Mental Health and the Justice System in Durham County (2020-2021)

In recent years, Durham County has taken many steps to improve the interaction between the criminal justice system and people with mental illness and substance use disorders. For example, the Crisis Intervention Team (CIT) was formed in 2007 to train law enforcement and first responders to recognize and deescalate mental health crises, connect affected individuals with crisis mental health services and help them avoid jail time. Additionally, Durham County joined the Stepping Up Initiative in 2012. This program involves all stages of justice involvement in a model to improve outcomes at each stage, from arrest through incarceration, trial, probation and release. Both groups have been active in setting up programs, changing practices and promoting awareness about their services, but have had less capacity to analyze impacts of the programs.

In partnership with CIT and the Stepping Up Initiative as well as the Criminal Justice Resource Center (CJRC), the Durham County Detention Facility (DCDF), Duke Health and the Lincoln Community Health Center, this project team examined the connections between substance use, mental illness and recidivism. The team began their work through a Summer 2020 Data+ project that focused on gaining a deep understanding of their study population and available data from DCDF and the health systems.

After finalizing datasets for analysis, the team found that substance use disorder is more strongly associated with higher rates of recidivism compared to serious mental illness diagnoses. Team members also found that the serious mental illness indicator captures different illnesses in the group of individuals in the DCDF with the jail-applied “Mental Health tag” compared to the group without the Mental Health Tag. For individuals without the Mental Health tag in the DCDF, major depressive disorder represents more than half of the serious mental illness diagnoses. In comparison, schizophrenia spectrum disorder is the predominant serious mental illness diagnosis among individuals with the Mental Health tag in the DCDF.

Team members also worked on understanding opioid overdose after jail release and found evidence of a critical time during the first two weeks after release from the DCDF in which there is a heightened risk for opioid overdose. Expanding these projects throughout the year, the team worked toward journal publication of three papers (see summary of findings).

Timing

Summer 2020 – Spring 2021

Team Outputs

Journal publications (in progress)

Data analysis

This Team in the News

In-Depth Look at Wilson Center-Affiliated Bass Connections Projects

See related teams, Mental Health and the Justice System in Durham County (2021-2022) and Stemming the Opiate Epidemic through Education and Outreach (2017-2018), and related Data+ summer project, Mental Health and the Justice System in Durham County (2020).

 

Image: Durham County Justice Center in Durham, NC, by Alexisrael, licensed under CC BY-SA 3.0

Durham County Justice Center.

Team Leaders

  • Nicole Schramm-Sapyta, Duke Institute for Brain Sciences
  • Maria Tackett, Arts & Sciences-Statistical Science

/graduate Team Members

  • Becky Tang, Statistical Science - PHD, Statistical Science - MS

/undergraduate Team Members

  • Luong Huynh, Neuroscience (BS)
  • Isabella Larsen, Psychology (AB)
  • Matthew Ralph, Statistical Science (BS)

/yfaculty/staff Team Members

  • Michele Easter, School of Medicine-Psychiatry: Social and Community Psychiatry

/zcommunity Team Members

  • Durham Crisis Intervention Team Leadership Collaborative
  • Durham County Detention Facility
  • Stepping Up Initiative
  • Justice Services Department