Problem

Problematic Behavior Or Activity

An estimated 70 percent of jail inmates have either a primary or underlying diagnoses of mental illness and approximately 16 percent of that population is seriously mentally ill. Local county jails are increasingly engaging with mentally ill individuals and now hold more of them than state hospitals do.

Impact On The Community

Addressing the mental health needs of inmates and the diversion of mentally ill individuals from the local jail to treatment and rehabilitation may ultimately reduce the high costs of incarceration. Positive impacts from a strong jail diversion program may decrease rates of re-offending, reduce the number of people who return to jail, and improve public safety.

Solution

Program Description

Lifeways, Inc., has provided Jail Diversion services in Malheur County since July 2014. Jail Diversion is defined as any service provided to divert individuals with behavior disorders and charged with low-level offenses from the criminal justice system or commitment to the Oregon State Hospital. The Jail Diversion team works closely with community partners, law enforcement agencies, courts, DHS, and Community Corrections, hospitals, acute psychiatric facilities, and the Veterans Administration to collaborate on achieving the best outcomes for those who will be released into the community. The Lifeways Jail Diversion team is certified in crisis intervention and participates as instructors in “Crisis Intervention for Law Enforcement,” a 40-hour training that provides education to law enforcement and other community partners.

Lifeways has a full-time Certified Alcohol and Drug Counselor (CADC-I) clinician who facilitates groups in the jail and at Community Corrections on drug and alcohol education and relapse prevention, as well as a group for inmates with co-occurring disorders. The clinician works with current and former inmates on an individual and group therapeutic level to decrease recidivism rates of those who committed crimes induced by alcohol or other drugs. If eligible, an inmate may be released to a local inpatient rehabilitation facility to begin treatment, thus reducing the likelihood of a relapse.

A Forensic Social Worker/Qualified Mental Health Professional (QMHP) works in the jail full time, providing crisis intervention support, mental health assessments, individual therapy, case management, and advocacy for those who are incarcerated. The social worker/QMHP works to find appropriate placements for those who have serious mental illnesses and may have acute psychiatric episodes that make them a risk to the community. The QMHP works closely with Lifeways crisis team at their Ontario clinic and with local law enforcement, to determine whether jail is the only option for those suffering from severe mental illness.

With a strong continuum of care and support from members of the community, the Jail Diversion team continues to increase awareness, educate law enforcement through CIT, bridge the gaps from jail to treatment, and help reduce recidivism rates of offenders in the county jail.

Based On Research

The program uses the Sequential Intercept Model, which was developed as a way to understand how those with mental illness interact with the criminal justice system. Each intercept addresses where interventions can be made to help prevent people with behavioral disorders from falling through the cracks. The model describes five intercepts where jail diversion can occur.

1. Pre-booking diversion: Crisis intervention (crisis intervention team, mobile crisis unit, and first responders)

2. Post-booking diversion: Arrest (booking, screenings, and arraignments)

3. Jail and court (identification, assessment, planning, and consultation with attorneys and judges and referrals to specialty courts such as mental health and drug court)

4. Reentry (transition, case management, Assertive Community Treatment, medication management, therapy, coordination)

5. Community Corrections/continued supports (supported employment, wraparound services, stabilization, and self-sufficiency)

Funding

Lifeways, Inc. secured an 18-month renewable grant through the Oregon Health Authority to provide certified staffing and other resources that assist in increasing wraparound services to individuals who have been diverted from jail to appropriate treatment, as well as ongoing community support services for individuals released from jail. Funding from Oregon’s Justice Reinvestment Grant Program has also assisted in providing offenders with treatment, housing, and other needs. This funding supports one full-time QMHP (master’s level clinician) and one full-time QMHA (CADC clinician) to serve Malheur and Umatilla Counties.

Outcome

Program Impact

The program has reduced the time severely mentally ill inmates spend in jail before receiving treatment, in turn reducing the burden on the jail and its staff. Individuals with behavioral disorders are being identified, screened, and provided appropriate interventions to address the maladaptive behaviors that contributed to their entry to the criminal justice system. Clients are now able to leave jail with an assessment and an appointment—and at times they complete court-ordered treatment before they are released from custody. Individuals who struggled with making their appointments through the Lifeways clinic in the past can now participate in substance use treatment at Community Corrections.

A strong partnership has developed between Community Corrections and Lifeways, Inc., due to increased collaboration between treatment providers and probation/parole officers. A positive impact is already being seen in the willingness of offenders to attend treatment at Community Corrections. A substance use program for sex offenders has been developed and implemented at probation and parole that has dramatically increased attendance among these high-risk offenders.

Strong community partnerships and constant boundary spanning have strengthened the continuum of care. The ultimate goal of the Jail Diversion program is to identify those who need interventions rather than incarceration and provide them a holistic approach to treatment that has been beneficial to clients, Community Corrections, jail staff, and the community.

Critical Success Factors

• Positive professional relationships among mental health providers and law enforcement. Crisis Intervention Team training is essential for the success of Jail Diversion.

• Support from the community partners and stakeholders has made the program much more successful. The Forensic Social Worker has an exemplary working relationship with all entities involved and this aids in a strong collaborative effort to assist people involved in the criminal justice system.

• It is imperative to have a Qualified Mental Health Professional working in the jail to help facilitate the movement of severely mentally ill inmates to appropriate treatment facilities and provide support to people with mental illness who are incarcerated.

Lessons Learned

Jail Diversion’s original focus was to divert individuals with mental health issues from the criminal justice system into more appropriate treatment facilities and follow up with community wraparound services. As the program has grown over the past 18 months, the importance of dealing with offenders who are or will be on supervision in the community has become paramount. Inmates in the jail are provided mental health screenings and the opportunity to begin substance use treatment. The relationships the inmates form with their counselors in jail helps bridge the gap between incarceration and community supervision.

Malheur County continues to have positive results with this program and would recommend this type of community partnership. Having a strong program at the jail that transitions with the offender into the community is a must.