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Disrupting the Cycle of Mental Illness, Substance Use, and Incarceration

A lack of coordinated care not only fails to address the underlying health issues that drive people into these systems, it perpetuates a never-ending loop of costly and ineffective responses.

A homeless camp
Social workers and police officers talk with a man at a homeless encampment in Everett, Washington, in February 2017. As overdose deaths spiked and the local jail turned into a de facto detox center, the mayor of Everett took steps to tackle the epidemic by cleaning up streets, hiring social workers to ride along with police officers, and building permanent housing for the chronically homeless. (Elaine Thompson/The Associated Press)

More than 60 percent of the 11 million people who spend time in local jails each year have a mental illness or substance use disorder; an additional 44 percent have a chronic health issue. Jail systems don’t often have the training and resources they need to respond to these conditions, and time spent behind bars can make them worse. People end up cycling through jails, hospital emergency rooms, and social service programs. A lack of coordinated care not only fails to address the underlying health issues that drive people into these systems, it perpetuates a never-ending loop of costly and ineffective responses. In fact, every year, taxpayers spend $22 billion on incarceration costs alone.

In 2017, we expanded our work to address the connections among mental illness, substance use disorder, and jail overcrowding with the launch of the Data-Driven Justice (DDJ) project. The initiative seeks to determine the best ways to link local jail, hospital, and service provider data so that mental health professionals and law enforcement can identify those who cycle through multiple systems and connect them to appropriate treatment programs. One of our initial efforts is focused on building the evidence base of interventions shown to improve outcomes for this target population. We are considering research proposals focused on studying established approaches such as crisis intervention teams, assertive community treatment, and cognitive-behavioral therapy, as well as promising new models.

This story is part of the 2017 Annual Report See Report

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