DIVERTING MENTALLY ILL JAIL DETAINEES

有近70万名患有严重精神障碍的囚犯被收治， 美国1988年的监狱 许多精神健康倡导者的主要推动力 服务，以解决精神病监狱被拘留者的需要是分流 从监狱到社区的心理健康项目。 虽然转移被认为是解决这一问题的主要办法， 对精神病患者不适当地使用监狱， 已经被精确地给予什么转移手段和什么类型的节目是 有效 应如何组织和运作分流，以最大限度地 精神病患者和监狱管理人员的福利从来没有 被检查过了 本研究的目的是：（1）记录 第一次确切地说，什么是在美国各地交付的名义， （2）确定哪些类型的节目被认为是 最有效的，以及感知的有效性如何因关键计划而异 特征，如监狱大小，程序长度，以及 监狱、司法机构和精神健康之间存在的联系 系统 这些目标将通过三个层次的研究设计来实现：（1） 向美国所有监狱邮寄调查表，对50多名被拘留者进行普查， 有多少监狱对精神病囚犯实施了分流方案; (2)对所有做出回应的监狱进行电话随访，表明他们 有转移方案，以评估组织和融资， 转移服务，服务的感知有效性，以及 监狱本身的描述;以及（3）36个实地考察，每个实地考察三次 在12个细胞中，美国的四个主要地理区域中的每一个。 由跨越12个小区的9个站点表示。 这些实地考察将收集 从一系列的惩教，司法和心理的详细信息， 与转移方案有关的卫生工作人员和更广泛的 社区精神卫生系统。 最终，这些数据将用于确定哪些类型的转移 针对精神病囚犯的项目似乎在哪种类型中效果最好 哪些类型的被拘留者。 实际上， 记录操作程序，并分析有效程序 组织服务充分说明，该准则将提供给 首次应用于开发更合适的服务，以应对 美国监狱里精神病患者的灾难性处境。 还有， 第二代研究，包括对照的纵向研究， 可以更恰当地设计有效性。

There were nearly 700,000 inmates with severe mental disorders admitted to U.S. jails in 1988. A major push of many advocates for mental health services to address the needs of mentally ill jail detainees is diversion from the jail to appropriate community-based mental health programs. While diversion has been put forward as a major solution to the inappropriate use of jails for mentally ill persons, little attention has been given to precisely what diversion means and what types of programs are effective. How diversion should be structured and operated to maximize its benefits for both mentally ill persons and jail administrators has never been examined. It is the goal of this research: (1) to document for the first time exactly what is being delivered across the U.S in the name of diversion; and (2) to determine which types of programs are perceived as the most effective and how perceived effectiveness varies by key program characteristics such as, jail size, program auspice, and the types of linkages that exist between the jails, the judiciary and the mental health system. These goals will be accomplished by a three-tiered research design: (1) a mail survey to all U.S. jails with a census over 50 detainees to determine how many jails have diversion programs for mentally ill jails detainees; (2) a telephone follow-up of all responding jails that indicate that they have diversion programs to assess the organization and financing of diversion services, the perceived effectiveness of the service, and descriptors of the jails itself; and (3) 36 sites visits, three from each of the 12 cells, with each of the four major geographic regions of the U.S. represented by 9 sites across the 12 cells. These site visits will gather detailed information from a range of correctional, judicial, and mental health staff associated with the diversion programs and the broader community mental health system. Ultimately, the data will be geared to determining which types of diversion programs for mentally ill jail detainees seem to work best in which types of jails for which types of detainees. With the range of actually operative programs documented and with analysis of how effective programs organize services fully described, the guidelines will be available for the first time to be applied to developing more appropriate services to respond to the catastrophic situations of the mentally ill in U.S. jails. Also, second generation research involving controlled, longitudinal studies of effectiveness can more appropriately be designed.