Jail diversion programs are prebooking or postbooking interventions aimed at decreasing the involvement of persons with serious mental illness (SMI) or co-occurring substance use disorders (COD) in the criminal justice system and channeling them into community-based treatment and other services. They are considered a diversion from typical criminal justice prosecution and sentencing and into community-based programs that can better meet the needs of offenders with complex behavioral health needs. Diversion may occur early in the justice processing, such as at arrest, or later by diverting an individual convicted of a crime from a jail or prison term and into a community program. This article provides an overview of the development and expansion of jail diversion, examines the opportunities, or intercepts, for diversion, then explores research findings on the effectiveness of this practice.
Development of Diversion
Jail diversion programs arose from the recognition that typical criminal justice processing of persons with SMI or COD was unsuccessful in slowing the revolving door of offending, arrest, incarceration, release, and reoffending. Moreover, it was recognized that it led to avoidable costs for unnecessary jail days. Jail diversion programs were developed to address these challenges. Justice-involved individuals with SMI and COD require significant services and supervision whether they are incarcerated or living in the community. Annually, over 2 million people, approximately 15% of men and 31% of women, entering U.S. jails have an SMI, between 50% and 100% of this group has a COD, and nearly all have significant trauma histories. Most jails are not equipped to provide intensive, individualized treatment for this population whose treatment needs include mental health, substance use, trauma, and more general habilitation such as housing and employment. While some jails in large metropolitan areas have extensive mental health services, most jail detainees are in small, local jails that do not have the staff or resources to provide appropriate evidence-based treatment. Jail diversion programs partner with community providers who are able to meet the significant treatment needs, while at the same time providing a reduction in criminal recidivism.
Expansion of Jail Diversion
The U.S. federal government has invested resources into jail diversion programs through the Department of Justice’s Justice and Mental Health Collaboration Project. The Substance Abuse and Mental Health Services Administration promoted diversion through Targeted Expansion Jail Diversion, Jail Diversion Trauma Recovery, Early Diversion, Adult Treatment Court Collaborative, and the Behavioral Health Treatment Court Collaborative grant programs. These federal initiatives gave communities the funding to pilot programs to target the expansion of jail behavioral health services, develop treatment courts, and establish reentry programs. Once communities established their new programs and were able to use evaluation data to confirm their success, they had leverage to obtain financial and political support to continue beyond the life of the federal funding.
Opportunities for Diversion
There are many points in traditional criminal justice processing where diversion opportunities occur. The Sequential Intercept Map provides a model for communities to target interventions to reduce the dual burden of difficult, resource-intensive detainees as well as the unnecessary justice involvement for this population. By examining where in the justice system there are evidence-based resources and significant gaps, communities can develop and implement successful jail diversion programs for people with SMI and COD. At each intercept, services must be available in the community for diversion to occur. Just as important, professionals working in the justice, treatment, and public health systems must know what programs exist and collaborate across the systems.
Intercept 1 is law enforcement and other first responders. Whether it is a result of proactive policing or in response to a call from the community, police and emergency services professionals can divert someone from the justice system into a community alternative in lieu of arrest. The purpose of these diversion programs is to disrupt deeper justice system penetration, protect the public, and funnel people into treatment. An example of an Intercept 1 diversion program is the police Crisis Intervention Team (CIT), which provides police with tools to identify persons in need of mental health or substance use treatment, deescalate often tense situations, and transport individuals to a safe treatment alternative rather than arrest them and take them to jail. For CIT to work in a community, police must work with other emergency services professionals, including dispatch and EMTs, and with the community-based behavioral health service providers. Police must have an alternative available to them other than transporting an individual to the jail or simply releasing him or her.
Intercept 2 is the initial detention and hearing that follows an arrest but before a plea has been entered. Diversion programs at this intercept require considerable coordination across the justice system, including the jail staff, prosecutor, defense counsel, pretrial services, probation, and the courts. When a person with SMI or COD is booked into the jail, there is an opportunity to screen for mental health, substance use, trauma, and suicide risk. While the individual has been arrested and booked, a diversion intervention at this point is available in some communities. For example, specialized intensive probation is a type of diversion in which probation officers have specialized training in mental health and/or substance use disorders and a reduced caseload. The prosecutor, defense, and court must agree to set aside the typical next steps of plea and sentencing to allow the community-based program to take over the case. In many communities, this is an adjournment in consideration of dismissal. Probationers typically must report to their probation officer more often than in traditional probation, and treatment is frequently a requirement. If the individual completes the conditions, the charges are dismissed. If not, he or she is further processed in the justice system.
Intercept 3 jail diversion programs include problem-solving courts such as drug courts, mental health courts, family drug courts, DWI courts, youth courts, and veterans’ courts. These court diversion programs intend to reduce further justice involvement through court-supervised community-based treatment; as a group, they are often referred to as treatment courts since mandated treatment is a common characteristic across all types. While there are some pre-plea treatment courts, most are post-plea in which the offender must enter a guilty plea to be eligible for the intensive supervision and community-based treatment that accompanies such programs.
Drug courts in particular have proliferated throughout the United States at the municipal and county level with substantial financial resources committed through both the federal and state governments. Mental health courts are not as widespread as drug courts, in part, because they have not received significant federal or state funding. While there is considerable variation across types of treatment courts and jurisdictions, they share some common features: a separate court docket; a court team that includes a judge who presides over status hearings, a prosecutor and defense attorney, treatment providers, probation, and increasingly a peer; a collaborative versus an adversarial approach; judicial supervision through regular status hearings; voluntary participation from defendants; use of incentives and sanctions; and dismissal of charges upon successful completion of program requirements.
Intercept 4 diversion occurs at reentry from either prison or jail. Programs at this intercept provide intensive wrap-around services and supervision for persons with SMI and COD who are leaving jail or prison. This population is often at high risk of reoffending, and diversion programs aim to disrupt the recidivism process by identifying needed services and putting them in place prior to, or immediately following, release. The justice and treatment systems prevent reoffending and reincarceration through linkage to community-based treatment and intensive justice supervision. Intensive Case Management was the first reentry model developed; it was largely based in the behavioral health services system. It includes smaller than typical caseloads, more frequent contacts with the individual, and an array of treatment programs. Two additional diversion programs at this intercept are Assertive Community Treatment and Forensic Assertive Community Treatment. They are similar to Intensive Case Management in that they focus on small caseloads and collaboration among many community-based treatment providers along with crisis intervention. Intensive Case Management, Assertive Community Treatment, and Forensic Assertive Community Treatment are generally targeted for persons leaving jail, and in some communities, the community linkage is established as part of the prerelease planning, sometimes called in reach. Similarly, individuals with COD and SMI leaving prison may receive significant prerelease planning to assist their transition into the community.
Intercept 5 jail diversion is the most common type of jail or prison diversion in that it includes probation (i.e., jail diversion) and parole (i.e., prison diversion), often referred to as community corrections. More individuals are under community supervision in the United States than in jails and prisons combined, with approximately 5 million men and women on probation or parole. A significant portion of the community corrections population has SMI or COD. For the reentry of these individuals to be successful (i.e., they do not reoffend), communities need evidence-based programs ready and available. People with SMI and COD have behavioral difficulty while incarcerated, especially if their mental illness is undiagnosed or untreated. They often have many behavioral infractions that lead to additional incarceration time; they are rarely released early. In addition, they are more likely than others to have their probation and parole revoked for technical infractions rather than new offenses. A diversion program at the community corrections stage would include specialized probation and parole. Similar to other forms of community-based diversion programs, these include reduced caseloads, specially trained officers, and a focus on treatment compliance. Rather than revoke probation or parole for an individual on this type of diversion program, it is more likely that the officer would work with treatment providers and the court to increase compliance.
Research on Jail Diversion
Overall, research on jail diversion programs supports the claim that community-based programs are more successful at reducing continuing criminal justice involvement for persons with SMI and COD than traditional interventions. All jail diversion programs that partner with community-based behavioral health treatment providers have an increase in treatment involvement. The research is less convincing, however, that programs improve clinical outcomes, despite the increase in treatment services.
CIT policing is one of the most popular early diversion programs adopted by police departments. By providing officers with 40 hr of training, communities can expect a reduction in the number of persons with SMI and COD who are arrested for minor infractions such as disturbing the peace. Another outcome of CIT is that there are fewer police officer injuries and less aggressive policing toward SMI and COD populations. Effective CIT police departments are typically more aware of treatment resources and have partnered with providers to address the needs of the justice-involved population with SMI and COD. Despite wide program variability, CIT is associated with overall positive outcomes.
Less is known about the impact of postarrest/prebooking diversion programs (perhaps because they are fewer in number). Because diversion at this point requires cross-system collaboration, such programs are more difficult to develop and implement, often due to inconsistency and change among key personnel. More research needs to be conducted on these programs to measure their effectiveness in meeting the diversion goals.
There is considerable evidence that treatment courts are effective in reducing criminal justice involvement of participants. Overall, drug courts and mental health courts show a reduction in jail days and arrest for participants, especially individuals who complete the court-mandated conditions and graduate. In addition, courts are successful in getting treatment for participants, with evidence showing that they are more likely to engage in treatment when supervised by the court. What has been challenging is establishing guidelines for what constitutes a treatment court and making sure that communities have available evidence-based services. Some states have created and monitor these programs to reduce variability from jurisdiction to jurisdiction, despite each having their own community and personnel characteristics. Community-based diversion programs (e.g., reentry, probation, parole) typically show improvements in criminal justice outcomes through fewer arrests, fewer jail days, and a longer time gap before reoffending.
Final Thoughts
Across the criminal justice system, diversion programs must be tailored for specific populations, including attention paid to individual characteristics. There is no one-size fits all approach. Also, communities may consider designing and implementing programs with collaboration across the spectrum of services that are necessary for success including justice, treatment, public health, social services, housing, employment, and more. Cost studies of diversion programs demonstrate that while there is a savings in reducing arrests and jail days, for example, there is a corresponding increase in treatment expenses. Diversion is a community approach and requires cross-system commitment of resources.
References:
- DeMatteo, D., LaDuke, C., Locklair, B. R., & Heilbrun, K. (2013). Community-based alternatives for justice-involved individuals with severe mental illness: Diversion, problem-solving courts, and re-entry. Journal of Criminal Justice, 41, 64–71.
- Steadman, H. J., & Naples, M. (2005). Assessing the effectiveness of jail diversion programs for persons with serious mental illness and co-occurring substance use disorders. Behavioral Sciences & the Law, 23, 163–170.