those individuals with behavioral health problems who are not a public safety threat. Although this front-end work is critical, the approaches advanced in this paper center on adults with behavioral health needs who, despite these efforts, continue to flow into the criminal justice system and fall under correctional control and supervision. Behavioral health professionals are concerned that criminal justice agencies refer the types of individuals for whom service providers have developed few effective interventions (such as for those who have personality disorders) and the expectations that treatment is sufficient to change their criminal behavior is unrealistic. Deep budget cuts also have sometimes led to staff reductions and a diminished capacity to offer services, including to those under correctional control or supervision.
Criminal Justice and Behavioral Health Systems’ Competing Priorities Criminal justice and behavioral health officials use different methods to prioritize their limited resources—and sometimes at cross-purposes. The foremost concern of criminal justice professionals is public safety, so their primary focus is on individuals who are likely to commit another crime. If an individual does not comply with his or her conditions of supervision or release, being revoked to jail or prison may be warranted. In contrast, behavioral healthcare administrators and providers target individuals whose disorders cause the greatest impairments or increase the risk of harm to themselves or others. Their principal goal is to stabilize a person within the community and advance individual recovery. Improving functioning and reducing hospital and emergency room use are key measures of their success. Although the two systems frequently serve the same population, their fundamentally different ways of allocating personnel and services result in corrections and behavioral health professionals sometimes disagreeing on which individuals should receive program placements. In addition, eligibility criteria for behavioral health services—often based on medical necessity—may not include individuals that corrections staffs believe are in need of treatment. Even when administrators from both systems agree on which individuals to serve, there are likely to be differences over which interventions to employ. Both the criminal justice and behavioral health systems have their own set of evidence-based policies, practices, and programs (EBPs). Each field’s EBPs may be unfamiliar to the other, and therefore their application to individuals with both behavioral health needs and a high risk for future criminal activity is not coordinated, undermining the effectiveness of both approaches.