June - July 2019

Mental Health Study:
Treatment Can Reduce Re-Incarceration
A recent report examined jail over-crowding and recidivism in ten Michigan counties. The report, published by the Wayne State University School of Social Work, Center for Behavioral Health and Justice, examined data for the five-year period of 2014 to 2019.

The authors found that investment in treatment for people with mental health disorders and training for law enforcement and jail personnel would reduce the numbers of people unnecessarily confined in jails.

Pilot intervention programs were initiated in multiple counties in 2014 by the Michigan Mental Health Diversion Council, an entity focused on diverting those with mental health disorders or disabilities from the criminal justice system. In 2015, pilot programs were funded in eight counties (Barry, Berrien, Kalamazoo, Kent, Marquette, Monroe, Oakland, and Wayne), and in 2017 two more counties (Livingston and St. Joseph) were added.

The researchers found that emergency dispatch units were organized differently in the counties, and the dispatchers used preapproved codes to indicate the nature of an emergency call; for example, a dispatch might indicate a heart attack or an assault or other criminal activity, so that the first responders, either EMS or police, would have an indication of the specific emergency. However, the dispatchers did not separately flag or indicate “mental health crisis” in emergency calls.

The authors noted that most police officers receive limited mental health training at police academies, and, as a result, officers responding to an emergency call may not recognize or be equipped to deal with a person suffering a mental health crisis. One training model, the Memphis CIT (Crisis Intervention Team) Model, has been increasingly used to train police. The Memphis Model was developed in 1998 by the Memphis police chief after a police-shooting of a mentally ill man, and it includes a community task force of police and mental health professionals and advocates, with a focus on diverting non-threatening, non-assaultive persons with mental health disorders from the criminal justice system. The CIT Model provides for three core elements: 40 hours of training for police, collaboration with mental health providers, and a psychiatric emergency drop-off with a no-refusal policy.

The Pilot Programs contained – with some variation in the counties – CIT training for police. In one county, the only one with a 24-hour drop-off center, the data revealed that before CIT training, police transported 9% of the persons encountered to the crisis center, and 91% to an emergency room. After CIT training, 31% of the individuals were transported to the crisis center, and 69% were transported to an emergency room. Other findings showed that for each increase of 1 mile between a call location and the crisis center, officers were 1% less likely to transport a person to the crisis center; non-intoxicated persons were 2.6 times more likely to be transported to the crisis center than those who were intoxicated; and officers with CIT training were 3 times more likely to transport an individual to the crisis center than were officers without CIT training.

In one county Pilot Program, corrections and jail officers received de-escalation training, and it was discovered that the officers “significantly changed their attitudes towards individuals with mental illness” and that there was a notable reduction in the use of a Cell Extraction Team (CET) to remove prisoners from cells. Prior to the training, the corrections officers called for a CET – officers trained to address non-compliant inmates – an average of 30.1 times in the 12-months preceding the training. In the months after training, there was an average of 16.4 calls for a CET.

For those persons who are jailed, the researchers found that in the jail facilities with community mental health services, in contrast to facilities with third-party providers, a person with a mental health issue was 2.5 times more likely to be identified, the person was 2.4 times more likely to be referred for treatment services, and the person was 2.1 times more likely to receive treatment. Screening practices varied among the jails examined, and there was no uniform or standard assessment in practice. Preparation of a person for reentry into the community varied in the counties, as did the involvement of probation and parole personnel in a post-release process. However, probation and parole agents were not given specialized training in any of the ten counties.

The authors concluded with multiple recommendations for continued and increased improvement. Included among the recommendations are: an integrated treatment for offenders with both a mental health disorder and substance dependency; utilization of the CIT model; development and use of a standardized screening model for use in jails to facilitate possible diversion; training corrections officers in de-escalation techniques; improving and expanding discharge services, including avoidance of non-business hours release (i.e., after 5:00 P.M.), which currently affects about 44% of those released; and enhancing the relationship between community mental health providers and probation and parole personnel to reduce recidivism.

Sources:  Pat Batcheller, “Study Finds Treating Inmates’ Mental Health Reduces Their Risk of Returning to Jail,” wdet.org, June 12, 2019:
Sheryl Kubiak, Ph. D., et al, “Mental Health Across the Criminal Legal Continuum: A Summary of Five Years of Research in Ten Counties,” today.wayne.edu, April 2019:

by Neil Leithauser
Associate Editor