Redirect People From Repeat Arrests

While rates of mental illness in the general U.S. population hover around 4%, the rates are nearly five times higher — almost 20% — among jail populations, according to research by Treatment Advocacy Center.

The cost of jailing people with mental illness is high and the outcomes are poor. People with mental illness and addiction are found to have longer jail stays, higher recidivism rates, and more criminogenic risk factors. Meanwhile, crisis centers and other behavioral health programs remain underfunded across the U.S.

Shifting the entire system that keeps people in cycles of incarceration takes moving beyond anecdotal insights. Those with the power to change need data and evidence from a range of sources, but there’s a technological barrier to connecting the disparate, siloed systems.

Today, Fulton County is taking an innovative technical approach, framed around the Sequential Intercept Model, to reimagine the entire continuum of care system.

“This important partnership with Tyler gives us the ability to more quickly identify those in greatest need of behavioral health services so that they can be diverted out of the criminal justice system and into the care of those agencies better equipped to provide needed support,” said Superior Court Judge Robert McBurney, chair of the county’s Justice and Mental Health Task Force. “Our effort will meaningfully reduce arrests and free up scarce resources at the county jail and in local police departments.”

The solution examines each intercept of the Sequential Intercept Model: community services, law enforcement, initial court hearings and detention, jail and courts, reentry, community supervision, and — at the root of all this — data-sharing.

“We want dispatchers, first responders, and other critical stakeholders to have access to integrated data to increase connections to community providers who can support people in need and reduce incarceration as the “go-to” response,” said Kristin Schillig, who manages the Justice and Mental Health Task Force at the Superior Court of Fulton County. “The current intervention and service delivery models need to be better connected and more responsive to our group of familiar faces. We know having real-time access to integrated data will have a benefit to the agencies involved, but more importantly to the people impacted by our current fragmented approach.”

A PERSON-FIRST, COMPREHENSIVE ANALYSIS

Fulton County’s strategic plan began several years ago on the basic tenet that no assumption of threat will be associated with any member of the community. One component of that takes a hard look at the criminal justice system, specifically leveraging data for better outcomes.

Police officers have few options outside of making an arrest to diffuse conflicts with people who are experiencing behavioral health issues. Once booked into jail, corrections officers have a limited picture of a person’s previous treatment unless they’ve been jailed before and provided details during intake. This increases costs and puts people at risk while in custody. This increase in arrests snowballs through the court system, overwhelming judges with dockets full of cases that would be better served by diverting these individuals to behavioral health care providers.

Despite its size (more than 1 million residents) and the prevalence of mental issues afflicting those who become involved in the criminal justice system, Fulton County still does not have a crisis center. Instead, the jail has become the county’s de facto mental health facility for arrestees — with a revolving door. The 100 people who were booked into Fulton County Jail most often from 2017 through 2019 had 1,146 total bookings — an average of 11.5 bookings each over the course of three years. Additionally, 82 of these 100 individuals were matched to Atlanta City Detention Center records and had an additional 855 bookings between 2017 and 2019, for an average of 10.4 bookings each over three years.

“People caught in the cycle of incarceration are often experiencing homelessness, they may have mental illnesses, or have chronic substance use issues, and they’ve got nowhere to go,” Schillig said. “We need to work towards building a public safety infrastructure that links people in need to community providers and services without criminal justice involvement.”

Analysts uncovered an important link between the top jail charges for familiar faces.

“The majority of charges could be considered quality of life offenses, things like criminal trespassing, disorderly conduct, minor shoplifting, or urban camping,” said Nick Heaghney, a court policy analyst with the Superior Court of Fulton County. “We also found an overlap of mental health issues and probabilities for co-occurring substance abuse and chronic homelessness.

SYSTEM-WIDE APPROACH TO TACKLE SHARED GOALS WITH DATA

The court’s effort stems from an initiative sponsored by Fulton County commissioner Joan Garner. In May 2016, Garner championed the county’s Stepping Up Initiative Resolution, modeled after the national initiative, to reduce the number of people with mental illness in jails.

The Fulton County Justice and Mental Health Task Force began convening with the support of a $250,000 grant from the United States Department of Justice. The task force, led by the Fulton County Superior Court, brought together a broad coalition of community partners to conduct system and gaps analysis and laid out a plan centered on Stepping Up’s four key measures: reduce arrests, reduce length of jail days, increase connections to treatment or social services, and reduce recidivism.

“Courts are the neutral party in the justice system, and we have the content expertise and the convening power to pull the pieces together,” Schillig said. “The idea is we integrate all these datasets, and this will have a benefit to all the agencies, from first responders to the jail to social workers doing re-entry. We have to have a way for data to be integrated and for people to have access to the information.”

Fulton County chose Tyler’s enterprise data platform to connect and share data across criminal justice, courts, and behavioral health systems. This solution helps examine each aspect of the continuum of care: pre-arrest, housing, court collaboration, medical treatment, and re-entry.

This effort involves pulling in jail data from Fulton County Jail and Atlanta City Detention Center, behavioral health data from Grady Health Systems and both Fulton and Georgia Departments of Behavioral Health and Developmental Disabilities, as well as housing data from the Homeless Management Information System, among others. Matching and sharing data across systems that do not traditionally share with each other allows for the development of a holistic view of a high-need population that constantly flows through county and city systems.

Teams can easily connect data from their existing systems via Tyler’s enterprise data platform without creating a heavy lift for data owners. Additionally, the platform provides the necessary controls to maintain security and work with source data — an important consideration given the privacy concerns surrounding much of the information being shared.

“We didn’t want to ask everybody to change their systems to use ours,” said Mike Rowicki, director of strategic planning and performance management for Fulton County. “With access granted to other stakeholder’s data, this technology gives us the capability to pull, clean, and make more data available in our system. We’ll be the repository for everyone to store data and help to filter and clean it so everyone’s working together.”

BUILT-FOR-GOVERNMENT DATA PLATFORM ENABLES COMPREHENSIVE VIEW

Fulton County brings data into the platform, which is HIPAA compliant, then a matching algorithm is applied to clean the data and match individuals across datasets. The platform provides each organization with a custom dashboard that masks data on a permissions-basis and relates to what each organization needs in an integrated data system.

“It is important that the data platform was built for government,” Rowicki said. “The majority of the people who will be working with it are tied to government organizations and the government-run judicial systems. The system has to be user friendly for government agencies and the data we’re trying to use.”

The platform is available to several types of users, including administrative roles with central IT, team administrators with department leaders, team publishers with department users, and general users with query ability. Users can query a dataset on the platform containing information on past behavioral health touches by government and contracted behavioral health providers. This query provides insights into the last touchpoint a client had with a behavioral health provider.

“Judges should be able to see what they’re doing in cases that are coming through,” Rowicki said. “When judges see people repeating and our jail system overflowing, these are the people we need to help and make sure they’re targeted. If we can get this focused, we can get them the services they really need.”

CONNECTING INSIGHTS INTO FULTON COUNTY’S FAMILIAR FACES

County judges see this approach as a path to reduce arrests, jail stays, and recidivism, and ultimately, free up funds that can be reinvested in treatment and prevention.

The technology helps the county tap into new insights to connect people in crisis to alternatives to arrest, improve crisis response and behavioral health service capacity, and expand court diversion programs throughout the community. Additionally, it streamlines how the court reports progress to county executives, judges, and the public. Bolstered with improved reporting, the county can tap into funding streams and additional grant sources to further the work.

The results of this work to divert people from the justice system to behavioral health providers are multi-faceted. At the frontline, police officers can use these insights to determine whether to transport a person to jail or a behavioral health care provider. Corrections officers now have greater insight into intake placement, services provided, and where to seek past treatment records for people in jail. And health providers can use the new approach to make the intake process more efficient.

Fulton County judges will have insights into people being detained and can produce a more complete history when it comes to behavioral and mental health services. This effort is poised to help judges reduce the COVID-induced backlog of cases and to divert people to treatment instead of incarceration when it is appropriate.

“It’s all about coordination of services for individuals,” Rowicki said. “We can make a difference in someone’s life. If we can connect them to Veterans Affairs, Social Security, and other support programs, we can give them the tools to help them succeed.”