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intake process and how it worked out positively. When a hospital case manager asked him why he didn’t take his medication, “my son said, of all the psychiatrists he’s had, they’ve only bothered to learn his name and his symptoms.” Earley praised the Fairfax County, Va. police officer who had crisis intervention training and, when he picked up Earley’s son walking naked down the street, exercised his discretion, did not handcuff him and drove him to the hos- pital while keeping him calm. Earley chronicled the process in his 2007 book Crazy. Ray Lay, both a mental health counselor and a patient with dual mental and substance abuse disorders, cautioned attendees to be patient expecting people with mental illness to adjust to medication. “It doesn’t take a matter of days,” he said. “It took me


three years to figure out what worked for me.” Cornyn cautioned against forcing a top-down approach


to reforming judicial processes. “It’s impossible, in my opinion, to try to initiate ideas on the national level and say we’ll do this for all 320 million Americans,” he said. “We can take successful levels at the local level and scale them up at the national level.” For that matter, though many urban counties partici- pated, the Stepping Up Summit also made room for rural counties to discuss how they approach the problem of re- ducing the occurrence of mental illness in jails despite lower population density. Pennsylvania Secretary of Corrections John Wetzel, who


worked as a correctional officer in Franklin and Berks coun- ties, said counties had to have clear plans for where offend-


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ers would go each step of the way, and make it clear who will benefit. “If what you’re doing, I can’t draw a line to how it’s going to benefit me, I’m not inclined to invest,” he said. Council of State Governments (CSG) Justice Center Di-


rector Michael Tompson sketched the future of the Step- ping Up initiative, which may include providing technical assistance to counties that demonstrate potential for reduc- ing the number of people with mental illness in their jails and designing and implementing state and local collabora- tions in selected jurisdictions.


CSG is considering holding an annual national summit of county teams and a diverse group of stakeholders to ad- vance comprehensive plans for system change and highlight promising practices and help counties track their progress. During the summit, the American Psychiatric Associa- tion presented the inaugural American Psychiatric Excel- lence (APEX) Awards to House Minority Leader Nancy Pelosi (D-Calif.), Sen. Al Franken (D-Minn.), Florida Sen. Miguel Díaz de la Portilla (R-Miami-Dade County), jour- nalist Cokie Roberts and the television show Orange Is the New Black. “Te APEX event was a tremendous success,” said APA


President Renée Binder, M.D. “Te compelling conver- sation between political commentator and emcee Cokie Roberts and the cast members of Orange Is Te New Black raised awareness of the issue of the criminalization of people with mental illness. I truly believe those in attendance left with a better understanding of the problem and a willing- ness to go back to their home states and take action.”


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