This quasi-experimental non-equivalent comparison group study examines outcomes for participants in eight programs conducting criminal justice diversion for people with co-occurring serious mental illness and substance use disorders compared with jail detainees eligible for diversion, but who were processed through standard criminal justice methods without diversion. Nearly 2000 participants were interviewed at baseline, and 1500 at 3 month and 1300 at 12 month follow-up to baseline. In these interviews, outcome measures of re-arrest, mental health functioning, substance abuse, quality of life, and service utilization were obtained. Those diverted were more likely to have received mental health counseling, mental health medication, and mental health hospitalization than those not enrolled in a diversion program, but were equally likely to have received substance abuse counseling. Overall, the differences in proportions receiving services between the two groups were small, even when these differences were statistically significant. The effect associated with diversion differed somewhat across the individual sites. However, overall cross-site pooled analyses revealed no outcome differences between groups on measures of mental health symptoms, substance use, criminal justice recidivism, or quality of life. Although the immediate benefit of diversion as an access mechanism to community treatment is indicated in pooled cross-site results, such access was driven by more coercive (pre-booking and court) models and results suggest that effecting substantially greater access to services or services use did not occur. The findings also suggest that mental health, substance abuse, and criminal justice outcomes remain dependent on the treatment intervention received, perhaps moderated by type of diversion intervention, rather than on a generic and initial diversion event.

Many cities, counties, and states have criminal justice diversion or jail diversion programs, in which those committing low-level offenses and who have mental illness or substance abuse are diverted from the criminal justice system into treatment. However, there is little existing evidence on the cost and cost-effectiveness of such programs. This article presents the first such estimates for four sites. Estimates of the impact of diversion on both costs and effectiveness varied across the sites. This variation likely reflects heterogeneity in the structure and implementation of the programs across the sites. Directions for future research are suggested.

The authors studied 175 mentally ill, substance-using adult jail detainees assessed at baseline, 3, and 12 months through a quasi-experimental comparison design. The study examines the effect of diversion, treatment, and individual characteristics on criminal justice, mental health, substance use, and life satisfaction outcomes. The intervention group included nonmandated and mandated diversion tracks. The comparison participants met diversion acceptance criteria but underwent standard criminal justice processes. Main findings included that mandated diversion clients were less likely to spend as much time in prison and more likely to spend time in the community, have been linked to residential and outpatient treatment, have received more treatment, and decrease drug use. However, those who did not perceive themselves coerced and had insight into their mental illness received more treatment regardless of diversion condition. Although mandated diversion was found effective for some outcomes, individual characteristics, treatment, and diversion in general significantly contributed.

Eight programs are described representing a variety of approaches to diversion in terms of point of criminal justice intervention (prebooking or postbooking), degree of criminal justice coercion, type of linkages provided to community-based treatment, and approaches to treatment retention. The authors also describe the characteristics of almost 1000 study participants who were diverted into these programs over an 18-month period and examine the extent to which systematic differences are observed between prebooking and postbooking subjects, as well as among sites in each of the diversion types. Results suggest that prebooking and postbooking diversion subjects were similar on most mental health indicators, but differed substantially on measures of social functioning and substance use and criminality, with postbooking subjects scoring worse on social functioning and reporting more serious substance use and criminal histories. Variability among sites was also observed, indicating differences in local preferences for the types of individuals deemed appropriate for diversion.

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