Why it matters
Treatment and supervision agencies must collaborate to develop integrated case plans in order to reduce recidivism and improve health outcomes for people who are most likely to reoffend and have the greatest behavioral health needs. People in the criminal justice system are more likely to reoffend if they receive treatment and services from different agencies that don’t collaborate or from community-based treatment providers that do not have the capacity to provide effective specialized care for this population. Further, states often fail to take advantage of available federal and other health care funding (e.g., Medicaid, federal block grants, and private health care plans) to pay for this care.
Criminal justice and behavioral health agency leaders are increasingly seeking opportunities to improve health outcomes and reduce recidivism for people who have behavioral health needs, but these efforts too often occur without cross-agency collaboration. Behavioral health and criminal justice agencies have different missions and different approaches to service delivery. Yet these agencies serve a shared population that cycles through the complicated landscape of state and local criminal justice and behavioral health agencies. Without collaborating and coordinating on providing services to this shared population, criminal justice and behavioral health agencies can duplicate efforts, inadvertently work at cross purposes, and fail to address gaps in services.
As criminal justice and behavioral health agencies take responsibility for improving behavioral health and reducing recidivism, collaboration is essential to meeting those goals. By working together, these agencies can share information to develop common priorities and coordinated approaches, as well as pursue integrated strategies and leverage resources to improve the range, capacity, and quality of services. However, it isn’t enough for state agencies to work together; state and county leaders must also collaborate to identify challenges at the state and local level and develop shared solutions to improve responses to people who have behavioral health needs in local criminal justice systems.
What it looks like
- Model collaboration at the state level by establishing a committee consisting of representatives from state and local criminal justice and behavioral health agencies to remove barriers and improve collaboration and information sharing.
- See Case Study: Pennsylvania establishes Mental Health and Justice Advisory Committee and Criminal Justice Advisory Boards
- Encourage interagency collaboration across local criminal justice and behavioral health agencies.
- Require appropriate information sharing across agencies to reduce gaps and redundancies.
- See Case Study: Arkansas improves infrastructure to track behavioral health data
- Encourage collaborative case planning between supervision agencies and behavioral health providers.
Key questions to guide action
- What can be done in your state to incentivize collaboration between criminal justice and behavioral health agencies, both at the state and local level?
- Is there a standing state-level committee consisting of representatives from criminal justice and behavioral health agencies and relevant stakeholders that is focused on improving health and public safety outcomes for people in the criminal justice system who have behavioral health needs?
- Are there county-level collaborative efforts to improve health and public safety outcomes for people in the criminal justice system who have behavioral health needs? If so, what can be done to replicate efforts in other counties?
Use the information that follows to inform your answers to these questions.
Collaboration between behavioral health and criminal justice agencies is key to successfully improving the identification of people who have behavioral health needs, developing a range of treatment and services, and improving quality.
Justice and Mental Health Collaboration Program
The federal government is assisting state and local leaders to improve collaboration through efforts such as the Justice and Mental Health Collaboration Program, which was created to help states, local governments, and tribal organizations improve responses to people in the criminal justice system who have behavioral health needs. The program facilitates collaboration among the criminal justice, juvenile justice, and mental health and substance addiction treatment systems to better serve people who have behavioral health needs and to increase public safety. (For additional information on federal funding, see Part 3, Strategy 3.)
Pennsylvania establishes Mental Health and Justice Advisory Committee and Criminal Justice Advisory Boards
The Pennsylvania Commission on Crime and Delinquency (PCCD), in collaboration with the Pennsylvania Office of Mental Health and Substance Abuse Services and the County Commissioners Association of Pennsylvania formed the Mental Health and Justice Advisory Committee in 2009 to provide guidance and structure to ensure statewide coordination of Pennsylvania’s criminal justice and mental health systems. The Committee includes representatives from state agencies and the courts, county leadership, district attorneys, public defenders, consumers, families, and other criminal justice and mental health advocates and practitioners from across the commonwealth.
PCCD has supported the development of Criminal Justice Advisory Boards (CJABs) in counties across Pennsylvania by making grant funds available to counties to create new CJABs and provide support for CJAB-sponsored projects. To receive this funding from PCCD, a local CJAB must follow the minimum operating standards and receive technical assistance from regional representatives to help the CJAB serve as a local criminal justice planning team in collaboration with behavioral health and human services authorities. Thanks to these grants, 66 of the 67 counties in Pennsylvania have established a CJAB.
As of May 2018, PCCD was reviewing Justice Assistance Grants (JAG) applications from counties. Among other activities, these counties are eligible to apply for funding to invest in housing services for people in the criminal justice system who have behavioral health needs, or to assess the availability of behavioral health treatment across the criminal justice system and identify barriers to diversion, if they choose. The PCCD mental health committee has approved $350,000 in funding for technical assistance in this area for FY2019, and plans to approve another $800,000 to $1 million within the next year. It is possible that counties will decide to use resources to work toward achieving the goals of the Stepping Up initiative to reduce the number of people in jails who have mental illnesses.
Arkansas improves infrastructure to track behavioral health data
Many states and local jurisdictions have recognized the importance of improving the IT infrastructure needed to track behavioral health data and to measure health outcomes for people in the criminal justice system. In Arkansas, the Department of Human Services is working with county officials and community-based treatment providers to identify behavioral health data to collect from four pilot Crisis Stabilization Units (CSUs) established through the state’s Justice Reinvestment legislation and designed to serve people experiencing a mental health crisis. This collaborative effort will enable county and state leaders to analyze the effectiveness and cost savings of the CSUs in diverting people from county jail and hospital emergency departments.