Issue Brief

Frequent Jail Users Frequent Utilizers Human Toll of Jail Jail Populations Mental Health July 25, 2023

Recommendations To Reduce Frequent Jail Contact

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:

  1. A systemwide examination of structural barriers and opportunities,
  2. A focus on policies to effectively implement and support evidence-based interventions, and
  3. A re-envisioning of how the behavioral health and criminal legal systems can coordinate trauma-informed responses for people with frequent jail contact.


1 Elsa Augustine and Evan White, High Utilizers of Multiple Systems in Sonoma County 1-31 (2020), uploads/2020/07/High-Utilizers-of-Multiple-Systems-in-Sonoma-County.pdf.

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),

Additional Downloads

Why Law Enforcement Should Be Doing More Deflection as A Primary Response

By: Shannon Magnuson, Amy Dezember

Diversion Frequent Utilizers Interagency Collaboration August 17, 2022

New research by Justice System Partners supported by the MacArthur Foundation’s Safety and Justice Challenge (SJC) shows the positive impacts of police-led deflection strategies on jail reduction efforts. Overall, “deflection first, arrest rare” as a primary policy for eligible offenses helps reduce criminal legal system involvement and improve equity by connecting individuals to the services they need. It no longer makes access to treatment conditional or contingent on arrest.

Download the report here. 

Deflection is different from diversion. Diversion programs make use of pending criminal charges as the mechanism to elicit treatment initiation and compliance from people living with severe mental health disorders and substance use disorders. Although diversion programs do not always include a formal booking to jail, the person does technically enter the legal system’s front door. In contrast, deflection programs entail no criminal legal system involvement beyond the interaction with the police officer in the field. There is no mechanism to coerce treatment initiation or compliance beyond an individual’s own wishes to enter a program. If an individual ultimately decides not to participate in the program they are referred to, there are no legal consequences. Police-led deflection programs also provide police agencies an opportunity to return to the streets and answer calls from 911 more quickly because transporting individuals to community services can take substantially less time than booking an individual in jail. Combined, police-led deflection can make police agencies more efficient while eliminating the collateral consequences of the legal system on individuals.

Police-led deflection allows officers to use discretion to replace arrest with outreach to community-based service providers for select offenses. It transforms police contact into opportunities to broker community resources, especially for individuals with severe mental health disorders and substance use disorders. It is key that we understand how deflection programs work in practice if we are going to improve and expand these programs, reduce jail populations, and improve equity and access to care by connecting people to the help they need.

The goal of the research was to understand how deflection works in Pima County, AZ, and in Charleston County, SC—two SJC sites. We sought to understand how police make decisions about who to deflect and how deflection to a local crisis center impacts people’s subsequent experience. In 2011, Pima County built the Crisis Response Center (CRC) with county bond funds. It is part of the Banner-University of Arizona Medical Center South Campus. The CRC is a short-term inpatient unit with a maximum length of stay of five days and has a “no wrong door” policy – which means they accept nearly everyone, except individuals who require hospitalization, from any law enforcement agency in the county. Similarly, Charleston County runs the Tri-County Crisis Stabilization Center (TCSC) which is a ten-bed voluntary adult crisis center embedded within the Charleston Drug and Alcohol Center where individuals can stay up to 14 days. Both counties’ crisis centers provide immediate treatment options and psychiatric care for individuals.

In Pima County, when people receive at least two voluntary deflections to the local crisis center, they are more likely to continue agreeing to subsequent deflections and, each time they return to the crisis center, they stay longer. In Charleston County, two-thirds of individuals deflected to the local crisis center had a previous case with the county’s mental health department, showing that both police and service providers are often interacting with the same people. These findings suggest that police-led deflection can help connect or re-connect individuals with treatment while reducing the number of individuals who are brought to jail—effectively creating a parallel treatment open door. Importantly, these repeat access points to treatment reflect research that suggests people need multiple opportunities to access treatment services before agreeing and engaging with the program. In this way, police-led deflection, particularly for individuals who have disproportionate police contact, can transform pathways to jail into pathways to the help they need for individuals historically excluded from access.

A parallel treatment open door does not mean failure to initiate or complete treatment. The treatment open door acknowledges the complexity and nuance of treatment and reflects the research about the need for multiple opportunities to remain engaged. When police policy allows multiple deflections of the same individuals, as in Pima and Charleston Counties, it means every interaction with individuals is another opportunity to engage them in treatment while eliminating the collateral consequences of the legal system and jail for these vulnerable populations.

In both counties, if the offense is eligible, the policy allows police to offer deflection to an individual regardless of how many times they offered deflection to the individual in the past. This means that while the policy itself reflects the research on multiple opportunities to engage in treatment, police in practice have the ultimate decision-making authority to deflect or arrest. As a result, police hold a lot of decision-making power for triaging people out of the legal system revolving door, and into a treatment system revolving door. As we continue to unpack how officers make decisions about who to deflect and under what conditions, it is important to consider the intersection of race, gender, and disability and how that impacts officer decision-making about who is “worthy” of deflection.

Officers in Pima County reported people’s willingness to start treatment as the most critical factor when deciding to deflect to a community-based resource. When people did not want to initiate treatment, officers tended to rely on arrest, even when they knew that jail would not help the individual. But the ability to deflect for certain eligible offenses means that the police have determined that no arrest is an acceptable response. This tension demands a critical examination: If people do not wish to go into treatment, are there other ways officers can diffuse and handle the situation without relying on arrest?

Officers in Charleston County cited victims’ wishes—including those of business owners—as the most critical factor when deciding whether or not to begin the process of deflection. For example, when victims remain at the scene and want police to arrest the individual, even when the offense is deflection-eligible and the officer recognizes jail is not helpful, police expressed feeling inclined to defer to the victim and make the arrest, anyway. This means victims are, in part, driving who is offered deflection and potentially contributing to disparate deflections. As such, we must critically examine the role of victims in the deflection initiation process and consider how victims’ own perceptions of justice and implicit bias can temper the positive impact of police-led deflection programs.

“Deflection first, arrest rare” as both policy and principle connects vulnerable individuals, who are historically excluded from the services they need, with easy access to treatment. It also lessens opportunities for implicit bias, determinations of “worthiness,” and non-clinical judgments about readiness for change to impact the decision to deflect. When agencies distance themselves from jail and deflect as the primary response, and do so for everyone, they no longer make access to treatment conditional or contingent.

Palm Beach County, FL

Change in Jail Population 19%

Action Areas Community Engagement Courts Defense Counsel Frequent Utilizers Racial Disparities

Last Updated


While Palm Beach County’s jail has not been overcrowded, too many individuals with low-level offenses who pose minimal risk to public safety are incarcerated. In addition, significant racial and ethnic disparities persist in the jail population. Specifically, jail admissions and length of stay are both disproportionate for people of color.

Palm Beach County’s jail is the biggest mental health care provider in the county. People with behavioral health issues, many of whom are homeless, regularly cycle in and out of the jail with no clear path for ending that cycle.


Palm Beach County has advanced a number of strategies to rethink and redesign its criminal justice system so that it is more fair, just, and equitable for all.



To reduce failures to appear in court and at mandatory appointments for individuals on pretrial supervision and probation, the county started a program to send text message reminders to defendants for court dates and required appointments.



The Public Defender’s Office established new positions including a client navigator and social services coordinator, who are responsible for identifying individuals with behavioral health or housing needs at first appearance and connecting them with community-based services to facilitate pretrial success and reduce recidivism.



Palm Beach County has been engaging the local community with a series of policing forums and “Dialogue To Change” meetings. Specific policy proposals stemming from these community forums will be presented to stakeholders for consideration and implementation.



In an effort to meaningfully reduce racial and ethnic disparities in its justice system, the county sought to infuse all its strategies with a racial equity lens. This started with establishing a Racial Equity Team, which is responsible for identifying areas of disparity and generating strategies to combat inequities.



The PalmFUSE (Frequent Users Systems Engagement) project was a pilot program to provide housing and case management for unhoused individuals with behavioral health issues who were frequently arrested and cycled in and out of the jail. The program is being expanded in 2021.



The county has worked to increase efficiencies in case processing by bringing individuals who are incarcerated while awaiting trial into court sooner for hearings. The goal was to resolve cases more quickly and reduce unnecessarily long stays in the jail.



The county collaborated with the local Clerk and Palm Beach County Sheriff to gain more robust and efficient access to court and jail data. Enhanced data will allow the county to better address challenges in its justice system. A public-facing criminal justice data dashboard is in development.


As a result of the above strategies, Palm Beach County has made progress towards its goal of rethinking and redesigning its criminal justice system.

Quartery ADP for Palm Beach County (2016-2024)

18.8% from baseline

More Results

Since joining the Safety and Justice Challenge, the jail population in Palm Beach County has been significantly reduced while keeping the community safe.

The county’s PalmFUSE program has demonstrated that housing frequent utilizers and providing them with wraparound services creates stability and ensures that people with behavioral health issues do not cycle in and out of jail. Launched as a pilot, the initial PalmFUSE project provided housing and case management for 12 unhoused individuals with behavioral health issues who were frequently arrested and cycled in and out of jail. Before the program, the 12 participants had been arrested 64 times collectively in the two years before they were housed. The pilot was completed in 2020. All participants have remained in housing, and no one has been rearrested since joining the program. A new contract has been signed to expand the program to 25 participants in 2021.

The county’s text message court date reminder system has successfully reduced the number of warrants issued for failure to appear by 62% for Public Defender clients, as of December 2020.

Initial Case Conference (ICC) hearings are designed to decrease the average length of stay for incarcerated individuals charged with second- and third-degree felonies. COVID-19 has unfortunately affected the program by increasing length of stay. Further research is being conducted to measure the program’s impact as court schedules return to normal.

There is productive collaboration among key stakeholders, including judges, prosecutors, law enforcement, public defenders, and community members, which has contributed to the progress to achieve a more fair and equitable use of jails.

Remaining Challenges

Palm Beach County is focused on addressing its remaining challenges in its local justice system.

The major challenge the county faces is significantly reducing racial and ethnic disparities in the justice system. The county is doubling down on the work to address disparities moving forward.

A second challenge is to examine changes the county has made in response to the COVID-19 pandemic to determine if they are effective and should be continued after the pandemic has subsided. These changes include amending the administrative bond schedule and scheduling bond hearings more quickly.

Lead Agency

Criminal Justice Commission

Contact Information

Katherine Shover


Judges of the Fifteenth Judicial Circuit, State Attorney, Public Defender, Palm Beach County Sheriff’s Office, Multiple municipal police departments, Felony and misdemeanor probation departments, Pretrial Services, Clerk and Comptroller, Community Partners of Southeast Florida, Local hospitals, The Lord’s Place, Gulfstream Goodwill, Healthier Neighbors

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