A Novel Police-Mental Health Linkage System to Promote Pre-Booking Jail Diversion

心理健康和刑事司法系统之间的广泛分歧导致许多人患有 严重的精神疾病被逮捕和监禁，而精神健康治疗将会更多 恰如其分。将这些人“定为刑事犯罪”是全美广泛记录的问题。 以顺序拦截模式为例，刑事司法最有效的干预点 防止不必要的逮捕和监禁的系统是一名警官和一名 严重精神疾病患者，这是刑事司法介入的第一步。这个R34项目 寻求实施一项新的警察-心理健康联系制度的试验，并测试其可行性和 最终用户的可接受性。我们的新联动系统将包括三个步骤。首先，一些个人谁 有严重精神疾病和刑事司法史的人将获得特别同意，允许 简要披露他们的精神健康状况，作为该州刑事司法登记的一部分 信息系统。第二，当一名警官将登记参与者的姓名或身份作为 例行背景调查期间，警官会收到一条电子信息，表明此人 有特殊的心理健康问题，并拨打1-800号码了解更多信息，将连接到 我们的联动专家。最后，Linkage专家将成为经认证的精神健康提供者，他将提供帮助 警官通过与警官一起思考观察到的行为和潜在的解决方案。我们预计这将在 在某些情况下，如果逮捕不是强制性的，那么警官会选择将其转介或转移到精神病院 而不是因为我们直截了当的，低级的-提供的信息而逮捕 成本体系。三个首要目标将指导这一试点干预项目。在目标A中，我们将实现一个 示范警察-心理健康联系系统，以便实施程序和发展 协议手册(用于更大规模的研究)，通过与三个主要合作伙伴合作，佐治亚州局 调查(维护格鲁吉亚的刑事司法数据库/信息系统)，萨凡纳-- 查塔姆大都会警察局和当地社区精神健康机构Gateway Behavial 卫生服务部。在目标B中，我们将通过重点评估所有关键利益相关者群体对可接受性的看法 与患者、巡警、警察部门领导和精神健康服务项目进行的小组合作 经理们。在目标C中，我们将论证可行性，并估计效果大小和其他参数以准备 进行更大规模的研究。可行性将在100名患有严重精神疾病的参与者中进行检查，并 刑事司法史。在为期一年的干预期间，他们的被捕人数将与之前的 年，我们将评估多少个电话导致逮捕与心理健康服务的联系。检视 联动系统如何运作及其对决策的影响，我们还将进行个人 与使用该系统的官员以及接听电话的Linkage专家进行面谈。

The widespread division between mental health and criminal justice systems leads to many persons with serious mental illnesses being arrested and incarcerated when mental health treatment would be more appropriate. The "criminalization" of such individuals is an extensively documented problem across the U.S. As illustrated by the Sequential Intercept Model, the most effective point of intervention within the criminal justice system to prevent unnecessary arrest and incarceration is the initial encounter between an officer and a person with a serious mental illness, which is the first step in criminal justice involvement. This R34 project seeks to implement a trial of a new police-mental health linkage system and to test its feasibility and acceptability among end-users. Our new linkage system will consist of three steps. First, some individuals who have a serious mental illness and a history of criminal justice involvement will give special consent to allow a brief disclosure of their mental health status to be included as part of a registry in the state's criminal justice information system. Second, when an officer runs an enrolled participant's name or identifiers as part of a routine background check during an encounter, the officer will receive an electronic message that the person has special mental health considerations, and to call a 1-800 number for more information that will connect to our Linkage Specialist. Lastly, the Linkage Specialist, who will be a certified mental health provider, will assist the officer by thinking through observed behaviors and potential resolutions with the officer. We expect that in some cases where an arrest is not obligatory, the officer will then choose to refer to or transport to mental health services instead of making an arrest because of the information provided by our straight-forward, low- cost system. Three overarching aims will guide this pilot intervention project. In Aim A, we will implement a demonstration of the police-mental health linkage system in order to operationalize procedures and develop the protocol manual (for a larger study) through collaboration with three key partners, the Georgia Bureau of Investigation (which maintains Georgia's criminal justice database/information system), the Savannah- Chatham Metropolitan Police Department, and the local community mental health agency, Gateway Behavioral Health Services. In Aim B, we will assess all key stakeholder groups' perceptions of acceptability through focus groups conducted with patients, patrol officers, police department leaders, and mental health services program managers. In Aim C, we will demonstrate feasibility and estimate effect size and other parameters to prepare for a larger-scale study. Feasibility will be examined among 100 participants with a serious mental illness and a criminal justice history. Their number of arrests during the 1-year intervention will be compared to the prior year, and we will assess the how many calls result in arrest versus mental health service linkage. To examine how the linkage system worked and the ways it impacts decision-making, we will also conduct individual interviews with officers who make use of the system, and the Linkage Specialists who take their calls.