Together with neighboring Sarpy County and Region 6 Behavioral Healthcare, Douglas County is part of a Criminal Justice-Mental Health Information Sharing Initiative to build data-driven strategies to reduce the number of people with mental illness in their local jails. Douglas County has been recognized as a Stepping Up Innovator County due to its robust implementation of validated jail screening for behavioral health, brain injury, and trauma, as well as data utilization and sharing. They have also built ongoing cross-system collaboration through a Familiar Faces Project, meeting the needs of individuals with serious mental illness and frequent jail contact. Through the IMPACT Network, Douglas County focuses on initial detention and court hearings, implementing the Public Safety Assessment (PSA) and a pretrial release program targeted to specific populations with frequent contact and mental health needs. They also plan to partner with Sarpy County to develop a crisis stabilization program, providing a more robust continuum of diversion options.
Lead Agency
Douglas County Department of Corrections
Contact Information
Justine Wall Rehabilitative Services Administrator, Douglas County Department of Corrections justine.wall@douglascounty-ne.gov
Partners
Douglas County Department of Corrections; Douglas County Public Defender’s Office; Region 6 Behavioral Healthcare; Douglas County Mental Health Center
Doña Ana County’s Competency Diversion Pilot Project supports individuals with frequent contact with the criminal justice system who may have competence and/or mental illness needs. Individuals meet with a forensic navigator for a warm handoff to services (e.g., housing, transportation, medications for opioid use disorder, medical, behavioral health, assisted outpatient treatment) within 72 hours. The detention center’s medication-assisted treatment (MAT) program provides induction, maintenance dosing, withdrawal management, and referral to an MAT provider upon release to the community. The county’s Reach, Intervene, Support, and Engage (RISE) program reduces reincarceration and homelessness by creating jail reentry plans and linking to community-based services.
In 2023, Doña Ana County Health and Human Services equipped cross-agency staff to provide trauma-informed response training, with support from the Substance Abuse and Mental Health Services Administration (SAMHSA).They conducted subsequent training with mental health and substance use disorder treatment providers, detention center cadets, crisis triage center personnel, and the fire department crisis response mobile unit team. Doña Ana County has also implemented several collaborative initiatives, including a taskforce to map racial and ethnic inequities and to gather data on justice-involved individuals, New Mexico’s first Certified Community Behavioral Health Clinic at Families & Youth Innovations Plus, and the LC3 Behavioral Health Collaborative of over 180 representatives across 70 cross-sector agencies, which works toward building an ideal behavioral health service system.
Lead Agency
Doña Ana County Health and Human Services
Contact Information
Monica Chavira Program Administrator, Doña Ana County Health and Human Services monicach@donaanacounty.org
Partners
Doña Ana County Health and Human Services; Families and Youth Innovations Plus (FYI+); 3rd Judicial District Court; Mesilla Valley Regional Dispatch Authority; NMSU Crimson Research; LC3 Behavioral Health Collaborative
Sarah L. Desmarais, Brandon Morrissey, Lisa Callahan, Samantha A. Zottola, Jen Elder, Kristin Lupfer, Elan C. Hope, & Richard A. Van Dorn
Although most jail admissions represent the only contact a person will have with the criminal legal system, there is a small group of people who experience more frequent jail contact and who represent a disproportionate number of both jail admissions and expenditures.1,2 People with frequent jail contact experience complex, interconnected social, economic, and behavioral health needs that may exacerbate (or be exacerbated by) their frequent jail contact. This group also experiences frequent contact with other services in the community, such as emergency rooms, homeless shelters, and treatment facilities. Strategies to implement services that meet complex needs and address structural barriers are critical to meaningfully and sustainably reduce system involvement among the population of people who experience frequent jail contact.
Effective change for people with frequent jail contact must proceed simultaneously on a systemic, policy level and on the individual services level. The population discussed in this policy brief typically has complicated behavioral and medical health needs, extensive criminal legal encounters, and significant social deficits such as poverty, isolation, and elevated risk of being unhoused. Many of their needs can be addressed with intensive, person-centered treatment in a coordinated continuum of care. The success of community-based solutions is supported by three foundational elements:
A systemwide examination of structural barriers and opportunities,
A focus on policies to effectively implement and support evidence-based interventions, and
A re-envisioning of how the behavioral health and criminal legal systems can coordinate trauma-informed responses for people with frequent jail contact.
2 Ross MacDonald, Fatos Kaba, Zachary Rosner, Allison Vise, David Weiss, Mindy Brittner, Molly Skerker, Nathaniel Dickey, and Homer Venters, The Rikers Island Hot Spotters: Defining the Needs of the Most Frequently Incarcerated, 105 American Journal of Public Health 2262–2268 (2015), https://doi.org/10.2105/AJPH.2015.302785.
Behavioral Health IMPACT: Addressing Mental Health Disparities in Local Jails
By:
Ashley Krider
Behavioral HealthIncarceration TrendsMay 23, 2023
Since 2015, Policy Research, Inc. (PRI) has partnered with MacArthur’s Safety and Justice Challenge (SJC) to reduce the number of individuals involved, or at risk of involvement with, the criminal legal system who have mental illness, substance use, and other complex needs. Studies highlight the importance of concentrating on this population as communities work to tackle the misuse and overuse of jails and create more equitable systems:
Despite overall jail population reductions in the last few years, many communities participating in the Safety and Justice Challenge have seen the proportion of individuals with mental illness increase.
As part of the Safety and Justice Challenge, PRI created the IMPACT Network to provide technical assistance to participating communities on issues related to the over-incarceration of individuals with mental illness and substance use disorders. The IMPACT Network communities engage in a peer-to-peer learning model to accelerate best and promising practices in behavioral health reform and jail diversion, with a commitment to pursuing community-driven, race-conscious solutions to reduce harm to populations overrepresented in, or disparately impacted by, the criminal legal system.
Over the past two years, these communities have participated in topical technical assistance meetings focused on behavioral health data tracking and evaluation, equity within the intersection of the criminal legal system and behavioral health, developing early diversion strategies, building a robust jail continuum of care, and other critical topics.
The communities participating in the IMPACT Network focus on a variety of strategies to decrease inappropriate incarceration of people with behavioral health needs.
Allegheny County, PA
Allegheny County’s Justice Related Services (JRS) provides assessment, treatment placement, and service coordination to court-involved individuals with mental health or co-occurring diagnoses. They are also focusing on balancing risk and needs during decision making for people with behavioral health needs, developing alternative response to certain 911 calls, and building out a broader continuum of peer supports for court-involved people.
Orange County, CA
In April 2022, the Orange County District Attorney’s Office launched their Focused Intervention Route to Services and Treatment (FIRST Point) pre-filing diversion pilot program. The pilot program connects people who have committed low-level crimes with services to address mental health and substance use issues to ensure a criminal proceeding does not inhibit future work and education opportunities.
San Juan County, NM
San Juan County has worked closely with community stakeholders and cross-agency representatives through their Sequential Intercept Mapping (SIM) process, identifying gaps in services available to individuals with behavioral health needs. As part of their post-SIM work, the county plans to identify a system for data collection that will assist stakeholders in tracking the county needs and build planning capacity toward creation of a mental health drop-in center.
In early 2023, PRI expanded the IMPACT Network by adding six additional communities: Doña Ana County, NM; Solano County, CA; Sarpy County, NE; Douglas County, NE; Issaquah, WA; and Natrona County, WY, for a total of 17 jurisdictions. This new group of counties brings to the IMPACT Network communities from the West and Midwest, including several smaller and more rural jurisdictions.
We are excited to further diversify the IMPACT Network and continue this important work toward the goals of reimagining systems, reducing the footprint of local jails, and increasing equity.
A visual representation of the IMPACT network from the SJC’s 2023 convening.
Behavioral HealthDisabilitiesPolicingRacial and Ethnic DisparitiesMay 26, 2022
Examining The Impacts Of Arrest Deflection Strategies On Jail Reduction Efforts
Shannon Magnuson, Cherrell Green, Amy Dezember, Brian Lovins—Justice System Partners
In 2015, the John D. and Catherine T. MacArthur Foundation launched the Safety and Justice Challenge (SJC), a multi-year initiative to reduce populations and racial disparities in American jails. To advance knowledge development grounded in a research agenda that explores, evaluates, and documents site-specific strategies to safely and effectively reduce jail populations and address racial and ethnic disparities, the Foundation engaged the Institute for State & Local Governance (ISLG) at the City University of New York (CUNY) to establish and oversee an SJC Research Consortium. Consortium members are nationally renowned research, policy, and academic organizations collaborating with SJC sites to build an evidence base focused on pretrial reform efforts.
Reducing jail populations and the collateral consequences of the legal system requires jurisdictions to critically examine the practices bringing these populations through the criminal legal system's front door. It requires implementing opportunities to reduce reliance on citation or arrest/booking, especially for populations with serious mental health disorders (SMHD) or substance use disorders (SUD), while also providing individuals the help and referrals they need to be well. Police-led deflection allows police officers discretion to replace arrest with outreach to community-based service providers. In an effort to learn more about how police-led deflection strategies operate, ISLG funded Justice System Partners to conduct mixed-methods studies of deflection strategies in two SJC sites.
Using administrative data from local crisis centers and interviews with police officers in Pima County, AZ and Charleston County, SC, this mixed methods study aimed to understand how deflection of individuals with SMHD/SUD operates in both sites.
Key takeaways include:
A parallel treatment revolving door to the legal system revolving door, which acknowledges the challenges of treatment initiation and engagement and provides individuals with SMHD/SUD with a "no wrong door" policy. This creates enhanced opportunities for treatment while eliminating collateral consequences of the legal system and jail for these vulnerable populations.
Deflection first, arrest rare as both policy and principle connects vulnerable individuals to the services they need. At the same time, it lessens opportunities for implicit bias and non-clinical judgements about readiness for change to impact the decision to deflect.
In summary, when police departments deflect as the primary response, they no longer make access to treatment conditional or contingent. In both Charleston and Pima counties, an individual can agree to treatment, receive a police transport to the local crisis center, and then at the door decide not to enter with no legal consequences, meaning that the individual is not arrested for refusing to initiate treatment. The findings suggest support for the implementation of deflection strategies, as well as a need for agencies to critically examine inconsistencies in policies that may result in disparate outcomes. Ultimately, the study finds that deflection strategies can be used to facilitate access to the treatment revolving door, rather than the justice system revolving door.
