Although local police, judicial officials, and human services personnel
have increasingly focused on the goal of keeping individuals with mental
illness out of the justice system over minor incidents, they have lacked,
until recently, a comprehensive guide for how to implement such an effort.
Developed as part of an effort to overhaul the approach of Summit County,
Ohio, to those with mental illness in the criminal justice system, the
sequential intercept model provides an outline of the law enforcement and
human services programs that local jurisdictions generally provide. The model
then highlights where those with mental illness generally enter and exit each
stage of the system.
Local officials who are beginning to assess the way they deal with people
in the criminal justice system who have mental illness can use the model to
identify points in the system where initial changes would have the biggest
impact, such as training police in how to approach those in a mental health
Other jurisdictions further along in developing a program designated for
people with mental illness can use the model to find weaknesses in their
system, such as inadequate training of probation officers to monitor the
medication compliance of those under court order to take medication for mental
"On the face of it, this work can look like an overwhelming problem
to local officials, so this just gives them a place to start," said Mark
Munetz, M.D., co-author of a paper describing the model and chief clinical
officer of the Summit County Alcohol, Drug Addiction, and Mental Health
The model was described in the report "Use of the Sequential
Intercept Model as an Approach to Decriminalization of People With Serious
Mental Illness" in the April Psychiatric Services.
The researchers who developed the model have worked extensively with
jurisdictions to improve their interactions with mentally ill individuals at
the law enforcement, adjudication, and human services levels.
The goal of the model is to ensure that most mentally ill people are
intercepted at early points—such as initial detention and initial court
hearing—with decreasing numbers found at each subsequent point. The
model's guidelines range from the use of best clinical practices—which
preclude arrest and are the best intercept—through community corrections
and community support.
"We came up with a model that makes it easy for people in social
services to understand how those with mental illness flow through the criminal
justice system, so they know better where they can help," said Patricia
Griffin, the report's co-author and senior consultant for the National GAINS
Center for People With Co-occuring Disorders in the Justice System, a
federally funded program that distributes mental health information.
The model is based on the belief that people with mental disorders should
not enter the criminal justice system at a greater rate than people in the
same community without mental disorders. The authors note that those who
commit crimes unrelated to their illnesses must be held responsible, but they
should not be arrested or jailed only due to their condition or the lack of
The model has already assisted several jurisdictions in which it was
introduced because it provides a "big-picture view" no one
official had of what happens to individuals with mental illness as they move
through the legal system, said Griffin.
The model allowed rural Bucks County, Pa., to find that all of their mental
health "interventions" were located at the jail and during the
pretrial phase, while there was no training for police in recognizing and
interacting with those with severe mental illness, she said.
Munetz said the model has also shown success in overcoming one
long-standing problem by allowing all of the officials of relevant agencies to
come together over a unifying document that starts the conversation on how to
improve the situation for those with mental illness.
The model has helped Munetz see that the local partnerships with the
greatest potential are often those between mental health professionals and
parole officers, because they have the authority and proximity to ensure
court-ordered medications are taken.
"Use of the Sequential Intercept Model as an Approach to
Decriminalization of People With Serious Mental Illness" is posted at<http://psychservices.psychiatryonline.org/cgi/content/full/57/4/544>.▪