SAMHSA promotes early intervention and treatment as healthier alternatives to detaining people with behavioral health conditions in U.S. justice systems.
Many individuals who come in contact with law enforcement and the criminal or juvenile justice systems have a mental and/or substance use disorder. Treatment for serious mental illnesses such as bipolar disorder or schizophrenia in incarcerated settings is costly and challenging. Finding treatment services can be a difficult process for people struggling with addiction, but it is especially difficult for those arrested and entering the criminal justice system. Among those who do receive treatment, the quality of those services varies from state to state.
Most people with mental illnesses are not violent, and most violent crimes are not committed by people with mental illnesses. Researchers have found the prevalence of violence among those with a major mental disorder who had received treatment and did not abuse substances was indistinguishable from people in a non-substance abusing comparison group. People with psychiatric disabilities are far more likely to be victims than perpetrators of violent crime.
Upon release from incarceration, individuals with behavioral health issues face many barriers to successful reentry into the community, such as lack of health care, job skills, education, and stable housing, and poor connection with community behavioral health providers, which may jeopardize their recovery and increase their probability of relapse and re-arrest. Individuals leaving correctional facilities often have lengthy waiting periods before attaining benefits and receiving services in the community.
Progress has been made in some state correctional systems, which now suspend rather than terminate benefits such as Medicaid or Social Security, while individuals are incarcerated, and then immediately restart their benefits post-release. However, waiting periods and termination of benefits have devastating effects on the lives of offenders who need to connect with treatment providers to maximize the likelihood of recovery and prevent re-incarceration. These barriers are especially challenging for minority groups, which rank highest among the uninsured and are disproportionately represented in the criminal and juvenile justice systems.
To reduce the human and fiscal cost and consequences of repeated arrests and incarceration for people with behavioral health issues, improved access to behavioral health and other support services must be made available to individuals involved in the criminal and juvenile justice systems. SAMHSA approaches the work through:
- Identification of individuals with mental and substance use disorders.
- Pre- and post-adjudication using evidence-based screening and assessment to ensure comprehensive treatment, supports, and services.
- Diversion of individuals from the justice system into home- and community-based treatment.
- Using evidence-based and promising practices demonstrated to be less costly and more successful than treatment provided in confinement settings.
- Provision of training and technical assistance for law enforcement officers, juvenile and family court judges, probation officers, and other judicial decision-makers.
- Assurance of equity of opportunities for diversion and linkage to community services and supports for all populations in order to decrease disproportionate minority contact with the justice system.