Researchers studied the Los Angeles County jail mental health population to identify those who would likely be appropriate for diversion with the aim of providing them with needed care and reducing recidivism. The report includes the results from a legal and clinical review of recently incarcerated individuals identified with a serious mental illness, as well as relevant recommendations for diversion in Los Angeles County.

Cover: Estimating the Size of the Los Angeles County Jail Mental Health Population Appropriate for Release into Community Services
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Estimating the Size of the Los Angeles County Jail Mental Health Population Appropriate for Release into Community Services

by Stephanie Brooks Holliday, Nicholas M. Pace, Neil Gowensmith, Ira Packer, Daniel Murrie, Alicia Virani, Bing Han, Sarah B. Hunter

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Research Questions

  1. What are the factors that contribute to ODR's decisionmaking when determining whether it will put someone forward as a candidate for diversion?
  2. What proportion of individuals incarcerated at the county jail could be diverted assuming that there were no limits on the types of programs or number of treatment slots available in the community?

In 2015, the Office of Diversion and Reentry Division (ODR), an internal department of the Los Angeles County Department of Health Services, was created to redirect individuals with serious mental illness from the criminal justice system. Part of ODR's mission is to identify individuals currently incarcerated in a Los Angeles County jail who are experiencing a serious mental health disorder and, to the extent practical, provide them with appropriate community-based care with the goals of reducing recidivism and improving health outcomes. Such redirection from the traditional criminal justice process is often characterized as diversion. To better build and scale efforts to support this work, in 2018, the Los Angeles County's Board of Supervisors asked for a study of the existing county jail mental health population to identify those who would likely be eligible for diversion based on legal and clinical factors. Researchers found that an estimated 61 percent of the jail mental health population were likely appropriate candidates for diversion; 7 percent were potentially appropriate; and 32 percent were likely not appropriate candidates for diversion. These findings will help the county determine how it would need to scale community-based treatment programs to accommodate these individuals. The authors also provide recommendations for future programming and research. This report will be of interest to state and county governments as well as other organizations serving criminal justice–involved populations with serious mental illness.

Key Findings

  • In June 2019, 5,544 individuals were in the Los Angeles County Jail mental health population, which includes those in mental health housing units and/or taking psychotropic medications.
  • Researchers developed a set of structured legal and clinical criteria to reflect the factors that contribute to ODR's decisionmaking when determining whether someone may be put forward as a candidate for diversion. Individuals were categorized as appropriate (i.e., no obvious bars to diversion are apparent), potentially appropriate (i.e., some factors may be viewed with disfavor by a judge or district attorney, but no complete bar was identified), or not appropriate candidates for diversion.
  • Based on a consideration of these legal and clinical factors, an estimated 61 percent of the jail mental health population (about 3,368 individuals) were determined to be appropriate candidates for diversion; 7 percent (414 individuals) potentially appropriate; and 32 percent (1,762 individuals) not appropriate candidates for diversion.
  • In conducting the review, researchers were not bound to existing diversion programs in the county (or the current capacity of existing programs). Because of this, these findings will help the county determine the full size of the population that would be appropriate for diversion and how it would need to scale community-based treatment programs to accommodate those individuals.

Recommendations

  • Determine the level of care needed by individuals appropriate for diversion and how this fits with current community-based capacity.
  • Consider ways to increase ODR's capacity for ongoing data collection.
  • Closely track the demand, process, and outcomes of diversion.
  • Engage a variety of stakeholders in developing solutions to address the needs of justice-involved individuals with mental illness.

Research conducted by

This research was prepared for the Los Angeles County Department of Health Services Office of Diversion and Reentry and conducted by the Justice Policy Program within RAND Social and Economic Well-Being.

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