How Miami-Dade's Mental Health Program Steers People To Treatment, Not Jail

Across the country, hospitals are embracing intensive intervention programs to help victims of violence — including those who have criminal histories — after they have been brought in for treatment of injuries. Such programs can help prevent retaliation, reduce the chance a patient will be violently injured again, and put people on track for success.

In Colorado, four communities are piloting a program that offers low-level drug or prostitution offenders an alternative to prison. This program, known as Law Enforcement Assisted Diversion, matches the offender with a case manager who in turn connects them with treatment and training resources.

Based out of the city of Addis Ababa in Ethiopia, a live radio show is tackling the stigma around mental health care by combining their platform with those in the mental health care field. Not only does the radio show discuss psychological issues on air, but it also offers free and reduced-cost mental health services to those that serve as guests on the show.

The Law Enforcement Assisted Diversion (LEAD) program in Alamosa, Colorado, gives police officers the option of sending people to substance abuse treatment rather than straight into the criminal justice system. Used in non-violent cases, the diversion program is based on a harm-reduction model that uses a health-care approach rather than a punitive approach to address the underlying issues when a crime is committed. Some police officers object to the program's mission, but proponents say that forcing compliance would be counterproductive.

More than 2,700 police departments in the U.S. have crisis intervention teams aimed at responding to mental health crises with fewer arrests and less violence, but the death of Daniel Prude in Rochester police custody offers clear lessons in the shortcomings and misuse of the CIT model. A lack of adequate mental health services across the country, coupled with superficial training of the police, too often means a police response to a crisis will not de-escalate the situation or lead to meaningful help for the person in crisis. A recent study found CITs have not shown they will lower violence.

As an alternative to traditional courts, community courts provide resources to those experiencing homelessness. Fines and jail time are often the punishment in traditional courts for those charged with trespassing or loitering, but community courts provide services that help people find housing, jobs, health care, and even offer mobile showers, food stamp assistance, and mental health care. While the long-term data are lacking and don't offer a clear picture of recidivism rates, community courts do provide a better quality of life for those living on the streets.

The Violence Against Women Act was billed as a way to make a patriarchal society, and policing profession in particular, take domestic violence more seriously. It encouraged policies making arrest of alleged abusers mandatory, even to the point of punishing victims who refused to cooperate in prosecutions. This has backfired on many victims, especially women of color who distrust police and their punitive approaches to solving family problems. The law also prioritizes punitive approaches in its awarding of federal grants, thus denying victim aid to women who do not wish to cooperate with arrests.

CAHOOTS has become a national model because of its uncommon partnership with the Eugene Police Department. The police chief says CAHOOTS' unarmed first responders to mental health crises can de-escalate crises before crimes occur or someone gets hurt. That's the idea behind the decades-old agency that takes calls where police can sometimes cause worse outcomes. The crisis intervention workers and medics treat people on the scene or transport them to places where they can get the help they need. Police are available but rarely needed for safety on those calls.

Thunder Bay police formed IMPACT (Integrated Mobile Police Assessment Crisis Team), pairing crisis responders with mental health expertise with police officers to respond 24/7 to people experiencing mental health crises. Instead of defaulting to police responses, which risk the use of force and often land people in custody or a hospital, the teams often are able to get people connected to needed social and health services. So far the team has managed to divert about 40 percent of calls to helping services.

The Prisoner Correspondence Project connects LGBTQ2S+ people who are incarcerated in the United States and Canada with pen pals who are not incarcerated. The consistent communication helps combat isolation and improve mental health and rehabilitation outcomes.