Assessing County-Level Behavioral Health and Justice Systems with the Sequential Intercept Model Practices, Leadership, and Expertise Scorecard

Community Ment Health J. 2023 Apr;59(3):578-594. doi: 10.1007/s10597-022-01042-5. Epub 2022 Nov 2.

Abstract

The Sequential Intercept Model has helped conceptualize interventions for people with serious mental illness in the criminal/legal system. This paper operationalizes the Sequential Intercept Model into a 35-item scorecard of behavioral health and legal practices. Using interviews, survey, and observational methods, the scorecard assesses an exploratory sample of 19 counties over 27 independent data collections. A series of ordinary least squares regression models assessed the predictor scores on four jail outcomes: prevalence of serious mental illness, length of stay, connections to treatment, and recidivism. Increases in pre-booking scores showed significant decreases in jail prevalence of serious mental illness at the p < 0.05 level, and post-booking scores and overall scores showed significant positive associations with connections to treatment at the p < 0.05 level, though these were non-significant after correcting for multiple comparisons. Preliminary findings suggest a combination of practices across the Sequential Intercept Model could have synergistic impacts on key jail diversion outcomes.

Keywords: County-level; Jail diversion; Mental illness; Sequential Intercept Model; Systems change.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Criminal Law
  • Humans
  • Leadership
  • Mental Disorders* / epidemiology
  • Mental Disorders* / therapy
  • Prisoners*
  • Psychiatry*