2/5/2020 HOW MANY? Estimating the Size of the Los Angeles County Jail Mental Health Population Appropriate for Release into Community Services STEPHANIE BROOKS HOLLIDAY, NICHOLAS PACE, NEIL GOWENSMITH, IRA PACKER, DANIEL MURRIE, ALICIA VIRANI, BING HAN, and SARAH B. HUNTER context County jails: the largest mental health facilities in the U.S. 30% 30% There is increasing interest in “diverting” Percentage of incarcerated individuals in the LA County jail system in mental these individuals from the criminal justice system to community-based clinical services health housing units and/or prescribed psychotropic medications on average in 2018 2 1
2/5/2020 context 2015: LA County established the Office of Diversion and Reentry (ODR) Ho How man w many in in the the incarcerated p in carcerated population pulation 44 4474 are appropriate for are appropriate for div diversi rsion? n? Number of people who have 2018: LA County Board of been diverted into community- Supervisors directed study of based care through ODR- divertible population and supported programs development of diversion road map 3 context methods How many in LA’s jail mental health population are appropriate for diversion? We developed sets of clinical and legal criteria to classify cases into 3 categories: ODR staff review cases District attorneys, appropriate for to determine if an public defenders, and diversion individual is a judges consider legal potentially appropriate candidate for diversion factors for diversion not appropriate for diversion 4 2
2/5/2020 methods How many in LA’s jail mental health population are appropriate for diversion? • Study focused on ODR’s decisionmaking when operationalizing our categories We developed sets of clinical and legal criteria to classify cases into 3 categories: • Tested reliability of the criteria against preliminary study conducted by ODR appropriate for diversion • Applied criteria to random sample of 500 potentially appropriate individuals from the jail mental health population for diversion not appropriate for • Results used to estimate the proportion of the full diversion jail mental health population that would be classified into each category 5 results Study shows that more individuals are appropriate for diversion than not 100 Percent of Our results are consistent with ODR’s findings in 5,544 90 their preliminary study individuals in • 56% appropriate 80 jail mental • 7% potentially appropriate 70 health 60.8% population 60 ~3,368 50 individuals 40 31.8% 30 ~1,762 individuals 20 7.5% 10 ~414 indiv. 0 Appropriate for Potentially appropriate Not appropriate for 6 diversion for diversion diversion 3
2/5/2020 results More women than men are appropriate for diversion 100 90 73.6% of 826 80 incarcerated women 58.5% of 4718 70 incarcerated men 60 50 40 30 20 10 0 Appropriate for Appropriate for 7 diversion diversion implications Knowing these numbers is the fi firs rst s step toward understanding the types of pr types of prog ogra rams, staf ms, staff, and f, and fundi funding need needed ed to treat those individuals in the community 8 4
2/5/2020 implications Going forward, it would be helpful to know: • Le Levels of ca of care needed • How many could be served in exist isting ing programs ograms • What other ty other types pes of programs are needed Ot Other p her points ints at which individuals could • be diverted (e.g., at initial police contact) • How to mee meet the need the needs of peop of people who who canno cannot be be div diverted ed (e.g., through jail mental health services or reentry 9 programming) implications Study limitations Criteria not validated against Limited ability to consider Estimates likely represent the true “successful” diversion nor full range of stakeholder upper bound of those who against diversion outcomes input into the diversion might be appropriate for process diversion 10 5
2/5/2020 implications Recommendations Track the process Increase ODR’s capacity for data collection and and outcomes of diversion integrating with other sources of data in the more carefully County (e.g., treatment utilization, recidivism) Consider ways to ensure that diversion is Collaborate with other local and state level appealing to public defenders and individuals stakeholders to provide a robust set of initiatives facing legal proceedings – and programs to address mental illness in such as increasing pre-plea offerings justice-involved populations 11 Relevant Links • Full report is available at the following link: • https://www.rand.org/pubs/research_reports/RR4328.html • Report describing initial outcomes of ODR Housing program is available at the following link: • https://www.rand.org/pubs/research_reports/RR3232.html 12 6
2/5/2020 Discussion and Questions Thank You 7
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