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Understand Their Perspective
As most advocates are aware, the influx of many of its clients into the criminal justice system is just one of numerous problems facing the overtaxed and underfunded mental health system. But the system's general disarray is not the only reason why mental health agencies struggle to provide services for those involved in, or at risk of involvement in, the criminal justice system. Other challenges the mental health system faces include the following:
Individuals with mental illness involved in the criminal justice system are often the toughest to serve. They may resist initial efforts at treatment engagement, and require mental health providers to reach out to them in homeless shelters, jails, or other non-clinical locations.
Many mental health agencies have experienced incidents in which a client with criminal justice history threatened or harmed a service provider, raising concerns about staff safety.
Long waiting lists and chronic budget shortfalls lead some providers to feel that they should focus on the vast majority of their clients who have not been involved in the criminal justice system, as they may be easier to serve and "more deserving."
Explain Why Addressing the Issue is in Their Interest
In many communities, mental health providers are the last group willing to focus on the criminal justice population. Their reticence stems from the reasons mentioned above, and from the perception that once involved in the criminal justice system, individuals with mental illness essentially become someone else's responsibility. Some arguments advocates can use to get mental health providers on board include the following:
They are already mental health system clients: Most individuals with mental illness in the criminal justice system are already clients of the mental health system. Providing services to them is part of the mental health system's core mission, regardless of where those individuals reside.
Enlist criminal justice allies: Addressing the problem can help mental health providers to enlist powerful allies in the criminal justice system who, together with mental health administrators, can raise awareness of the need for improved community-based mental health services.
Improve continuity of care: Providing effective services to criminal-justice-involved clients can help prevent their future arrest and incarceration, which makes it easier for mental health agencies to provide continued effective treatment to their clients.
Elected officials are demanding accountability: Elected officials are increasingly demanding measurable results from mental health providers, including proof that they can prevent criminal justice involvement of their clients.
Propose an Initiative
Every initiative mentioned in this handbook requires close collaboration between criminal justice agencies, mental health treatment providers, and advocates, and should strive to engage representatives of both systems as they propose new strategies. At the same time, there are some efforts that the mental health system is particularly well-positioned to spearhead on their own and are promising areas for advocacy. In particular, advocates can work to ensure that the mental health system implements evidence-based practices, or mental health services for which consistent scientific evidence demonstrates their ability to improve outcomes for individuals with mental illness.
Forensic Assertive Community Treatment Teams: Mental health agencies have recently begun to adapt the Assertive Community Treatment (ACT) model to target individuals with mental illness involved in the criminal justice system.
Integrated co-occurring disorder treatment: More than three-quarters of the individuals with mental illness in the criminal justice system have co-occurring substance use disorders, which are most effectively treated in an integrated fashion. Unfortunately, integrated treatment is not consistently available for any person with mental illness, let alone those with criminal histories, and this service gap contributes greatly to the high numbers of people with mental illness in the criminal justice system.
Supportive housing : Recognizing the critical importance of stable housing linked closely with services in recovery, some mental health agencies have taken the lead in developing supportive housing for all clients, especially those involved with or at risk of involvement with the criminal justice system.
In-reach: Some mental health providers committed to engaging clients prior to their reentry from jail and prison are conducting "in-reach" -- visiting clients while they are still incarcerated and developing a relationship and plan for treatment when they are released.
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