Diversion: Where Public Safety and Mental Health Converge

Here’s a startling fact. North America holds the dubious distinction of housing more individuals with mental illnesses in jails and prisons than those in community-based programs, making the Criminal Justice System the biggest institution in the field of mental health (Ryan, Brown, & Watanabe-Galloway, 2010).

According to the Mental Health Commission of Canada, 2020, 73% of men and 79% of women federally incarcerated have some kind of mental illness, including mood, psychotic, substance use, anxiety, and eating disorders. 12% of men and 17% of women have a serious mental illness such as bipolar, major depressive, or a psychotic disorder.

Mental Health and Criminal Justice

This isn't simply a Canadian problem. The issue of an increasing number of individuals with mental health conditions has repercussions for criminal justice systems in most countries, from health, fiscal, as well as human perspectives. This is why some countries allocate significant resources towards diverting individuals with such conditions away from prisons and toward community-based mental health care. This becomes an essential strategy to provide the right kind of support while eliminating unnecessary involvement from criminal justice systems.

In the last 30 years, such diversion programs have gained much popularity, where low-risk individuals with mental illnesses are diverted to community-based treatments and connected to resources such as addiction and mental health agencies, housing support, education, employment services, case management, and crisis support.

Do Diversion Programs Work?

The simplest way of looking at how mental health diversion schemes operate is to think of them as an interface between mental health and criminal justice. What these schemes try to ensure is that those with mental health problems who come into contact with criminal justice are identified in time and directed towards the care they need as an alternative to imprisonment.

Research shows that there are several benefits to this approach, beginning with savings and cost efficiency within the criminal justice system. It also leads to a reduction in re-offending, besides the obvious improvements in mental health to those who take advantage of the specialised care offered. Effective treatment is always a more sensible option when compared to short sentences in prison.

Though every diversion program is unique to its community, which makes statistical analysis of their effectiveness difficult, most research points to a decrease in recidivism, emergency room visits, stays in hospital psychiatric wards, time spent in jail, substance use, homelessness, incidents of violent behaviour while improving quality of life (a good summary of the literature can be found here). Studies indicate they are cost effective (Mitton et al., 2007).

The Importance of Mental Health Courts

One interesting aspect of diversion programs has been the implementation of mental health courts. As opposed to traditional court systems, which are adversarial, mental health courts are a rehabilitative response with a holistic approach. These courts have sympathetic judges, and psychiatrists, psychologists, caseworkers, and social workers who help guide the decision process to best address the underlying issues (Schneider, 2007). They even advise what the judge says to the individual, prompting them to make encouraging observations on their progress.

As collaborative alternatives that provide specific services and treatment to defendants dealing with mental illness, mental health courts focus on problem-solving models that connect defendants to rehabilitative services or support networks. What every mental health court aims to do is help troubled individuals return to society, improving their quality of life while eventually increasing public safety. This creates a perception of fairness and compassion while still promoting accountability, which has been linked to improved outcomes for those who are diverted through mental health courts (Fisler, 2005).

These courts work by, firstly, accepting individuals with demonstrable mental illnesses that can then be connected to their illegal behaviour. They are supervised by teams of professionals, often comprising members of the justice system, mental health providers, and related support systems. Defendants must consent to involvement too because participation in a mental health court is voluntary. Screenings and referrals occur as soon as possible after an arrest not only because an early intervention is crucial, but because it allows a court to evaluate whether or not it can provide appropriate resources and support.

As of 2015, there were 19 mental health courts in Ontario, according to the Human Services and Justice Coordinating Committee, 2017.

The Way Forward For Criminal Justice

The notion of 'therapeutic jurisprudence' is based upon the idea that some offenders are not evil, but ill. It places upon the justice system a responsibility to heal as well as protect, believing that some individuals accused of crime must also be heard and given positive encouragement rather than threat, to create an atmosphere of healing. Studies have shown that adult mental health courts have a positive effect on rehabilitation and criminal behaviour during and after participation.

After an individual has been identified and assessed of mental health problems in prison, the next step is an appropriate referral to prison mental health inreach teams, followed by transfer to an appropriate medical facility and the creation of a resettlement plan. The continuity of care is equally important, as are assertive interventions to ensure continuing engagement, support with lifestyle changes, and support for affected families. 

With proper implementation and adequate funding for community resources, diversion can decrease the strain on police, hospitals, and prisons while improving public safety and quality of life for those traditionally marginalized by the criminal justice system. 

Studying criminal justice is more than just focusing on the impact of crime. A degree in criminology from Wilfrid Laurier University takes an interdisciplinary approach to crime and punishment. Our online Master of Public Safety degree and graduate diplomas are also Canada’s first and only programs of their kind, created in alignment with Public Safety Canada. Find out more about the programs we offer.

References:

Mental Health Commission of Canada. (2020). Mental health and the criminal justice system: “What we heard.” Ottawa, Canada

Human Services and Justice Coordinating Committee (2017) ‘Mental health courts in Ontario: A review of the initiation and operation mental health courts across the province’

https://ontario.cmha.ca/wp-content/uploads/2017/11/Mental-Health-Courts-in-Ontario-1.pdf

Fisler, C. (2005). Building trust and managing risk: A look at a felony mental health court. Psychology, Public Policy, and Law, 11, 587–604.

Mitton, C., Simpson, L., Garnder, L., Barnes, F., & Mcdougall, G. (2007). Calgary diversion program: A community-based alternative to incarceration of mentally ill offenders. The Journal of Mental Health Policy and Economics, 10(3), 145-151.

Ryan, S., Brown, C. K., & Watanabe-Galloway, S. (2010). Toward successful postbooking diversion: What are the next steps? Psychiatric Services, 61(5), 469- 477. doi:10.1176/appi.ps.61.5.469 

Schneider RD, Bloom H, Heerema M. Mental health courts: decriminalizing the mentally ill. Toronto: Irwin Law; 2007.