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

描述（由申请人提供）：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时被逮捕和监禁。如顺序拦截模型所示，刑事司法系统内防止不必要的逮捕和监禁的最有效干预点是官员与患有严重精神疾病的人之间的首次接触，这是刑事司法参与的第一步。这个R34项目旨在实施一个新的警察-精神健康联系系统的试验，并测试其可行性和最终用户的接受程度。我们新的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参与史的人将特别同意允许简要披露他们的精神健康状况，作为该州刑事司法信息系统登记的一部分。第二，当一名官员运行登记参与者的姓名或标识符作为例行背景检查的一部分，在遭遇，该官员将收到一个电子消息，该人有特殊的心理健康考虑，并呼吁1-800号码为更多信息，将连接到我们的链接专家。最后，联系专家，谁将B一个认证的心理健康提供者，将通过思考观察到的行为和潜在的解决方案与官员协助官员。我们预计，在某些情况下，如果逮捕不是强制性的，官员将选择转介或运送到精神健康服务，而不是 因为我们直接的低成本系统提供的信息。三个首要目标将指导这一试点干预项目。在目标A中，我们将实施警察与心理健康联动系统的演示，以便实施程序并制定方案手册（对于一项更大的研究）通过与三个主要伙伴，格鲁吉亚调查局（负责维护格鲁吉亚的刑事司法数据库/信息系统）、萨凡纳-查塔姆大都会警察局和当地社区精神卫生机构，Gateway行为健康服务。在目标B中，我们将通过与患者、巡警、警察局领导和精神卫生服务项目经理进行的焦点小组讨论，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，我们将证明可行性并估计效应量和其他参数，为更大规模的研究做准备。将在200名患有严重精神疾病和有刑事司法史的参与者中审查可行性。他们在1年干预期间的逮捕数量将与前一年进行比较，我们将评估有多少电话导致逮捕与精神卫生服务联系。为了研究联系系统的运作方式及其对决策的影响，我们还将与使用该系统的人员和接听他们电话的联系专家进行个别访谈。

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.