title: An analysis of post-booking jail diversion programming for persons with co-occurring disorders.
abstract: For persons with co-occurring disorders, interaction with criminal justice systems is a frequent occurrence. As a result, a variety of diversionary programs have been developed nationwide. In this study, a total of 248 individuals with co-occurring disorders of serious mental illness and substance use disorders who had been arrested and booked on misdemeanor charges participated in a post-booking jail diversion program in two urban communities. A quasi-experimental design was used with individuals assigned to diversion or non-diversion status based upon the decision processes of the mental health-criminal justice systems. The effectiveness of the jail diversion program was evaluated from a variety of sources, including structured interviews, behavioral health service utilization patterns, and criminal justice recidivism patterns. Analyses revealed general main effects for time on many of the outcome variables, with few main effects or interaction effects detected on the basis of diversion status (diverted versus non-diverted). Across all measures assessing mental health and substance abuse, study participants displayed improvements over time, irrespective of their diversion status or program location. Participants generally displayed no significant changes in their rates of accessibility to, or frequency of use of, the various mental health, substance abuse, and other services, and few changes for diversion status were detected with regard to service utilization. Although a number of indicators of criminality and violence were reduced over time, these reductions were statistically insignificant, with changes for diversionary status or time identified at follow-up. These results are discussed in light of their implications for jail diversion programming and future research in this area.
authors.affiliation: University of Arizona, Applied Behavioral Health Policy Division, 721 North Fourth Avenue, Tucson, AZ 85721, USA. shafer@u.arizona.edu
authors.forename: Michael S
authors.initials: MS
authors.lastname: Shafer
authors.forename: Brian
authors.initials: B
authors.lastname: Arthur
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Franczak
mesh_terms: D000437:Alcoholism / Q000175:diagnosis / Q000453:epidemiology* / Q000534:rehabilitation; D001130:Arizona; D001521:Behavior Therapy / Q000331:legislation & jurisprudence; D019090:Case Management / Q000331:legislation & jurisprudence; D003134:Commitment of Persons with Psychiatric Disorders / Q000331:legislation & jurisprudence*; D003156:Community Mental Health Services / Q000331:legislation & jurisprudence / Q000706:statistics & numerical data; D015897:Comorbidity; D005500:Follow-Up Studies; D006801:Humans; D008329:Managed Care Programs / Q000331:legislation & jurisprudence; D019964:Mood Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000534:rehabilitation; D010043:Outcome and Process Assessment, Health Care; D010342:Patient Acceptance of Health Care / Q000523:psychology / Q000706:statistics & numerical data; D011329:Prisoners / Q000331:legislation & jurisprudence / Q000523:psychology; D011330:Prisons / Q000331:legislation & jurisprudence*; D012017:Referral and Consultation / Q000331:legislation & jurisprudence*; D012559:Schizophrenia / Q000175:diagnosis / Q000453:epidemiology* / Q000534:rehabilitation; D019966:Substance-Related Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000534:rehabilitation; D014600:Utilization Review