My Job as an Embedded Social Worker

by Mikki Morrissette

10/14/2021

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Jessica Angeles, Hennepin County embedded social worker

In 2015, Hennepin County personnel re-raised the alarm on the numbers of people in jail that incarceration did not properly serve. Each year the Minneapolis Police Department was responding to more than 6,000 calls involving people experiencing a mental health crisis; 100 people a day were being booked into jail, often suffering from untreated mental health substance use issues. There were many repeat calls to the same people in crisis — 75 percent had previous bookings.

As a five-year joint report of city and county attorneys, police officers, and public defenders, and Health and Human Services personnel described it in a 2020 report: “Together, we realized that there was a lack of coordination, ineffective policies, and outdated service models that failed to address urgent underlying needs. Our environmental scan revealed that services were fragmented and focused on people who already were in the criminal justice system. We knew we needed to do more on the front end, to try to divert people from jail.”

They developed a Sequential Intercept Model to understand interactions between criminal justice and mental health systems, identify how to make a difference, and pinpoint strategies to improve safety and well-being. In the first year, the report says, there was a 48 percent reduction in rebooking people into the criminal justice system, and a 61 percent reduction in emergency room visits.

Hennepin County is one of six national sites for a Transition From Jail to Community project. As Cynthia Arkema-O’Harra, program manager for the Hennepin County Adult Behavioral Health program, said in the five-year report: “I want to see continued growth. We have a lot of great resources for citizens to get connected to resources other than going to jail or sitting in the emergency department because police don’t know what else to do.”

Program Highlights

A co-responder pilot was launched in 2017. Together, a patrol officer and a mental health professional responded to 911 emergency disturbed person (EDP) mental health calls. The co-responder unit followed up with the resident to help them stabilize and connect with supports in the community.
A mental health crisis residential program at 1800 Chicago in downtown Minneapolis was opened in 2018, receiving $10 million in state and federal funding for a triage and assessment clinic. This 103,000-square-foot facility is staffed by community paramedics, health care providers, social workers, peer recovery specialists, and case management assistants. During the pilot phase, about 500 people visited the clinic and received more than 800 referrals for community-based services. After two years, data showed that about 94 percent of people were discharged to living spaces less restrictive than prison, and 87 percent experienced fewer crisis symptoms and improved stability.
In 2019, the embedded social worker system started. By 2020, the one-year pilot program with embedded social workers had led to mental health support for 80 percent of the people referred and 15 percent were connected to substance use treatment.
Additionally, $750,000 was granted from the county board to support two residential treatment programs. An opioid-related grant was given to offer treatment to people in jail. A 50-bed detoxification program was converted into a 64-bed withdrawal management program, with medication-assisted treatment, peer recovery, and care, operated by American Indian Community Development Corporation.
In 2020, with reduced capacity due to the pandemic, this program had 5,400 admissions.

Currently, the Hennepin County team is working to identify policy reform that will enable better early identification of issues that can be better remedied by treatment resources than the criminal system. Clinical social workers, alongside public defenders, assess needs, make referral recommendations, help navigate the behavioral care system, complete clinical evaluations, determine treatment plans and funding options, and monitor progress. Licensed alcohol and drug counselors provide assessments and referrals, coordinate care, and offer short-term case management.

With the upcoming local elections focused on where voters land on public safety needs — the $180-million, 600-plus-person Minneapolis police department being a central piece of the conversation — we are focused on providing information about what solutions are getting committed, long-term resources. There has been a history — as we see in our Minnesota Women’s Press archives — of short-term investments in healing justice solutions.