Final Report on Shelby County Jail Diversion Program

Executive Summary  

Here is the full report on substance abuse treatment related to the diversion program of Shelby County Jail study. The Shelby County jail diversion program proved to be a promising method for defining and implementing suitable diversion strategies substance abuse treatment that outlined how to connect to required community recovery programs and tools. People with co-occurring mental health and substance abuse disorders were removed from the criminal justice system and were placed into community-based care programs by a joint coordination mechanism with criminal justice and community partners.

The diversionary method for substance abuse treatment, proof-based comprehensive recovery programs were financed by a Center for Mental Health Services program from the first of June 2003 to the end of May 2007. Foundations Associates, a pioneering mental healthcare organization with proof-based recovery programs for people with co-occurring conditions, offered comprehensive medical treatment paired with best-practice strategies for criminal justice involving communities.  

From February 2004 to May 2007, a diversion program for substance abuse treatment participants participated in grant-funded programs and was given the option to engage in a comprehensive review of diversion program services. This assessment report aims to document and explain the substance abuse treatment project's conclusions and outcomes. A concise overview of project programs follows a short history and intent of the prison diversion project. Brief highlights for each year of grant-funded services are included in a chronological overview of project activities. The remaining sections go into assessment procedures and outcomes, as well as a summary of the conclusions. Between February 2004 to October 2006, 128 people with co-occurring psychological health conditions and drug use problems were effectively admitted and were entitled to at least one “register”. The diversion program respondents who attended community-based recovery programs for substance abuse treatment were slightly less likely to report to the criminal justice system six months and 12 months after the diversion. The program included evidence-based, comprehensive treatment facilities. Highlights from this report's evaluation are here:  

• Between February 2004 to October 2006, 128 people with co-occurring psychological health conditions and drug use problems were effectively admitted and were entitled to at least one “register” by the completion of grant-funded treatment. From February 2004 to May 2007, a total of 149 people were diverted.  
• The comprehensive evaluation and panel, discussion analysis process revealed that 60 out of the 220 eligible applicants for the intervention program did not meet the requirements. Owing to multiple procedural purposes (case discarded, unable to break co-defendant case, extra penalties) before submission to the courts, an extra 32 applicants fulfilled initial selection requirements but did not finish the group linkage preparation procedure for presentation to the courts (44 percent). Other factors included release 24 percent, medical criteria 17 percent, refusal 12 percent, and being referred somewhere 3 percent.  
• Regarding the generalized demographics such as age, sex, or ethnicity, there were no substantial variations amongst diversion applicants admitted to the program.  
• Sixty-two percent of those diverted finally finished 6-8 weeks of community-based intensive outpatient care programs that included evidence-based, comprehensive treatment facilities.  
• When correcting for other significant predictor variables of repeat offenders, diversion program respondents who attended community-based recovery programs were slightly less likely to report to the criminal justice system six months and 12 months after diversion and this proved the success of the diversion program for mental health patients.  
• Overall, opioid use decreased from 81 percent at baseline to 30 percent at six months and 27 percent at 12 months, with comparable patterns of increased results for those registering original medication, marijuana, and alcohol use to overdose.  

Annually, over Eleven million inmates are admitted into prison, with over 800,000 suffering from a severe psychiatric disorder. Although the overall prevalence of the severe mental disease is about 5%, 16% of prison prisoners are diagnosed with severe psychological illness issues. Users of the public psychological health services are five times more likely than the overall community to be imprisoned. Approximately 600,000 (75 per cent) of the 800,000 psychological health patients reported per year had a co-occurring opioid use disorder. This is unsurprising considering the scarcity of health resources offered to individuals with co-occurring disorders. We recognize that many individuals with co-occurring disorders first access the healthcare environment via the criminal justice system.  

As a result, attempts at prison rehabilitation would specifically meet consumers' concerns who have co-occurring disabilities. Due to deinstitutionalization's burden on community-based healthcare professionals' low budgets, our jails and prisons often shelter people with severe mental impairment and co-occurring drug use disorders. Through growing understanding of insufficient care, patients released from hospital-based rehabilitation usually have a high incidence of substance abuse, detention, and utilization of closely monitored service settings. People whose care demands substance abuse treatment include various recovery distribution systems often find themselves in constitutional criminal justice environments.  

Failure to incorporate effective solutions for substance abuse treatment endangers public safety, especially when it comes to the service requirements of individuals with co-occurring disabilities engaged with the criminal justice system, and is correlated with higher rates of abuse than the general community. Post-booking prison rehabilitation programming provides a viable solution to conviction and detention that carries little increased chance of further convictions and illegal activity. Even though creative diversion efforts, the Shelby County Division of Corrections have seen an approximate 507 per cent rise in the number of inmates housed, from a total of 571 inmates a day in 1985 to an average of 2,900 currently. Compared to national rates, the majority of convictions in Shelby County are on illegal substance offences. About 12%, or 3,600, of the 30,000 inmates handled annually in Shelby County are reported to be SPMI, and up to 3,000 of these have co-occurring MH/SA conditions.  

Instead of focusing on specialized court frameworks, the Shelby County Diversion scheme used a novel diversion mechanism primarily guided by the Public Defender's Office and Pretrial Services (e.g., Mental Health Court, Drug Court). Almost as a consequence, the Shelby County diversion initiative used the criminal justice system's current framework. Correctional centers, rehabilitation, parole, judges, and law enforcement are often involved in diversion services.  

The Shelby County Jail Diversion model for substance abuse treatment was created to combat the county's rapid growth in prison inmates since 1985. The county's criminal justice system is one of the country's largest centralized mental health care facilities suppliers. The initiative, which was developed for inmates with a psychiatric disorder and co-morbid drug addiction, was created to offer critical stopgap connectivity during the most vital phase of pre-sentencing/post-release, where targeted victims frequently neglect substantial advantages and the knowledge to manage the state's dynamic network of programs and resources.  

Further to the grant award in May of 2003, the project's initial development efforts were postponed for several weeks. The incorrect department inside the Shelby County government got notification of the grant award and early correspondence from SAMHSA grants administration. Regarding this minor setback, we encountered more severe setbacks due to many SAMHSA-mandated project adjustments, which necessitated re-approval from Shelby County's investigative committee before submitting the final agreements for all contract partners. These early developments necessitated an external evaluation of project testing procedures by our Institutional Review Board before the beginning of the substance abuse treatment grant registration. Given these initial barriers, diversion initiatives were soon introduced after attempts to negotiate the required application procedures were made. Owing to a shortage of accessible facilities anywhere in the city, several grant-funded applicants were lodged at Foundations Associates during their first year of admission. Owing to the lack of Medicaid funds accessible to Foundations Associates, this drain on finances within a sole local organization was incredibly challenging. Thankfully, Shelby County requested and obtained additional funds to include a robust network of recovery programs that would consist of further opportunities for those effectively released from the criminal justice system. Housing facilities for similarly released inmates that needed more comprehensive forms of treatment were provided under this proposed grant initiative.  

Throughout the award, early sample size enrollment estimates projected that the design methodology potential would be between 360 and 480 people with co-occurring conditions and criminal justice activity. Regarding fruitful diversion attempts, these expectations were lowered to support increasingly comprehensive community-based outpatient rehabilitation programs. Accompanying a year of successful substance abuse treatment project programs, local assessment results revealed disparities in existing options following grant-funded initiatives. As a result of the effectiveness of program diversion initiatives, available support for community-based programs was unable to adequately accommodate this surge of increasingly disadvantaged and nearly impossible to treat individuals. The limited programs that were accessible lacked resources that encouraged the use of evidence-based approaches. Consequently, after six weeks of evidence-based integrated recovery programs, linking to these reduced services usually resulted in adverse results right away.  

Adjustments to the substance abuse treatment program were made to improve connections to appropriate services with fewer appointments and diversion participants. According to initial estimates, more than 360 participants were expected to be covered by the diversion program's referral and recovery facilities. Due to the high number of cases, the initial program's investment focused on supporting active diversionary strategies with just six weeks of outpatient community-based care. Due to lower attendance rates, our plan expanded case management programs from 6 weeks to 4-6 months across the region for those who needed more linkage and assistance. As a consequence of these improvements, fewer diversion participants participated in 2005 and 2006.  

This is not the full report but a summary of essential points; you can read the full report.