SAMHSA supports treatment and recovery efforts for people in criminal and juvenile justice systems with mental and/or substance use disorders.
Given the high prevalence of people with mental and substance use disorders involved with the justice system, SAMHSA has prioritized this population. Recognizing that behavioral health treatment and recovery support services are critical but also need to be balanced with the community priority of public safety, SAMHSA has created an array of programs, technical assistance centers, resources, and policy initiatives that take these issues into consideration.
SAMHSA’s criminal justice work is organized around a framework for intervention referred to as the Sequential Intercept Model. This model identifies five key points for “intercepting” individuals with behavioral health issues, linking them to services and preventing further penetration into the criminal justice system. This model builds on collaboration between the criminal justice and behavioral health systems; highlights where to intercept individuals as they move through the criminal justice system; identifies critical decision-makers who can authorize movement away from the justice system and into treatment; and delineates essential partnerships among mental health, substance abuse, law enforcement, pre-trial services, courts, judges, jails, community corrections, social services, and others. Through its criminal justice initiatives, SAMHSA aims to:
- Bring about strategic linkages with community-based behavioral health providers, the criminal justice system and community correctional health
- Promote effective diversion and reentry programs
- Foster policy development at the intersection of behavioral health and justice issues
Examples of SAMHSA Initiatives at Each Intercept
Intercept 1: Community and Law Enforcement
The Early Diversion Program aims to divert people with mental health, substance use, or co-occurring disorders from the criminal justice system and into community services without the leverage of the court. The program focuses on the role of law enforcement officials working collaboratively with community behavioral health providers to prevent arrest and adjudication. Through this partnership law enforcement and behavioral health agencies design, implement, and oversee comprehensive strategies for diversion and engagement practices. Developed with input from a partnership with the International Association of Chiefs of Police, this program aims to divert individuals at the earliest opportunity into community-based service alternatives, for crisis intervention, screening, assessment, and referral to treatment before an arrest is made, while simultaneously maintaining public safety.
The Teen Court Program focuses on preventing juvenile crime by diverting youth with substance use treatment needs from deeper immersion in the traditional juvenile justice system to teen courts. SAMHSA’s Teen Court program provides substance use treatment services and related recovery support services to youth with substance use or co-occurring treatment needs. Teen courts are peer-run courts where youth sentence their peers for minor delinquent and status offenses and other problem behaviors, providing positive alternative sanctions for first-time offenders. Expected outcomes from this program include reduced substance use and criminal activity, improved health and better quality of life, and increased productivity.
Intercept 2: Arrest and Initial Detention/Court Hearings
The Adult Behavioral Health Treatment Court Collaborative aims to allow local courts more flexibility to collaborate with multiple criminal justice system components and local community treatment and recovery providers to address the behavioral health needs of adults who are involved with the criminal justice system and provide the opportunity to divert them from the criminal justice system. The collaborative will allow eligible individuals to receive treatment and recovery support services regardless of what court they enter. This program will focus on connecting with individuals early in their involvement with the criminal justice system and prioritizing the participation of municipal and misdemeanor courts in the collaborative.
Municipal courts have been prioritized in this program as they are often the court of first appearance and have the potential for earliest diversion from the justice system. Most arrested people appear before a municipal court (or its equivalent). Given the high volume of cases, the high prevalence of individuals presenting with behavioral health disorders, and the likelihood of less-serious charges, municipal courts are an opportune vehicle for diverting people with behavioral health needs into treatment. Diversion through municipal mental health courts has been effective in improving public safety; reducing incarceration rates for people with mental and/or substance use disorders; connecting participants to services and increased treatment success; and improving access to housing and other community supports−all towards enhancing participants’ quality of life.
Intercept 3: Jails/Specialty Courts
At this intercept, most of SAMHSA’s efforts involve working with specialty or problem-solving courts. These courts may include drug courts, mental health courts, tribal wellness courts, veterans’ courts, and domestic violence courts. The focus of these courts is to address the underlying mental health and substance use issues and related needs of offenders by using the sanctioning power of the court to connect with treatment and other alternatives to incarceration. For example, research has demonstrated that drug courts help reduce recidivism and substance use among offenders and increase their likelihood of successful habilitation through early, continuous, and intense judicially supervised treatment; mandatory periodic drug testing; and the use of appropriate judicial sanctions and linkage with other services and supports.
In FY 2013, SAMHSA awarded new grants under its Jail Diversion program. This three-year grant program emphasizes early diversion of people with behavioral health conditions at risk of being arrested. This program has prioritized veterans.
Adult Treatment Drug Courts expand and/or enhance substance abuse treatment services (screening, assessment, case management, recovery support services) in existing adult and family “problem solving” courts, which use the treatment drug court model with defendants/offenders. Adult drug court models include drug courts serving adults, tribal healing-to-wellness courts, driving-while-intoxicated/driving-under-the-influence courts, co-occurring drug and mental health courts, veterans’ courts, and municipal courts that use the problem-solving model. The program provides a coordinated, multi-system approach designed to combine the sanctioning power of treatment drug courts with effective treatment services to break the cycle of criminal behavior, alcohol and/or drug use, and incarceration or other penalties.
The Joint Adult Drug Court Solicitation to Enhance Services, Coordination, and Treatment (DOJ/BJA) aims to expand and/or enhance the drug court capacity of states, localities, and tribes to reduce crime and substance abuse among high risk/high need offenders. This evidence-based approach includes the key elements of judicially supervised treatment, drug testing, community supervision, appropriate sanctions, and recovery support services. This grant program serves high risk/high need populations diagnosed with substance dependence or addiction to alcohol/other drugs and identified as needing immediate treatment. The program also provides services for co-morbid conditions, such as mental health problems.
Adult Tribal Healing to Wellness Courts Program provides resources for tribal courts to divert American Indians and Alaska Natives with substance use and co-occurring mental health disorders away from the criminal justice system and into behavioral health treatment.
The Juvenile Treatment Drug Court Program diverts young people from juvenile detention to community-based behavioral health treatment, with the goal of treatment and recovery and prevention of deeper involvement with juvenile and criminal justice systems.
Reclaiming Futures is a jointly funded program among SAMHSA, the Department of Justice’s (DOJ) Office of Juvenile Justice and Delinquency Prevention, and the Robert Wood Johnson Foundation. This is an intensive youth diversion and community integration program. SAMHSA’s role within this initiative is the provision of behavioral health services for the youth in treatment drug courts.
A Juvenile Mental Health Treatment Courts Database, maintained by the SAMHSA GAINS Center, provides resources for case management and support for youth with behavioral health needs in the juvenile justice system. Juvenile courts focus on treatment and rehabilitation and help divert youth from juvenile detention facilities to community-based services in their local systems of care.
The Adult Mental Health Treatment Courts Database, also maintained by the SAMHSA GAINS Center, provides a roster of mental health courts in the United States. It includes:
- The location of each mental health court
- The year established
- Target participants
- Approximate annual enrollments or total enrollments
- Contact information
Intercept 4: Reentry from Jails and Prisons to the Community
Individuals with mental and/or substance use disorders involved with the criminal justice system can face many obstacles accessing quality behavioral health services. Too often, many return to drug use, criminal behavior, or homelessness upon reentry into society. Those with mental and/or substance use disorders have even greater challenges, and many end up cycling back through the system. The Office of National Drug Control Policy reports:
- More than 40% of offenders return to state prison within 3 years of their release
- 75% of men and 83% of women returning to state prison report using illegal drugs
SAMHSA uses a two-pronged approach to help meet the needs of individuals returning to the community, and the needs of the community, through:
- Supporting grant programs such as the SAMHSA Offender Reentry Program (ORP) that expands and enhances substance use treatment services for individuals reintegrating into communities after being released from correctional facilities
- Actively partnering with other federal agencies to address myriad issues related to offender reentry through the implementation of policy changes, making recommendations to U.S. states and local governments, and eliminating myths surrounding offender reentry
SAMHSA’s Offender Reentry Program expands and enhances substance use treatment and related recovery and reentry services for adult offenders who are returning to their families and community after incarceration in state and local facilities including prisons, jails, or detention centers. The program encourages stakeholders to work together to give adult offenders with co-occurring substance use and mental health disorders the opportunity to improve their lives through recovery. The program also helps people develop the capacity and skills to become productive members of the community and reduce the probability of re-offending and re-incarceration.
Other Resources and Programs
Some Offender Reentry grantees are using SAMHSA’s Opioid Overdose Prevention Toolkit, which equips communities and local governments with materials to develop policies and practices that help prevent opioid-related overdoses and deaths. It also addresses issues for first responders, treatment providers, and those recovering from opioid overdose.
SAMHSA’s Treatment Locator is an online source of information for people seeking treatment facilities in the United States or U.S. territories for mental and/or substance use disorders. The Locator can be searched by state, city, or address.
Visit the SAMHSA GAINS Center and the SAMHSA store for additional reentry publications and information. The SAMHSA-funded STAR (Support, Technical Assistance, and Resources) Center has developed a three-part series (PDF | 1.37 MB) to support the justice-involved community. These products focus on supporting people with psychiatric disabilities in the criminal justice system, and provide a self-advocacy and empowerment toolkit and a promising practices guide.
The Affordable Care Act presents opportunities to expand coverage to individuals who generally have not had health insurance in the past and are reentering the community from jails and prisons. SAMHSA’s Enrollment Coalitions Initiative targets these uninsured individuals in the new Health Insurance Marketplace through its Criminal Justice Organizations coalition. This initiative developed the Criminal Justice Health Insurance Market Toolkit. The Health Insurance Marketplace website also has outreach and education information for people in courts and corrections systems. Or visit Healthcare.gov’s section on incarcerated people to learn more.
SAMHSA is involved in the Federal Interagency Reentry Council, established by the Attorney General in 2011, which works to improve the criminal justice system and connections with the community in order to minimize the challenges for people reentering the community from incarceration. The council consists of cabinet level representatives from 20 federal agencies who work to make communities safer by reducing recidivism and victimization, assisting those who return from prison and jail to become productive citizens, and saving taxpayer dollars by lowering the direct and collateral costs of incarceration.
The Council represents a significant executive branch commitment to coordinating reentry efforts and advancing effective reentry policies. It is premised on the recognition that multiple federal agencies play a role in offender reentry. The reentry population comes into contact with a wide range of systems beyond the criminal justice system: health care systems, employment and workforce systems, housing and homeless shelters and supports, child support offices, etc.
A primary focus of the Council is to remove federal barriers to successful reentry, so that motivated individuals who have served their time and paid their debts are able to compete for a job, attain stable housing, support their children and their families, and contribute to their communities. Participating council agencies are taking concrete steps towards these ends, to not only reduce recidivism and high correctional costs but also to improve public health, child welfare, employment, education, housing, and other key reintegration outcomes.
The Federal Interagency Reentry Council has information and resources related to health care for prisoners, including Snapshot: Health Care and Behavioral Health.
SAMHSA’s Criminal Justice programs and policy staff are key participants in multiple Federal Interagency Reentry Council workgroups, including:
- The DOJ-led Reentry Council Support Workgroup
- The DOJ-led Reentry Research Workgroup
- The Department of Health and Human Services’ (HHS) Reentry Health Care Access Workgroup
- The HHS-led Women and Reentry Workgroup
- The HHS-led Reentry and Child Support Workgroup
- The HHS-led Benefits Access Plan Workgroup
- The DOJ and HHS’ Reentry Program Management Subcommittee
DOJ’s National Reentry Resource Center (NRRC) provides education, training, and technical assistance to states, tribes, territories, local governments, service providers, non-profit organizations, and corrections institutions working on prisoner reentry. The NRRC’s mission is to advance the reentry field through knowledge transfer and dissemination and to promote evidence-based best practices. Specifically, the NRRC provides a one-stop, interactive source of current, evidence-based, and user-friendly reentry information; individualized, targeted technical assistance for Second Chance Act grantees; and training, distance learning, and knowledge development to support grantees and advance the reentry field.
Established in 2008 by the Second Chance Act (Public Law 110-199) (PDF | 221 KB), the NRRC is administered by DOJ’s Bureau of Justice Assistance and is a project of the Council of State Governments Justice Center, along with key project partners including the Urban Institute, the Association of State Correctional Administrators, and the American Probation and Parole Association.
SAMHSA, along with other federal agencies, serves on the Federal Interagency Reentry Council Subcommittee for Children of Incarcerated Parents. As this subcommittee report – 2014 (PDF | 264 KB) notes, the arrest of a parent can have a significant impact on a child’s social and emotional well-being. The sudden loss of a parent to incarceration and the trauma associated can have lasting consequences for a child. These children may face increased risk of homelessness, household disruption, problems at school, and behavioral and emotional difficulties, including depression, fear for their incarcerated parent, confusion, and anger towards authorities.
Intercept 5: Community Corrections.
SAMHSA has no major programs addressing the Community Corrections at this time. Access DOJ’s National Institute of Justice for more information on community corrections.