The Sequential Intercept Model provides a conceptual framework for communities to use when considering the interface between the criminal justice and mental health systems as they address concerns about criminalization of people with mental illness. The model envisions a series of points of interception at which an intervention can be made to prevent individuals from entering or penetrating deeper into the criminal justice system. Ideally, most people will be intercepted at early points, with decreasing numbers at each subsequent point. The interception points are law enforcement and emergency services; initial detention and initial hearings; jail, courts, forensic evaluations, and forensic commitments; reentry from jails, state prisons, and forensic hospitalization; and community corrections and community support. The model provides an organizing tool for a discussion of diversion and linkage alternatives and for systematically addressing criminalization. Using the model, a community can develop targeted strategies that evolve over time to increase diversion of people with mental illness from the criminal justice system and to link them with community treatment.

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Use of the Sequential Intercept Model as an approach to decriminalization of people with serious mental illness.

Objectives: In recognition of the fact that police are often the first responders for individuals who are experiencing a mental illness crisis, police departments nationally are incorporating specialized training for officers in collaboration with local mental health systems. This study examined police dispatch data before and after implementation of a crisis intervention team (CIT) program to assess the effect of the training on officers’ disposition of calls. Methods: The authors analyzed police dispatch logs for two years before and four years after implementation of the CIT program in Akron, Ohio, to determine monthly average rates of mental disturbance calls compared with the overall rate of calls to the police, disposition of mental disturbance calls by time and training, and the effects of techniques on voluntariness of disposition. Results: Since the training program was implemented, there has been an increase in the number and proportion of calls involving possible mental illness, an increased rate of transport by CIT-trained officers of persons experiencing mental illness crises to emergency treatment facilities, an increase in transport on a voluntary status, and no significant changes in the rate of arrests by time or training. Conclusions: The results of this study suggest that a CIT partnership between the police department, the mental health system, consumers of services, and their family members can help in efforts to assist persons who are experiencing a mental illness crisis to gain access to the treatment system, where such individuals most often are best served. (Psychiatric Services 57:232–237, 2006)

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Crisis intervention team training for police officers responding to mental disturbance calls.

Purpose – The purpose of this paper is to explore police officer perceptions of their contacts with the mentally ill and examine outcomes of an innovative police training program designed to improve police handling of cases involving the mentally ill.Design/methodology/approach – The study utilizes a sample of 126 police officer respondents from five departments in northern Indiana to understand their perceptions of important aspects of their contacts with the mentally ill.Findings – Results show the actual dispositions for the mentally ill frequently do not match the outcomes officers desire, police training on responding to the mentally ill is not sufficient, and the training component of an innovative reform holds promise for improving officers' ability to respond to situations that involve the mentally ill.Research limitations/implications – The study is limited to one community and results may not generalize to communities with distinct mental health resources. Perceptions of police contacts with the...

Officer perceptions of police responses to persons with a mental illness

This study examined how the characteristics of people with mental illness who are participants in post-booking jail diversion programs affect recidivism and time spent incarcerated. The study employed data from a multi-site, federally funded jail diversion initiative. A pre-post comparison design was used to compare experiences of arrest and days spent in jail of diverted individuals for the 12 months following enrollment with the 12 months prior to enrollment. Also compared were differences in 12-month public safety outcomes. Data were collected between February 2003 and August 2007. The findings suggest that people with mental illness who are diverted from jail to community-based services experience fewer arrests and jail days. Approximately half of the sample were never arrested during the 12 months following enrollment. The strongest differences between people who experienced reduced contact with the criminal justice system and people with unchanged or increased contact were found in measures of criminal history. The results suggest that services targeted to diverted individuals with mental illness should address public safety goals, not just those of public health.

Who succeeds in jail diversion programs for persons with mental illness? A multi-site study

There is a growing awareness of the incidence of mental disorders among women involved in the criminal justice system. Two hundred and eighty-three women were participants in a federally-funded study and all met DSM-IVcriteria for at least two Axis I disorders, including one substance abuse diagnosis. Posttraumatic Stress Disorder (chronic) was the primary mental health diagnosis for 75% of the sample. Based on findings, the need for rigorous and accurate diagnostic evaluation for women in criminal justice settings is discussed; specific recommendations include: providing evidence-based, integrated, trauma-informed treatment, and designing comprehensive gender-specific programs to improve outcomes for incarcerated women.

Co-Occurring Mental Disorders among Incarcerated Women: Preliminary Findings from an Integrated Health Treatment Study.

In 1972, a federal court reinforced the deinstitutionalization of state psychiatric hospitals when they held that people with mental illness have a constitutional right to treatment (Wyatt v. Stickney, 1972). Although many states released patients and closed hospitals in response to this decision, they neglected to provide adequate community-based treatment resulting in the unintended reinstitutionalization of this population into our state and local jails. Recently, many state and local stakeholders have come together to address this situation. This article will discuss how the criminal justice system has become a primary mental health provider and strategies being utilized to reform the current system.

Alina Perez

Papers

Reversing the Criminalization of Mental Illness