Diversion in Healthcare

According to researchers Jerry M. Stott, Jordan T. Giese, Lisaann S. Gittner, Robert E. Forbis, Jr., and Jeff A. Dennis, the consistent objectives of diversion across various disciplines are rehabilitation, efficient case processing, and reducing resources. “From institutionalized mental health programming in detention facilities to social workers and officers on the front lines, the criminal justice and health care systems [are] attempt[ing] to decrease recidivism among justice-involved individuals with mental illness” (Stott, Giese…, 2023). The complexity of diversion requires a comprehensive approach that integrates theory, practice, and evaluation. By fostering interdisciplinary collaboration and knowledge sharing, we can advance diversion practices and address the complex challenges at the intersection of criminal justice and health care systems (Stott, Giese…, 2023).

Diversion programs involving criminal justice and healthcare are usually oriented around mental illness. The programs provide pre-arrest, pre-booking, post-booking, post-charge, and post-adjudication opportunities for individual and societal success. An outdated belief surrounding mental illness that has inhibited progress toward diversion program institutionalization is “that mental illness puts individuals at a higher propensity for crime and creates perceptions where the belief is individuals with mental illness should be managed differently than average citizens” (Stott, Giese…, 2023). The prejudice surrounding this assumption is that instead of receiving the assistance these individual’s need, people with “‘mental illness’ get treated as criminals, arrested, charged, and jailed for a longer time in jail compared to the general population” (Stott, Giese…, 2023). Individuals with a predisposition toward mental health crises are at greater risk of recidivism within the criminal justice and healthcare systems.

It is important to understand that “incarcerated individuals are 3-5 times more likely to have a diagnosed mental illness as adults in the general population and individuals with mental illness are charged with minor offenses ‘just to get them off the streets as a means of obtaining mental health treatment [that is] not available’ in the community” (Gittner & Dennis, 2023). In the criminal justice system, the objective of diversion is to reduce the number of individuals with mental illness in detention, with successful outcomes ranging from reduced length of jail stay, reduction in charges, and lower recidivism. However, reductions in recidivism rates are reliant on the healthcare system to sustain mental health treatment of justice-involved individuals. Successful outcomes of the health care system include stabilization of mental health symptoms, medication, and reduced number of acute mental health episodes. These two bodies often act as independent entities, highlighting the need for a system that works more synergistically. Neither system alone resolves the underlying issue, and neither system has the capacity to truly help without the other system’s assistance (Gittner & Dennis, 2023).

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The Restart Diversion Program (RESTART), led and implemented by the Monmouth County Prosecutor’s Office (“MCPO”), hopes to advocate for non-violent, low-level offenders with pending 3rd or 4th degree charges in the Monmouth County Superior Court. The overall goal of RESTART is to work with candidates who agree to comply with supervised treatment plans and social services in hopes of lowering recidivism rates and offering tools for the individuals after the successful completion of the program. RESTART prioritizes participants who have a suspected mental health disorder that may have led to their conviction. The process starts with admission into the program (through a referral that meets eligibility requirements), followed by acceptance and plea, compliance, and eventual graduation (Restart Diversion, 2024).

There is a legal and clinical screening process prior to acceptance into the program, with an outlined admission criteria and exclusionary criteria. Admission is dependent on residency of the Monmouth County, eligibility evaluations, pending charges, a prior criminal history, with criminal acts being non-violent in nature. Exclusion criteria range from violent criminal history, involvement in sexually based crimes, offenses involving firearms, arson, substance use as the primary mental health diagnosis, and criminal conduct with no relation to mental health disorders (Restart Diversion, 2024).

Upon acceptance into the program, the defendant must plead guilty with a recommended jail alternative. The defendant is required to agree to an Order of Acceptance, which details the logistics and conditions of RESTART. The defendant’s sentence is temporarily suspended throughout this process. The defendant will continuously be represented by a defense attorney, as the defendant is required to appear before the court for routine reviews determined by the RESTART team. If a compliance violation surfaces during treatment, the clinical team and Monmouth County Prosecutor’s Office determines a verdict. This decision is not subject to further review or deliberation. Once terminated, the defendant’s case will no longer be suspended, and the prior plea will not be withdrawn. Should the individual successfully graduate from the program, a motion for their dismissal will be made (Restart Diversion, 2024).

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Citations

Restart diversion program office of the Monmouth County Prosecutor. Office of the Monmouth County Prosecutor. (2024, March 12). https://mcponj.org/restart-diversion-program/

Stott, J. M., Giese, J. T., Gittner, L. S., Forbis, R. E., & Dennis, J. A. (2023). Perspectives on diversion in the Criminal Justice and Health Care Systems. Journal of Contemporary Criminal Justice, 39(4), 464–470. https://doi.org/10.1177/10439862231189410

By: Mason Mehr, Intern