Ucation campaigns could also be developed to encourage people to donate food vouchers to panhandlers instead of money (Scott, 2002). In all such efforts, a commitment to procedural justice can be maintained. Moving our focus from “places” to “cases”, there is indeed fragmentation in police, ambulance and behavioral health data systems. This is due in part to laws governing health information privacy. Notwithstanding, the police, as well as security providers could contribute to behavioral health “surveillance”, defined as “the ongoing, systematic collection, analysis, interpretation, and R1503 web dissemination of data on health-related events for use in public health action to reduce morbidity and mortality and to improve health” (Horan Mallonee, 2003, p. 24). There’s little opportunity to share health data with police, with some exceptions related to crisis situations and missing persons (Petrila Fader-Towe, 2010), but police data (as well as ambulance data) could help fill out the behavioral health picture on repeat utilization among the dually labeled. For instance, some “low level” recidivists for the police might also be caught up in a cycle of civil commitment, without underlying substanceNIH-PA Author Manuscript NIH-PA Author Manuscript NIH-PA Author ManuscriptInt J Law Psychiatry. Author manuscript; available in PMC 2015 September 01.Wood and BeierschmittPageuse issues being addressed. Systemic data such as this could inform targeted case management efforts that provide intensive follow-up care, including the monitoring of medication adherence (see again related efforts in Victoria, Australia, Victorian Department of Health, 2010). If a mobile unit, what one might term a Mobile Assessment and Resource Center (MARC) could be established in different hotspots, it would provide for another data point in a better coordinated system. A MARC could serve as an upstream triage mechanism centered on screening and assessing for multiple needs, and channeling people into treatment and support, with appropriate follow-up mechanisms. Similar to the Hub of Hope, a MARC could be staffed by those with expertise in physical and behavioral health as well as housing support. This staff could link (either physically or virtually) to a criminal justice representative who could help remove unnecessary legal blockages ?such as bench warrants for minor criminal behavior ?that might otherwise get in the way of a successful recovery. A MARC could thus fill a void in the continuum of intervention consistent with a recovery philosophy. It could provide an attractive means of persuading people to access help, while promoting procedural justice and autonomy. MARCs could function as a form of what Thaler and Sustein (2008) describe as “choice architecture” ?a physical (but mobile) location offering behavioral health interventions that “preserve freedom of choice while also nudging people in directions that will improve their lives” (Ibid.,, p. 252). Currently, informal efforts on the part of the police, security and others to help vulnerable people are not formally recorded because they don’t constitute “official” activity. Referrals to a MARC however, could easily be captured because they would be voluntary in nature, and there would be a “handoff” to a behavioral health intake person. Within a MARC, a clinician or other agent with authority to access personal health information could access the larger case history of an individual’s recovery BUdR site process and refer th.Ucation campaigns could also be developed to encourage people to donate food vouchers to panhandlers instead of money (Scott, 2002). In all such efforts, a commitment to procedural justice can be maintained. Moving our focus from “places” to “cases”, there is indeed fragmentation in police, ambulance and behavioral health data systems. This is due in part to laws governing health information privacy. Notwithstanding, the police, as well as security providers could contribute to behavioral health “surveillance”, defined as “the ongoing, systematic collection, analysis, interpretation, and dissemination of data on health-related events for use in public health action to reduce morbidity and mortality and to improve health” (Horan Mallonee, 2003, p. 24). There’s little opportunity to share health data with police, with some exceptions related to crisis situations and missing persons (Petrila Fader-Towe, 2010), but police data (as well as ambulance data) could help fill out the behavioral health picture on repeat utilization among the dually labeled. For instance, some “low level” recidivists for the police might also be caught up in a cycle of civil commitment, without underlying substanceNIH-PA Author Manuscript NIH-PA Author Manuscript NIH-PA Author ManuscriptInt J Law Psychiatry. Author manuscript; available in PMC 2015 September 01.Wood and BeierschmittPageuse issues being addressed. Systemic data such as this could inform targeted case management efforts that provide intensive follow-up care, including the monitoring of medication adherence (see again related efforts in Victoria, Australia, Victorian Department of Health, 2010). If a mobile unit, what one might term a Mobile Assessment and Resource Center (MARC) could be established in different hotspots, it would provide for another data point in a better coordinated system. A MARC could serve as an upstream triage mechanism centered on screening and assessing for multiple needs, and channeling people into treatment and support, with appropriate follow-up mechanisms. Similar to the Hub of Hope, a MARC could be staffed by those with expertise in physical and behavioral health as well as housing support. This staff could link (either physically or virtually) to a criminal justice representative who could help remove unnecessary legal blockages ?such as bench warrants for minor criminal behavior ?that might otherwise get in the way of a successful recovery. A MARC could thus fill a void in the continuum of intervention consistent with a recovery philosophy. It could provide an attractive means of persuading people to access help, while promoting procedural justice and autonomy. MARCs could function as a form of what Thaler and Sustein (2008) describe as “choice architecture” ?a physical (but mobile) location offering behavioral health interventions that “preserve freedom of choice while also nudging people in directions that will improve their lives” (Ibid.,, p. 252). Currently, informal efforts on the part of the police, security and others to help vulnerable people are not formally recorded because they don’t constitute “official” activity. Referrals to a MARC however, could easily be captured because they would be voluntary in nature, and there would be a “handoff” to a behavioral health intake person. Within a MARC, a clinician or other agent with authority to access personal health information could access the larger case history of an individual’s recovery process and refer th.
