SJR 97/HJR 142: Committee to Study Treatment Options for Offenders with Mental Illness and Substance Abuse Disorders

June 28, 2002

The 2002 Session of the General Assembly directed the Joint Commission on Behavioral Health Care and the Virginia Commission on Youth to continue the study of treatment options for offenders with mental illness and substance abuse disorders for two more years. SJR 97/HJR 142 authorized three meetings per year with a final report to the 2004 Session of the General Assembly. The resolutions also authorized the commissions to establish a committee to provide leadership and direction for an interagency work group, oversee implementation of the SJR 440 (2001) recommendations, and conduct further research concerning diversion programs that would prevent some individuals with mental illness and substance abuse disorders from entering the criminal justice system in the first place.

Staff described the actions taken by the 2002 General Assembly on the committee’s SJR 440 recommendations and outlined a proposed work plan, which was approved by the committee with the addition of opportunities for public comment. A copy of the work plan is available on the committee’s website.

Secretary of Health and Human Resources

Status of Current Funding

Secretary of Health and Human Resources Jane H. Woods described the services to offenders provided by state and local agencies associated with the Health and Human Resources Secretariat and delineated changes in funding available for mental health and substance abuse treatment for offenders as a result of the 2002-2004 biennium Appropriation Act.

Funding appropriated to the Department of Mental Health, Mental Retardation and Substance Abuse Services for existing mental health services in community services boards and state facilities was maintained. However, no new funds were provided to address unmet needs or to develop an adequate state and community-based system of mental health services. In addition, funding for substance abuse assessment and treatment services for offenders was reduced by 70 percent, creating a loss of essential substance abuse treatment capacity across the Commonwealth. Ten adult and two juvenile drug court treatment programs provided through community services boards were continued for one year at 80 percent of their previous funding levels. Full funding of drug courts is a high priority for Secretary Woods.

Priorities and Goals

The Secretary articulated a list of goals and priorities in regard to offenders with mental illness and substance abuse disorders:

  • Define statutory responsibilities for treatment services to adult and juvenile offenders;
  • Develop standards for mental health and substance abuse services that should be available to adult and juvenile offenders, including diversion, assessment and diagnostic services, expansion of drug courts, involvement of case managers in pre-release planning, and assertive case management and treatment for offenders on probation;
  • Develop model agreements for coordination and cross-training among jails, detention centers, court services, probation and parole and community services boards;
  • Increase the availability of psychiatrists;
  • Evaluate the effectiveness of community-based programs for offenders;
  • Develop the capacity to collect and analyze data on the availability and costs of treatment services; and
  • Develop a comprehensive and systematic approach to set priorities and fund service gaps.

Secretary of Public Safety

Status of Current Funding

Secretary of Public Safety John W. Marshall affirmed that multiple needs compete for resources in institutions and communities. While public safety is the first priority, other needs include mental health and substance abuse treatment, education, job skills and transitional services. However, lower than expected general fund revenues have forced reductions in current programs. Exacerbating the problem is the potential expiration within one to four years of a number of federal grants that funded mental health, substance abuse and sex offender treatment programs.

For the 2002-2004 biennium, Substance Abuse Reduction Effort (SABRE) funding totaling $9.2 million, which provided substance abuse treatment services in the community, was eliminated. Additional reductions that will impact community-based substance abuse and mental health treatment include:

  • Reduction of $15 million per year for the Virginia Juvenile Community Crime Control Act (VJCCCA), which removes much of the capacity for localities to provide treatment services to juvenile offenders;
  • Reductions in funding for Drug Courts, jail treatment grants, and SABRE program evaluations; and
  • Closing of Department of Corrections day reporting centers and reductions in juvenile programs, including Richmond Continuum ($780,000) and the Norfolk and Portsmouth Marine Institutes ($1 million).

The Secretary indicated that reductions in VJCCCA could result in increased costs for the Comprehensive Services Act or increased commitments to juvenile detention or to the state, when judges believe that required treatment is not otherwise available.

Priorities and Goals

The Secretary emphasized the need "to improve our abilities to assess, prioritize and evaluate so that we can do the most good with what we have available to us." He also indicated that the Governor has said that developing new initiatives should not cease because of the downturn in funding; rather a "laundry list" of initiatives should be ready when revenues improve.

Secretary Marshall further elaborated that some individuals may be placed in the criminal justice system at considerable cost when treatment, not sanctions, is the primary need. The focus has tended to be on those individuals who are already incarcerated, but the Commonwealth needs to do a better job of identifying and addressing the needs of those for whom intervention and early treatment might prevent entry into the criminal justice system. Moreover, a balance needs to be achieved between those individuals with acute treatment needs, who absorb a disproportionate share of resources, and the escalation of illness in individuals with lower level treatment needs. Screening and assessment of offenders with substance abuse is required by the Code of Virginia, but the resources for providing treatment have been reduced considerably. Finally, program evaluation, while important for defining appropriate treatment methods, is difficult to accomplish when the scope of programs is reduced or eliminated.

Diversion Analysis

Henry J. Steadman, president of Policy Research Associates, Inc. and a leading authority on mental illness, co-occurring substance abuse disorders and the criminal justice system, addressed the committee on diversion: What types of diversion work? Under what circumstances? And for whom?


Priority issues surrounding diversion are keeping people out of jail who do not need to be there, providing adequate services to incarcerated individuals who need them, and linking people to services when they are released from jail so they do not keep recycling back. A study of Cook County Jail in Chicago revealed that of people with a serious mental illness, 72 percent of men and 75 percent of women have a co-occurring substance abuse disorder. The fundamental question is who are the people that we should try to keep out of jail and for whom there should be some alternative. Dr. Steadman stated that the first priority should be on those who (i) have a clinical diagnosis of serious mental illness and a co-occurring substance abuse disorder, (ii) depend on the public sector for income and insurance support, and (iii) cycle in and out of jail repeatedly.

What needs to be understood about diversion? First is the target population. Most communities usually start with a category of charges (i.e., misdemeanors or felonies). Further, some communities have established additional criteria; for example, meeting the definition of priority population for mental health services. Second, diversion is a specific program with dedicated staff whose job is to find the target group when they come in contact with the criminal justice system. The third characteristic of diversion is that it is community-based mental health and substance abuse services in lieu of jail or reducing jail time; it is not competency evaluation that results in placing the individual in the forensic inpatient system.

Diversion can take on a variety of forms, including charges not being filed, conditions of bail or probation, or deferred prosecution. The diversion program, whether it is police-, court-, or jail-based, is the identification of the target group and "cutting a deal" between the public defender and the prosecutor. But there have to be adequate community-based services, including mental health and substance abuse treatment, housing, health, entitlements and employment.

Pre-Booking Programs

What are the options? Pre-booking is a police-based program where persons are diverted before the charge is filed. Post-booking programs can be court-based or jail-based. There are three basic models for police-based programs: police team, social workers working for police or mobile crisis team. The Memphis Crisis Intervention Team (CIT) is a group of specially trained officers who are called to the scene and then become responsible for the resolution of the occurrence; currently about one-sixth of the Memphis police force, distributed in precincts all over the city, receive the special training. Birmingham has five social workers who work with the police department and are called upon to deal with situations. Los Angeles has four or five mobile Systemwide Mental Assessment Response Teams (SMART), consisting of a police officer and a mental health professional who can respond to the scene.

Post-Booking Programs

Post-booking programs can be court-based or jail-based. Court-based programs can occur at first appearance in a regular court or in a specialty court, such as a mental health court. Disposition can include dropping charges and relying on voluntary compliance, continuing the charges and deferring prosecution, or pleading the case resulting in either probation with terms and conditions or deferred sentence with terms and conditions.

In jail-based programs (usually pre-trial services), staff, who can identify those persons who need to be moved through the system more quickly, are located in the jails. The staff meets with the prosecutor and the public defender to get agreement on disposition. Usually, this process takes approximately one week, and, typically, the person is diverted from the jail, the charges are continued, and the person is given a court date. The court’s discretion over punishment is retained since the court still retains jurisdiction. Part of the responsibility of the staff is to make sure that the individual actually appears on the court date, since failure to appear is often a problem.


What do the empirical data say about the effectiveness of these programs? Unfortunately, not much research data are available. On pre-booking programs, a much smaller percentage (approximately two percent versus 16 percent) of persons actually get arrested where the programs are in effect. The second finding is that the time in jail is reduced for pre-and post-booking programs, and offenders pose no greater risk to the community for re-arrest or violent re-arrest than anyone else. Not much can be said about treatment outcomes because the persons who are diverted may still not get services in most communities. Diversion only helps identify persons who need services.

While there are data to show the positive impact of mandated treatment for substance abuse, there are no data to show the impact of mandated treatment for persons with mental illness.

How can evaluation be accomplished? Usually when programs are established, basic data collection is not included. Dr. Steadman suggested looking to universities for graduate students who need research projects. Also federal grants are sometimes available to fund evaluations of mental health and substance abuse programs, but someone needs to be looking for these opportunities.

Dr. Steadman says significant results have occurred, often with very little additional money, when the right people get to the table and form partnerships. The basic philosophical point is that "people. . . with serious mental illness who continually come in contact with the criminal justice system is not a criminal justice problem; it is a community responsibility." Dr. Steadman went on to say that until the thinking is shifted about community responsibility, it is a hopeless battle; however, family members have historically been prime movers in helping to change community thinking.

Member Discussion

Members raised several points in summary. One noted that the system is fractured, with little discussion between criminal justice and treatment professionals. Moreover, there is no evidence that the current system is working, so the status quo should not be viewed as preferable to new initiatives. A discussion also occurred concerning the potential for required treatment following incarceration. There was concern expressed that the responsibility would need to follow the individual, since offenders may be released into communities other than their own. Moreover, a requirement for treatment for those involved in the criminal justice system would push others further down on the waiting list for services in the communities.

The next meeting of the committee will be on October 18.


The Hon. Stephen H. Martin

For information, contact:

Nancy L. Roberts
Division of Legislative Services



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