The Ultimate Intercept
An accessible & effective mental health care system
States and communities throughout the U.S. are making efforts to address the complex issue of devising accessible, effective and comprehensive systems of care for persons living with mental illness who become involved in the criminal justice system. Often the focus of these efforts is to implement “Jail Diversion” programs which will redirect persons with mental illness to evidence based community treatment alternatives designed to address symptoms associated with mental illness that may lead to problem behaviors which result in interaction with the justice system.
More recent evidence indicates that effective treatment of the symptoms of mental illness alone is not sufficient in preventing initial or repeat contact with the criminal justice system. Persons with serious mental illness are over-represented in the criminal justice system as a result of additional risk factors that often combine with untreated, symptomatic mental illness. These include trauma, environmental and social disadvantages, situational stressors, substance dependence and criminogenic risks. In order for the mental health system to serve as the “ultimate intercept,” treatment of these additional risk factors likely needs to be integrated within that system of care, or mental health services need to be strategically coordinated with a criminal justice system that provides effective interventions to address trauma, social disadvantages, stressors, and criminogenic risks.
The Criminal Justice Coordinating Center of Excellence (CJCCoE) promotes use of the Sequential Intercept Model to engage local stakeholders in discussion and planning surrounding effective practices, gaps in services, and barriers to cross-systems improvement related to serving persons with mental illness at all points of intercept in the criminal justice system. The CJCCoE also encourages collaboration and sharing within and among communities to improve awareness, knowledge, and access to helpful resources.
Standard Authorization Form
The Ohio Department of Medicaid (ODM), in collaboration with the Ohio Attorney General’s Task Force on Criminal Justice and Mental Illness Policy and Legislative Subcommittee, and other stakeholders developed a standard authorization form with the goal of improving care coordination for patients, especially those with behavioral health needs who are justice involved.
Under Ohio Revised Code §3798.10, the form will cover the use and disclosure of Protected Health Information (PHI) in alignment with the Health Insurance Portability and Accountability Act (HIPAA) privacy of individually identifiable health information and the confidentially of substance use disorder patient records by a Part 2 program. ODM has filed the Standard Authorization Rule with an effective date of January 3, 2019. Ohio health care providers are not required to utilize the form but beginning February 2, 2019, providers will be required to accept the new form.
Best Practices in Schizophrenia Treatment Center
The Best Practices in Schizophrenia Treatment (BeST) Center at NEOMED in the Department of Psychiatry is dedicated to promoting recovery and improving the lives of as many people with schizophrenia as possible by accelerating the adoption of evidence-based and promising practices. The BeST Center works with mental health consumers, family members, expert consultants, policy makers and mental health partners from Ohio. The BeST Center offers training, consultation, evaluation, education and outreach activities to build the capacity of local systems to provide state-of-the-art care.
SAMHSA’s GAINS Center for Behavioral Health and Justice Transformation also collects and disseminates information and provides consultation and technical assistance to help communities achieve integrated systems of mental health and substance abuse services for individuals in contact with the justice system. The Center’s primary focus is on expanding access to community based services for adults diagnosed with co-occurring mental illness and substance use disorders at all points of contact with the justice system. To support communities in these efforts, the Center released a web-based resource on jail diversion for serious mentally ill offenders: and in cooperation with the Council of State Governments a Checklist for Implementing Evidence-based Practices and Programs (EBP’s) for Justice Involved Adults with Behavioral Health Disorders.
The Patient Protection and Affordable Care Act (PPACA) and the Health Care and Education Reconciliation Act (AKA “health reform” law), signed into law by President Barack Obama in March 2010 may have a significant impact on how people involved in the criminal justice system can access public health insurance and services. This document addresses the implications of the law for justice-involved adults.
DiPietro, Barbara. Frequently Asked Questions: Implications of the Federal Legislation on Justice Involved Populations. New York Council of State Governments Justice Center 2011.