CLINICAL HANDBOOK OF SCHIZOPHRENIA

50. Jail Diversion 525of law enforcement. Jails range in size from 10-cell facilities in rural counties to themegajails in large cities, such as Chicago, New York, and Los Angeles, that accommodate8,000–10,000 detainees in single or multiple complexes. Jails serve as adjuncts to thecourts, detaining individuals awaiting trial, those convicted and sentenced for 1 year orless, and those on hold pending transfer to other state or Federal authorities. Jails are designedas short-term facilities, so they are not equipped or staffed to provide a lot of servicesfor their detainees. Most individuals admitted to jails are released within 48 hours.In 2000, there were 1,320 adult state prisons, 84 Federal prisons, and 264 privateprisons that operated under contract with government (mostly Federal) agencies. Prisonshouse convicted felons, persons who have committed serious crimes and are sentenced bythe courts for a few years to life imprisonment. These facilities are operated by state orFederal departments of corrections, which are staffed separately from law enforcement.As long-stay facilities, they are equipped and staffed to provide recreational, vocational,and health care services for their inmates. All persons serving time in prison have spentsome time in jail as part of their criminal justice processing.On June 30, 2004, there were 713,990 persons in jails and another 1,494,216 inprisons. Although prisons house twice as many inmates as jails on any given day, morepeople pass through jails than through prisons over the course of a year, because jails areshort-stay, quick-turnaround facilities, whereas prisons are long-stay facilities. In 2004,jails had about 13.5 million admissions, whereas state and Federal prisons combined hadonly 28,000 admissions.The fates of persons with mental illness have always been intertwined with the shiftingboundaries between the criminal justice and mental health systems. The presence ofpersons with mental illness in jails is not new; the problem has been around for 200years, since the very beginnings of organized efforts to improve the care of persons withmental disorders in the United States. What is new is the volume of cases involving personswith severe mental illness now processed through jails. Just as state mental hospitalsonce served as the institutions of last resort for the care and confinement of persons withmental illness, jails have become the last secure environment in most communities for thecontrol of difficult-to-manage and noncompliant behavior. So, to a large extent, jails havenow taken on the social custody and time-out role once reserved for state mental hospitals,but on a short-term, revolving-door basis.The primary locus of diversion for persons with mental illness is law enforcementand jails, not prisons. With determinant sentencing, by the time a person with a severemental illness is convicted of a serious crime and gets sentenced to prison, it is too late todivert him or her to a community-based treatment program. The opportunity for diversion,if there is one, occurs during the initial, pretrial detention period in the jail or, forless serious offenders, during their sentenced time in jail. The more serious the offense,however, the less the likelihood that criminal justice authorities will consent to diversionof a person with mental illness. As a consequence, diversion of most people at the pointof jail detention is for misdemeanor, nonviolent charges.There is growing concern about the large numbers of people with severe mental illnessbeing released either through parole, when a substantial portion of a sentence hasbeen served, or at completion of a full sentence. For prisons, effective reentry into thecommunity requires arrangements for housing, restoration of entitlements, and participationin appropriate treatment to ease reintegration of prisoners whose ties to family andthe community have been strained or severed as a result of several years of incarceration.Although it is correct to view these reentry programs as efforts to avoid future incarcerations,they are better thought of as prevention programs rather than true diversion programsthat avoid arrest or secure early release of persons from criminal justice sanctions.