Diversion and Jail Discharge Strategies

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Diversion and Jail Discharge Strategies

• Presentation by Ron Honberg, NAMI
• National Alliance to End Homelessness Conference
• Washington, DC
• July 18, 2006

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. . . jails and prisons are de-facto
psychiatric hospitals
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Statistics

• About 16 (in excess of 300,000) jail and prison
  inmates suffer from severe mental illnesses.
  (U.S. DOJ, 1999)
• Prevalence rates even higher in juvenile justice
  facilities
• Approximately 550,000 people on probation suffer
  from severe mental illnesses. (15 of total).
• African-Americans and other minority populations
  disproportionately represented.
• Nearly 3/4 of inmates with a mental illness have
  a co-occurring substance abuse problem.
• 20 of inmates with SMI were homeless during the
  year before incarceration.
• Very high rates of recidivism, particularly among
  prison inmates with SMI (75).

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Types of Crimes

• Jails - most individuals with SMI charged with
  non-violent misdemeanors or felonies.
• Trespassing, disorderly conduct, public nuisance,
  loitering, etc.
• Prisons - 53 of inmates with SMI convicted of
  violent crimes, versus 46 for all other inmates.

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High Costs

• Inmates with severe mental illnesses cost more
  per day to incarcerate.
• E.g. Pa. Dept. of Corrections
• Average per diem cost of incarceration, inmates
  with SMI - 140 per day.
• Average per diem cost of incarceration, all
  inmates - 80 per day.

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Jail Diversion

• Pre-booking
• Police-based (e.g. Crisis Intervention Team (CIT)
  Model.
• Provider-based (e.g. Montgomery County, Pa.).
• Post-booking
• E.g. Mental Health Courts
• Regardless of model, linkages with appropriate
  services are critical.

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Essential Services

• Intensive case management/assertive community
  treatment (ACT), including mobile crisis
  management
• Supportive housing (preferably, permanent
  housing)
• Integrated mental health/substance abuse
  treatment
• Access to medications/medication management
• Acute care services
• Supported employment
• Peer education and peer supports

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Californias AB 2034 Program
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Cost Savings
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Reentry Challenges and Opportunities

• How to initiate reentry planning prior to
  discharge?
• Timely restoration of benefits (SSI/SSDI
  Medicaid/Medicare)
• Intensive mental health treatment and supports
• E.g. Forensic Assertive Community Treatment
  (F-ACT) programs
• Housing and employment.
• Specialized parole and probation
• Information sharing
• Treatment engagement strategies.

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Federal Funding for Diversion and Community
Reentry

• Mentally Ill Offender Treatment and Crime
  Reduction Act (P.L. 108-414)
• Currently a 5 million program.
• SAMHSA jail diversion grants.
• Federal Mental Health Courts program.
• Byrne grants (administered by DOJ, awarded to
  states).