Policy and Practice February 2019

locally speaking By Christina Finello

Critical Intercepts: Breaking the Cycle Through Multisystem Collaboration

L ike many places, Bucks County is dealing with the growing popula- tion of individuals in the criminal justice system with mental illness, substance abuse, or co-occurring dis- orders. Solving the problem requires more than merely decreasing their numbers. It is about connecting individuals with behavioral health issues to appropriate community supports to avoid a return to the criminal justice system. Individuals with behavioral health issues repeatedly come back into the criminal justice system. Researchers note that persons with mental illness have higher rates of recidivism and those with co-occurring disorders of substance abuse and mental illness are more likely to recidivate than individuals with only serious mental illness. 1 Undoubtedly all levels of the criminal justice system are seeing more individuals with mental illness, substance use, or co-occurring dis- orders as their number continues to rise. They often stay in jail longer, are less likely to make bail, and are more likely to experience delays in case processing. The arrest rate for persons with behavioral health issues is also higher—4.1 percent compared with 1.2 percent for individuals without those issues. The arrest rate is as high as 16.1 percent for individuals with a mental illness and a substance use disorder. Recent studies place the rate of serious mental illness in jails at 14.5 percent for men and 31.0 percent for women (taken together, 17 percent of those entering those facilities), and 68 percent of jail inmates have a sub- stance use disorder. 2 Of the 17 percent

health issues in the criminal justice system requires true multisystem col- laboration. Working within a complex system, like human services, can be challenging at times and bringing in another equally complicated system— criminal justice—can compound those challenges. How can two seemingly distinct systems work together to achieve the goal of a better life for our county’s residents? In Bucks County, we recognized that a roadmap is needed to help focus efforts to solve the problem. We use a framework, the Sequential Intercept Model (SIM), 3 to achieve that purpose. The SIM is an organizing tool that helps conceptualize how to reduce the number of people with mental illness, substance abuse, or co-occurring

of individuals in jail with a serious mental illness, about 72 percent have a co-occurring substance use disorder. 3 This trend is evident in Bucks County, as stakeholders from both the systems of human services and criminal justice collaborate to devise strategies to reduce these numbers. Creating opportunities for diversion through appropriate community- based services outside of the criminal justice system would ameliorate this issue. Breaking the cycle of criminal activity for those with mental health or substance abuse issues requires understanding the pattern that formed the habitual behavior and those determinants that can be changed to improve the health and quality of life of individuals. Reducing the number of people with behavioral

See Intercepts on page 30

Illustration by Chris Campbell

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Policy&Practice February 2019