Treatment in Lieu of Jail: Diversion Succeeds

Decreasing the number of individuals with mental illness in the criminal justice system remains a public mental health priority – one that has even reached the U.S. Supreme Court. Diverting individuals with mental illness from jail or prison decreases their exposure to that traumatic environment and addresses security concerns of corrections professionals charged with their care and management. When diversion is coupled with the court-based, problem-solving approach of monitored care and treatment in the community, public safety is improved and the clinical success of the individual is enhanced. When treatment in the community includes an explicit focus on criminogenic factors, the ability to meet public safety goals are enhanced even further. Given these several goals, as well as the considerable variability from jurisdiction to jurisdiction in court resources, treatment resources, social supports, political philosophies, and fiscal realities, the types of diversion that will work for one community may not work for another. However, the overwhelming majority of the data is clear that diversion can be implemented with documented success in the domains described above, and that there are a number of beneficial models for client intercept and associated programming. This chapter reviews the major models used to divert those with serious mental illness from incarceration, paying attention to some of the legal and clinical issues that arise as a result of diversion initiatives. Brief overviews of those interventions, including drug and mental health courts, jail diversion programs, and alternatives to incarceration for the mentally ill, are presented.

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Principles and practices of risk assessment in mental health jail diversion programs

CNS Spectrums ◽

10.1017/s1092852919001652 ◽

2019 ◽

Vol 25 (5) ◽

pp. 593-603

Author(s):

Sarah L. Desmarais ◽

Evan M. Lowder

Keyword(s):

Mental Health ◽

Risk Assessment ◽

Criminal Justice ◽

Public Safety ◽

The Body ◽

Assessment Tools ◽

Diversion Programs ◽

Jail Diversion ◽

Risk Assessment Tools ◽

The Impact

Eligibility criteria for participation in mental health jail diversion programs often specify that, to be diverted, a candidate must not pose a level of threat to public safety that cannot be managed in the community. Risk assessment tools were developed to increase consistency and accuracy in estimates of threat to public safety. Consequently, risk assessment tools are being used in many jurisdictions to inform decisions regarding an individual’s appropriateness and eligibility for mental health jail diversion and the strategies that may be successful in mitigating risk in this context. However, their use is not without controversy. Questions have been raised regarding the validity and equity of their estimates, as well as the impact of their use on criminal justice outcomes. The purpose of this review is to provide an overview of the science and practice of risk assessment to inform decisions and case planning in the context of mental health jail diversion programs. Our specific aims include: (1) to describe the process and components of risk assessment, including differentiating between different approaches to risk assessment, and (2) to consider the use of risk assessment tools in mental health jail diversion programs. We anchor this review in relevant theory and extant research, noting current controversies or debates and areas for future research. Overall, there is strong theoretical justification and empirical evidence from other criminal justice contexts; however, the body of research on the use of risk assessment tools in mental health jail diversion programs, although promising, is relatively nascent.

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