Law enforcement officers, prosecutors, defenders, and judges - people on the front lines every day - believe too many people with mental illness become involved in the criminal justice system because the mental health system has somehow failed. They believe that if many of the people with mental illness received the services they needed, they would not end up under arrest, in jail, or facing charges in court. Mental health advocates, service providers, and administrators do not necessarily disagree. Like their counterparts in the criminal justice system, they believe that the ideal mechanism to prevent people with mental illness from entering the criminal justice system is the mental health system itself  -  if it can be counted on to function effectively. They also know that in most places the current system is overwhelmed and performing this preventive function poorly.

Policy Statement 1 and the recommendations that follow describe the role that the mental health system should play in helping people with mental illness avoid inappropriate contact with the criminal justice system. For the most part, they reflect general principles and do not delve into areas of detail similar to those found elsewhere in the report.  Readers may know whether the services described in this section are available in their communities; if large numbers of people with mental illness are in contact with the criminal justice system, it is likely that necessary services are lacking.

Chapter VII contains a comprehensive examination of the elements of an effective mental health system, upon which implementation of many of the policy statements throughout the report depend. 

1.  Involvement with the Mental Health System

There are communities across the country where appropriate and necessary mental health services were never developed, have closed down, or for some other reason are not available. In large cities, the wait for an appointment with a mental health professional may be measured in months, while in small rural communities the responsible agency may be based in a town many miles across the county. In either case, it cannot be said that mental health services are available when or where they are most needed.

To be effective, services must meet the immediate needs of those who seek them. They must be comprehensive, meaning they must be prepared to address the full range of issues presented by an individual with mental illness. They must also be flexible enough to be tailored to each person who enters the system.  In highlighting the need for improved access to mental health services, advocates, providers, and others in the mental health field frequently use these two phrases. On first glance, these terms may appear to be contradictory, but the two concepts can be entirely complementary.   A "no wrong door" policy addresses the critical need to engage people in care while a "single point of entry" is a mechanism for integrating services in response to an individual's complex needs. (See sidebars below for more on the concepts)

No Wrong Door

No wrong door refers to a service system that welcomes people in need wherever they try to gain access. Persons with mental illness often have a broad array of associated health, social service, and support needs.  Not knowing the mission of an agency or the relationship between agencies, they may present different providers with any one of a number of concerns.  "No wrong door" policies commit all service agencies to respond to the individual's stated and assessed needs through either direct service or linkage to appropriate programs, as opposed to sending the person from one agency to another until he is able to establish a connection with the system. Many people with mental illness lack the capacity to navigate the complicated array of services or they may feel rejected in their efforts to obtain help. Discouraged, they simply drop out of the system and join the ranks of untreated, homeless people with mental illness who come into frequent contact with the criminal justice system. A no wrong door policy accepts that the first step toward successful mental health care is engaging the individual. ^[1]  

Single Point of Entry

A single point of entry is a mechanism for ensuring an individual gets the appropriate range of services.  The "single point of entry" system accepts the burden of integrating services rather then placing that burden on the individual.  It places responsibility with a designated agency to oversee each client's movements through the different services and programs available in a given community. The care that person needs can then be coordinated, even when more than one agency is involved in providing it.  An individual with multiple needs who seeks care in a community with a "no wrong door" policy may be referred to a "single point of entry."

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