Diversion Strategies Workgroup Executive Summary
Background: Data shows that up to 64% of jail inmates in our state and up to 22% of Michigan prison inmates have a mental illness. Governor Snyder has stated that preventing the unnecessary incarceration of those with behavioral health conditions that these data reflect is a priority for his administration. Hence, in his September 2011 Health and Wellness message Governor Snyder remarked on the 'disproportionate share of persons with behavioral health issues behind bars' in directing the establishment of a workgroup to create an action plan to address the following recommendations from the 2008 Mental Health Work Group report: (1) improve mental health services in the community, in the jails, and in the court system, (2) institute diversion programs, (3) improve the management of individuals in jail, and (4) share information appropriately across the criminal justice system.
Through the direction of the Michigan Department of Community Health (MDCH) and the Michigan Department of Corrections (MDOC), the Diversion Strategies Workgroup was formed in January 2012, with Lynda Zeller of MDCH as Chairperson and consisting of judges and other trial court personnel, law enforcement, mental health professionals, and advocates for persons with mental illness. In March, Governor Snyder reemphasized the importance of the workgroup's charge in his Public Safety message. Under the leadership of Chairperson Zeller, the Workgroup in June completed the Diversion Action Plan, implementation of which would represent a "systems change" in how Michigan accomplishes the diversion of individuals with mental illness away from incarceration and to monitored treatment.
Workgroup Recommendations: Recognizing that there are several "points of intercept" where those with mental illness may encounter the criminal justice system, the workgroup recommends the following systemic changes to improve the opportunities for diversion and improvement of care.
- Strengthen pre-booking diversion. Every day, all across the state, law enforcement interfaces with individuals with mental illness, and in many cases diversion from jail is appropriate. It has been shown that law enforcement who are trained in Crisis Intervention Team (CIT) techniques employ diversion much more frequently and reduce potentially dangerous escalations in the field. Pre-booking diversion can be strengthened through a coordinated implementation of CIT throughout the state (perhaps beginning with local, urban pilots) as well as by ensuring that a commitment to jail diversion applies to all law enforcement agencies in addition to Community Mental Health (CMH) programs. By collecting data of the prevalence of pre-booking diversion we will also learn over time how successful our efforts have been.
- Improve mental health treatment in jails. The first step to improving the treatment in jail of those with mental illness is to survey the prevalence of mental illness in jails and identify any service gaps. Other important steps include making jail mental illness screening and evaluation instruments uniform, improving prisoner mental health information, and ensuring continuity of medications on transfer to jail or prison.
- Expand post-booking diversion options. Even after someone with mental illness has been charged with a crime diversion out of jail if often appropriate. By expanding mental health courts and the use of mental health services in probation as well as by making the use of jail-based diversion uniform across the state, post-booking diversion can be increased.
- Reduce opportunities for incarceration and re-incarceration. Changes outside of law enforcement, jails, and criminal courts can achieve diversion through prevention. Hence, by reviewing the involuntary mental health treatment process in Probate Courts and improving mental health treatment upon re-entry, among other initiatives, the number of those with mental illness who are incarcerated can be reduced.
- Establish a mechanism to coordinate and assist with implementation of above goals. In order to ensure the above substantive goals and the systems change they represent are accomplished, it is critical to establish a diversion coordinator as well as an advisory committee.
Return-on-Investment Potential: As some nationally-recognized models have shown, a comprehensive diversion solution can result in an overall cost savings. For instance, a recent analysis of the model employed in Bexar County (San Antonio) – a model that employs a span of diversion techniques similar to that recommended here – shows savings ranging from $3200 per person diverted pre-booking to $1200 per person diverted post-booking. As we go forward, success stories like Bexar County should be studied closely so that Michigan's solution realizes a return on investment not only with respect to agency efficiency and a reduction in unnecessary incarceration but also with respect to the total amount of resources expended.
Suggested Next Steps: If the action plan meets the approval of the Governor, we suggest the following next steps for implementation:
- Coordinator and Advisory Committee. Create the paid position of State Diversion Coordinator and hire a coordinator. Establish a State Diversion Advisory Committee, a volunteer body to provide feedback and advice to the coordinator on diversion action steps.
- Initial Coordinator Charge. Charge the coordinator with these initial tasks: (1) formulate specific implementation requirements for workgroup action steps, including any required changes in legislation, policy, or rule; (2) provide an initial financial analysis of action step implementation, including any necessary funding allocation. It is contemplated that the coordinator would use a limited number of focused stakeholder groups in accomplishing the above tasks.