Research to identify practices for reducing incarceration of those with mental illnesses

Faye Taxman

University Professor Faye Taxman is helping spearhead a study of the Stepping Up Initiative, a national effort to reduce the number of those in jails who have mental illnesses.

The research will help determine the efficacy of data-driven change strategy as well as describe the effective parts. The findings are expected to inform future policy changes related to this multi-need population.

The National Institute of Mental Health (NIMH) awarded $3.5 million to the project over five years.

“What this tells us is that NIMH recognizes we have the capability of doing complex studies of very complex problems,” Taxman said.

The award is also a recognition of the interdisciplinary work done by Taxman, a health service criminologist, and her Center for Advancing Correctional Excellence. Also on the project are Alison Evans Cuellar, a professor of health administration and policy in Mason’s College of Health and Human Services; Niloofar Ramezani, an assistant professor of statistics in the Volgenau School of Engineering; and James Witte, a professor in the Department of Sociology and Anthropology in the College of Humanities and Social Sciences.

Helping spearhead the study is Jennifer Johnson, professor of public health at Michigan State University. Jill Viglione, assistant professor at the University of Central Florida, is the project director.

“The goal,” Taxman said, “is to answer the question: How can you better implement change in complex systems like the criminal justice system?”

According to a 2017 report by the Bureau of Justice Statistics, approximately two-thirds of female inmates in prisons and jails and approximately one-third of men report having been diagnosed with a mental health disorder.

The Stepping Up Initiative, led by the Council of State Governments, the National Association of Counties and the American Psychiatric Foundation, currently involves 500 U.S. counties, making it the largest-ever effort to set up system reforms directed at putting justice-involved people into needed treatment and services, the NIMH reported.

Participating counties commit to identifying validated mental health screening tools, implementing an assessment process, collecting and reviewing the flow of individuals with mental illnesses in and out of jails and behavioral health services, and examining community treatment capacity.

Counties also committed to track and measure progress on reduced jail bookings, jail length of stay, increased connections to evidence-based treatments, and reduction of recidivism. Counties can adapt individual approaches.

The research team will measure how each county implements the steps of the initiative to determine their effect on the availability and use of evidence-based treatment services by the population. The study will identify effective implementation processes that counties can use to change systems, Taxman said.

“What’s really exciting is there are very few studies that focus on implementation and which processes of implementation are more effective and generate the most impact on reducing the use of incarceration and expanding use in the community,” Taxman said. “We’re looking at system-wide change, how (counties are) implementing different practices, what procedures they’ve changed, how they’re reconfiguring staffing, and which efforts result in the most change.”

According to the NIMH, the study will provide the first empirical evidence of the effectiveness of the Stepping Up Initiative and shed light on how to best implement evidence-based practices and procedures in jail and the community to improve the health and well-being of individuals with mental illnesses and substance abuse problems, reduce or eliminate their episodes of incarceration and enable them to live stably in the community.

“The question is, can other jurisdictions have similar successes, and if so, how do they assemble their change processes?” Taxman said.