Facts and Trends • • • •
At the end of 2012, federal and state corrections facilities held over 1.5 million prisoners—or one in every 201 U.S. residentsi —and another 4.8 million were on probation or parole.ii In a five-site study of jail populations, researchers found rates of serious mental illnesses that are three to six times more than those found in the general population: 15 percent of men, 31 percent of women.iii Of people under probation supervision, individuals with mental illnesses are nearly twice as likely as others to have their probation revoked, prolonging their involvement in the criminal justice system. Reasons for revocation may be directly or indirectly related to a person’s mental illness.iv About three-quarters of jail prisoners who were identified as having a mental illness also met the criteria for substance abuse or dependence.v
Federal Funding of MIOTCRA FY2006
$5 million
FY2007
$5 million
FY2008
$6.5 million
FY2009
$10 million
FY2010
$12 million
FY2011
$9.9 million
FY2012
$9 million
FY2013
$8.8 million
FY2014
$8.2 million
The Mentally Ill Offender Treatment and Crime Reduction Act Background The number of people with mental disorders who come in contact with our criminal justice system is high. A 2006 Department of Justice study showed that approximately 45 percent of federal inmates, 56 percent of state inmates,and 64 percent of jail inmates displayed symptoms or had a history of a mental disorder; among female inmates in state prisons, the rate was nearly three out of four. In comparison, according to the National Institute of Mental Health, roughly one out of four adults in the general U.S. population is diagnosed with a mental health disorder in a given year.
The Mentally Ill Offender Treatment and Crime Reduction Act (MIOTCRA) In 2004, Congress authorized the Justice and Mental Health Collaboration Program through the MIOTCRA. This $50 million grant program, administered by the Bureau of Justice Assistance, was created to help states, local government, and tribal organizations improve responses to people with mental disorders who are involved with the criminal justice system. The program facilitates collaboration among the criminal justice, juvenile justice, and behavioral health systems to better serve individuals with mental disorders and to increase public safety. In 2008, Congress reauthorized the MIOTCRA program for an additional five years. The reauthorization bill expanded training to improve law enforcement responses to individuals with mental disorders; it also supported the development of law enforcement receiving centers to assess individuals in custody for mental health and substance abuse treatment needs, as an alternative to jail booking.
About the MIOTCRA Grant Program Each grantee is given the opportunity to tailor its responses to best fit their particular location and the unique needs of their community. Grants may be used for a broad range of activities, including: l
Specialized law enforcement-based programs l Mental health courts l Mental health and substance abuse treatment for incarcerated individuals l Community reentry services l Cross-training of criminal justice and mental health personnel l Training for local law enforcement officials on identifying symptoms of mental disorders and safely resolving encounters with people who are experiencing a mental health crisis
March 2014
MIOTCRA Making a Difference: Examples of Grant-Funded Initiatives Specialized Law Enforcement Responses: The health department and sheriff’s office in Marion County, OR, are collaborating to reduce the number of individuals with mental health needs in the criminal justice system by diverting them to treatment and other services in the community. Grant funds awarded in 2012 support crisis intervention training to educate local and statewide partners; a community outreach response team to provide timely assessment and response to referrals from law enforcement; and a wide range of support services, including mentoring, skills training, transportation, and transitional housing. As of February 2014, nearly 300 individuals have been served under the grant project, almost three times its initial goal. Jail-Based Interventions: In 2011, the New York City Department of Health and Mental Hygiene received a grant to enhance services and treatment in three critical areas—in-jail treatment, in-jail court advocacy, and post-release follow up—for individuals with co-occurring mental health and substance use disorders. With the goals of reducing recidivism and increasing public safety, the program takes a comprehensive, collaborative approach to supporting the individuals’ needs in jail and in the community. Juvenile Diversion Programs: The L.I.F.E. Program in Montgomery County, OH, provides youth in the juvenile justice system and their caregivers with clinical and home-based services with a goal of decreasing admissions to the Ohio Department of Youth Services. The program offers a continuum
of care that incorporates evidence-based Functional Family Therapy, and includes behavioral health screening, home-based treatment, access to prosocial opportunities and mentoring, and, if needed, residential intervention. Since its inception in 2006 and with grant funds awarded in 2012, the program has been successful in steadily expanding the youth population it serves to address specific needs in the community.
Mental Health Courts: Outagamie County, WI, used its 2012 grant to develop plans for a post-adjudication, recovery-oriented mental health court program. Since accepting participants into the program in July 2012, the program has refined its target population to serve individuals with a high risk of committing new offenses or violating terms of supervision and has adopted a treatment approach to reduce their likelihood of recidivating. The program has also worked to establish very strong connections with key community partners, including the local chapter of the National Alliance on Mental Illness, and is exploring adding certified peer support specialists. Strategic Planning: The Virginia Department of Behavioral Health and Developmental Services has received two MIOTCRA grants (2007, 2010) for the Cross Systems Mapping project, which helps local jurisdictions understand how individuals with co-occurring mental health and substance use disorders come in contact with and move through their criminal justice system, enabling them to identify opportunities for collaboration to better allocate resources and improve services for these individuals.
Additional Initiatives Funded by MIOTCRA In addition to providing grants to individual jurisdictions or programs for specific projects, MIOTCRA also funds a number of activities in other sites and initiatives that benefit the criminal justice and mental health fields at large, including: The County Justice and Behavioral Health Systems initiative works with local leaders to develop data-driven policies at the intersection of criminal justice and behavioral health systems. It is part of a larger national effort to utilize a research-based framework to assist policymakers in prioritizing scarce public resources to promote both public safety and individual recovery outcomes. In-depth technical assistance supports work with local stakeholders to analyze data and existing policies, processes, and resources to better understand system drivers and identify opportunities to improve systems coordination through the use of information about risk of reoffense and behavioral health needs. Projects have been completed in
Notes i. E. Ann Carson and Daniela Golinelli, Prisoners In 2012: Trends In Admissions And Releases, 1991-2012 (Washington, DC: U.S. Department of Justice, Bureau of Justice Statistics, 2013), available at http://www.bjs.gov/ content/pub/pdf/p12tar9112.pdf. ii. Thomas P. Bonczar and Laura M. Maruschak, Probation And Parole In The United States, 2012 (Washington, DC: U.S. Department of Justice, Bureau of Justice Statistics,
Johnson County (KS), Hillsborough County (NH), and New York City, and are currently underway in Bexar County (TX) and Franklin County (OH). DOJ’s Bureau of Justice Assistance and the CSG Justice Center have identified five mental health court and six law enforcement learning sites to promote peer-to-peer learning and sharing of expertise. Representing a diverse cross-section of strategies that other jurisdictions may consider when developing their own programs, the sites include: Akron Municipal Mental Health Court (OH), Bonneville County Mental Health Court (ID), Bronx County Mental Health Court (NY), Dougherty Superior Court Mental Health/Substance Abuse Division (GA), and Washoe County Mental Health Court (NV); Los Angeles Police Department (CA), University of Florida Police Department, Portland Police Department (ME), Houston Police Department (TX), Salt Lake City Police Department (UT), and Madison Police Department (WI).
2013), available at http://www.bjs.gov/content/pub/pdf/ ppus12.pdf. iii. Henry J. Steadman, et al., “Prevalence of Serious Mental Illness among Jail Inmates,” Psychiatric Services 60 (2009): 761–765. iv. Jennifer L. Skeem and Jennifer Eno Louden, “Toward Evidence-Based Practice for Probationers and Parolees Mandated to Mental Health Treatment,” Psychiatric Services 57 (2006): 333-342. v. SAMHSA’s GAINS Center for Behavioral Health and Justice
Transformation, The Prevalence of Co-occurring Mental Illness and Substance Use Disorders in Jails (Rockville, MD: SAMHSA’s GAINS Center for Behavioral Health and Justice Transformation, 2004), available at http://gainscenter.samhsa.gov/pdfs/disorders/gainsjailprev.pdf. vi. National Association of State Budget Officers, Fiscal Year 2008 State Expenditure Report (Washington, DC: National Association of State Budget Officers, 2009), available at http://www.nasbo.org/Publications/StateExpenditureReport/ tabid/79/Default.aspx.