First-Episode Incarceration Creating a Recovery-Informed Framework for Integrated Mental Health and Criminal Justice Responses

First Epi Sq Final


The number of people diagnosed with serious mental illness in the U.S. criminal justice system has reached unprecedented levels. Increasingly, people recognize that the justice system is no substitute for a well-functioning community mental health system. Although a range of targeted interventions have emerged over the past two decades, existing approaches have done little to reduce the overall number of incarcerated people with serious mental illness. This report, modeled on promising approaches in the mental health field to people experiencing a first episode of psychosis, outlines a new integrated framework that encourages the mental health and criminal justice fields to collaborate on developing programs based on early intervention, an understanding of the social determinants that underlie ill health and criminal justice involvement, and recovery-oriented treatment.

Key Takeaway

The over-criminalization of people experiencing mental illness demands new approaches to service that convert a person’s initial contact with the justice system into his or her first step toward long-term mental health.

Publication Highlights

  • The focus of evidence-based practices must be expanded beyond linkage with mental health treatment to target other risk factors including antisocial thinking, addiction, stress, housing, employment, and education needs.

  • Experts cite the need for holistic interventions for people who have both mental illness and early criminal justice system involvement.

  • Front-end, comprehensive, recovery-driven interventions have real potential to disrupt a path of criminal justice involvement. Such interventions envision people as citizens and not only as justice-involved.

Key Facts


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Drug overdose is the leading cause of accidental death in the United States, and communities across the country are struggling to respond. But the punitive approach exemplified by the “war on drugs” has driven mass incarceration, exacerbated racial disparities within the criminal justice system, and devastated communities of color. The United State...

  • Jason Tan de Bibiana, Charlotte Miller, Leah Pope, Susan Stellin, Jim Parsons, David Cloud
February 21, 2020