Chapter III: Pretrial Issues, Adjudication and Sentencing

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Outline
Introduction
Policy Statements:
7
8
9
10
11
12
13
14
15
16
Conclusion
Additional Resources

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Policy Statement 13: Intake at County / Municipal Detention Facility

Ensure that the mechanisms are in place to provide for screening and identification of mental illness, crisis intervention and short-term treatment, and discharge planning for defendants with mental illness who are held in jail pending the adjudication of their cases.

Overview
Recommendations:
a
b
c
d
e
f
g

Recommendation g: Commence discharge planning at the time of booking and continue the process throughout the period of detention.

One reality for jail staff attempting to address the mental health needs of pretrial detainees is that a detainee may be released at any time with little or no warning to jail staff - the detainee may post the bail or plead guilty and be sentenced to time served, or the prosecutor may dismiss the charges. Given this situation, it is of little surprise that recidivism rates among people with mental illness released from jail are exceptionally high. ^[1] Thus, it is important that planning for the ultimate discharge of the individual be an ongoing process during the time the individual is detained. Such planning should include arranging for services immediately upon release; ensuring that there is no disruption in medications made available to the individual; and assisting with other needs, such as housing, food, clothing, and transportation.

Example: Discharge Training, Fairfax County (VA) Jail

Discharge planning at the Fairfax County Jail is the responsibility of Offender Aid and Restoration (OAR), a nonprofit organization. OAR staff conduct weekly meetings with the jail's psychiatrist to set plans for release for all inmates with serious mental illness, and provide emergency services for those released before a plan is completed. Staff of OAR carry caseloads, and the same case manager works with an inmate with mental illness from the time of booking through discharge.

Example: Case Management Services for Pretrial and Sentenced Offenders, Hampshire County (MA) Jail

At the Hampshire County jail, all inmates, regardless of whether they have a mental illness, are assigned case managers, who have a typical caseload of approximately thirty detainees. Inmate treatment needs are assessed at intake, and the case manager then provides individual counseling, meets with the family, and makes referrals to appropriate resources both inside and outside the facility. Assignment of sentenced and pretrial inmates to a case manager facilitates the process from intake through discharge planning (and reentry, if applicable). A high level of contact between the client and the case manager ensures that inmates have access to services and that they do not slip through the cracks. ^[2]

One of the most pressing problems facing individuals with mental illness who have become involved in the criminal justice system is the lack of affordable housing. Housing for people with mental illness should be directly linked to other services, including mental health and substance abuse treatment, life skills, and job training. This model of "supportive housing" has been shown to have significantly higher retention rates than housing alone or housing that is not directly linked to services. ^[3] Long-term housing is crucial for helping individuals with mental illness maintain stability and avoid involvement in the criminal justice system. (See Policy Statement 38: Housing.)

Example: Maryland Community Criminal Justice Treatment Program (MCCJTP)

Through the Maryland Community Criminal Justice Treatment Program, staff in jails throughout the state work to provide treatment and aftercare plans for inmates with mental illness, and then provide community follow-up after their release. The MCCJTP has been widely recognized for impressive cross-system collaboration, focus on co-occurring disorders, transitional case management services, and attention to long-term housing needs. A $5.5 million grant from the U.S. Department of Housing and Urban Development, complemented by matching local funds, allows MCCJTP case managers to help offenders with mental illness who qualify as homeless to become eligible for Shelter Care Plus housing funds. ^[4] Local service providers participating in MCCJTP support Shelter Care Plus recipients with vocational training, substance abuse treatment, and life-skills training to ensure that these individuals have access to meaningful daytime activity.

Example: Conditional Community Release Program, Maricopa County (AZ) Adult Probation Department

The Maricopa County Adult Probation Department has instituted a program called the Conditional Community Release Program, which is geared toward early jail release of offenders with mental health issues and provides appropriate treatment in the community at a reduced cost. This program utilizes a contract psychiatrist, probation officer, surveillance officer, and intake specialist to identify, diagnose, and supervise offenders with mental illness. Once referred, the inmate is evaluated within 72 hours by an intake specialist. If appropriate, the inmate is admitted to the program and jail release planning is undertaken. The psychiatrist will see the person in jail in order to ensure continuity of care once released, and the probation officer will see the client to complete all necessary paperwork.

Once released, the probationer may be placed in a housing facility funded by Adult Probation, or released to their home if appropriate. While in the community, the client is supervised by the probation officer and surveillance officer, and seen by the psychiatrist for follow‑up treatment if not enrolled in community treatment. Using contracts with a local medical services agency, medication is provided at a reduced cost and necessary psychological testing is performed.

The program is 45 days in length, at which time the client is transferred back to his or her original probation officer, or referred to a specialized mental health caseload. In the event the client is not stabilized psychiatrically, the county will continue to serve the client until this is accomplished.

Lois A. Ventura, Charlene A. Cassel, Joseph E. Jacoby, Bu Huang, "Case Management and Recidivism of Mentally Ill Persons Released From Jail," Psychiatric Services 49:10, Oct. 1998, pp. 1330-37. This study examined the effect of community case management on recidivism for jail detainees who have mental illness. The study followed releasees for 36 months. Within the 36 months, 188 of 261 subjects (72 percent) were rearrested
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As reported in H. Steadman and B. Veysey, "Providing Services for Jail Inmates with Mental Disorders," National Institute of Justice Research in Brief, National Institute of Justice, Office of Justice Programs, U.S. Department of Justice, January 1997, p.4.
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Dennis P. Culhane, Stephen Metraux, and Trevor Hadley, "The Impact of Supportive Housing for Homeless People with Severe Mental Illness on the Utilization of the Public Health, Corrections, and Emergency Shelter Systems," Housing Policy Debate 12, 2001.
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The McKinney Act of 1987 is the major federal housing program to support people who are homeless. This act defines a homeless individual as (1) "an individual who lacks a fixed, regular, and adequate nighttime residence; and (2) an individual who has a primary nighttime residence that is - a) a supervised publicly or privately operated shelter designed to provide temporary living accommodations (including welfare hotels, congregate shelters, and transitional housing for the mentally ill); b) an institution that provides a temporary residence for individuals intended to be institutionalized; or c) a public or private place not designed for, or ordinarily used as, a regular sleeping accommodation for human beings." Technically, individuals coming out of detention facilities are not considered homeless until they have spent one night in a shelter or similar location. See www.hud.gov/offices/cpd/homeless/rulesandregs/laws/index.cfm
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