Mental Health Intervention vs. Incarceration

Today’s prison system finds a disproportionate amount of people with mental health challenges.
Recent figures indicate that 37% of adult prisoners have a mental illness.1 Additionally, 65% of prisoners and inmates have a primary or comorbid substance use disorder (SUD).2 The system is not set up to address the mental health needs of inmates or provide potentially life-saving treatment. This is why identifying individuals with mental health challenges or SUD before they become involved in the justice system is the first step to diverting them to community-based care. Early identification and intervention are especially important for justice-involved minors since 65-75% of the two million children arrested each year in the United States have a mental health disorder.3

Unique challenges exist for vulnerable populations

People experiencing a mental health crisis may exhibit behaviors that frighten others or that seem to violate the law. The response to this type of event can have life-changing consequences, as it often determines an individual’s path through one system or another. Are they directed toward appropriate mental health care or do they become entangled in the juvenile or criminal justice system?

Sometimes people feel so desperate they plead guilty to charges in an attempt to get the care they need while incarcerated. However, accessing care in the prison system can be so complex that people often don’t know where to start. In addition, many states cancel Medicaid enrollment upon incarceration, which means individuals must reapply when released, creating gaps in access to care. This creates a vicious cycle of recidivism—with 50% of people with a mental illness reentering prisons within three years of release.4

Carelon Behavioral Health developed the Sequential Intercept Model (SIM) to identify six points—or intercepts—at which individuals come into contact with the criminal justice system. SIM demonstrates how an organized crisis system can react at each of those points to prevent continued criminal justice involvement.

Crisis system components include:

  1. 1-800 hotlines
  2. Mobile crisis units
  3. Community-based locations for law enforcement drop-off and crisis walk-in
  4. Crisis stabilization centers
  5. Crisis and community collaboratives
  6. Integrated SUD/MAT solutions
  7. Providers at all levels of care
  8. System oversight and management

A coordinated behavioral health crisis system fosters collaboration between behavioral health and criminal justice agencies, improves identification of people with behavioral health needs, helps develop a service continuum and improves quality of care.