Mental Health and the Justice System in Durham County (2021-2022)


A significant issue in the Durham County criminal justice system is the management of individuals with severe mental illness. Durham County has taken many steps in recent years to support these individuals, including establishment of a Crisis Intervention Team among law enforcement and first responders, Community Paramedics who perform home visits to those identified with active mental health issues, Mental Health Services at the County Detention Facility and follow-up upon release from the facility. Duke University Medical Center is the major provider of health care services in Durham County, yet the two entities have not explicitly collaborated to address the needs of this population. 

Project Description

This project is a continuation of the 2020-2021 team. In the past year, team members have performed descriptive analyses and laid the groundwork, via data cleaning and verification, for more detailed analyses and hypothesis-testing around questions of the interaction between Duke Health and the Durham County Detention Facility (DCDF). 

Building on previous work, the 2021-2022 team will analyze data to help county stakeholders better understand mental health service utilization among the justice-involved population in Durham County. Team members will examine rates of re-arrest in this population and how it relates to health service utilization, using statistical methods both to describe the current state of the interaction and to make predictions so that future interventions can be better targeted. The team will do this by using a merged dataset that combines arrest records from the DCDF with health system records from Duke Health. 

The team will test hypotheses and complete longitudinal modeling with the dataset, asking questions such as:

  • Is there a relationship between health service utilization and the likelihood of re-arrest? 
  • If so, does this relationship differ between those with a severe mental health diagnoses and those without? 
  • How does substance use impact recidivism and health outcomes? 

Team members will also work with more recent data from several new initiatives in Durham County, including the initiation of Medication-Assisted Treatment for opioid addiction in the DCDF, the ending of cash bail for non-violent misdemeanor offenders by the Durham County District Attorney and the effects of COVID-19. 

Learn more about this project team by viewing the team's video.

Anticipated Outputs

Journal publications, stakeholder reports, recommendations

Student Opportunities

Ideally, this project team will include 1-2 graduate students and 2-4 undergraduate students with interests in statistics, psychology and public policy. Some previous experience in statistics (equivalent to an introductory statistics course) is preferred. 

Prospective team members should demonstrate enthusiasm for the topic, a willingness to learn and the ability to work well on a team. 

Graduate student project managers will gain skills in team leadership and project management, publication credit and practice in presenting to stakeholders. Undergraduate students will gain expertise in conducting statistical analyses (using R) along with skills for working within a protected data environment (PACE). They will interact with local stakeholders from Durham County government and Duke Health and communicate their statistical results to this audience. They will also enhance their skills in scientific writing, publication, presentation and group collaboration. 

In Fall 2021, the team will meet on Tuesdays and Thursdays from 3:00-4:15 p.m.

Becky Tang will serve as project manager.


Fall 2021 – Spring 2022

  • Fall 2021: Data analysis; prepare for publication; present to stakeholders
  • Spring 2022: Finalize publications; continue analyses; make recommendations


Academic credit available for fall and spring semesters

See related Data+ summer project, Mental Health and the Justice System in Durham County (2021) and earlier related team, Mental Health and the Justice System in Durham County (2020-2021).


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

Durham County Justice Center in Durham, NC.

Team Leaders

  • Nicole Schramm-Sapyta, Duke Institute for Brain Sciences
  • Maria Tackett, Arts & Sciences-Statistical Science
  • Becky Tang, Arts and Sciences-Statistical Science-Ph.D.Student

/yfaculty/staff Team Members

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

/zcommunity Team Members

  • Stepping Up Initiative
  • Criminal Justice Resource Center
  • Durham County Detention Facility
  • Durham Crisis Intervention Team (CIT)