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

描述(申请人提供)：精神健康和刑事司法系统之间的广泛分歧导致许多患有严重精神疾病的人在精神健康治疗更合适的时候被逮捕和监禁。将这类人“定罪”是全美广泛记录的问题。正如顺序拦截模式所表明的那样，在刑事司法系统中，防止不必要的逮捕和监禁的最有效的干预点是警官与患有严重精神疾病的人之间的首次接触，这是刑事司法介入的第一步。这一R34项目旨在实施一项新的警察-心理健康联系系统的试验，并测试其在最终用户中的可行性和接受性。我们的新联动系统将包括三个步骤。首先，一些有严重精神疾病和刑事司法介入史的个人将特别同意，允许将其精神健康状况的简要披露作为国家刑事司法信息系统登记的一部分。其次，当一名警官在遭遇期间运行登记参与者的姓名或身份识别码作为例行背景调查的一部分时，该警官将收到一条电子消息，表明该人有特殊的精神健康问题，并拨打1-800电话询问更多信息，以便与我们的联系专家联系。最后，联系专家将是一名经过认证的精神健康提供者，他将通过与官员一起思考观察到的行为和潜在的解决方案来帮助官员。我们预计，在某些情况下，如果逮捕不是强制性的，该人员将选择转介或转送到精神健康服务机构。 由于我们直截了当、低成本的系统提供的信息，逮捕的可能性很大。三个首要目标将指导这一试点干预项目。在目标A中，我们将通过与三个主要合作伙伴--佐治亚州调查局(负责维护格鲁吉亚的刑事司法数据库/信息系统)、萨凡纳-查塔姆市警察局和当地社区精神卫生机构--Gateway行为卫生服务机构的合作，实施警察-精神卫生联系系统的示范程序，并编写礼仪手册(用于更大规模的研究)。在目标B中，我们将通过与患者、巡逻员、警察部门负责人和精神健康服务项目经理进行的焦点小组，评估所有关键利益相关者群体对可接受性的看法。在目标C中，我们将论证可行性，并估计效应大小和其他参数，为更大规模的研究做准备。将在200名有严重精神疾病和刑事司法史的参与者中审查可行性。在为期一年的干预期间，他们的被捕人数将与前一年进行比较，我们将评估多少电话导致逮捕与心理健康服务之间的联系。为了研究联动系统如何运作，以及如何影响决策，我们亦会个别访问使用该系统的人员，以及接听电话的联动专家。

DESCRIPTION (provided by applicant): 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 b 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 200 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.