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Principles of Community-based Behavioral Health Servicesfor Justice-involved Individuals: A Research-based GuideA bridge to the possible
AcknowledgmentsThis report was prepared for the Substance Abuse and Mental Health Services Administration (SAMHSA)under contract number HHSS283201200058I/HHSS28342003T with SAMHSA, U.S. Department ofHealth and Human Services (HHS). Nainan Thomas served as contracting officer representative.DisclaimerThe views, opinions, and content of this publication are those of the author and do not necessarily reflectthe views, opinions, or policies of SAMHSA or HHS. Nothing in this document constitutes a direct orindirect endorsement by SAMHSA or HHS of any non-federal entity’s products, services, or policies, andany reference to non-federal entities’ products, services, or policies should not be construed as such.Public Domain NoticeAll material appearing in this publication is in the public domain and may be reproduced or copied withoutpermission from SAMHSA. Citation of the source is appreciated. However, this publication may not bereproduced or distributed for a fee without the specific, written authorization of the Office of Communications,SAMHSA, HHS.Electronic Access and Printed CopiesThis publication may be downloaded or ordered at http://store.samhsa.gov or by calling SAMHSA at1-877-SAMHSA-7 (1-877-726-4727).Recommended CitationSubstance Abuse and Mental Health Services Administration: Principles of Community-based BehavioralHealth Services for Justice-involved Individuals: A Research-based Guide. HHS Publication No. SMA19-5097. Rockville, MD: Office of Policy, Planning, and Innovation. Substance Abuse and Mental HealthServices Administration, 2019.Originating OfficeOffice of Policy, Planning, and Innovation, Substance Abuse and Mental Health Services Administration, 5600Fishers Lane, Rockville, MD 20857, HHS Publication No. SMA-19-5097. Released 2019.Nondiscrimination NoticeSAMHSA complies with applicable federal civil rights laws and does not discriminate on the basis of race,color, national origin, age, disability, or sex. SAMHSA cumple con las leyes federales de derechos civilesaplicables y no discrimina por motivos de raza, color, nacionalidad, edad, discapacidad, o sexo.U.S. Department of Health and Human ServicesSubstance Abuse and Mental Health Services AdministrationOffice of Policy, Planning, and Innovation3PRINCIPLES OF COMMUNITY-BASED BEHAVIORAL HEALTH SERVICES FOR JUSTICE-INVOLVED INDIVIDUALS
ContentsAcknowledgments . 5Introduction. 7SAMHSA’s Vision and Values for Serving Justice-involved Individuals. 7Purpose and Scope . 8The Eight Principles . 9Frequently Asked Questions . 13Criminal Justice . 13Collaboration . 16Providing Optimal Health Services . 18Disparate Outcomes . 29Resources . 31Collaboration . 31Health Care Coverage . 31Reentry . 31Clinical Care and Case Management . 31Criminogenic Risk and Recidivism . 32Trauma . 32Special Populations . 32Glossary of Terms . 33Endnotes . 384PRINCIPLES OF COMMUNITY-BASED BEHAVIORAL HEALTH SERVICES FOR JUSTICE-INVOLVED INDIVIDUALS
AcknowledgmentsThis publication was written by Jennie M. Simpson, Ph.D., with support from Larke N. Huang, Ph.D.;Anita Everett, M.D., DFAPA; Captain David Morrissette, Ph.D., L.C.S.W.; and Jon Berg, M.Ed., L.P.C.SAMHSA would like to thank our Expert Panel, peer reviewers, and federal partners:– Stephen Amos, M.S., National Institute of Corrections, Federal Bureau of Prisons– Samuel Awosika, St. Elizabeths Hospital, District of Columbia Department of Behavioral Health– Rebecca Bowman-Rivas, M.S.W., University of Maryland School of Law– Dan Buccino, L.C.S.W-C., B.C.D., Johns Hopkins University School of Medicine– Joel Dubenitz, Ph.D., Office of the Assistant Secretary for Planning and Evaluation, U.S. Departmentof Health and Human Services– Marissa Farina-Morse, Ed.S., N.C.C., C.A.A.D.C., L.P.C, Fairfax/Falls Church (Virginia) CommunityServices Board– Maria Fryer, M.S., Bureau of Justice Assistance, U.S. Department of Justice– Mimi Gardner, L.C.S.W., Behavioral Health System Baltimore– Dan Gillison, American Psychiatric Association Foundation– Maeghan Gilmore, M.P.H., National Association of Counties– Neil Gowensmith, Ph.D., University of Denver– Jhamirah Howard, Office of the Assistant Secretary for Planning and Evaluation, U.S. Department ofHealth and Human Services– Denise Juliano-Bult, M.S.W., National Institute of Mental Health– Stephanie Le Melle, M.D., M.S., Columbia University– Philip Magaletta, Ph.D., Federal Bureau of Prisons, U.S. Department of Justice– Mark Mitchell, Ph.D., MARCON Consulting– Redic Morris, 2nd Lieutenant, Fairfax County (Virginia) Sheriff’s Office– Melissa Neal, Dr.P.H., M.P.H., Policy Research Associates– J. Niki Novak, L.M.F.T., L.P.C, Pathways to Housing, Washington, DC– Hannah Ong, M.D., St. Elizabeths Hospital, District of Columbia Department of Behavioral Health– Fred Osher, M.D., Council of State Governments Justice Center– Lynn Overmann, J.D., Laura and John Arnold Foundation– Travis Parker, M.S., L.I.M.H.P., C.P.C, Policy Research Associates, Inc.5PRINCIPLES OF COMMUNITY-BASED BEHAVIORAL HEALTH SERVICES FOR JUSTICE-INVOLVED INDIVIDUALS
– Madeleine Solan, M.S., District of Columbia Department of Human Services– Anthony Shobe, Captain, Fairfax County (Virginia) Sheriff’s Office– Judith Steinberg, M.D., M.P.H., Health Resources and Services Administration– Nick Szubiak, M.S.W., L.C.S.W, National Council for Behavioral Health– Ashwin Vasan, M.D., Ph.D., New York City Department of Health and Mental Hygiene– Amy Watson, Ph.D., University of Illinois-Chicago– Eric Wargo, Ph.D., National Institute on Drug Abuse– Tisha Wiley, Ph.D., National Institute on Drug Abuse6PRINCIPLES OF COMMUNITY-BASED BEHAVIORAL HEALTH SERVICES FOR JUSTICE-INVOLVED INDIVIDUALS
Introductionofficers use discretion to arrest when they believe aperson needs health care services that are provided inthe jail.SAMHSA’s Vision and Valuesfor Serving Justice-involvedIndividualsArrest and incarceration often destabilize anindividual’s life, including their housing, health care,employment, and social connectedness. Researchershave found that even brief incarceration leads toadverse consequences, including loss of employmentand future employment opportunities, poorer physicaland behavioral health due to breaks in health careservices and treatment, loss of housing and futurehousing opportunities, and disruptions in family lifeand social connections.2 Once in the criminal justicesystem, individuals with mental and substance usedisorders stay in jails longer, have an increased riskfor self-harm, and receive more frequent punitiveresponses to infractions.3 Due to funding and staffinglimitations, many people with mental illnesses do notreceive the services they need and their conditions oftenworsen inside jail settings.4 For individuals alreadyreceiving medications and treatment in the community,these services may be interrupted during incarceration,creating lapses in treatment and difficulties in resumingtreatment upon release and reentry to the community.Without continuous coordinated care throughout andfollowing incarceration, these individuals are at riskfor re-incarceration,5 emergency department use,6,7 andhospitalization.8Community-based behavioral health providers andsystems have an essential role in serving individualswith mental and substance use disorders who arecurrently or formerly involved with the criminaljustice system. These individuals are a part of everycommunity, and as for all community members withbehavioral health needs, individualized, integrated,comprehensive, coordinated, and continuous service isthe standard of care.Individuals with behavioral health issues areoverrepresented in jails and prisons across theUnited States.1 Most of these individuals return totheir communities, families, and social networks andsubsequently require community-based behavioral andphysical health care services. Research has shown thatmental and substance use disorders affect people fromall walks of life, with or without justice involvement,and, with the services and supports of behavioral healthproviders, many people recover. Community-basedbehavioral health providers play a key role in ensuringthat every individual they serve has the treatment,support, skills, and opportunity for recovery and livesproductively with dignity and respect.Unfortunately, people who need access to qualitycommunity-based care may be arrested instead. Inmany communities, people with behavioral healthdisorders cannot access adequate community-basedservices and find themselves channeled into the justicesystem. This may happen when a person is arrestedfor behaviors or actions related to his or her untreatedmental illness. Additionally, some law enforcement7Clinical and case management skills of communityproviders are the foundation of effective treatment andservices for justice-involved individuals. Additionaltraining, knowledge, and skills may be needed, butthe goals of community-based treatment—improvingbehavioral and physical health through treatment andservices, promoting social wellbeing, and preventingor reducing the likelihood of contact with the criminaljustice system—remain the same. The Principleselevate essential components to achieving the goalsof community-based treatment and quality care forjustice-involved individuals.PRINCIPLES OF COMMUNITY-BASED BEHAVIORAL HEALTH SERVICES FOR JUSTICE-INVOLVED INDIVIDUALS
Purpose and ScopeThis document is intended to assist community-basedbehavioral health providers in their clinical and casemanagement practice with people with mental andsubstance use disorders who are currently involvedwith or have a history of involvement in the adultcriminal justice system. The focus of this document ison services provided in the community rather than ininstitutional settings (i.e., jail, prison, or hospital). Theinformation provided is intended to be used in practice,and is therefore appropriate for any staff providingdirect services in community settings. However, topractice these principles, organizations may need toreconsider staff training, evidence-based practices,and other programmatic elements to ensure thatstaff providing direct services have the information,policy support, and resources needed. This documentis also intended for agency leaders and programdevelopers who are responsible for shaping how theirorganizations deliver community-based services. ThePrinciples provide a foundation for realizing a quality,community-based behavioral health treatment systemthat is responsive to all individuals with mental andsubstance use disorders and skilled in serving thosewith histories of justice involvement.The eight principles and accompanying frequentlyasked questions (FAQs) in this document are based onthe most current and relevant research. Resources arealso included that provide additional information andtools to achieve quality practice.The content for this document was developed througha collaborative process. An expert panel was convenedin August 2017, and additional review was solicitedthrough a peer-review process and public comment.The Substance Abuse and Mental Health ServicesAdministration (SAMHSA) is committed to supportingthe shared goals and responsibilities for achievingpublic health and public safety with our criminaljustice colleagues. SAMHSA encourages behavioralhealth providers and criminal justice professionals towork together and across systems to improve the livesof individuals with mental and substance use disorders,their family members’ lives, and their communities.“The Principles provide afoundation for realizing a quality,community-based behavioralhealth treatment system.”8PRINCIPLES OF COMMUNITY-BASED BEHAVIORAL HEALTH SERVICES FOR JUSTICE-INVOLVED INDIVIDUALS
The Eight PrinciplesPRINCIPLE 1Community providers are knowledgeable about the criminal justicesystem. This includes the sequence of events, terminology, andprocesses of the criminal justice system, as well as the practicesof criminal justice professionals.The criminal justice process starts at the point of contact with a law enforcement officer. Such contactmay result in an arrest and entry into the criminal justice system, including prosecution and pretrialservices, adjudication, sentencing and sanctions, and corrections, the last of which may involve jail,prison, or community supervision. Understanding the criminal justice system can help communityproviders facilitate continuous and coordinated treatment and services for justice-involved individualswith mental and substance use disorders. This understanding also helps providers know where in thecriminal justice system and with what criminal justice personnel their client is currently involved.Understanding the system also helps community providers recognize where opportunities exist todivert clients into treatment and services, both before and after entry into the criminal justice system.PRINCIPLE 2Community providers collaborate with criminal justiceprofessionals to improve public health, public safety, and individualbehavioral health outcomes.Collaboration between community providers and criminal justice professionals is essential forensuring continuity of care and care coordination during transitions to and from incarceration andsustaining treatment and supports both in correctional settings and in the community. This includessharing information, responsibility, and accountability. Clarifying roles and responsibilities, ensuringtreatment and supervision efforts are complementary, and working collaboratively with individuals toidentify and meet their treatment and supervision goals are the cornerstones of effective partnerships.For individuals under the supervision of community corrections, partnering with parole and probationprofessionals can facilitate coordinated care and adherence to supervision requirements.9PRINCIPLES OF COMMUNITY-BASED BEHAVIORAL HEALTH SERVICES FOR JUSTICE-INVOLVED INDIVIDUALS
The Eight PrinciplesPRINCIPLE 3Evidence-based and promising programs and practices inbehavioral health treatment services are used to provide highquality clinical care for justice-involved individuals.Evidence-based programs and practices for mental and substance use disorders should be usedfor all individuals, with adaptations specific to justice involvement when appropriate. Adaptationsinclude practices that specifically address criminal thinking through cognitive-skills training focusedon judgment and criminal behaviors. Treatment should be tailored to the individual and addressmotivation; problem solving; skill building to improve cognitive, social, emotional, and coping skills;and assist in building prosocial supports and activities. Where needed, integrated treatment for cooccurring mental illness and substance use disorders should be provided to ensure coordination andcontinuity of care. As with all clinical care, community providers should track treatment outcomes andadjust treatment as needed.PRINCIPLE 4Community providers understand and address criminogenic riskand need factors as part of a comprehensive treatment plan forjustice-involved individuals.Criminogenic risk is the likelihood that an individual will engage in future illegal behavior in the formof a new crime or failure to comply with conditions of probation or parole. Criminogenic needs arefactors that increase an individual’s likelihood of re-offense, such as lack of employment or livablewages, or the presence of a substance use disorder. Criminogenic risk and need factors are malleableand responsive to intervention. Research indicates that behavioral health treatment alone does notreduce recidivism, and conversely, interventions that address only criminogenic risk and need factorsdo not improve behavioral health outcomes.9 Effective treatment for justice-involved individualsincludes evidence-based and promising programs and practices that address an individual’s mentalillness, substance use, and criminogenic risk and need factors.10PRINCIPLES OF COMMUNITY-BASED BEHAVIORAL HEALTH SERVICES FOR JUSTICE-INVOLVED INDIVIDUALS
The Eight PrinciplesPRINCIPLE 5Integrated physical and behavioral health care is part of acomprehensive treatment plan for justice-involved individuals.Formerly incarcerated populations are at increased risk for serious and complex chronic healthconditions and may require coordinated care with other health care professionals. Rates of infectious andnoncommunicable chronic diseases are high in incarcerated populations and those under communitysupervision. Furthermore, incarceration may exacerbate these existing medical conditions. Testing forinfectious and noncommunicable diseases and coordinating medical services are part of an effectivetreatment plan for justice-involved populations. By integrating physical and behavioral health care,community providers can offer whole-person care that is well coordinated and convenient for anindividual, thereby improving access to and engagement with services. Where needed, this shouldinclude integrated treatment for co-occurring mental and substance use disorders.PRINCIPLE 6Services and workplaces are trauma-informed to supportthe health and safety of both justice-involved individuals andcommunity providers.Justice-involved populations have high rates of exposure to traumatic events.10 Individual traumaresults from an event, series of events, or set of circumstances that is experienced by an individualas physically or emotionally harmful or life threatening and that has lasting adverse effects on theindividual’s functioning and mental, physical, social, emotional, or spiritual well-being. Whileincarcerated, individuals may experience trauma specific to the jail or prison setting, including sexualviolence, physical violence, intimidation, confinement, isolation, and coercion. Prior trauma maybe compounded by experiences of trauma while incarcerated. Creating and promoting a traumainformed approach to services and the workplace p
PRINCIPLES OF COMMUNITY-BASED BEHAVIORAL HEALTH SERVICES FOR JUSTICE-INVOLVED INDIVIDUALS – Madeleine Solan, M.S., District of Columbia Department of Human Services – Anthony Shobe, Captain, Fairfax County (Virginia) Sheriff’s Office – Judith Steinberg, M.D., M.P.H., Heal
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