New County Case Studies on Reducing the Number of People with Mental Illnesses and Substance Use Disorders in Jails

September 6, 2017


By Nastassia Walsh

In collaboration with the Stepping Up initiative, the Data-Driven Justice initiative and the One Mind Campaign, the Substance Abuse and Mental Health Services Administration (SAMHSA) convened a Best Practices Implementation Academy to Reduce the Number of People with Mental Illnesses and Substance Use Disorders in the Criminal Justice System (the Academy) in June 2017 in Washington, D.C. At the Academy, delegations from 23 jurisdictions involved in one or more of the three initiatives met to showcase best practice strategies and advance implementation efforts to address the issue of mental illness and substance use disorders in jails.

The case studies below are part of a series highlighting the six counties that constituted the “Best Practices” teams representing the Data-Driven Justice initiative and the Stepping Up initiative at the Academy. Click on the links below to access each case study.

Johnson County, Kan.: Using Mental Health Screening and Assessment to Serve Individuals with the Most Needs

Through a culture of collaboration, Johnson County, Kan., has developed numerous systems and processes to help collect, share and use data on individuals who come into contact with their county’s justice and human services systems, including those with behavioral health needs. The county uses these systems and processes to inform policy and funding priorities to better identify individuals with mental health treatment needs and connect them to services.

Fairfax County, Va.: The Diversion First Initiative to Reduce Incarceration of People with Mental Illnesses

Fairfax County, Va., launched its Diversion First initiative in 2015 to offer alternatives to incarceration for people with mental illnesses and/or developmental disabilities who come into contact with the criminal justice system for low-level offenses. The initiative began with an initial 40-person stakeholder group that has expanded to more than 18 members who meet quarterly as a whole and participate in various work groups on issues such as data and evaluation, communications, Crisis Intervention Team (CIT) training and more. Through every step of the initiative, the leadership and stakeholders’ groups communicate to the community about the work being done and the potential impact of these efforts to gain and maintain public support and trust.

Douglas County, Kan.: Using Mental Health Screening and Assessment to Serve Individuals with the Most Needs

In 2015, recognizing a need to relieve jail overcrowding and identify alternatives to jail for people with mental illnesses, Douglas County, Kan., leaders sought out policy and practice changes that could be put into place that would lead to better outcomes for their residents. The County Board of Commissioners supported the development of a Criminal Justice Coordinating Council to enhance collaboration among the various agencies and systems (including other municipal law enforcement agencies) needed to work on this issue. The Douglas County Sheriff’s Office was awarded a U.S. Department of Justice’s Justice and Mental Health Collaboration Program (JMHCP) grant and worked with the Bert Nash Community Mental Health Center and the University of Kansas to develop the Assist-Identify-Divert (AID) Program.

Coconino County, Ariz.: Building a Culture of Collaboration to Inform Criminal Justice Initiatives

In 2010, the Coconino County Board of Supervisors requested a recidivism study on people being released from the county jail. This request kicked off the county’s efforts to better collect, share, analyze and use data among county stakeholders and move to a culture of collaboration between partners to generate the best outcomes for individuals involved with the criminal justice system.

Middlesex County, Mass.: Building Regional Partnerships to Address Emerging Behavioral Health and Criminal Justice Trends

Middlesex County, Mass., is a large and diverse county encompassing 54 different cities and towns of various sizes. Throughout these jurisdictions, leaders were seeing similar trends in opioid-related crimes and fatalities and increasing law enforcement contact with people with co-occurring mental illnesses and substance use disorders. The Middlesex Sheriff’s Office was seeing the impact on its jail population. In 2016, the county adopted a regional approach to combat these issues by establishing partnerships between the sheriff and chiefs of police from police departments within the county. As of June 2017, 21 of the 54 police departments within the county had joined the Data-Driven Justice initiative and assigned a staff person to work collaboratively to address these issues.

Johnson County, Iowa: Using Data to Tell the Story of People with Mental Illnesses in the Community and in the Jail

Johnson County, Iowa, has been working on jail diversion since 2005 and has seen dramatic reductions in its jail population due to the foundation leaders created through the Crim­inal Justice Coordinating Committee (CJCC) and other efforts. Johnson County’s CJCC engages county and city leadership from law enforcement, behavioral health and the courts, as well as state leadership to help drive changes. One way leaders have continued the momentum and changed the community dialogue around these issues is by using data to help tell the story of the individuals they are trying to help and the potential impact of making changes to policies and programs.


SAMHSA contracted with Policy Research Associates (PRA), which operates SAMHSA’s GAINS Center for Behavioral Health and Justice Transformation, to facilitate the Academy. Additional partners included Optum Health, the National Institute of Corrections (NIC) and the Bureau of Justice Assistance (BJA), as well as the lead organizations of the Stepping Up initiative (the National Association of Counties, the American Psychiatric Association Foundation and the Council of State Governments Justice Center), the Data-Driven Justice Initiative (the National Association of Counties and the Laura and John Arnold Foundation) and the One Mind Campaign (the International Association of Chiefs of Police).

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