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By David Cloud, program associate, Substance Use and Mental Health Program
There are significant legal, practical, and ethical barriers that prevent health and justice agencies from sharing information about the treatment needs of a large and underserved population: people with serious mental health and substance use needs who are involved in the criminal justice system. These communication barriers severely compromise the ability of agencies to coordinate services for people with treatment needs as they transition between criminal justice and community settings. This lack of connectivity is leading to potentially serious lapses in essential care and uncounted avoidable crimes.
To help jurisdictions improve services for a vulnerable population that historically has limited access to treatment services, Vera’s Substance Use and Mental Health Program (SUMH) has launched the Justice and Health Data Exchange initiative (JAHDE) with support from the Bureau of Justice Assistance. JAHDE aims to provide policy makers and practitioners with the resources and support to share data confidentially, legally, and ethically to increase treatment access, improve individual and community outcomes, maximize the use of funds, and eliminate bureaucratic duplication.
Current epidemiological trends exemplify how the worlds of public health and criminal justice often intersect. Disproportionately high rates of communicable infections, chronic diseases, drug and alcohol problems, and mental disorders afflict populations involved in the criminal justice system and the communities they inhabit. Many people enter jail or prison with serious physical and mental illnesses and receive a range of health services during their incarceration. However, there is a fundamental disconnect between correctional and community health that affects both public health and safety.
When people are released from jail or prison, their personal health information collected by correctional health providers is rarely made accessible to community clinicians. Similarly, when people enter the justice system, health professionals working in a facility do not have access to health information from the community. This lack of communication disrupts continuity in care, duplicates services supported by limited public resources, and exacerbates service fragmentation; which for people with mental health and substance use needs increases the risk of recidivism.
In response to these issues, behavioral health and justice agencies increasingly recognize the value of sharing information as a way to increase access to substance use and mental health treatment, improve continuity of care for people moving through the justice system, reduce recidivism, and save money. As noted in the GAINS Center’s Sequential Intercept Model, there are several windows of opportunity across the justice process where communication between health and justice professionals can yield improved outcomes. However, opportunities for diversion are missed when health and justice systems operate in informational silos and lack the mechanisms to communicate effectively with one another and coordinate services to ensure consistent care for a shared pool of clients.
Key government players continue to push for more interagency solutions that address the nexus of health needs and crime, yet there is no single source that offers practical guidance and tools to assist health and justice entities share data for better case management and policy analysis capacity. To address this need, the JAHDE online knowledge bank will compile information on behavioral health and justice data-sharing and make it accessible to a wide range of audiences. Set to launch in January 2013, the knowledge bank will compile existing literature and guidelines, translate strategies for data-sharing from related fields, feature case studies of model information-sharing projects, and offer guidance for governments at various phases of information-sharing capacity to overcome common barriers to working collaboratively.