Meeting the Needs of Justice-Involved People with Serious Mental Illness within Community Behavioral Health Systems

People with serious mental illness are over represented in the justice system. For example, most county jails in the United States house three times as many people with serious mental illness as would be expected from community-based estimates. In this article, they will review the complex array of factors that contribute to the problem of the over representation of people with serious mental illness in the justice system and offer suggestions on how an integrated community behavioral health system, including mental health and substance use services, can coordinate efforts across multiple systems to address this problem.

National, state, and local efforts to address the over representation of people with serious mental illness in the justice system have proliferated over the past 20 years. An increasing number of police officers receive training in ways to recognize and safely resolve incidents involving people with serious mental illness through the crisis intervention team (CIT) model. In addition, many judges are better equipped to manage mental illness in their courtrooms, and probation and parole departments are developing specialized units. More than 500 counties have signed up for the National Stepping Up Initiative to develop reentry programs to reduce the number of people with mental illness in their county jails

The over representation of people with serious mental illness in the justice system is a complex issue that requires systematic change and collaborative problem solving. They believe that an integrated community-based behavioral health system is ideally situated to address the complex needs of this population and prevent criminal justice involvement. If adequately supported, this system could provide accessible, effective, and criminologically informed services to address the clinical, criminogenic, and social support services needs of people with serious mental illness who are involved in the justice system. The goal is to identify people who would be best served in community settings and expand the continuum of services available within the behavioral health system to meet people where they live, work, and receive services. The role of the justice system will move toward collaboration and away from the need to build a parallel treatment system to address the treatment needs of justice-involved people with serious mental illness. We believe that this approach can improve individual and systems outcomes by preventing justice involvement, reducing service redundancy, and improving health and quality of life of people who are living in the community. All of society needs to take on the larger social issues that disproportionately affect people with serious mental illness.

Population: All incarcerated, formerly incarcerated

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Date: 2020