Diversion programs and alternatives to incarceration

Decreasing the number of individuals with mental illness in the criminal justice system remains a public mental health priority – one that has even reached the U.S. Supreme Court. Diverting individuals with mental illness from jail or prison decreases their exposure to that traumatic environment and addresses security concerns of corrections professionals charged with their care and management. When diversion is coupled with the court-based, problem-solving approach of monitored care and treatment in the community, public safety is improved and the clinical success of the individual is enhanced. When treatment in the community includes an explicit focus on criminogenic factors, the ability to meet public safety goals are enhanced even further. Given these several goals, as well as the considerable variability from jurisdiction to jurisdiction in court resources, treatment resources, social supports, political philosophies, and fiscal realities, the types of diversion that will work for one community may not work for another. However, the overwhelming majority of the data is clear that diversion can be implemented with documented success in the domains described above, and that there are a number of beneficial models for client intercept and associated programming. This chapter reviews the major models used to divert those with serious mental illness from incarceration, paying attention to some of the legal and clinical issues that arise as a result of diversion initiatives. Brief overviews of those interventions, including drug and mental health courts, jail diversion programs, and alternatives to incarceration for the mentally ill, are presented.