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Global Health Action: Connecting health inequity to criminal justice policy and change for families

Introduction to Global Health Action

In 1972, Dr. Ada Fort and Miss Virginia Proctor, two administrators at Emory University’s Woodruff School of Nursing, recruited and inspired a group of leaders from Atlanta’s health, religious, business, and education communities, to establish Global Health Action’s precursor, the International Nursing Services Association (INSA). Founded to help foster healthier communities around the world, INSA initially focused on health education and management training for nurses from developing countries. The idea was to not only improve the participants’ technical skills but, more importantly, to build their administrative and leadership skills enabling them to return to their home countries and multiply their impact within the communities they served. In 1993, the organization’s name was changed to Global Health Action (GHA) to better reflect the organization’s broader purpose and global outreach. Today, GHA builds on this history by linking evidence to policy and practice, expanding the knowledge and effectiveness of in-country health leadership, and by promoting community-driven solutions for addressing barriers to health, both locally and globally.

GHA’s programs invest in affected communities with education, resources, and tools for mobilization and sustainable community-led solutions. GHA’s work consists of working alongside communities to identify and address the deeply rooted barriers to health for all. GHA currently is working in the US, the Caribbean, SubSaharan Africa, and Asia.

Background 7% of Georgia’s general population have a serious mental illness compared to the population of Georgia’s Correctional Institutions which reports 17% of its population having a serious mental illness. Georgia moved its Pardons and Parole, which had been a separate state department, to fall within the Department of Corrections [and renamed it the Department of Community Supervision (DCS)]. Individual counties are adjusting their budgets and personnel to maintain the unique Community Coordinator positions, which are responsible for fostering maximum service provider coordination for returning citizens.

According to Mental Health America of Georgia, Georgia’s overall mental health system ranks 34th in the US, and 6 of 10 young persons with clinical depression do not receive treatment. Most of Georgia’s Criminal Justice/Corrections improvements have focused on post-arrest with the exception of Fulton County which has a pilot pre-arrest program. For a jurisdiction to re-orient to a pre-arrest focus, there must be an adequate and integrated behavioral health, physical health and social services infrastructure. Georgia is currently lacking this. The current professional, institutional and general citizenry cultures are not reoriented to a bifurcated focus on restorative justice in the pre- and post-arrest arenas.

Solution GHA, National Incarceration Association, Mental Health Alliance, Legal Action Center, Southern Center for Human Rights, Georgia Chapter of the National Alliance on Mental Illness, and Golden Memorial United Methodist Church partnered to conduct the No Health=No Justice series of community conversations (in Atlanta, Douglasville and Macon). The Georgia No Health=No Justice campaign is focused on helping state and local jurisdictions to prioritize health and mental health care as the primary response to decrease incarceration and recidivism in Georgia. As a follow up to the GHA co-sponsored Families Impacted by Incarceration event in April of 2018, and in alignment with the goal to conduct a Health Impact Assessment, GHA and lead partner National Incarceration Association saw this campaign as a strategic opportunity to combine and extend efforts to begin to collect data and generate community level conversations on the impacts of incarceration on families. The Legal Action Center’s No Health = No Justice Campaign, a multi state advocacy and organizing campaign to ground decarceration efforts in ensuring that people are no longer prosecuted and criminalized for their health needs, but are instead provided with real access to care. The campaign highlights the intersection of historic and ongoing racism in the health care and criminal justice systems, directly linking health inequities to the over-criminalization and disproportionate incarceration of Black and Latinx individuals. Together, these forms of discrimination continue to make life difficult and disempowering for many people of color and profoundly affect their communities. Justice means making sure people and communities are no longer criminalized for health-related conditions.

Impact The partnership collectively facilitated local audiences of impacted individuals and their families, local organizations providing best practices, service providers (such as Grady Health, River-Edge, Douglas Community Service Board – all of whom are state or county contractors), and government agencies, including Department of Community Supervision, law enforcement, judges, district attorneys and public defenders, along with other community stakeholders. These intimate, highly interactive conversations allowed for honest open dialogue about what is working and where the gaps are in Georgia communities.

In all three Georgia counties (Fulton, Bibb, and Douglas), stakeholder participants committed to working together to address the “silos problem” and identified a list of other solutions to improve health and justice in the community. These community-generated suggestions include:

  1. Increase and expand training on de-escalation tactics and other mental health crises management for all first responders (law enforcement and emergency personnel) and community supervision officers

  2. Create community wellness and safety centers to provide health and behavioral/mental health crisis management services, so law enforcement can escort individuals with immanent needs to appropriate services (diagnostic, treatment) instead of arresting them or burdening hospitals

  3. Increase and improve public transportation systems so more people can get to work and to treatment

  4. Provide more mental health crisis management training to family members

  5. Increase public service announcements (PSAs) to publicize the availability of publicly funded behavioral health services in the community, and to counter stigma/negative public perceptions of behavioral health challenges

  6. Fund incentives for persons to become educated in psychiatry in Georgia Colleges and Universities and then remain in Georgia, and to increase training for certification for more peer support specialists and health navigators

  7. Increase funding for Community Service Boards to provide prevention and pre-arrest services

  8. Increase access to affordable housing for families of incarcerated individuals and for formerly incarcerated people and their families

  9. Create strong practitioner coalitions to advocate for these policy changes at the state level

Get Involved!

In this time of unprecedented need, we ask that you join us at GHA to effect and sustain positive change in communities at home and around the world!!

GHA is a member of the Georgia Global Health Alliance.

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