Data is key to reducing the number of people with mental illnesses in jails

The disproportionate number of people who have mental illnesses in jails has reached national crisis levels.

Estimates show that 2 million U.S. jail admissions each year involve people who have serious mental illnesses, many of whom also have substance use disorders. Several individual county studies have also found that people who have mental illnesses are three to six times more likely to be booked in jail compared to the general public. The issue disconnects people from critical mental health treatment, does little to improve public safety, and strains already-tight budgets of communities large and small.

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In recent years, a broad coalition of law enforcement officials, judges, policymakers, and behavioral health professionals have stepped up, committing themselves and their counties to preventing jails from becoming de facto psychiatric facilities. Now, with that leadership in place across hundreds of counties nationwide, it is time to address the next challenge: Many counties need help accurately identifying the number of people who have mental illnesses in their jails.

Without knowing that number, counties simply cannot solve this issue—how do you reduce a population when you don't know its size?

In response, Stepping Up—a national initiative designed to help reduce the number of people who have mental illnesses in jails—this month announced that it is expanding its efforts to ensure every county in the nation has the capacity to collect accurate, accessible data on 1) the number of people booked into their jails who have mental illnesses; 2) their length of stay in these facilities; 3) whether they are being connected to needed treatment after they’re released; and 4) how often they return to jail. Consistently collecting and analyzing this data will not only help counties create a system-wide impact, but also ensure more efficient use of taxpayer dollars.

Stepping Up’s partners—The Council of State Governments Justice Center, the National Association of Counties, and the American Psychiatric Association Foundation—will provide technical assistance on this issue to counties across the country. Those counties include the more than 425 across 43 states—representing 40 percent of the U.S. population—that have already joined the initiative.

This assistance is designed to help counties implement a three-step process to collect the data they need, which includes: establishing a shared definition of serious mental illness for local criminal justice and behavioral health systems; ensuring that every person booked into jail is screened for mental illness, including follow-up clinical assessments for those who screen positive; and regularly reporting on this population to stakeholders.

There are a number of barriers that make it difficult for counties to collect accurate data on this critical population, including the lack of staff capacity and/or validated screening tools to identify people who come into jail with mental illnesses; difficulty following up with people who are often released from jail within 48 hours; and challenges establishing policies and procedures related to data collection and analysis, information sharing across systems, and reporting on this population.

Despite the challenges counties face in gathering this data, it is not an impossible task. In fact, a number of counties across the country are already demonstrating that this type of data collection is both critical and achievable. As part of Stepping Up’s newest effort, a collection of seven Innovator Counties—rural and urban jurisdictions ranging in population from 22,000 to 2.6 million—have been selected to share their experience to help other counties improve their data collection efforts.

This first set of Stepping Up Innovator Counties includes Calaveras County, Calif.; Miami-Dade County, Fla.; Champaign County, Ill.; Douglas County, Kan.; Johnson County, Kan.; Franklin County, Ohio; and Pacific County, Wash.

By helping counties better identify and collect data on these individuals, we can progress even further toward meaningful reductions in the prevalence of people who have mental illnesses in jails, putting communities on paths to success and creating justice systems that work for all.

Roy Charles Brooks is the president of the National Association of Counties and Commissioner from Tarrant County, Texas; Tracy Plouck is vice-chair of The Council of State Governments Justice Center Board of Directors and director of the Ohio Department of Mental Health and Addiction Services; and Dr. Altha Stewart is president-elect of the American Psychiatric Association.