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Jail Diversion for People with Co-occurring Disorders - USA

Page history last edited by Robert Hackett 10 years, 3 months ago

Note: please note that this issue brief should (a) link back to the issue overview on this topic, (b) be focused either the local, state, national, or global level, and (c) be neutrally presented, based on facts, and include footnotes for each of the items.  See the Research Guide and Information Sources to assist you. 

 

Link here to the Jail Diversion for People with Co-occurring Disorders overview page.

 

Scope of the Problem  factual statements on the extent of the problem in the past, current, or future


  • Research study results vary in the percentages of persons with co-occurring mental health and substance disorders ("co-occurring disorders" or sometimes also referred to as "dual diagnosis"), depending on study samples, demographics, settings, and assessment methods (Mueser, Drake, and Miles, 1997), but overall results are clear: persons with co-occurring disorders make up a significant percentage of those being treated for mental health and substance use disorders. These persons can also be found in significant numbers in prisons and among the homeless (Chavez testimony published in SAMHSA report, 1997). It is estimated that 3% of the general population in the U.S. suffers with dual disorders (Watkins, Burnam, Kung, Paddock, 2001).[1]
  • Researchers have documented that the prevalance of severe mental disorders is significantly higher in jails than in the general population (Lamb& Grant, 1982; Teplin, 1983, 1990c). [2]
  • The lead article in the June 2009 issue of Psychiatric Services by Henry J. Steadman, PhD and colleagues found that 14.5% of male and 31.0% of female inmates recently admitted to jail have a serious mental illness. [3]
  • With regard to the prevalence of substance disorders among those with severe mental disorders, research indicates that both male and female detainees have a 72% rate of co-occuring substance use disorders (Abram & Teplin, 1991; Abram et al., 2001). [4]

 

Past Policy  key legislation and milestones including significant policy and funding shifts, major studies, etc.


  • Although American Bar Association (1986) standards state that misdemeanants who are mentally ill should be diverted into the mental health system, in practice, they are often arrested (Matthews, 1970; Rock, Jacobson, & Janepaul, 1968; Teplin 1984a in press; Urmer, 1973). 

  • Grant programs offered by the federal agency SAMHSA (Substance Abuse and Mental Health Services Administration, a branch of Health and Human Services) have funded local and state-wide intiatives around the U.S. to build consensus for and implement the use of integrated treament strategies, and to build collaborative efforts among the treatment and criminal justice systems. 

    • In 2003, SAMHSA funding was available for 1-5 year grants for 6-10 awards ranging from $500,000 to $1.1 million per grantee per year under the Co-Occurring State Incentive Grant (COSIG) program. The goal was to develop and enhance the infrastructure of States and federally-recognized Tribes and their treatment service systems "to provide accessible, effective, comprehensive, coordinated/integrated, and evidence-based services to persons with co-occurring substance abuse and mental health disorders, and to their families" (www.samhsa.gov). 

    • Additionally, in 2006, $2.1 million was available for the COSIG program. (A link to contact information for 19 state-level grantees can be found below.) 

 

Current Policy  summary of current policies in the form of legislation, programs, and funding


  • Targeted Capacity Expansion (TCE) Grants for Jail Diversion Programs[5]

    • Launched by SAMHSA's Center for Mental Health Services (CMHS) in 2002, the program targets the unnecessary incarceration of nonviolent adult offenders with mental illnesses. Instead, it uses police crisis intervention teams, mental health courts, and other strategies to divert people away from the criminal justice system and into community-based mental health and substance abuse treatment.

    • "We want these people to recieve appropriate treatment," said U.S. Public Health Service Commander and Project Officer David Morrissette, Ph.D., LCSW, noting that forthcoming research from the U.S. Department of Justice (DOJ) suggests that 16 percent of inmates have serious mental illnesses. "We want to break the cycle of arrest, incarceration, and release." Three year grants were awarded in 2007 for $723,000 by the Center for Mental Health Services.

  • Only recently have drug courts been useful adjuncts to jail diversion programs for persons with mental illness and co-occurring substance use disorders. [6]

 

 

Key Organizations/Individuals   contacts for public and private organizations and key individuals


 

 

  • Substance Abuse and Mental Health Services Administration (SAMHSA) website for grant programs, best practices, and archives: 
  • U.S. Department of Justice:  To enforce the law and defend the interests of the United States according to the law; to ensure public safety against threats foreign and domestic; to provide federal leadership in preventing and controlling crime; to seek just punishment for those guilty of unlawful behavior; and to ensure fair and impartial administration of justice for all Americans.
  • U.S. Department of Health and Human Services:  The Department of Health and Human Services (HHS) is the United States government’s principal agency for protecting the health of all Americans and providing essential human services, especially for those who are least able to help themselves.

 

  • Dr. Kenneth Minkoff, M.D. and colleague Dr. Chris Cline:  Drs. Minkoff and Cline are recognized as two of the nation's leading experts on integrated treatment of individuals with co-occurring psychiatric and substance disorders (ICOPSD) or "dual diagnosis", and on the development of integrated systems of care for such individuals, through the implementation of a national consensus best practice model for systems design: the Comprehensive Continuous Integrated System of Care (CCISC), referenced in SAMHSA's Report to Congress on Co-occurring Disorders (2002). He has developed an integrated conceptual framework for treatment of co-occurring disorders based on application of a disease and recovery model - with parallel phases of treatment and recovery.  http://www.kenminkoff.com/       
  •  Kathleen Sciacca, M.A.:  Founding Executive Director of Sciacca Comprehensive Service Development for Mental Illness, Drug Addiction and Alcoholism (MIDAA), located in New York City. She is a forerunner in the development of treatment methods, programs and comprehensive services for clients who have dual/multiple disorders (MIDAA), including severe, persistent mental illness. She began developing programs for dual and multiple disorders in 1984 when there were no program models available, and little attention given to these clients as a priority. Her treatment methods and services are carefully adapted to the special needs of dually diagnosed clients.  http://users.erols.com/ksciacca/about.htm    http://users.erols.com/ksciacca/#bibliography

 

 

 

Bibliography   web sites, reports, articles, and other reference material 


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Footnotes

  1. Whitaker, L. 2003. “Public Health Service Grant Application, Project Narrative & Supporting Documentation: Section A: Project Description and Justification of Need”.
  2. Abram, K., Teplin, L. 1991. “Co-Occurring Disorders Among Mentally Ill Jail Detainees: Implications for Public Policy”. http://www.ncbi.nlm.nih.gov/pubmed/1746771. July 20, 2009.
  3. Policy Research Associates. 2009. “New Study on Prevalence of Serious Mental Illness Among Jail Inmates”. http://www.prainc.com. July 20, 2009.
  4. GAINS Center. 2004. “ The Prevalence of Co-occurring Mental Illness and Substance Use Disorders in Jails”. http://74.125.95.132/search?q=cache:f-mn5jQQr2AJ:gainscenter.samhsa.gov/pdfs/disorders/gainsjailprev.pdf+the+prevalence+of+co-occurring+mental+illness+and+substance+use+disorders+in+jails&cd=2&hl=en&ct=clnk&gl=us. July 20, 2009.
  5. Clay, R. 2009. “Treatment as an Alternative to Jail for People with Mental Illness”. http://74.125.95.132/search?q=cache:H0PPcKBId_oJ:sentencingcommission.alacourt.gov/News/Treatment%2520as%2520an%2520Alternative%2520to%2520Jail%25205.7.09.doc+treatment+as+an+alternative+to+jail+for+people+with+mental+illness&cd=2&hl=en&ct=clnk&gl=us. July 20, 2009.
  6. GAINS Center. 1999. “Drug Courts as a Partner in Mental Health and Co-occurring Substance Use Disorder Diversion Programs”. http://gainscenter.samhsa.gov/pdfs/courts/Drug_Courts.pdf. July 20, 2009.

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