ABSTRACT
There are over 3,000 jails in the United States, which are often used as de facto facilities for people with mental illness. Because jails offer little treatment programming and can, in many cases, be detrimental to mental health, a major question is what type of implementation processes can reduce the use of jails for people with mental illness. This chapter examines which implementation factors – and whether they focus on public safety, public health, or a hybrid approach – support policy reforms that affect the size and type of jail populations. In particular, this study focuses on understanding which type of implementation efforts yield impact on the size of the jail population and the number and types of programs for people with mental illness that exist in a jurisdiction. The study uses a sample of 130 Stepping Up jurisdictions and similar control counties (matched on sociodemographic characteristics and population size). Data come from an online survey and interviews with select counties. The implementation factors identified with exploratory factor analysis techniques are: (1) relationship building with other agencies in the county and/or state, (2) infrastructure development related to data driven (3) quality programming, and (4) capacity building. Multilevel models provide understanding as to which implementation factors affect policy reform efforts focusing on local jails. This study illustrates the impact of varied approaches to reform depending on the size of the jurisdiction, size of the jail, orientation of reform, and the resources allocated. Lessons learned from different approaches to reform emphasize clarifying how a safety-health approach can affect how the jail can best serve their community.
