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Most Jail Diversion Participants Do Not Perceive Coercion

iNIC Cusak Stock_000015796063Medium_purchased Cusack, K.J., Steadman, H.J., and Herring, A.H. Perceived coercion among jail diversion participants in a multisite study. Psychiatric Services 61(9):911-6, 2010.

By Lori Whitten, Staff Writer, RTI International, Rockville, MD

Mentally ill people who have been arrested are increasingly being diverted from jails to community-based behavioral health services. The goal of such jail diversion programs is to decrease future interaction with the criminal justice system and improve mental health outcomes. Although criminal justice systems consider jail diversion to be appropriate and humane, there has been very little research on participants' perceptions of coercion-lack of choice or control-and any possible impact on engagement in mental health treatment.

Karen Cusack, Ph.D., and colleagues interviewed 905 jail diversion participants-most of whom had committed nonviolent misdemeanors-from 13 programs of the Targeted Capacity Expansion Jail Diversion Initiative of the Substance Abuse and Mental Health Services Administration. The results indicated that about one-third of jail diversion participants reported some level of perceived coercion. Specifically, 10 percent of participants reported a high level of coercion, and another 26 percent reported a moderate level. The levels of perceived coercion reported among this sample of jail diversion participants were comparable to those reported by voluntary psychiatric outpatients or participants in a mental health court in prior studies, the researchers say. Moreover, prior research suggests that some samples of involuntary psychiatric inpatients or psychiatric outpatients report much higher levels of perceived coercion.

Charge type and sexual abuse history influenced whether jail diversion participants perceived coercion, the researchers found. Participants with a drug charge reported lower perceived coercion, probably because diversion programs seem a positive alternative to incarceration for these individuals. Individuals who had experienced recent sexual abuse but were not substance abusers perceived higher levels of coercion.

For 6 of the 13 sites (348 of the participants), Cusack and colleagues were able to determine mental health treatment engagement during the next 12 months. Perceived coercion at the beginning of the diversion program did not affect treatment engagement during the following year. Participants who were older, those with more severe psychiatric symptoms, and individuals with a history of sexual abuse without co-occurring substance abuse or experiences of physical abuse used a higher level of outpatient mental health services than others in the study.

 For more information, contact Dr. Karen Cusack, Department of Psychiatry and Cecil G. Sheps Center for Health Services Research, University of North Carolina, Chapel Hill, North Carolina email:

Posted Fri, Mar 2 2012 1:00 PM by Tracey Vessels


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