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May 26, 2020

Stepping up to reduce mental illness in jails

The national Stepping Up Initiative is helping hundreds of counties nationwide reduce the number of people with mental illnesses in jails. A Michigan State University professor and her colleague have been awarded a grant to study how the program works and determine what techniques can be adopted to improve treatment for individuals with mental illnesses and keep them out of jail.

“Our primary goal is to learn more about how county agencies can work together to reduce the number of mentally ill people in county jails,” said Jennifer Johnson, a C.S. Mott Endowed Professor of Public Health at MSU College of Human Medicine. “It’s a chance to learn what works and how we can help counties address these problems.”

The National Institute of Mental Health awarded Johnson and George Mason University Professor Faye Taxman a $3.2 million, five-year grant to study the national Stepping Up Initiative.

About two-thirds of individuals in jails have mental health problems, many of them serious, and an estimated three-quarters of them also have substance abuse problems. Yet most jails are ill-equipped to deal with those complex issues. 

“Many people in jail are there because of their mental health problems – they went off their medications and were acting erratically,” Johnson said. “When the police don’t know where to take someone, they take them to jail. Most people go through the jails so quickly that it’s tough for most jails to effectively coordinate services afterward, meaning that they are back out, still not taking medications, and it becomes a vicious cycle. Stepping Up helps counties plug the gaps in a fractured system so that people who would be better served by mental health treatment aren’t filling up the county jails.”   

The Stepping Up Initiative, led by the Council of State Governments, the National Association of Counties and the American Psychiatric Foundation, was created to help counties redirect individuals with mental illnesses into treatment and reduce their numbers in jails. More than 500 counties in 43 states, including 20 counties in Michigan, participate in the initiative.

Johnson and Taxman plan to examine how well and why the program succeeds in many of those counties nationwide compared with counties that don’t use Stepping Up.

“Our hypothesis is that Stepping Up counties will have faster rates of improvement in the number of justice-involved individuals served with evidence-based mental health services,” Johnson said. “We’re going to look at how they’re doing that to draw generalizable lessons for other counties.”

For many counties, the answer likely is improved coordination and communication among county agencies to redirect individuals with mental illnesses into treatment.

“What do we need to do to help the people who are falling through the cracks?” Johnson asked. “The idea is to keep individuals with mental illnesses out of the justice system and get them the help that they need.”