By Bret Jaspers  It’s been about three months since Sophia Lewis’ son Shamond died after being arrested and taken to the Dallas County Jail. She wants answers. For now, she only has questions. Medical records say Shamond came to Parkland Hospital unresponsive. That was about thirteen hours after Dallas Police took him to the jail. He died six days after arriving at the hospital. Sophia wants to know what happened between his arrest and his arrival at the hospital. She was at the scene of the arrest. While he appeared to be having a psychotic episode, Sophia said he was otherwise physically fine. Shamond’s severe mental illness is at the heart of his story. The 24-year-old had struggled with schizophrenia for about five years, sometimes landing in law enforcement custody and other times in the care of a mental health facility. The conversation around how law enforcement responds to patients with mental illness often focuses on that first, unpredictable interaction on the street. Wayne State University professor and dean Sheryl Kubiak said there’s been an increased push for training and awareness that must go beyond the initial arrest. Kubiak researches the intersection of the criminal and legal systems and behavioral health. “We have to expand it not only to law enforcement officers on the street, but we also have to do it for law enforcement and corrections officers who are working in institutional settings,” Kubiak said. Kubiak says 20 to 25% of people in jails nationally are like Shamond Lewis — folks with serious mental illnesses like schizophrenia, bipolar disorder, and serious depression. And jailers don’t always know that that’s what’s going on. “Because of confidentiality, it may be that just the medical staff has that information,” she said. “And I think that, unfortunately, jail administrators and jail staff aren’t generally trained in understanding mental illness or mental health.” 

By Mark Link  Newspaper boxes are being stocked with boxes of naloxone, the generic version of the medication Narcan, used to reverse opioid overdose. Stocking the nasal spray version of the medication in repainted newspaper boxes, placed with permission around Michigan, is the newest initiative by Harm Reduction Michigan, a statewide healthcare nonprofit (previously named “MiWhoSoEver”) and founded in Traverse City in 2009. Sheriff’s offices in some Michigan communities have, for several years, offered free Narcan from repurposed vending machines — an initiative that began as a partnership with researchers at Wayne State University and pre-dates Harm Reduction Michigan’s use of newspaper boxes.  

A Michigan State University professor will help lead a newly established suicide prevention research center focused on reaching people in the jail system who are at risk of taking their own lives. The National Center for Health and Justice Integration for Suicide Prevention will be funded for five years with a $15 million grant from the National Institute of Mental Health. The data gathered will be used to notify administrators at three Michigan jails taking part in the studies when someone who is being held is identified as at-risk for suicide and in need of further assessments or support, said Sheryl Kubiak, dean of social work at Wayne State University and director of the Center for Behavioral Health and Justice. Kubiak, who will oversee the study, said the jails involved aren’t yet finalized. She’s hoping it presents another tool for jail staff in identifying people in crisis and addressing that. “Most of the mechanisms that jails have when people come in are self-reporting,” she said, and while staff at every jail ask people during intake if they are suicidal, there are many things that stop people from being honest about their mental state.  

Vending machines that distribute lifesaving shots of Narcan represent the latest effort to combat the wave of opioid overdose deaths plaguing the country. Across the U.S., cities are installing vending machines and locker kiosks stocked with nasal sprays that contain naloxone, a medication that can be used in emergencies for someone who has overdosed on opioids, including fentanyl. Often referred to as Narcan, the spray medication can bring someone back from the brink of death, instantly enabling them to breathe. In Michigan, Wayne State University is installing 15 machines across the state, including on its campus in Detroit. “For our program, it does not require any payment or any kind of access identification,” said Matt Costello, the program manager for the Center of Behavioral Health and Justice at Wayne State. “The payment mechanism has been shut off on all the machines that we’ve distributed. So, an individual just goes and hits B7 and the kit drops out and then they go on their way.”

By Phoebe Taylor-Vuolo  An addiction recovery center in Otsego County has introduced the first naloxone vending machine in New York. Naloxone, also known as the brand name drug Narcan, can reverse opioid overdoses. Experts hope these vending machines will improve access to the lifesaving drug. The machine was inspired by a program out of the Wayne State University Center for Behavioral Health and Justice. Matt Costello, WSU’s program manager, works with county jails and community centers to bring in naloxone vending machines. The machines are placed in visiting rooms, or in release areas, so people can access them on their way out of jail. Costello said the vending machines offer anonymity, helping to reduce the barriers that people who use drugs often face accessing naloxone. “Again, this is a population that is already dealing with a lot of challenges…many of them stigma-based, shame-based,” Costello said. He said that reducing stigma and providing anonymity are key, and that vending machines should also be placed in areas that are accessible 24 hours a day. “[It would be] nice if crises only happened from nine to five on Monday through Friday,right? We know in the real world, that just doesn’t happen. So if you have a strategically placed machine, it offers the opportunity for ease of access,” Costello said. The program in Michigan has placed 50 machines and distributed 19,000 kits of naloxone.  

By Amber Ainsworth  Free naloxone, known by the brand name Narcan, is now available from the Washtenaw County Sheriff’s Office. Naloxone is used to reverse an opioid overdose. It does not have any impact on a person who does not have opioids in their system, making it a good antidote to have in case someone may be overdosing. The Washtenaw County Sheriff’s Office partnered with the Wayne State University Center for Behavioral Health and Justice and the Michigan Department of Health and Human Services to get the vending machine.  

Vending machines distributing the opioid-overdose-reversing-drug Narcan are being installed in strategic locations in an effort to reduce the number of overdoses in Michigan and throughout the country. Wayne State University’s Center for Behavioral Health and Justice has used grant money to place 15 vending machines across the state, in places like county jails, centers that provide services for drug users, and the university’s undergraduate library. “You could administer Narcan, and if you are wrong – and the person is not overdosing – there is no harm to the individual,” said Wayne State University Center for Behavioral Health and Justice program manager Matthew Costello. Costello speaks with Paul W. Smith about the benefits the machines have for the community, and how people can assess and decide to administer Narcan. “We’re very excited about this program…we know it’s a lifesaving program…,” said Costello. Some of the people who are at most of overdosing are those coming out of jail. “Narcan is just one approach that the CBHJ has to address this issue. Part of my responsibility is to set up assistance programming inside our county jails so those people who are opioid-involved coming into the jails can either continue or begin treatment for their opioid addiction while they’re incarcerated…” 

By Georgea Kovanis The newest vending machines in Michigan aren’t dispensing pop or chips, they’re doling out Narcan, the medication that reverses opioid overdoses. Popping up at strategic locations, the machines represent the latest attempt to make Narcan more available to the public in an effort to quell the staggering number of overdoses in Michigan and across the nation. Using grant money, Wayne State University’s Center for Behavioral Health and Justice has placed 15 vending machines across the state, including the university’s undergraduate library, as well as centers that provide services for drug users. Eight of the machines are located in county jails – Monroe, Jackson, Manistee, Washtenaw, Delta, Kalamazoo, Wexford and Oakland county jails – for use by inmates who are being released after serving time or, in some cases, by jail visitors. Jails are especially important locations because research shows drug users leaving incarceration are at high risk of fatal overdoses. “The data is clear about overdose rates about people post incarceration,” said Matthew Costello, program manager at the Center for Behavioral Health and Justice. “It’s been proven time and time again in state and state and site and site. So we understand that vulnerability. To ignore that is criminal in its own right.”

By Erin Marie Miller Over 30 years ago, Dr. Sheryl Kubiak made an observation that would alter the course of her career forever and, eventually, impact the future of Michigan’s incarcerated. After developing and operating a long-term residential re-entry program for pregnant women addicted to crack cocaine in Detroit for nearly seven years, Kubiak noticed many of the women she was working with struggled with unacknowledged behavioral issues, keeping them locked in a cycle that was often difficult to break free from. “I found out then that the vast majority of people who are coming out into the community (from corrections facilities), or are involved in the criminal/legal system, have behavioral health issues that they are trying to find their way through. What happens is, a lot of times, that behavior gets misinterpreted as ‘bad behavior’ or ‘illegal behavior,' and then they get wrapped up in a system they can't get out of,” Kubiak says. Now the Dean of the Wayne State University School of Social Work, Kubiak is the founding director of the Center for Behavioral Health and Justice (CBHJ) — an initiative that provides research, evaluations, training and support to local communities, behavioral health, and law enforcement agencies, and other organizations in Michigan related to jail diversion, re-entry, crisis response and more.

A jail in southeastern Michigan has a vending machine that dispenses kits designed to reverse the effects of opioid overdoses. Naloxone nasal rescue kits are available free of charge to inmates being discharged from the Oakland County Jail in Pontiac. As part of the release process, deputies advise discharged inmates they can take the kits for personal use or for a family member who may be dependent on opioids. The narcan project is through Wayne State University’s School of Social Work and its Center for Behavioral Health and Justice.