When Political Will Is Not Enough

Abstract

This article describes a project that generated the recommendations of a panel of experts regarding the jail as a venue for the delivery of behavioral health care services. The project was a component of the MacArthur Foundation's Safety and Justice Challenge initiative, which seeks to address over-incarceration by changing the way jails are conceptualized and used. The recommendations were grounded largely in the sequential intercept model that rests on two core principles: minimize the inappropriate penetration of persons with mental illness into the criminal justice system and recognize that the community is the unit of analysis to address criminal justice-mental health problems successfully. Other topics presented in the context of the initiative included bringing the community to scale, jail diversion, the limits of jail responsibility, and the Affordable Care Act's role in providing insurance coverage for detainees.

Substance use disorder and rural detention center readmission: Results from a 3-year prospective cohort study.

“…Recent population-based estimates indicate the use of certain substances has become more prominent in rural areas (Substance Abuse and Mental Health Services Administration, 2022), and researchers have shown less densely populated communities experience disproportionate hardship due to SUD (Moody et al, 2017; Palombi et al, 2018), but little attention has been devoted to these conditions among adults who are admitted to rural detention centers. Jails have increasingly become the primary medical and behavioral health care providers in many communities, and while they are far from the ideal venues in which to deliver vital services, it has become increasingly apparent that these facilities must be utilized to identify pressing health conditions, including SUDs (Nagami et al, 2022; Steadman et al, 2016).…”

“…(Moody et al, 2017;Palombi et al, 2018), but little attention has been devoted to these conditions among adults who are admitted to rural detention centers. Jails have increasingly become the primary medical and behavioral health care providers in many communities, and while they are far from the ideal venues in which to deliver vital services, it has become increasingly apparent that these facilities must be utilized to identify pressing health conditions, including SUDs (Nagami et al, 2022;Steadman et al, 2016). One of the primary objectives of this study was to provide a contemporary assessment of the prevalence of specific SUDs in a rural jail population to better inform practices designed to identify these conditions.…”

Isomorphic Pressures on Jail Diversion: From Serious Mental Illness to Opioid Use Disorder

“…Federal funding and technical assistance from the Substance Abuse and Mental Health Services Administration (SAMHSA) promoted the growth of jail diversion programs for PSMI, including those with co-occurring substance use disorders. From 2002 to 2009, the Targeted Capacity Expansion (TCE) initiative funded jail diversion program development in 37 localities, and from 2008 to 2015, the Jail Diversion Trauma Recovery Priority for Veterans funded 13 states to develop diversion programs targeting veterans and other justice-involved individuals with trauma history (Steadman et al, 2015). Additionally, beginning in 2004 the Bureau of Justice Assistance funded 254 grants to 46 states through the Justice and Mental Health Coordination program to plan, implement, and expand diversion initiatives (Steadman et al, 2015).…”