Critical Issues - Jail Diversion Programs

Focus on the States

Maryland Seeks to Break Cycle of Crime, Hospitalization and Homelessness

Eighteen of Maryland's twenty-three counties participate in a state initiative designed to break the cycle of criminal justice recidivism, hospitalization and homelessness among persons with mental illness and co-occurring mental illness and substance use disorders. Initiated in 1993, the Maryland Community Criminal Justice Treatment Program identifies individuals with these conditions who are incarcerated for minor offenses in local detention centers and enables them to participate in appropriate community-based services as an alternative to jail.

"These are among our neediest clients," notes Joan Gillece, Ph.D., Assistant Director of the Maryland Mental Hygiene Administration for Special Needs Populations. "Mental health clinic services alone are not enough. We develop a plan that includes housing, case management, education, job training and a range of other services and supports." According to Dr. Gillece, this intensive, multi-agency approach has been a resounding success during the program's first five years. Of the more than 2,000 persons who have participated in the program, fewer than 10 percent have returned to jail, hospitals or homelessness.

When a person is arrested for a misdemeanor in one of the participating Maryland counties, the individual goes through a screening process at the jail designed to identify persons with mental illness and co-occurring mental illness and substance use disorders. Once identified, a person is referred to the local program director for an initial evaluation and then to a psychiatrist for diagnosis and treatment recommendations. Based on their findings, a case manager works with the defendant, family members and applicable agencies to develop a service plan. If the plan is approved by the presiding judge, the client is released. To ensure continuity of services, the case manager serves as a liaison between the defendant and community-based service providers.

To receive state "seed" funding to develop a community criminal justice treatment program, Maryland counties must establish an advisory board whose members include representatives of mental health and substance abuse agencies, consumer and family organizations, public defenders' and prosecutors' offices, courts, law enforcement and the state parole and probation agency. This advisory board develops a memorandum of agreement with the state specifying the services that each agency will provide. Once the program is established, the board continues to play an active role, meeting regularly to provide oversight and collaborating with state and local agencies to improve and expand services.

Maryland's Mental Hygiene Administration contributes $1 million in state funds annually to support case management and psychiatric services for counties that participate in the community diversion program. In addition, the program has attracted funding from sources as varied as the U.S. Department of Housing and Urban Development's Shelter Plus Care program ($5.5 million for housing services), the federal Byrne Memorial Grant Fund Program ($341,000 for substance abuse services) and the Center for Mental Health Services' Projects for Assistance in Transition from Homelessness (PATH) ($335,000 for services for persons who have mental illness and who are homeless). "Our strategy is to keep bundling money and services together from different federal, state and local resources," Dr. Gillece explains. "We push for every single dime we can get. We're passionate about this program."

In addition the Substance Abuse and Mental Health Services Administration has committed $1.6 million per year for three years to Maryland to establish a demonstration jail diversion program focusing on women with co-occurring mental illness and substance use disorders in Wicomico County on the state's rural Eastern Shore. Through this program, which was slated to begin in April 1998, women with co-occurring mental illness and substance use disorders who have been charged with minor criminal violations have the opportunity to participate in community-based mental health and support services as an alternative to incarceration.

"We are trying to keep families together and avoid contributing to the cycle of crime, hospitalization and homelessness," notes Lori Tindall, Director of Behavioral Health for Wicomico County, which also participates in the community jail diversion program. Consumers have played a key role in developing this program, she notes. A series of focus groups involving women incarcerated in county corrections facilities provided the basic program design.

For more information, contact Joan Gillece, Ph.D., at 410-767-6603 and Lori Tindall at 410-334-3497.

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