"Mentally ill people shouldn't go to jail for being mentally ill," said Erio Alvarez, a criminal justice specialist on the staff of the sheriff of Hillsborough County, Fla. The county, which includes Tampa, sees far too many "frequent flyers," people arrested and jailed again and again for minor infractions such as urinating in public, petty theft, and trespassing.

These people are often homeless, with severe and persistent mental illness and comorbid substance abuse problems.

A small percentage cycle in and out of the systems and utilize disproportionate resources, said Alvarez. He cited the case of one man who was arrested at least once in every month in 2005.

Now the Substance Abuse and Mental Health Services Administration (SAMHSA) will give Hillsborough County and jurisdictions in Connecticut, New Mexico, Missouri, Texas, and Pennsylvania about $400,000 a year over the next three years to implement programs to place offenders in treatment instead of jail.

Authorities hope to provide better outcomes for them and reduce society's burden of recidivism.

Programs to divert people with psychiatric illnesses who are accused of crimes from the criminal justice system and into treatment have been growing for about a decade (Psychiatric News, April 21). These six programs will receive grants totaling $7.2 million to expand or develop such jail-diversion programs.

The grants call for care that integrates best mental health practices with substance abuse treatment, medication management, psychiatric and gender-based trauma services, and use of the assertive community treatment model, a multidisciplinary team approach.

"All too often individuals with mental illness, often with co-occurring substance abuse, are incarcerated instead of receiving treatment for their disorders," Charles Curie, M.A., SAMHSA administrator said in a statement. "These grants offer an alternative. By providing treatment and support services, we can avoid the unnecessary criminalization and incarceration of nonviolent adult offenders with mental illness."

Nueces County, Texas, will use its grant to target the top 100 repeat offenders in the county system with a mental illness or substance history, said Chief Deputy Sheriff Jimmy Rodriguez, project director for the jail-diversion program in Corpus Christi.

"We have about a thousand prisoners in the county jail, and 60 percent of them have substance abuse or mental illness problems," Rodriguez told Psychiatric News.

Nueces County will contract with state, private, or nonprofit agencies to provide psychiatric and psychological services, drug and alcohol abuse counseling, medication management, family support, and short-term drug treatment, he said.

Part of the grant money will help train more deputies to deal with mentally ill citizens. One man was arrested 30 times last year, he said. With better training, officers might have recognized his problems sooner, and they or case workers might even have visited him before an incident occurred to be sure he was in treatment and taking needed medications, Rodriguez said.

"This is a way to integrate law enforcement with mental health care," Rodriguez explained. "It beats arresting someone 30 times a year, booking him, transporting him across town from the city to the county jail, and then having the officer appear in court."

In Florida, the SAMHSA grant will let Hillsborough County target offenders arrested three times in the preceding 12 months, if their latest arrest is for a misdemeanor, said Alvarez in an interview.

The county will begin by refining a strategic plan with the help of the Florida Mental Health Institute at the nearby University of South Florida. The plan will help integrate elements of the system already in place.

The next step will be linking the databases of all the elements in the system to better track offenders. Each has its own information system, but the systems are not tied together, said Alvarez.

"Someone being seen by a mental health team can be arrested, but the team won't know [the person is] in jail."

With the SAMHSA grant, the mental health center would be notified immediately and contacted again for follow-up before the person leaves jail. In between, the judge at the initial hearing will also have better information to direct disposition of the case.

The third element in Hillsborough's plan will be to improve what happens to mentally ill persons on their release from jail, said Alvarez. They need transportation to a shelter for a short-term place to stay, then help with housing, medical, and psychiatric care.

"We need to put it together to work as a system, try to reduce episodes, and do right by this population," he said.

Information about the SAMHSA grant program is posted at<www.samhsa.gov/news/newsreleases/060420_jails.htm>.▪