A Simulation Modeling Approach for Planning and Costing Jail Diversion Programs for Persons with Mental Illness

Abstract

In jail diversion programs, individuals with serious mental illness (and often co-occurring substance use disorders) are diverted away from jails toward community-based treatment and support services instead. Such programs are one of the primary strategies recommended by the Subcommittee on Criminal Justice of the President’s New Freedom Commission on Mental Health (http://www.bipolarworld.net/pdf/CJ_ADACompliant.pdf). This chapter provides details on a simulation model for projecting the costs and benefits of these more comprehensive and evidence-based services. Two key findings from the simulations produced a net savings for the county: First, people charged with the most serious misdemeanors and low-level felonies must be included for diversion, or there will be no cost savings, as too few jails days are avoided. The simulations also suggest that the most significant cost savings are associated with post-booking jail diversion programs that serve individuals who have more severe clinical diagnoses and more serious criminal charges and who spend more time in the diversion program. Second, the cost burden shifts from the criminal justice system to the community-based service system, which is already strained for resources. However, the cost of community treatment can be shared with the federal government for those divertees enrolled in Medicaid. The Mental Health/Jail Diversion Simulation Model addresses an important public policy consideration: specifically, whether and to what extent jail diversion achieves current and future public-level cost savings. Results of the simulations provide stakeholders responsible for designing jail diversion programs with insight into how eligibility criteria affect the pool of individuals who can be intercepted, as well as the overall fiscal impact of the interception itself.