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TAPA Center for Jail Diversion
* Funded by Substance Abuse and Mental Health Services Administration (SAMHSA) / Center for Mental Health Services (CMHS) since 2002
* National resource and TA center
* Coordinating center for 20 CMHS-funded jail diversion programs
* Along with the GAINS Center for Evidence-Based Programs (EBP) in the Justice System, comprises the National GAINS Center
Resources
* GAINS Center: http://www.gainscenter.samhsa.gov
* Criminal Justice/ Mental Health Consensus Project: www.consensusproject.org
* Bureau of Justice Assistance Mental Health Courts Grant Program briefs (available in May 2005) at: http://www.consensusproject.org/mhcourts/)
Presenters
* Henry J. Steadman, Ph.D.
* Judge Steven Leifman
Jail Diversion Logic Model
Basic Research Questions
* What types of diversion work?
* For whom?
* Under what circumstances?
“What did I buy?”
“What good did it do?”
Outcome Measures
* How many and who served?
* What services delivered?
* With what effects?
Outcome Measures
* How many and who served?
– Number screened
– Number eligible
– Number accepted
– Relevant characteristics of accepted and not accepted
– Time between key decision points
Data
* Most programs do not count number considered for diversion eligibility
* Compared to other jail detainees, divertees are more likely to be:
– Women
– White
– Older
Outcome Measures
* Got what services? (Before-After)
– Case management
– Medication appointments
– Psychosocial rehabilitation
– Housing
– Residential substance abuse
– Integrated services for co-occurring disorders
– Supported employment/other vocational
– Self-help groups
– Etc.
* With what effects? (Before-After)
– Criminal Justice System
– Mental Health System
– Client
Outcome Measures
* Criminal Justice System
– Arrests (# / rate)
* All
* Violent
– Incarcerations (#)
* New offenses
* Technical violations
- Jail days
Data
* Reduced jail days
* Reduced rates of arrest
* Similar percentage arrested
Data: Nathaniel Project (N=53)
Data: SAMHSA KDA (6 sites)
Outcome Measures
* Mental Health System
– Inpatient hospitalizations
– ER evaluations/treatment
Data: SAMHSA KDA (6 sites)
Outcome Measures
Client
* Symptoms
* Days homeless
* Victimization
* Service system satisfaction
* Quality of life
Data: SAMHSA KDA (6 sites)
Data: SAMHSA KDA Cost Studies (Cowell et al, 2002)
Case studies—a great complement!
Key Evaluation Challenges and Some Solutions
Key Challenges Solutions
* Money set aside to do evaluation 1a. Approach local foundations
1b. Involve local college students
* Being too ambitious 2a. Less, done well = better
2b. Get pro bono evaluation help
* Documenting treatment services actually received 3a. Doing #’s 1 & 2
3b. Hard work
* Thinking about these things soon enough 4a. Just do it
4b. Line up a prime local evaluation ally
* Cost data 5. Fairly sophisticated or not at all
Evaluating Jail Diversion Outcomes: Making the Case for Jail Diversion
Eleventh Judicial Circuit of Florida
Criminal Mental Health Project
Judge Steve Leifman, Miami-Dade County Associate Administrative Judge
Build It and They Will Come
In the beginning . . .
We Had Nothing
* No data
* No research
* No staff
* No resources
The 2000 GAINS Summit
The Summit: Initial Data Gathering
* Miami-Dade highest % of mental illnesses of any urban community (9.1%)
* 800-1200 people with mental illnesses in jail (20%)
* Recidivism of defendants with mental illnesses > 70%
* Defendants with mental illnesses stay in jail 8 x longer at 7 x the cost
* 7 people with mental illnesses killed during a police encounter (now 13)
The Summit continued…
* Analyzed existing system – concluded it was embarrassingly dysfunctional
* Produced GOALS – must develop a system that works for people with mental illnesses, not us
* Produced Cooperative Agreement – everything in writing
* Created the 11th Judicial Circuit Criminal Mental Health Project
* Motto “Diversion and Linkages to Comprehensive Care Makes Jail the Last Resort”
11th Judicial Circuit’s Criminal Mental Health Project
* Pre-Booking Diversion:
– Crisis Intervention Team Policing (CIT)
* Post-Booking Diversion
– County Court Jail Diversion Program
* Comprehensive Care Program
* Assisted Living Facility (ALF) Quality of Care Program
* Housing & Transition Program
* Identification Card Program
11th Judicial Circuit’s Criminal Mental Health Project continued
* Stakeholders/Partnerships
* Planned Computer Linkage System
* Research – FIU/Dr. Jim Rivers & In-house
An Excellent Researcher from a University working on the project from the beginning is CRITICAL
Why?
We had a project, but still:
* No research
* Little data
* Little staff
* No resources
Who?
A Reputable Public Policy Researcher
* You get along with
* You trust
* Adds credibility to the Project
* Ability to produce practical, useful data
* Ability to collaborate and write grants
How?
Interview, Interview, Interview
* Go to different Universities/different departments
* Review past projects
* Check references/reputation
Research/Data Needs
* Apply for grants
* Educate policymakers
* Increase public funding
* Educate community
* Justify continued funding
* Justify system/policy changes
Required Research
* Jail mental health population survey
* National, State and local data on mental illness
* Costs of incarcerating people with mental illnesses
* Costs of acute care
* Recidivism studies
* Costs of forensic hospitalization
* Outcome data
Study of Mental Health Population at Miami-Dade Co. Jail
* Data on jail mental health population needed for grant application
* With funding from the Health Foundation of S.F. and the Dept. of Children and Families, Dr. Rivers conducted first- ever study of the mental health population in Miami-Dade Co. Jail
* Provided critical data about mental health population: demographics, charges, and number of arrests
Highest Utilizers Study
* Examined costs associated with mental health acute service delivery for the recidivists of the Miami-Dade County Jail Diversion Program
* Highest utilizer defined as anyone who participated in the Jail Diversion Program more than one time within a calendar year
Methodology
* Identified a one-year time period (1/1/01- 1/1/02)
* Identified the highest utilizers (recidivists) of the program for time period
* Collected data elements for each high utilizer
* Collaborated with multiple agencies to collect data elements
* Calculated total costs for group of highest utilizers
* Isolated costs for each service examined
Results
* 1,955 Jail Days
* 830 Crisis Stabilization Days
* 14 court ordered psychological evaluations
* 138 Emergency Room & Inpatient Admissions
Results
Grand Total
$540,321.22
Outcomes of Diversion Project
* Misdemeanor recidivism reduced 70% to 18%
* Improved public safety
* Reduced police injuries
* Faster return to patrol
* Saving Miami-Dade Co. $2.3 million annually
* Saving lives – No deadly force by Miami Police Department – 2 yrs
* De-criminalization of mental illness
Outcomes of Research
* SAMHSA Targeted Capacity Expansion Jail Diversion Grant
* Funding for a Computer Linkage Program ($160,000)
* Commitment from County to continue funding 2 court staff positions and absorb all grant staff positions
* $22 million dollar Bond to build new County Forensic Facility
Outcomes of Research continued
* Miami-Dade County Grand Jury Report: “Mental Illness and the Criminal Justice System: A Recipe for Disaster/A Prescription for Improvement”
* Proposed legislation for a $1 million dollar revolving fund pilot program to provide gap funding for individuals with mental illnesses accessing federal entitlements after incarceration
Packaging the Data
*Follow the money/Determine gov’t interests
*County Govt’s have little idea how much $ is spent on Corrections Mental Health and Liability
*The States are keenly aware of the amount of $ being spent on Forensic State Hospitals and are looking for ways to reduce costs
*The Police have little idea on the number of mental health calls they handle
*The public has no idea that more people with mental illnesses are in jail than hospitals
Packaging the Data: Audiences
Everyone
* Using data, put the issue in context
- How the problem began
- The extent of the problem
- Who’s paying and who’s suffering
Packaging the Data: Audiences
The County/Law Enforcement
- Jail mental health population
- Costs of incarceration
- Liability costs
- Recidivism rates
- Savings from diversion
- Outcome data
Packaging the Data: Audiences
The State
- Forensic commitment costs vs. diversion costs
- Recidivism rates
- Highest Utilizer Study – Cost of doing nothing
- Outcome data
The Messenger
*As a Judge, I invited non-traditional stakeholders to a MH Summit – Everyone Attended
*10 years earlier as an Asst. Public Defender, I did the same and No One Attended
Other Viable Messengers
*Elected Officials
*Police Chiefs
*Sheriffs
FOR MORE INFORMATION CONTACT:
Judge Steve Leifman
sleifman@jud11.flcourts.org
Alina Perez, M.A.
Mental Health Project Coordinator
alperez@jud11.flcourts.org
Dr. Jim Rivers
riversj@fiu.edu
| Gains@prainc.com | The CMHS National GAINS Center | GainsTAPA@prainc.com |
| 800.311.GAIN | 866.518.TAPA | |
Funded by the Center for Mental Health Services of the Substance Abuse and Mental Health Services Administration < Privacy Policy > For Alternative Access to Web Documents : Email gains@prainc.com  USA.gov is the U.S. government's official web portal to all federal, state and local government web resources and services. |
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