CLINICAL HANDBOOK OF SCHIZOPHRENIA

50. Jail Diversion 527several distinct points at which a defendant with severe mental illness might be interceptedand diverted to community-based mental health treatment (Munetz & Griffin,2006; see Figure 50.1). For a mental health clinician the significance of this “sequentialintercept model” is that the different intercept points identify the main criminal justicepartners that must be engaged if diversion is to work, as well as the legal constraints withwhich he or she must deal in developing a diversion plan, as discussed below.Basically, there are two types of jail diversion programs: prebooking and postbookingdiversion. Prebooking diversions occur before arrest and before charges are filed.Here, the partnership is between mental health clinicians and police officers. The goal isto avoid charging a person with a crime when there is evidence of severe mental illnessand the behavior or offense is a nonviolent misdemeanor (low-level offense). This is diversionat the “front door” of the criminal justice system, because the individual neverenters the system via arrest and detention.Several models of police–mental health clinician collaboration have been developed,including the traditional referral approach, whereby police officers bring persons withmental illness to a community mental health center for evaluation and treatment, and thecolocation approach, in which civilian mental health clinicians are employed by the lawenforcement agency to work alongside police officers. But the most effective current formof police-based diversion is the crisis intervention team (CIT), whose members are swornofficers trained to act as liaisons to the mental health system and to learn about basicconcepts of mental illness, special management techniques for diffusing disturbances involvingpersons with mental illness, and procedures for transporting persons with mentalillness to a no-refusal psychiatric emergency service rather than jail. With the endorsementand support of the National Alliance on Mental Illness (NAMI), CITs have diffusedrapidly since the prototype program was developed in Memphis, Tennessee, in the early1990s. Now CITs can be found in police departments in many large and mid-size citiesacross the country.Postbooking diversions occur at one of several points after the filing of formalcharges by a police officer. Here, the police officer exits the diversion scene, and severalFIGURE 50.1. GAINS Center sequential intercept model. This diagram is a modification of theSequential Intercepts for Change: CJ-MH Participation model, which can be found at www.gainscenter.samhsa.gov.