The number of Michigan counties stepping up to divert individuals with mental illness from county jails has grown by 42% since 2018, and that number is expected to continue to rise. The Wayne State University School of Social Work Center for Behavioral Health and Justice (CBHJ) began providing technical assistance to Stepping Up counties in May 2018 under a grant from the Michigan Department of Health and Human Services (MDHHS) and the Michigan Mental Health Diversion Council (MMHDC).

The impact of mental health and substance use concerns is large for county jails. Approximately 2 million times each year, individuals with serious mental illnesses are admitted to jails across the nation. The CBHJ has identified that 21% of individuals booked into Michigan county jails have a mental health concern and an additional 16% have a co-occurring substance use concern. Those identified within the jail as having a mental health concern generally remain in jail 14 days longer than those not identified by the jail. Additionally, those with co-occurring mental health and substance use concerns are at greater risk for recidivism.

The CBHJ has identified that 21% of individuals booked into Michigan county jails have a mental health concern and an additional 16% have a co-occurring substance use concern.

The Stepping Up initiative offers communities a framework to begin identifying and/or improving ways to divert those with mental health or substance use concerns from jail to appropriate treatment. Of the 19 counties that endorsed Stepping Up resolutions through 2018, eight were already receiving assistance and evaluation from the CBHJ under a separate jail diversion pilot grant from MDHHS/MMHDC. In the remaining 11 counties, efforts generally stalled once the resolution was signed, often due to changes in leadership, insufficient data or lack of technical capacity, and lack of resources to organize the effort. The technical assistance from the CBHJ afforded under the Stepping Up MDHHS/MMHDC grant is intended to help those communities move forward with jail diversion efforts and is provided at no cost to the county, though key stakeholder support and participation is a requirement of the assistance. The CBHJ team - comprised of a project coordinator, project assistant, data analyst, data assistant, strategic planner, law enforcement specialist, and post-doctoral fellow - guides key county criminal/legal and behavioral health stakeholders through a multi-step process framed by the national Stepping Up initiative's "Six Questions Counties Need to Ask".

The aim of the CBHJ's technical assistance is to engage county criminal/legal and behavioral health stakeholders in discussion, collaboration, information sharing, and data gathering that will result in a comprehensive analysis of the current system and the identification and implementation of evidence-based or best practices to optimize the diversion of those with mental health and/or substance use concerns from the county jail to appropriate treatment. The end result of the nine-month process is the county's ability to affirmatively answer all six Stepping Up questions.

One of the most tangible deliverables of the technical assistance process is the identification of the county's prevalence and baseline data. The county's prevalence rate (the proportion of those booked into the county jail who are experiencing a mental health and/or substance use concern) and baseline data (the measurement of the system before changes are made) are important to the county to measure the impact of the changes made within the system and to inform grant proposals. Of the counties receiving Stepping Up technical assistance from the CBHJ to date, three of them - Calhoun, Muskegon, and Washtenaw - received multi-year federal grant awards totaling $3.1 million. In addition, two counties - Jackson and Muskegon - were selected as recipients of state and private grant awards funneled through the CBHJ totaling $700,000.

Of the counties receiving Stepping Up technical assistance from the CBHJ to date, three of them - Calhoun, Muskegon, and Washtenaw - received multi-year federal grant awards totaling $3.1 million. In addition, two counties - Jackson and Muskegon - were selected as recipients of state and private grant awards funneled through the CBHJ totaling $700,000.

News of these successes and the benefits of Stepping Up technical assistance is quickly spreading across the state. Over the last six months, seven counties have endorsed Stepping Up resolutions in order to become eligible for the technical assistance provided by the CBHJ including Antrim, Cheboygan, Eaton (pictured below), Emmett, Grand Traverse, Hillsdale, and Ogemaw. This movement has been driven largely by Northern Michigan counties influenced by Charlevoix County's successful experience with the CBHJ.

All five slots for technical assistance in 2020 have been filled, so the CBHJ is now actively enrolling counties for assistance in 2021 and plans to begin working in those communities late this summer. Send us an email to get more information about CBHJ Technical Assistance in your community.

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About the Center for Behavioral Health and Justice: The Center for Behavioral Health and Justice and Wayne State University's School of Social Work envisions communities in which research, data, and best practices are used by multiple stakeholders to enhance the optimal well-being of individuals with mental illness and/or substance use disorders who come into contact with the criminal/legal system. Learn more

About the Stepping Up Initiative: Stepping Up is a national initiative to reduce the number of people with mental illnesses in jails and is the result of a collaboration between the National Association of Counties, The Council of State Governments Justice Center and the American Psychiatric Association Foundation. The initiative was launched in May 2015 and since then over 450 counties across the country have endorsed resolutions in support of the effort. In Michigan, 27 counties have now endorsed a Stepping Up resolution, up from 19 in 2018. Learn more.

About the Michigan Mental Health Diversion Council: Created by Executive Order 2013-7, the Mental Health Diversion Council was created in the Michigan Department of Community Health to advise and assist in the implantation of the Diversion Action Plan and provide recommendations for statutory, contractual or procedural changes to improve diversion. The Council is charged with "reducing the number of people with mental illness or intellectual or developmental disabilities (including comorbid substance addiction) from entering the corrections system, while maintaining public safety". Learn more.