of this treatment approach.

EVIDENCE-BASED UNDERSTANDING OF EMPATHY AND SEXUAL OFFENDING Elijah Morrow, PsyD Adam Yerke, PsyD Sexual offenders are commonly assumed to lack, or have limited empathy – otherwise, how could they commit such horrendous acts? Likewise, many sexual offender treatment programs maintain that development of “victim empathy” is imperative for rehabilitation. However, researchers have continually found this intervention to have limited impact on reducing sexual recidivism. This presentation provides evidence-based information about the relationship between empathy and sexual offending. Presenters describe the history of this topic, giving an overview of theories, research, and practices. Most notably, results from a meta-analysis completed by the presenters in 2018 are delineated, including significant differences found between sexual offenders and the general population for general and cognitive empathy, but not affective empathy. In light of these findings, implications for effective management of sexual offenders are explored, including evidence-based treatment.

(Regency IV/V/VI) CE: CPA/BBS/BRN/MCLE/POST 1.5 CE hrs

THE TURNAROUND: SANTA BARBARA COUNTY’S APPROACH TO IST TREATMENT AND DIVERSION John Lewis, PhD Many California jurisdictions have experienced increased rates of individuals adjudicated to be Incompetent to Stand Trial on misdemeanant charges, which often strains limited treatment resources and results in delayed access to treatment. This presentation will describe how Santa Barbara County has sought to address the matter through collaboration among partner agencies and the expansion of outpatient competency restoration procedures. The speaker will also describe plans to increase opportunities for diversion and conclude with a list of lessons gleaned from this experience.

THE GOOD NEWS ABOUT BURNOUT Melissa Piasecki, MD This interactive workshop looks at the "good news" about burnout: that there are evidence-based tools and strategies that we can apply to increase resilience and decrease the impact of chronic stress. Participants will have a hands-on experience with brief interventions and will be invited to craft a change plan to promote individual and institutional wellness.

UNDERSTANDING SUICIDE AND SUICIDE RISK IN SPECIFIC INMATE GROUPS: LIFERS, FEMALES, AND THE SEVERELY MENTALLY ILL Robert Horon, PhD Justine Schmollinger, JD, PhD Amber Carda, PsyD This presentation will feature three integrated talks regarding risks for suicide that are specific to certain groups of inmates. First, one panel member will discuss the unique vulnerabilities to suicide of inmates with major mental illness, incorporating findings from a large study of patients in a correctional inpatient hospital. Next, a second panel member will present research on male inmates with life crimes, noting the distinguishing suicide risk factors in the group from both a research and clinical perspective. Third, a panelist will discuss differences in suicidal behaviors in female inmates based on interviews and analyses of suicide attempts in women’s prisons. The presentation will conclude with a discussion of implications in working with each group and a question and answer session.

WORDS TO DEEDS – THE CASE FOR DIVERSION Katherine Warburton, DO State and national expert, Dr. Katherine Warburton will provide a review of the historical, national and research trends that support the case for mental health diversion with specific emphasis on diversion of individuals found incompetent to stand trial (IST). The session will enhance audience understanding of the national IST problem and provide insight as to why more and more individuals with serious mental health disorders are ending up in jail; and why we must look to community-based solutions to help solve the problem. Attendees are encouraged to ask questions to improve their own professional effectiveness.

10:30—10:45 am COFFEE BREAK 10:45 am—12:15 pm BREAKOUT PRESENTATION 2

WHAT DOES CHANGE MANAGEMENT HAVE TO DO WITH FORENSIC MENTAL HEALTH? PART 1 Will Cash Tom Granucci, LCSW If you have been recently tasked with starting the implementation of evidence-based practices (EBPs) in your agency or you are in the middle of an EBP implementation effort, then this workshop is for you. The workshop will begin with a brief review of the Risk-Need-Responsivity (RNR) model. The focus will be to use implementation science as a framework for successful implementation of EBPs. The workshop will assist attendees to practically integrate the RNR model into their day-to-day mental health practice. The presenters will facilitate a series of small group discussions which will cover organizational development areas of: 1. becoming an evidence-based organization vs. training in an EBP; 2. implementation stages; 3. paradigm shift; 4.. change management leadership, including technical & adaptive leadership; 5. selection, training, and coaching; and 6. data driven decision making. Participants will have time to interact around implementation science ideas and their application to forensic mental health work. This workshop is designed to be highly interactive and to provide attendees with networking opportunities. Within the workshop, attendees will choose their small groups based on their desire to network with colleagues who are geographically local or to expand connections across California.

RISK ASSESSMENT APPROACHES FOR YOUTH WHO HAVE SEXUALLY OFFENDED: THE VIOLENCE RISK SEXUAL-YOUTH SEXUAL OFFENSE VERSION (VRS-YSO) PART 1 Mark Olver, PhD This half day seminar provides an overview of assessment approaches, recent findings, and issues in sexual offense risk assessment with male juvenile populations. The Violence Risk Scale-Youth Sexual Offense version (VRS-YSO), a dynamic risk assessment and treatment planning tool for youth who have sexually offended, will be reviewed in detail as an illustrative approach. Attendees will have the opportunity to complete a practice case scoring the VRS-YSO and to discuss their own cases. Implications for sexual offense risk management and support for youth and families to prevent future sexual offending and promote healthy functioning and wellbeing will be discussed.

(Windjammer) CE: CPA/BBS/BRN/MCLE/POST 1.5 CE hrs

FIELD RELIABILITY OF SVP EVALUATION Joseph Lockhart, PhD, ABPP Melinda DiCiro, PsyD, ABPP James Rokop, PhD Sexually Violent Predator (SVP) evaluations have high stakes consequences for public safety and individual rights and civil liberties. They must be reliable. Statistical reliability is the foundation of test validity and predictive ability. Similarly, diagnoses must be reliable statistically, especially for use in high-stakes decisions. Poor inter-rater reliability might be due to poor or inadequate training, or possibly to bias. Examining the field reliability of these evaluations is the best way to test these features. This presentation explores research recently conducted at the Department of State Hospitals which demonstrates a high level of field reliability in the conduct of SVP evaluations for inmates facing potential SVP commitment after their prison terms. The presenters first review the ethical and scientific foundations of objective assessment, particularly evaluator vulnerability to bias. They review key studies demonstrating limited reliability in some field studies of risk assessment instruments. Ways to mitigate and control for bias and enhance reliability of evaluator decision-making are discussed. The specific outcomes of the research are explored in this context. The results showed high inter-rater reliability of actuarial risk assessments for both negative and positive SVP report findings. As well, higher actuarial risk ratings were associated with a higher probability of a positive SVP outcome. The kappa reliability of pedophilic disorder was substantial for both positive and negative outcomes. This suggests that evaluators determine outcome on both diagnosis and risk, as is fitting base on established theory, empirical evidence, and statutory require-ments. The research showed no significant difference between state-employed and contractor employees, suggesting little “adversarial allegiance” in this sample.

CREATING AND MAINTAINING A BEHAVIORAL HEALTH PROGRAM IN SAN MATEO COUNTY CORRECTIONAL FACILITIES Shivika Dharamrup, PsyD Dustin Boots This presentation will describe the successes and challenges of creating, maintaining and expanding a behavioral health programing unit in a correctional setting. Presenters from both San Mateo County’s Correctional Health Services and Sheriff’s Office will discuss their perspectives, creative programing strategies, and the multi-disciplinary collaboration that is essential for a successful unit. The presentation will review the incentive based programing offered, incentives used, multi-disciplinary approach to selecting intimates, re-entry planning, collaboration with program providers within the jail as well as in the community. Additionally, we will review the jail’s crisis continuum to include our in-custody Acute Stabilization Unit (ASU). This is a LPS unit in which we can 5150 inmates and provide force medications. It is a co-ed 10 bed housing pod within the jail.

WORDS TO DEEDS – BRINGING HEALTHCARE TO THE STREETS: HOW TWO PROGRAMS REDUCE RECIDIVISM BY CARING FOR THE MOST VULNERABLE Aislinn Bird, MD, MPH Alison Livingston, LMFT Kathleen Lacey, LCSW StreetHealth and the Citywide Community Response Team are two innovative programs that provide a high level of wraparound services to people with behavioral health conditions, which may lead to a reduction in incarceration. StreetHealth is Alameda County Health Care for the Homeless’ backpack street medicine team, which provides behavioral health care, substance use treatment and physical medicine to people who are houseless in Alameda County. We will discuss the importance of public psychiatry, and why health care should be brought directly to people who are living on the streets. The details of our backpack medicine team will be explored, including our MAT and LAI programs. We will also discuss our importance of our community partners, including law enforcement. The Citywide Community Response Team provides short term intensive case management to adults that have been identified as high priority by San Francisco’s Department of Public Health who are high utilizers of multiple emergency crisis systems and homeless. We will discuss program design and creative interventions utilized with adults that have struggled to engage in traditional care models, are homeless and are not necessarily interested in treatment but are cycling through emergency systems and the jail.

12:15—1:15 pm (Regency Main & Terrace)

1:15—2:45 pm BREAKOUT PRESENTATION 3

WHAT DOES CHANGE MANAGEMENT HAVE TO DO WITH FORENSIC MENTAL HEALTH? PART 2 Will Cash Tom Granucci, LCSW If you have been recently tasked with starting the implementation of evidence-based practices (EBPs) in your agency or you are in the middle of an EBP implementation effort, then this workshop is for you. The workshop will begin with a brief review of the Risk-Need-Responsivity (RNR) model. The focus will be to use implementation science as a framework for successful implementation of EBPs. The workshop will assist attendees to practically integrate the RNR model into their day-to-day mental health practice. The presenters will facilitate a series of small group discussions which will cover organizational development areas of: 1. becoming an evidence-based organization vs. training in an EBP; 2. implementation stages; 3. paradigm shift; 4. change management leadership, including technical & adaptive leadership; 5. selection, training, and coaching; and 6. data driven decision making. Participants will have time to interact around implementation science ideas and their application to forensic mental health work. This workshop is designed to be highly interactive and to provide attendees with networking opportunities. Within the workshop, attendees will choose their small groups based on their desire to network with colleagues who are geographically local or to expand connections across California.

THE ELUSIVE COMPETENCE TO STAND TRIAL ELEMENT: (IN)ABILITY TO ASSIST COUNSEL IN THE CONDUCT OF A DEFENSE IN A RATIONAL MANNER ELEMENT OF COMPETENCE: HOW TO CONSIDER IT; HOW TO EVALUATE IT John Phillipsborn, Med, MAS, JD Charles Hendrickson, BA, JD The assessment of the accused possible incompetence to stand trial should, according to the California statutory definition, involve the assessment of whether that accused is “unable…to assist counsel in the conduct of a defense in a rational manner.” In order to assess that element, it is important to understand it as it is defined in the law, and as courts and standards of practice have defined the concept. Both courts and experts in the field have described this element as one that is outside the frame of knowledge of many assessing mental health professionals. This session will provide a discussion of relevant authorities, and will review how the element is discussed in case law, and in relevant literature.

FIELD RELIABILITY OF SVP EVALUATION Joseph Lockhart, PhD, ABPP Melinda DiCiro, PsyD, ABPP James Rokop, PhD Sexually Violent Predator (SVP) evaluations have high stakes consequences for public safety and individual rights and civil liberties. They must be reliable. Statistical reliability is the foundation of test validity and predictive ability. Similarly, diagnoses must be reliable statistically, especially for use in high-stakes decisions. Poor inter-rater reliability might be due to poor or inadequate training, or possibly to bias. Examining the field reliability of these evaluations is the best way to test these features. This presentation explores research recently conducted at the Department of State Hospitals which demonstrates a high level of field reliability in the conduct of SVP evaluations for inmates facing potential SVP commitment after their prison terms. The presenters first review the ethical and scientific foundations of objective assessment, particularly evaluator vulnerability to bias. They review key studies demonstrating limited reliability in some field studies of risk assessment instruments. Ways to mitigate and control for bias and enhance reliability of evaluator decision-making are discussed. The specific outcomes of the research are explored in this context. The results showed high inter-rater reliability of actuarial risk assessments for both negative and positive SVP report findings. As well, higher actuarial risk ratings were associated with a higher probability of a positive SVP outcome. The kappa reliability of pedophilic disorder was substantial for both positive and negative outcomes. This suggests that evaluators determine outcome on both diagnosis and risk, as is fitting base on established theory, empirical evidence, and statutory require-ments. The research showed no significant difference between state-employed and contractor employees, suggesting little “adversarial allegiance” in this sample.

CREATING AND MAINTAINING A BEHAVIORAL HEALTH PROGRAM IN SAN MATEO COUNTY CORRECTIONAL FACILITIES Shivika Dharamrup, PsyD Dustin Boots This presentation will describe the successes and challenges of creating, maintaining and expanding a behavioral health programing unit in a correctional setting. Presenters from both San Mateo County’s Correctional Health Services and Sheriff’s Office will discuss their perspectives, creative programing strategies, and the multi-disciplinary collaboration that is essential for a successful unit. The presentation will review the incentive based programing offered, incentives used, multi-disciplinary approach to selecting intimates, re-entry planning, collaboration with program providers within the jail as well as in the community. Additionally, we will review the jail’s crisis continuum to include our in-custody Acute Stabilization Unit (ASU). This is a LPS unit in which we can 5150 inmates and provide force medications. It is a co-ed 10 bed housing pod within the jail.

WORDS TO DEEDS – BRINGING HEALTHCARE TO THE STREETS: HOW TWO PROGRAMS REDUCE RECIDIVISM BY CARING FOR THE MOST VULNERABLE Aislinn Bird, MD, MPH Alison Livingston, LMFT Kathleen Lacey, LCSW StreetHealth and the Citywide Community Response Team are two innovative programs that provide a high level of wraparound services to people with behavioral health conditions, which may lead to a reduction in incarceration. StreetHealth is Alameda County Health Care for the Homeless’ backpack street medicine team, which provides behavioral health care, substance use treatment and physical medicine to people who are houseless in Alameda County. We will discuss the importance of public psychiatry, and why health care should be brought directly to people who are living on the streets. The details of our backpack medicine team will be explored, including our MAT and LAI programs. We will also discuss our importance of our community partners, including law enforcement. The Citywide Community Response Team provides short term intensive case management to adults that have been identified as high priority by San Francisco’s Department of Public Health who are high utilizers of multiple emergency crisis systems and homeless. We will discuss program design and creative interventions utilized with adults that have struggled to engage in traditional care models, are homeless and are not necessarily interested in treatment but are cycling through emergency systems and the jail.

12:15—1:15 pm (Regency Main & Terrace)

WHAT DOES CHANGE MANAGEMENT HAVE TO DO WITH FORENSIC MENTAL HEALTH? PART 2 Will Cash Tom Granucci, LCSW If you have been recently tasked with starting the implementation of evidence-based practices (EBPs) in your agency or you are in the middle of an EBP implementation effort, then this workshop is for you. The workshop will begin with a brief review of the Risk-Need-Responsivity (RNR) model. The focus will be to use implementation science as a framework for successful implementation of EBPs. The workshop will assist attendees to practically integrate the RNR model into their day-to-day mental health practice. The presenters will facilitate a series of small group discussions which will cover organizational development areas of: 1. becoming an evidence-based organization vs. training in an EBP; 2. implementation stages; 3. paradigm shift; 4. change management leadership, including technical & adaptive leadership; 5. selection, training, and coaching; and 6. data driven decision making. Participants will have time to interact around implementation science ideas and their application to forensic mental health work. This workshop is designed to be highly interactive and to provide attendees with networking opportunities. Within the workshop, attendees will choose their small groups based on their desire to network with colleagues who are geographically local or to expand connections across California.

THE ELUSIVE COMPETENCE TO STAND TRIAL ELEMENT: (IN)ABILITY TO ASSIST COUNSEL IN THE CONDUCT OF A DEFENSE IN A RATIONAL MANNER ELEMENT OF COMPETENCE: HOW TO CONSIDER IT; HOW TO EVALUATE IT John Phillipsborn, Med, MAS, JD Charles Hendrickson, BA, JD The assessment of the accused possible incompetence to stand trial should, according to the California statutory definition, involve the assessment of whether that accused is “unable…to assist counsel in the conduct of a defense in a rational manner.” In order to assess that element, it is important to understand it as it is defined in the law, and as courts and standards of practice have defined the concept. Both courts and experts in the field have described this element as one that is outside the frame of knowledge of many assessing mental health professionals. This session will provide a discussion of relevant authorities, and will review how the element is discussed in case law, and in relevant literature.

INTERVENTIONS FOR DEVELOPMENTALLY DELAYED ADULTS WITH SEXUAL OFFENDING BEHAVIORS: CREATING PATHWAYS FOR HEALTHY SEXUAL THINKING AND BEHAVIORS Alan Stillman, LCSW Developmentally Delayed Adults (DDA) with severe behavior issues and co-occurring disorders are being transitioned from institutions to community homes. Many of the severe behaviors include sexual inappropriateness and sexual offending resulting in legal system referrals and determinations. However, the very idea of moving toward the topic of Healthy Sexuality, DDA is fraught with obstacles; court decisions, inconsistent or non-existent sexual offending treatment designed for DDA, preconceived ideas about sexuality and DDA and their ability to change and a reluctance from the various systems (Treatment and Legal) to move toward defining options for ‘Sexual Health for DDA. This workshop will challenge some of the existing thinking and stereotypes, provide new program designs that have specific interventions for interdisciplinary teams of professionals to utilize in addressing sexual thinking and behaviors. The forensic related issues of Risk Assessments, court options for sentencing, professional testimony, working relationships among the court and treatment and consumer stakeholders will be reviewed and suggestions made for improving communication and understanding. A discussion with workshop attendees will address the topic of how defining the differences among sexually legal behaviors, offending/illegal sexual behaviors and healthy and unhealthy sexual behaviors. DDA consumers with long histories of institutionalization also experience a totally different ‘Normal Sexual Experience’ from non-Institutionalized individuals; this will be explored for the impact it has on DDA development and thinking. The presentation will augment discussions with handouts and will highlight the current research (very limited) and growing base of reference material in articles, etc. The presentation will challenge thinking about DDAs and what we can do to change our expectations which will challenge consumers in changing their expectations. This can lead to changes in the manner and content of questions ask consumers and support Person Centered Planning (PCP) at new levels. The topic of ‘Criminal Thinking’ and how it impacts DDAs in different ways will be reviewed. We have reached the time for discussions among the treatment and legal systems regarding severe behavior issues, especially sexual behaviors, and ways to intervene for positive, healthy, legal, safe outcomes for the consumer and community.

(Big Sur) CE: CPA/BBS/BRN/MCLE/POST 1.5 CE hrs

THE 5 PILLARS OF THE PSYCHOLOGICALLY HEALTHY WORKPLACE: APPLICATIONS TO CORRECTIONAL AND FORENSIC SETTINGS Parker Houston, PsyD, ABPP Melinda DiCiro, PsyD, ABPP Correctional and forensic settings pose unique challenges to leaders. This is particularly true for developing a psychologically health work place. Presented with tough missions, leaders and workers also often face direct threats to their physical safety, competing demands, restricted resources, and. When not addressed, such challenges harm morale and productivity. The American Psychological association (APA) defines a psychologically healthy workplace as one that “ (1) fosters employee health and well-being (2) while enhancing organizational performance and productivity.” For almost 20 years, Center for Organizational Excellence of the American Psychological Association (APA) has researched organizations to identify the essential building blocks of psychologically healthy workplace. In their years of study, they have distilled the 5 critical elements of a psychologically healthy workplace: Employee Health and Safety; Involvement. Work-Life Balance; Growth and Development; and Recognition. The presenters bring their experience as leaders in both types of settings and knowledge of human performance and productivity to fostering each of these pillars. This presentation will define and explore each of the 5 Pillars as they apply to these settings. The presenter will focus on concrete, actionable ways leaders can apply these elements to supercharge their organizations and foster productive and thriving employees and teams.

WORDS TO DEEDS – TRENDS AND FINDINGS IN MENTAL HEALTH AND CRIMINAL JUSTICE LINKED DATA Marcus Galeste, PhD Latonya Harris, PhD Mental Health Services Oversight and Accountability Commission [MHSOAC] staff will provide an overview of Mental Health Services Act [MHSA]-funded services and programs. Full Service Partnership [FSP] and Client and Service Information [CSI] data were linked with Department of Justice arrest data from 2006 to 2015. Preliminary findings regarding individuals arrested who have been found incompetent to stand trial will be explored and discussed. Workshop attendees will also be given the opportunity to review and provide feedback on a dashboard which summarizes the potential effects of program services on arrest rates. Future directions in analyses and implications will be explored.

2:45—3:00 pm BREAK

FEIGNED SUICIDALITY IN CORRECTIONS: A NECESSARY BUT PERILOUS DIFFERENTIAL DIAGNOSIS Joseph Obegi, PsyD Among the most challenging diagnostic assessments is differentiating genuine from feigned presentations of suicidality. Although feigning suicidality is common in correctional settings, most clinicians feel unprepared to tackle this differential diagnosis. This workshop demystifies feigned suicidality. Participants will be introduced to a theoretical model for understanding feigning, recognize common features of feigned suicidality, and learn a structured method of assessment. Finally, participants will understand how to systematically document their assessments in ways that communicate professionalism, facilitate sound decision-making, and mitigate liability threats.

BLUEPRINT FOR A SUCCESSFUL MENTAL HEALTH COURT: THE YOLO COUNTY MODEL Kristi Abbott, MSW, LCSW Chris Bulkeley, JD Allison Zuvela, JD Mental Health Courts (MHC) generally began in 1997. They came to be due to the ever increasing number of people with Serious Mental Illness (SMI) involved in the criminal justice system. As of 2009, there are more than 250 mental health courts across the country, with many additional courts in the planning phase. Mental Health Courts have evolved in the 20 plus years since they began and there is great variety in how individual MHC’s are operated. Yolo County’s Mental Health Court began in 2013 and since its inception has seen great success. Even a year after completing the program graduates have a 96% reduction in recidivism, 100% reduction in Department of State Hospital bed days, and a 67% reduction in local hospital bed days. In this presentation Mental Health Court representatives from the District Attorney’s Office, the Public Defender’s Office, and Health and Human Services Agency will discuss what they believe are the 3 keys to the program’s success: the District Attorney’s Office involvement, effective interagency collaboration, and an intense & holistic treatment approach.

INTERVENTIONS FOR DEVELOPMENTALLY DELAYED ADULTS WITH SEXUAL OFFENDING BEHAVIORS: CREATING PATHWAYS FOR HEALTHY SEXUAL THINKING AND BEHAVIORS Alan Stillman, LCSW Developmentally Delayed Adults (DDA) with severe behavior issues and co-occurring disorders are being transitioned from institutions to community homes. Many of the severe behaviors include sexual inappropriateness and sexual offending resulting in legal system referrals and determinations. However, the very idea of moving toward the topic of Healthy Sexuality, DDA is fraught with obstacles; court decisions, inconsistent or non-existent sexual offending treatment designed for DDA, preconceived ideas about sexuality and DDA and their ability to change and a reluctance from the various systems (Treatment and Legal) to move toward defining options for ‘Sexual Health for DDA. This workshop will challenge some of the existing thinking and stereotypes, provide new program designs that have specific interventions for interdisciplinary teams of professionals to utilize in addressing sexual thinking and behaviors. The forensic related issues of Risk Assessments, court options for sentencing, professional testimony, working relationships among the court and treatment and consumer stakeholders will be reviewed and suggestions made for improving communication and understanding. A discussion with workshop attendees will address the topic of how defining the differences among sexually legal behaviors, offending/illegal sexual behaviors and healthy and unhealthy sexual behaviors. DDA consumers with long histories of institutionalization also experience a totally different ‘Normal Sexual Experience’ from non-Institutionalized individuals; this will be explored for the impact it has on DDA development and thinking. The presentation will augment discussions with handouts and will highlight the current research (very limited) and growing base of reference material in articles, etc. The presentation will challenge thinking about DDAs and what we can do to change our expectations which will challenge consumers in changing their expectations. This can lead to changes in the manner and content of questions ask consumers and support Person Centered Planning (PCP) at new levels. The topic of ‘Criminal Thinking’ and how it impacts DDAs in different ways will be reviewed. We have reached the time for discussions among the treatment and legal systems regarding severe behavior issues, especially sexual behaviors, and ways to intervene for positive, healthy, legal, safe outcomes for the consumer and community.

(Big Sur) CE: CPA/BBS/BRN/MCLE/POST 1.5 CE hrs

THE 5 PILLARS OF THE PSYCHOLOGICALLY HEALTHY WORKPLACE: APPLICATIONS TO CORRECTIONAL AND FORENSIC SETTINGS Parker Houston, PsyD, ABPP Melinda DiCiro, PsyD, ABPP Correctional and forensic settings pose unique challenges to leaders. This is particularly true for developing a psychologically health work place. Presented with tough missions, leaders and workers also often face direct threats to their physical safety, competing demands, restricted resources, and. When not addressed, such challenges harm morale and productivity. The American Psychological association (APA) defines a psychologically healthy workplace as one that “ (1) fosters employee health and well-being (2) while enhancing organizational performance and productivity.” For almost 20 years, Center for Organizational Excellence of the American Psychological Association (APA) has researched organizations to identify the essential building blocks of psychologically healthy workplace. In their years of study, they have distilled the 5 critical elements of a psychologically healthy workplace: Employee Health and Safety; Involvement. Work-Life Balance; Growth and Development; and Recognition. The presenters bring their experience as leaders in both types of settings and knowledge of human performance and productivity to fostering each of these pillars. This presentation will define and explore each of the 5 Pillars as they apply to these settings. The presenter will focus on concrete, actionable ways leaders can apply these elements to supercharge their organizations and foster productive and thriving employees and teams.

WORDS TO DEEDS – TRENDS AND FINDINGS IN MENTAL HEALTH AND CRIMINAL JUSTICE LINKED DATA Marcus Galeste, PhD Latonya Harris, PhD Mental Health Services Oversight and Accountability Commission [MHSOAC] staff will provide an overview of Mental Health Services Act [MHSA]-funded services and programs. Full Service Partnership [FSP] and Client and Service Information [CSI] data were linked with Department of Justice arrest data from 2006 to 2015. Preliminary findings regarding individuals arrested who have been found incompetent to stand trial will be explored and discussed. Workshop attendees will also be given the opportunity to review and provide feedback on a dashboard which summarizes the potential effects of program services on arrest rates. Future directions in analyses and implications will be explored.

2:45—3:00 pm BREAK

FEIGNED SUICIDALITY IN CORRECTIONS: A NECESSARY BUT PERILOUS DIFFERENTIAL DIAGNOSIS Joseph Obegi, PsyD Among the most challenging diagnostic assessments is differentiating genuine from feigned presentations of suicidality. Although feigning suicidality is common in correctional settings, most clinicians feel unprepared to tackle this differential diagnosis. This workshop demystifies feigned suicidality. Participants will be introduced to a theoretical model for understanding feigning, recognize common features of feigned suicidality, and learn a structured method of assessment. Finally, participants will understand how to systematically document their assessments in ways that communicate professionalism, facilitate sound decision-making, and mitigate liability threats.

BLUEPRINT FOR A SUCCESSFUL MENTAL HEALTH COURT: THE YOLO COUNTY MODEL Kristi Abbott, MSW, LCSW Chris Bulkeley, JD Allison Zuvela, JD Mental Health Courts (MHC) generally began in 1997. They came to be due to the ever increasing number of people with Serious Mental Illness (SMI) involved in the criminal justice system. As of 2009, there are more than 250 mental health courts across the country, with many additional courts in the planning phase. Mental Health Courts have evolved in the 20 plus years since they began and there is great variety in how individual MHC’s are operated. Yolo County’s Mental Health Court began in 2013 and since its inception has seen great success. Even a year after completing the program graduates have a 96% reduction in recidivism, 100% reduction in Department of State Hospital bed days, and a 67% reduction in local hospital bed days. In this presentation Mental Health Court representatives from the District Attorney’s Office, the Public Defender’s Office, and Health and Human Services Agency will discuss what they believe are the 3 keys to the program’s success: the District Attorney’s Office involvement, effective interagency collaboration, and an intense & holistic treatment approach.

WORDS TO DEEDS - LEARNING IS A TWO-WAY STREET: OVERVIEW OF THE MEDI-CAL HEALTHIER CALIFORNIA FOR ALL INITIATIVE AND INTERACTIVE DISCUSSION WITH PARTICIPANTS TO SHARE IDEAS FOR DESIGNING AND IMPLEMENTING IMPROVEMENTS THAT WILL BENEFIT INDIVIDUALS INVOLVED IN THE CRIMINAL JUSTICE SYSTEM WHO HAVE BEHAVIORAL HEALTH NEEDS Brenda Grealish, MA The California Department of Health Care Services (DHCS) launched a bold Medi-Cal redesign initiative, called Medi-Cal Healthier California for All, aiming to create a Medi-Cal program of the future – one where people can get the care they need, when they need it, where administration and finances are streamlined, the right care is incentivized, and behavioral health care is integrated. This presentation will cover the basics: • supporting the right care in the right place through streamlined medical necessity criteria • integrating the administration and financing of specialty mental health and substance use

services – ultimately in support of integrating clinical care • considering pursuing a waiver of the Institutions for Mental Disease exclusion to support a

robust continuum of care • supporting regional models to integrate physical, behavioral and dental health • supporting Medi-Cal enrollment and behavioral health “warm-hand-offs” prior to jail release • adding new enhanced care management benefits and wrap-around services for the highest

risk individuals – including housing supports. DHCS will invite feedback from participants to help inform the direction of the Medi-Cal Healthier California for All initiative, particularly focused on the unique behavioral health needs of individuals involved with the criminal justice system.

FRIDAY, MARCH 13

9:00—10:30 am (Regency I/II/III/Main) CE: CPA/BBS/BRN/POST 1.5 CE hrs

SOCIAL JUSTICE AND MENTAL HEALTH Ruth Shim, MD, MPH The relationship between social justice and mental health is multi-faceted, complex, and has significant implications – not only for individual patients, but also for society. To understand social justice as it relates to mental health, one must consider the framework of the social determinants of mental health – the conditions into which we are born, grow, live, work, and age – as they are most responsible for the health and mental health inequities that exist in society. Certain segments of our population (especially people with serious mental illnesses) disproportionately experience striking inequities and disparities in health outcomes. Furthermore, people who have serious mental illness have an increased vulnerability to the deep-rooted inequities in major systems such as criminal justice, child welfare, and healthcare. This presentation aims to introduce forensic mental health practitioners to the concept of social justice and to the role of social injustice in perpetuating these inequities.

10:30 am—10:45 pm BREAK

10:45 am—12:15 pm (Regency I//II/III/Main) CE: CPA/BBS/BRN/POST 1.5 CE hrs

CO-OCCURRING DISORDERS AND THE OPIOID CRISIS Thomas Freese, PhD This presentation will provide current information of the current opioid crisis, including the impact of increasing availability of fentanyl. Information will be provided on how use and mortality rates in California compare to national data. Specific evidence based treatments for opioid use disorder and for opioid overdose prevention and intervention will be discussed. The presentation will then turn to a review of current strategies for addressing co-occurring disorders in patients with a substance use disorder. Data no the how health, mental health and substance use disorders are interconnected and specific ways of adapting interventions to address them simultaneously will be discussed. Finally, the presentation will end with a question and answer session. 20 21

WORDS TO DEEDS - LEARNING IS A TWO-WAY STREET: OVERVIEW OF THE MEDI-CAL HEALTHIER CALIFORNIA FOR ALL INITIATIVE AND INTERACTIVE DISCUSSION WITH PARTICIPANTS TO SHARE IDEAS FOR DESIGNING AND IMPLEMENTING IMPROVEMENTS THAT WILL BENEFIT INDIVIDUALS INVOLVED IN THE CRIMINAL JUSTICE SYSTEM WHO HAVE BEHAVIORAL HEALTH NEEDS Brenda Grealish, MA The California Department of Health Care Services (DHCS) launched a bold Medi-Cal redesign initiative, called Medi-Cal Healthier California for All, aiming to create a Medi-Cal program of the future – one where people can get the care they need, when they need it, where administration and finances are streamlined, the right care is incentivized, and behavioral health care is integrated. This presentation will cover the basics: • supporting the right care in the right place through streamlined medical necessity criteria • integrating the administration and financing of specialty mental health and substance use

services – ultimately in support of integrating clinical care • considering pursuing a waiver of the Institutions for Mental Disease exclusion to support a

robust continuum of care • supporting regional models to integrate physical, behavioral and dental health • supporting Medi-Cal enrollment and behavioral health “warm-hand-offs” prior to jail release • adding new enhanced care management benefits and wrap-around services for the highest

risk individuals – including housing supports. DHCS will invite feedback from participants to help inform the direction of the Medi-Cal Healthier California for All initiative, particularly focused on the unique behavioral health needs of individuals involved with the criminal justice system.

FRIDAY, MARCH 13

9:00—10:30 am (Regency I/II/III/Main) CE: CPA/BBS/BRN/POST 1.5 CE hrs

SOCIAL JUSTICE AND MENTAL HEALTH Ruth Shim, MD, MPH The relationship between social justice and mental health is multi-faceted, complex, and has significant implications – not only for individual patients, but also for society. To understand social justice as it relates to mental health, one must consider the framework of the social determinants of mental health – the conditions into which we are born, grow, live, work, and age – as they are most responsible for the health and mental health inequities that exist in society. Certain segments of our population (especially people with serious mental illnesses) disproportionately experience striking inequities and disparities in health outcomes. Furthermore, people who have serious mental illness have an increased vulnerability to the deep-rooted inequities in major systems such as criminal justice, child welfare, and healthcare. This presentation aims to introduce forensic mental health practitioners to the concept of social justice and to the role of social injustice in perpetuating these inequities.

10:30 am—10:45 pm BREAK

10:45 am—12:15 pm (Regency I//II/III/Main) CE: CPA/BBS/BRN/POST 1.5 CE hrs

CO-OCCURRING DISORDERS AND THE OPIOID CRISIS Thomas Freese, PhD This presentation will provide current information of the current opioid crisis, including the impact of increasing availability of fentanyl. Information will be provided on how use and mortality rates in California compare to national data. Specific evidence based treatments for opioid use disorder and for opioid overdose prevention and intervention will be discussed. The presentation will then turn to a review of current strategies for addressing co-occurring disorders in patients with a substance use disorder. Data no the how health, mental health and substance use disorders are interconnected and specific ways of adapting interventions to address them simultaneously will be discussed. Finally, the presentation will end with a question and answer session. 20 21

Since 2003, Words to Deeds has provided a unique forum that has evolved into a standard best practice for creating a true shift in the paradigm between criminal justice and mental health by fostering successful and ongoing collaboration among courts, criminal justice agencies, mental health professions, and governmental and non-governmental organizations. Mission The leaders in criminal justice and mental health participating in this effort strive to end the criminalization of individuals with mental illness by supporting proven strategies that promote early intervention, access to effective treatments, a planned reentry and the preservation of public safety. Vision A true shift in the paradigm between criminal justice and mental health will embody an effective jail diversion system that fosters a successful and ongoing exchange of information among courts, criminal justice agencies, mental health professions, government and non-government organizations, to achieve a substantial positive change in the way individuals with mental illness are treated within our communities.

THANKS TO OUR SUPPORTING PARTNERS OF WORDS TO DEEDS XIII!

THANKS TO OUR SPONSORS OF THE WORDS TO DEEDS TRACK 2020!

CONTINUING EDUCATION Find your license type below and follow the instructions to receive CE credit. It is recommended that you use the Sign In/Out form provided in your conference packet to ensure FMHAC has a record of your session attendance. Don’t forget to be signed in and out of your sessions. Please don’t ask FMHAC to sign for a session outside the meeting rooms, after a class has started, or before a class has ended. We can’t put our CE providership in jeopardy! CE - CPA/BBS/BRN - All Workshops Approved CPA OPD (Psychologists) - Provider #FOR005 BBS (MFT, LCSW) - The Board of Behavioral Sciences accepts CEs approved by the CPA. BRN (RN, NP, LVN, Psych Tech) - Provider #CEP 5965 Utilize the Sign In/Out form to record attendance. One form is provided to each attendee. Make sure to obtain FMHAC initials at each workshop you attend and ensure a member of the FMHAC Board signs the form at the end of the conference. Maintain the yellow copy. Fill out the Evaluation Survey to receive credit. The Evaluation is electronic and will be emailed to you on the final day of the conference. All sessions approved for CE certification. CE Statement: FMHAC is approved by the California Psychological Association to provide continuing professional education for psychologists. FMHAC maintains responsibility for this program and its content. MCLE - See Courses Marked MCLE CA State Bar Provider #15388 Fill out the Evaluation Survey to receive credit. The Evaluation is electronic and will be emailed to you on the final day of the conference. It is recommended that you utilize the Sign In/Out form provided in your conference packet: One form is provided to each attendee. Obtain FMHAC initials at each workshop you attend, have FMHAC sign the form at the end of the conference and maintain the yellow copy.

Selected Sessions:

POST All sessions approved for POST certification. Post approval number: 2540-28002-19003. CJER FMHAC is an approved provider through the Center for Judicial Education and Research. Education is not limited to the approved providers referred to in (a). Any education from another provider that is approved by the Chief Justice, the administrative presiding justice, or the presiding judge as meeting the criteria listed below may be applied toward the continuing education expectations and requirements for justices, judges, and subordinate judicial officers or requirements for clerks/executive officers or court executive officers. Similarly, any education from another provider that is approved by the clerk/executive officer, the court executive officer, or the employee's supervisor as meeting the criteria listed below may be applied toward the orientation or continuing education requirements for managers, supervisors, and other employees or the content-based or continuing education requirements for probate court investigators, probate attorneys, and probate examiners in rule 10.478. STC - Special Certification The FMHAC Conference does not qualify for the Pre-Certification of STCs. However, you may still be able to receive STCs if you apply for Special Certification through your STC training manager/coordinator. 24 25

• NOTE: THIS SESSION MEETS ELIMINATION OF BIAS STANDARD SOCIAL JUSTICE & HISTORICAL REPAIR: RACE, CULTURE, DIVERSITY & THE LIVES OF HEALERS IN FORENSIC MENTAL HEALTH

• THE ELUSIVE COMPETENCE TO STAND TRIAL ELEMENT: (IN)ABILITY TO ASSIST COUNSEL IN THE CONDUCT OF A DEFENSE IN A RATIONAL MANNER ELEMENT OF COMPETENCE: HOW TO CONSIDER IT; HOW TO EVALUATE IT

• INTERVENTIONS FOR DEVELOPMENTALLY DELAYED ADULTS WITH SEXUAL OFFENDING BEHAVIORS: CREATING PATHWAYS FOR HEALTHY SEXUAL THINKING AND BEHAVIORS

• THE 5 PILLARS OF THE PSYCHOLOGICALLY HEALTHY WORKPLACE: APPLICATIONS TO CORRECTIONAL AND FORENSIC SETTINGS

• THE TURNAROUND: SANTA BARBARA COUNTY’S APPROACH TO IST TREATMENT AND DIVERSION

• BLUEPRINT FOR A SUCCESSFUL MENTAL HEALTH COURT: THE YOLO COUNTY MODEL

• THE DIAGNOSIS DEBATE: ITS USE IN NGI, IST, MDO AND SVP EVALUATION – PART 1 AND PART 2

• FIELD RELIABILITY OF SVP EVALUATION