Shoplifting, trespassing and disturbing the peace are just some of the crimes that keep mentally ill offenders coming back to jail time and time again in Lancaster County, Nebraska.  But, in reality, many of these people need treatment, not another stay behind bars.  Recognizing that, county officials have created a new jail diversion program to keep mentally ill offenders out of jail and get them the help they need in the community.

"[This program] was something that our community was certainly in need of," said Travis Parker, director of the Lancaster County Mental Health Jail Diversion Project.  "[We thought that] one of the biggest things we could do to eliminate or reduce the revolving door for people was to help them meet many of the basic needs that they weren't having met."

The program, which began last November and is funded by a grant from SAMHSA, is designed to do just that - help mentally ill offenders access a variety services in the community, including treatment, housing and employment.  Its goal is to stabilize these offenders in the community and prevent them from returning to jail.

"What we are hoping this program will do is get people to the right services and then [they] will not come back to jail," said Michael Thurber, Director of Corrections in Lancaster County.  "We're hoping that the lion's share, maybe a high 90 percent [of the offenders who are diverted], will not come back [and] will not be rebooked for a charge for something else."

Qualifying for Diversion

According to Parker, offenders are identified for the program when they are arrested.  At intake, they go through a standard questioning process and answer 14 questions pertaining to their mental health, such as whether or not they have ever been diagnosed with a mental health or substance abuse problem or if they are currently taking any medications prescribed by a psychiatrist.

"If the individual that is being booked in answers in the affirmative [to one of those questions], then a flag automatically goes up and they are identified as a person for our mental health clinician to screen a little bit further," Parker said.  "If one or more of those flags pops up, [the clinician] will come in and initially do a paper review of why it is they are [at the jail] and what their mental health and substance abuse needs may be."

According to Parker, based on the paper evaluation, the clinician first decides if the offender meets the legal criteria for the program, which requires that an individual's offense be a non-violent, low-level, misdemeanor.  If they qualify for the program, she then meets with them face-to-face to obtain more information. 

"We have a standard interview process that she follows, which will solicit very detailed legal history, psychiatric and substance abuse history, trauma histories - the whole gamut of life experiences for this person," Parker said.

After the interview, the clinician conducts a criminal investigation to verify the information that the offender provided to her and she tries to gather records from any previous substance abuse and mental health treatment providers the offender has seen, Parker said.

If the clinician believes offenders have a severe and persistent mental illness or co-occurring disorder and they are interested in being diverted, she recommends them for the program at their first court appearance

If the judge and prosecutors agree to release an offender into the program, the next step is the creation of a treatment plan by both the mental health clinician and the individual.

Intense Support

According to Parker, the treatment plan consists of rules an offender must to abide by, such as abstaining from drug and alcohol use, meeting with a case manager as scheduled, taking psychotropic medications as prescribed by a psychiatrist and refraining from any law violations.

Once the treatment plan has been ironed out, one of the program's two intensive case managers typically picks up the offenders from the county jail and ensures that their most basic, immediate needs, like food and shelter, are being met.  Then, they schedule an appointment with the offender for the next day. 

The intensive case managers serve to connect offenders to resources in the community and provide them with the support they need to remain stable in society.

According to Parker, the case managers assist the offenders with housing and applying for federal assistance, like Medicaid and food stamps.  They also try to help them access treatment in the community, he said.

The program, Parker said, employs an intensive case management model, meaning that the case managers have no more than 15 clients on their caseload, which enables them to provide the offenders with a great deal of attention and support.

"Our case managers rack up a lot of miles out in the community, meeting with their clients," Parker said.  "They meet with some of their clients daily," he added.  "Having that support in place has really proved helpful for them."

In meeting with their clients, the case managers work to get them into community treatment programs, which often have waiting lists, Parker said. 

"The treatment community is very saturated," Parker said.  "Usually, when an individual comes into the program, we anticipate that they are going to spend an average of six to nine months working with that case manager while they are on a waiting list trying to access more stabilized treatment in the community."

In the interim, Parker said the program is fortunate that Kimberley Mundil, the Project's mental health clinician, is a licensed mental health practitioner and is available to provide short-term therapy for the offenders.

Aside from helping them get into treatment programs, the case managers also provide a variety of other services to the offenders, such as meeting their transportation and employment needs.

So far, with the support of these case managers, the program has successfully diverted 46 offenders from jail, Parker said.  He is encouraged by the results.

Positive Results

"We've been really pleased with the improvement in the quality of life that we have seen [for] many of our people that have been diverted, but also just the real reduction in the number of times and even the elimination of seeing people go back to jail as many times as they were," Parker said.

In the future, Parker hopes that the program will be sustained beyond the three-year grant the county received from SAMHSA.  But he also would like to see the program expand to include other types of offenders.

"In the near future, we hope to be able to look at diverting [people] with higher-level misdemeanor crimes and lower-level felony crimes," Parker said.

But, for the time being, both Parker and Thurber believe that this program can really make a difference in Lancaster County.

"I think [this program] is going to show that partnering with your local community mental health agencies is the only way [jails] are going to be able to deal with the mentally ill," Thurber said.  "This [program] is certainly one that is going to show some gains in keeping people out of jail that do not need to be there."

Resources:

Parker (402) 441-7940

Thurber (402) 441-8922