New York City Mayor's Office, NY

The EXIT Program is a post-booking jail diversion program for non-violent, repeat misdemeanor offenders experiencing mental illness who are arraigned in Manhattan's Criminal Court. Diversion occurs after arrest when the individual is waiting in the holding pens to be arraigned. Program staff select individuals who meet the criteria for prior involvement with the criminal justice system and conduct screening interviews to gather psychosocial, mental health, medical, and substance abuse histories and assess current psychological symptoms. If the individual is eligible and agrees to participate in the diversion program, the program staff and defense counsel advocate for the judge's approval to release the defendant to complete the 3-hour mandated treatment assessment session (MTAS). Accepted participants plead guilty and are sentenced to a conditional discharge, adjournment in contemplation of dismissal, or sentencing is deferred. Other services provided by the diversion program include treatment planning services, which take place during the MTAS; psychiatry; six-month voluntary case management services; funds for immediate needs such as clothing, food, and medications; peer support services; and linkage to 20 designated permanent housing and Assertive Community Treatment slots; and referrals and placement to other housing and treatment services. The EXIT Program has increased access to peer support services and has seen high rates of participants accepting voluntary case management services.

Alabama Department of Mental Health and Mental Retardation (Birmingham)

The Birmingham program provides post-booking diversion for adults with a primary diagnosis of a serious mental illness who have been charged or convicted of misdemeanors. Eligible individuals have high rates of jail or hospital service utilization and must reside within a designated catchment area or be experiencing homelessness. Potential candidates are referred to the jail psychiatrist by the jail social workers, nurses, or medical doctors or by police, corrections officers, or the judge. The jail psychiatrist and a representative from the diversion program conduct an assessment to determine whether the individual meets all criteria. Potential candidates are assigned to usual care or to diversion with treatment through the Research Evaluation Assertive Community Treatment (REACT) team for a randomized study. Services provided through the REACT team include Assertive Community Treatment, case management, initial and ongoing assessments, psychiatric services, employment and housing assistance, family support and education, and substance abuse services.

South Carolina Department of Mental Health (Columbia)

Project CALM is a post-booking diversion program for adults facing non-violent misdemeanor charges and experiencing serious mental illness. Other requirements include area of residence and previous utilization of services. Screening for eligibility is performed by project staff who review the jail booking log, self-reported or observed symptoms and behaviors, and history of serious mental illness/substance use disorders and conduct clinical assessments. Most program participants are offered suspended sentencing with the potential for dismissal of charges. Treatment services include: intensive case management; Assertive Community Treatment; assessment; service coordination; medication monitoring; integrated mental health and substance abuse treatment; assistance with finding housing; therapy; life skills training; educational and vocational services; health care; and gender-based services for women.

Tulsa County Board of Commissioners, OK

The Tulsa County Jail Diversion Project seeks to divert individuals at any point in the criminal justice process. Law enforcement, who have received mental health training, utilize the Pre-Booking COPES Jail Diversion Team for crisis calls when necessary. Referrals to the post-booking program are made by a Registered Nurse who does a mental health assessment on each individual upon arriving at the jail, by jail staff, and by two Post-Booking COPES Jail Diversion Team members who are housed inside the jail. The Court Liaison and the COPES Team members work with the Judiciary, District Attorney, and Public Defender or private counsel with the goal of getting charges reduced or dropped for individuals who enter the diversion program. Upon reentry into the community, the individual is aided by two Jail Diversion COPES Team members provide comprehensive case management services. Since receiving funds, the Tulsa County Jail Diversion Project has achieved greater collaboration among the program stakeholders, with the result of reduced caseloads and shorter dockets. Community awareness of the program and program participants have also increased.

Connecticut Department of Mental Health and Addiction Services (Hartford)

The Women's Support Program (WSP) is a post-booking diversion program that serves adult women experiencing mental illness and substance use disorders. Screening is conducted by WSP staff, which interviews all women on the arraignment list and takes referrals from the Public Defender's Office, the Bail Commissioners, and the Judge. Women who meet the criteria for the WSP participate in psychotherapeutic and psychoeducational groups and receive individual counseling and intensive case management services. Group treatments emphasize the TARGET model for post-traumatic stress disorder management and a combination of Motivational Enhancement Therapy and Pastoral Care. Charges are usually dismissed with completion of the program, except in the case of felony charges, which are transferred to the Probation Office. Highlights of the Women's Support Program since receiving funds include organizing the First Women's Expo to facilitate networking between community agencies and service providers, as well as creating an Advisory Committee composed of WSP members to suggest program modifications.

Chesterfield County, VA

Chesterfield County's post-booking jail diversion program (DRC-DDT) targets adults with co-occurring disorders who are determined to be non-violent based on criminal history and current charges. Prior to arraignment, candidates go through three different screening processes (completed by a CCS Pretrial Services officer, a DRC-DTT Pretrial Services officer, and a member of the DRC-DTT clinical staff) that evaluate mental health and substance abuse. After the third screening, if an individual is approved for the program, DRC-DTT staff presents a recommendation to the court for diversion. The diversion program lasts approximately six months, and clients are required to report to the Day Reporting Center on a daily basis for the first few months. The number and duration of the contacts is based on each client's behavior and changes with the program phases. Clients receive comprehensive services at or coordinated through DRC-DTT, focusing on relapse prevention (through educational and cognitive-behavioral techniques), substance abuse issues, coping skills, moral recognition therapy (MRT), job skills, and mental health issues.

State of Hawaii Department of Mental Health

Hawaii County operates a post-booking jail diversion program for non-violent misdemeanants. Referrals come from police personnel and social workers from the Department of Public Safety's Intake Service Center, who observe the individuals in jail before arraignment. The Jail Diversion Case Manager receives referrals, conducts interviews with the detainees, and works with Intake Service Center personnel to check the mental health and criminal justice records. For individuals eligible for diversion, an Initial Service Plan containing treatment recommendations is developed. The Jail Diversion Case Manager communicates with defense and prosecution about the proposed Initial Service Plan, and with the consent of the individual and the court, the individual is placed on supervised release status. Treatment options have access to all the core services provided by the Adult Mental Health Division of the Hawaii State Department of Health including intensive case management, aid in finding housing, and crisis management. The Jail Diversion Advisory Council has been an effective tool in crafting the diversion program while balancing the interests of different stakeholders. Since receiving funds, the Advisory Council has completed a program manual and reached a consensus regarding the length of supervision in the program and the use of the deferred prosecution with supervision model. Jail Diversion Program Staff are currently working on procedural manuals to guide the screening process.

Cumberland County Government, ME (Portland)

Cumberland County, Maine's Project DOT serves people with mental illness and/or co-occurring disorders who are deemed to be low-risk. Referrals come, post-arraignment, from Probation and Parole, Portland Police Crisis Intervention Team officers, Cumberland County Jail, courts, lawyers and family members. If the client can be safely released to the community, the courts are asked for release to supervision under Maine Pretrial Services. If approved the client is released and referred to either Maine Medical Center's ACCESS Assertive Community Treatment team or the Volunteers of America residential program. Services provided under Project DOT include: psychiatric and case management services; recovery based services; housing support; medication support; vocational support; health promotion; financial management; and overall day-to-day support.

Dubuque County Board of Supervisors, IA

The Dubuque County program diverts persons with mental illness both pre-booking and post-booking. The pre-booking component consists of a Mobile Counselor who accompanies police responding to active mental health crises and refers the individual experiencing mental illness to the Boundary Spanner and to mental health hospitalization or other service providers. Boundary Spanners provide guidance, complete paperwork, obtain necessary releases of information, make referrals, and act as an advocate through the criminal justice process. Other referrals come from the District Court, newly developed police Mental Health Incident Reports, Dubuque County Jail rosters, the Department of Corrections, and public and private attorneys. Since receiving funds the Dubuque County Program has established an up-to-72 hour respite program for individuals needing housing and added a psychiatric triage nurse to the staff at Mercy Medical Center to assist with emergency room care for patients with mental illness. The program has received positive feedback on changes in behavior of law enforcement's approach and has engaged in community outreach through holding a Spanning the Boundaries Community Jail Diversion Conference.

Missouri Department of Mental Health

St. Louis's post-booking diversion program serves eligible individuals with serious mental illness and non-violent municipal or county ordinance violations. The Jail Diversion specialist conducts a mental health and criminal history screening for eligibility and seeks approval of the judge or prosecutor for the current case. Program participants receive frequent, regular face-to-face meetings with an intensive case manager for approximately 90 days. Other treatment services include the development of a personal treatment plan; referrals to psychiatry services and medication management; assistance with housing, employment, life skills, applying for benefits, and transportation to appointments. After stabilization, the individual is referred to other ongoing community-based support services. Since receiving funds, the program has seen an increase in referrals and is beginning to expand eligibility to other types of charges. The program staff have received gender and trauma training from the TAPA Center for Jail Diversion and are also working to develop a Regional Coordinating Council to bring together the jail diversion program with the city and county Crisis Intervention Teams and the community's mental health court.