Short Stay Behind Bars Before Diversion Does Not Affect Mental Health Outcomes, Study Finds

Criminal offenders who went to jail before being diverted into mental health treatment fared no better in the long run than those who go straight into diversion programs, according to a study of Connecticut defendants.

“Short stays in jail before diversion did not appear to be associated with improved mental health and reoffending outcomes, even though they appeared to improve receipt of psychotropic medication,” said Allison Robertson, Ph.D., M.P.H., an assistant professor of psychiatry and behavioral sciences at Duke University, and colleagues online this week in Psychiatric Services in Advance. The researchers compared 102 diversion participants who first went to jail with 102 who went directly into diversion.

The “jail first” strategy did lead to a greater chance that the prisoner would receive psychotropic medications, but all other indicators—use of outpatient services, psychiatric hospitalizations, jail days, emergency visits, or rearrest—demonstrated similar outcomes whether the person was sent to jail or diversion first.

These findings may indicate that the participant’s risk may be influenced not only by mental health treatment but also by criminogenic factors like unstable housing, unemployment, or lack of social services, said Robertson. “These analyses offer an early but important indication that a brief incarceration before diversion to the community does not ultimately achieve the goals of the courts—reduced recidivism and improved public safety,” the researchers said.

To read more about diversion programs for offenders with mental illness, see the Psychiatric News articles, "Program Prepares Defendants for Return to the Community" and "Combined Effort Needed to Prevent Incarceration of Mentally Ill People."

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Police Training Boosts Likelihood That People With Mental Illness Will Get Needed Care

Police officers with Crisis Intervention Team (CIT) training not only know more about mental illness than their untrained counterparts but are more likely to obtain professional help for people with mental disorders when encountering them in the course of their work.

CIT training improved officers’ knowledge, attitudes, and skills regarding mental illness, wrote Michael Compton, M.D., M.P.H., of the Department of Psychiatry at Lenox Hill Hospital in New York City, and colleagues in two related articles published online (here and here) in Psychiatric Services in Advance.

The greatest effect size was for de-escalation skills, which are particularly important, the researchers said, "because the ‘criminalization’ of mental illnesses may be prominently related to impulsivity or emotionally motivated responses [by police] to perceived provocation, rather than to untreated symptoms alone.”

CIT-trained officers were also more likely to refer or transport subjects to treatment sites rather than arrest them after encounters. This was especially true when the officers needed physical force to control the individual. In those cases, they were more likely to refer to services rather than to arrest. These results suggest that CIT training serves its intended purpose as a form of prebooking diversion from the criminal justice system, concluded Compton and colleagues.

To read more in Psychiatric News about training police officers to respond to individuals with mental illness, see the article Crisis Intervention Teams Enhance Safety of Police, Patients."

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