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Diversion and Jail Discharge Strategies

Diversion and Jail Discharge Strategies. Presentation by Ron Honberg, NAMI National Alliance to End Homelessness Conference Washington, DC July 18, 2006. . . . jails and prisons are de-facto “psychiatric hospitals”. Statistics.

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Diversion and Jail Discharge Strategies

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  1. Diversion and Jail Discharge Strategies Presentation by Ron Honberg, NAMI National Alliance to End Homelessness Conference Washington, DC July 18, 2006

  2. . . . jails and prisons are de-facto “psychiatric hospitals”

  3. 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%).

  4. 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.

  5. 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.

  6. 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.

  7. 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

  8. California’s AB 2034 Program

  9. Cost Savings

  10. 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.

  11. 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).

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