Improving Responses to
People with Mental Illnesses
The Essential Elements of
Specialized Probation Initiatives

Improving Responses to
People with Mental Illnesses
The Essential Elements of
Specialized Probation Initiatives

A report prepared by the
Council of State Governments Justice Center
for the
National Institute of Corrections,
U.S. Department of Justice,
Federal Bureau of Prisons

Seth J. Prins
Fred C. Osher, M.D.

This project was supported by cooperative agreement numbers 07HI03GJP4 and 08HI06GJVO from the National
Institute of Corrections, U.S. Department of Justice.
Points of view or opinions in this document are those of the authors and do not necessarily represent the official
position or policies of the U.S. Department of Justice, members of the Council of State Governments, or the project’s
advisory group. The National Institute of Corrections reserves the right to reproduce, publish, translate, or otherwise
use and to authorize others to publish and use all or any part of the copyrighted material contained in this publication.
The Council of State Governments Justice Center is a national nonprofit organization that serves policymakers at the
local, state, and federal levels from all branches of government. The Justice Center provides practical, nonpartisan
advice and consensus-driven strategies, informed by available evidence, to increase public safety and strengthen
communities.
This report is informed by, and builds on, two previous Essential Elements publications for court and law enforcement
specialized responses to people with mental illnesses (available at www.consensusproject.org).
Council of State Governments Justice Center, New York 10005
© 2009 by the Council of State Governments Justice Center
All rights reserved. Published 2009.
Cover design template by Nancy Kapp & Company. Final cover design and interior layout by David Williams.

Contents

Acknowledgments
Introduction

v
vii

Ten Essential Elements
1 | Collaborative Planning and Administration

1

2 | Defining, Identifying, and Assessing a Target Population

3

3 | Designing the Initiative and Matching
Individuals to Supervision and Treatment Options

6

4 | Setting Conditions of Community Supervision

9

5 | Developing an Individualized Case Plan

11

6 | Providing or Linking to Treatment and Services

13

7 | Supporting Adherence to Conditions of
Community Supervision and Case Plans

15

8 | Providing Specialized Training and Cross-training

18

9 | Sharing Information and Maintaining Confidentiality

20

10 | Conducting Evaluations and Ensuring Sustainability

22

Conclusion

24

Acknowledgments
This publication was made possible through the
leadership and support of the National Institute
of Corrections (NIC), U.S. Department of Justice.
In particular, the Justice Center thanks Morris
Thigpen, Director; Thomas Beauclair, Deputy
Director; George Keiser, Chief of the Community
Corrections Division; and Mike Dooley, Correctional Program Specialist.
The Council of State Governments Justice
Center would also like to thank the members of
this publication’s advisory group, listed below,
who reviewed drafts of the document. A subset
of the advisory group (indicated by an asterisk)
met in September 2008 to discuss their reactions
to an earlier iteration.
• Mr. Thomas Beauclair, Deputy Director,
National Institute of Corrections
• Mr. Brad Bogue, President, Justice System
Assessment and Training*
• Ms. Carole Carothers, Executive Director,
NAMI Maine*
• Dr. Valerie Chakedis, Director of Diversion,
Re-Entry and Community Education, New York
State Office of Mental Health*
• Mr. Bryan Crocker, Assistant District Attorney,
Mecklenburg County (NC)*

• Ms. LaVerne Miller, Senior Project Associate,
Policy Research Associates*
• Hon. Brent Moss, Judge, Bonneville County
(ID) Mental Health Court*
• Mr. Timothy Murray, Executive Director,
Pretrial Justice Institute*
• Dr. Geraldine Nagy, Director, Travis County
(TX) Adult Probation Department*
• Mr. Dave Norman, Staff Attorney, Public
Defender Service, Mental Health Division,
District of Columbia*
• Mr. Jeff Walters, President and CEO, Rushford
Center (CT) and Secretary-Treasurer, National
Council for Community Behavioral Healthcare*
The authors also thank Carl Wicklund, Executive Director of the American Probation and Parole
Association; Michael Thompson, Director of the
Council of State Governments Justice Center; and
Nancy Fishman, Director of the Justice Center’s
Criminal Justice/Mental Health Consensus Project for their valuable feedback. Finally, the authors
are grateful to Katharine Willis and Regina Davis
for their careful copyediting.

• Ms. Cheryl Frenette, Probation Supervisor
(Ret.), Denver (CO) Adult Probation
Department*

The Essential Elements of Specialized Probation Initiatives

v

Introduction
Probation officers across the country—already
facing staggeringly large caseloads and expanding workloads—are supervising unprecedented
numbers of people with mental illnesses, most
of whom have co-occurring substance use disorders. This population has extensive treatment
and service needs and requires supervision strategies that traditional probation agencies were not
designed to provide.1 Probation supervision, however, represents a crucial window of opportunity
to link people with mental illnesses to treatments
and services that can help them avoid rearrest
and reincarceration and ultimately become contributing members of their communities. But all
too often this opportunity is missed: people with
mental illnesses are nearly twice as likely as others under supervision to have their community
sentence revoked, deepening their involvement
in the criminal justice system.2 These revocation
rates also confirm what many probation administrators and community treatment providers
already know to be true—that inadequate or inappropriate responses to this group can heighten
risks to individual and public safety, miss crucial
public health opportunities, and make inefficient
use of taxpayer dollars.
As a growing number of communities grapple with implementing specialized probation
responses, there is a commensurate demand for
more information on the key components, or elements, that communities should consider and

address to successfully implement such an initiative. This report articulates 10 essential elements
for all probation interventions that involve people
with mental illnesses, regardless of the particular program model. The elements are intended
to provide practitioners and policymakers with
a common framework for designing and implementing an initiative that will achieve positive
outcomes while being sensitive to every jurisdiction’s distinct needs and resources.

1. Some portions of this document draw heavily from the Justice
Center’s Improving Outcomes for People with Mental Illnesses
under Community Corrections Supervision: A Guide to ResearchInformed Policy and Practice (New York: Council of State
Governments Justice Center, 2009), which was developed
on a parallel track.
2. Dauphinot, L. “The Efficacy Of Community Correctional
Supervision For Offenders With Severe Mental Illness” (PhD.
diss., University of Texas at Austin, 1996); Skeem, J., and J. E.
Louden, “Toward Evidence-based Practice for Probationers and
Parolees Mandated to Mental Health Treatment,” Psychiatric

Services 57 (2006); Porporino, F. J., and L. Motiuk, “The Prison
Careers of Mentally Disordered Offenders,” International
Journal of Law and Psychiatry 18 (1995): 29–44; Messina, N.,
W. Burdon, G. Hagopian, and M. Prendergast. “One Year
Return to Custody Rates among Co-disordered Offenders,”
Behavioral Sciences and the Law 22 (2004): 503–18.
3. To learn more about the overrepresentation of people with
mental illnesses in the criminal justice system, see Council
of State Governments. Criminal Justice/Mental Health
Consensus Project (New York: Council of State Governments.
June 2002), http://consensusproject.org/the_report.

About the Problem
The reasons why increasingly large numbers of
people with mental illnesses become entrenched
in the criminal justice system generally, and the
probation system specifically, are complex and
involve multiple systemic and individual factors.3
It is clear, however, that once people with mental
illnesses are under probation supervision, it can
be extremely difficult for them to succeed in the
community. This difficulty may be linked to their
mental illnesses in a number of ways:
• They might be unable to access treatment,
decompensate, and then be arrested for disturbing or dangerous public behavior;
• Functional impairments may make it difficult
for them to comply with standard conditions of
release, such as maintaining employment and
paying fines;

The Essential Elements of Specialized Probation Initiatives

vii

• Their federal benefits (in particular, Medicaid
coverage of pharmacy costs), which were probably terminated rather than suspended upon
incarceration, were not reinstated immediately
upon release;
• They often have unaddressed risk factors associated with criminal behavior and increased
public safety concerns, such as antisocial peers
or attitudes;
• Probation officers may monitor them exceptionally closely and report technical violations
readily because they mistakenly believe that
people with mental illnesses are more likely to
be violent.
Compounding these challenges, traditional
probation supervision strategies and techniques
may make it even more difficult for people with
mental illnesses to succeed in the community.
Some agencies may view their role solely as
monitors of compliance and not consider that

addressing their supervisees’ complex treatment
and service needs can be integral to maintaining public safety and reducing recidivism. In
some jurisdictions, challenges to supervising
this population (for example, the increased time
and energy this group frequently requires) may
be perceived as disincentives for probation officers to keep people with mental illnesses on their
caseloads. In such jurisdictions, the traditional
probation response contributes to poor outcomes
for these individuals.
From the perspective of over-burdened probation officers, the complicated circumstances
and comprehensive needs of people with mental
illnesses can represent a nearly insurmountable
challenge. Officers’ caseloads can reach into the
hundreds, and their workloads (for example, the
number of supervision conditions for which they
must ensure compliance) have also increased.
They typically do not receive the resources or training to collaborate with community-based treatment
providers, monitor individuals’ compliance with

Pre-Trial Release
There are a variety of pre-trial interventions
that avoid court-ordered supervision
for people with mental illnesses when
appropriate. In these circumstances, the
criminal justice and mental health systems
can collaborate before an individual with
mental illness is convicted of an offense,
so that conviction and sentencing are
not the mechanisms that trigger linkages
to appropriate treatments and services.
Successful adherence to the terms of these
pre-trial interventions (which often include
mandated treatment) can then result in
reduced or dismissed charges. For example,
police-based responses can link people
with mental illnesses to treatment without
processing charges. Mental health courts
can supervise conditions of release without
corrections involvement.

viii

In many cases, probation agencies may
be involved with pre-trial services. Probation
officers may help monitor the conditions of
pre-trial release for people with mental illnesses
who are charged with minor offenses and who
prosecutors, attorneys, and judges agree should
not become further involved with the criminal
justice system. Pre-trial programs that involve
probation agencies are beyond the scope of
this document, but the authors encourage
policymakers to consider these and other “frontend” interventions that prevent an appropriate
subset of individuals from becoming entrenched
in the criminal justice system altogether.
For further reading on these and related
issues, please see Improving Responses to People with
Mental Illnesses: The Essential Elements of a Specialized
Law Enforcement-Based Program and Improving
Responses to People with Mental Illnesses: The Essential
Elements of a Mental Health Court available at
http://consensusproject.org.

Improving Responses to People with Mental Illnesses

treatment, and watch for potentially harmful or
dangerous behaviors.4 From the perspective of
equally over-burdened mental health treatment
providers, coordinating both the legal and clinical issues of people with mental illnesses under
probation supervision presents a challenge—
made even more daunting by the large number
of clients without justice involvement competing
for the same scarce resources.

Specialized Probation
Responses
Many community corrections officials and their
counterparts in the mental health system understand that their target populations—and their public
safety and public health missions—overlap, and
that the need for new approaches has never been
greater. Across the country, a growing number of
probation officials are working with law enforcement officers, jail and prison administrators,
judges, prosecutors, defense attorneys, and community-based treatment providers to develop
strategies that maintain public safety while
improving outcomes for people with mental illnesses under probation supervision.

This heterogeneous group often faces a variety of challenges. They face clinical conditions,
functional impairments, socioeconomic challenges, and criminal charges or convictions of
varying severity, and they pose different degrees
of risk to public safety. Probation strategies and
interventions designed to improve outcomes for
this diverse group are therefore wide-ranging
and can be spearheaded by probation systems,
community-based mental health systems, or
collaboratively by both systems. The essential
elements outlined in this document apply to
specialized probation responses to people with
mental illnesses that are delivered in any of these
three ways, but focus primarily on initiatives in
which participants have been adjudicated and
sentenced to participate, with conditions, in a
specialized probation initiative after or in lieu of
a jail term.

About the Elements
Each of the 10 essential elements contains a short
statement (in italics) describing criteria that specialized probation initiatives should meet in
order to be effective, followed by an explanation

Generalizing from Specialized Probation to Parole
This document focuses squarely on locally
administered probation responses to people
with mental illnesses; however, it may have
utility for those interested in specialized parole
or other types of community supervision.
Individuals with mental illnesses under parole
supervision have much in common with those
under probation supervision. Both groups
share similar challenges to reentry and may
even compete for the same limited resources.
In some jurisdictions the same community
corrections officers provide supervision for

4. See Policy Statement 22, Council of State Governments Justice
Center. Criminal Justice/Mental Health Consensus Project Report

both populations. Nevertheless, there are
issues unique to parole populations and parole
responses that this document does not explicitly
address.
For information on strategies to improve
outcomes for all individuals on parole (not
people with mental illnesses specifically), please
see Solomon, A. L., Jenny W. L. Osborne, Laura
Winterfield, Brian Elderbroom, Peggy Burke,
Richard P. Stroker, Edward E. Rhine, and William
D. Burrell. Putting Public Safety First: 13 Parole
Supervision Strategies to Enhance Reentry Outcomes.

(New York: Council of State Governments Justice Center,
2002).

The Essential Elements of Specialized Probation Initiatives

ix

of the element’s importance and how its principles can be achieved. All of the elements rest
on two key assumptions. First, each element
depends on meaningful collaboration among
professionals in the criminal justice and mental
health systems. Although achieving the requisite
level of collaboration is often difficult—particularly when faced with long-standing systemic or
cultural barriers—successful partnerships are
needed to carry out each element. Second, probation represents only one “intercept point” for
individuals with mental illnesses who have been
in contact with law enforcement, courts, jails,
and, in some cases, prisons. To address problems raised by the large number of people with
mental illnesses in the criminal justice system,
a comprehensive community- and system-wide
strategy in which specialized probation interventions play only one part is required. Therefore,
such an initiative’s impact on other components
of the criminal justice and community mental
health systems must be considered during the
planning and implementation process.
This report is meant to guide agents of change
in communities that want to develop a specialized
probation intervention. As such, it can be used
as a practical planning tool at each stage of the
process (designing the initiative, developing or
enhancing policies and procedures, monitoring

5. Although this document is intended to assist in the design
and implementation of programmatic interventions for people
with mental illnesses under probation supervision, there may
be state legislative or statutory issues that policymakers must
address before such programs can be effectively developed.
For more information on improving community corrections

x

practices, and conducting evaluations).5 It can
also be used by personnel from seasoned, longstanding initiatives to improve the organization
and functioning of an existing effort. The Essential
Elements is intended to be a “living document”
that will be updated or supplemented as specialized probation responses mature, incorporating
new research findings that can provide a stronger
base of knowledge about how these initiatives
can best operate, their impact on the community,
and the relative importance of each of the essential elements.

Methodology
The essential elements are based on information from a variety of sources, including the
experiences of probation officials, mental health
professionals, advocates, and consumers of mental health services, as well as a review of the
scholarly and policy literature. A panel of national
experts composed of policymakers and practitioners
guided early drafts of this document. They also
gathered at an advisory meeting in September
2008 to review, discuss, and debate each element
in depth. Comments and suggestions from the
advisory meeting and from subsequent reviews
by other national experts, are reflected in this
publication.

at the state level, including full provisions and suggested
language for legislation, please see The Public Safety
Performance Project of the Pew Center on the States.
Policy Framework to Strengthen Community Corrections
(Washington: The Pew Charitable Trusts, 2008).

Improving Responses to People with Mental Illnesses

The Essential Elements

1

collaborative planning and
administration
A multidisciplinary committee of elected and appointed officials, agency administrators
and their staffs, treatment providers, consumers of mental health services, and other
community stakeholders—representing the criminal justice, mental health, substance
use treatment, and social service systems—work together to articulate the goals and
objectives of the specialized probation initiative and guide the design, implementation,
and oversight of the initiative.

Specialized probation responses to people with
mental illnesses occur at the intersection of the
criminal justice, mental health/substance use
treatment, and social service systems. Their planning and implementation should reflect extensive
collaboration among policymakers and practitioners from each of these fields who have the
authority to implement significant changes in
their agencies’ policies, procedures, funding, and
staffing. A planning committee should be convened by an official (or officials) with the respect
and stature to encourage these changes.6
People with mental illnesses under probation supervision have been in contact with law
enforcement, courts, and/or jails. Their mental illnesses may be known to these agencies,
either from self-reporting or through screening
and assessment procedures. A judge, in consultation with prosecutors and defense attorneys,
likely determined the conditions of their supervision. Community-based providers may have
treated many of these individuals and appropriately shared information about their diagnoses,

6. This element can be adapted to well-established, operational
initiatives whose planning has long since concluded. If
the planning process for such programs did not initially

psychotropic medications, and treatment plans
with court, jail, and probation staff. For others,
contact with the criminal justice system may be
the first time they have been assessed as having
a mental illness and linked to community treatment and support services. Because the operation
of a specialized probation response is linked so
closely with the operations of these and other
agencies and systems, the planning committee should include—at minimum—probation
agency directors and officers, jail administrators/
sheriffs, jail staff, judges, pre-trial services staff,
prosecutors, defense attorneys, law enforcement
officials, mental health and substance use treatment agency directors and case workers, and
individuals with mental illnesses and their family members.
In addition to this core group, the planning
committee should include advocates, victims of
crime committed by people with mental illnesses,
housing agencies, and other community stakeholders to reflect and integrate broader efforts

consider aspects of this element, program administrators are
encouraged to adapt the element to the ongoing oversight and
administration of their initiative.

The Essential Elements of Specialized Probation Initiatives

1

to improve outcomes for people with mental illnesses involved in the criminal justice system.
The composition of the planning committee
raises two critical issues that each community
must resolve in its own way. First, there are key
local and state agencies in every jurisdiction
whose absence from the initial planning process may complicate all subsequent activities.
Second, and conversely, in many jurisdictions
there may be key stakeholders who present
obstacles to collaborative efforts, even when
included in the planning process from the beginning. Resolving these issues requires strong
leadership and effective tactics that will differ
by locale. If obstacles arise from the competing
interests of different stakeholders (for example
between the public defenders and prosecutors),
tackling these issues, identifying shared goals,
and devising appropriate compromises can actually strengthen collaborations—and initiative
design—in the end.
The planning committee should examine the
particular issues facing its community; identify
clear, specific, and measurable goals and objectives to address them; and consider how they will
measure (and others will evaluate) their progress.
This will entail early consideration of key process
and outcome data (see Element 10). Committee
members, in collaboration with other partners,
should also assess gaps in services and identify
mechanisms to address them. In so doing, the
committee should also determine how it will
relate to other criminal justice/mental health
boards or task forces that may already exist at the
local and state levels.

The next step is to develop processes for
determining the initiative’s clinical and legal
eligibility criteria, supervision conditions, and
treatment/service linkages. It should also develop
a review process to ensure the policies and procedures of all relevant agencies and organizations
are consistent with the goals and objectives of
the specialized probation response.7
The planning committee should also identify
the lead agency or agencies that will administer
the initiative’s day-to-day activities, train probation officers and community treatment providers,
measure the initiative’s progress toward achieving stated goals, and resolve ongoing challenges
to effectiveness. Administrators should report
back regularly to the planning committee, which
can advise on adjustments to the initiative’s
policies, procedures, and operations where
appropriate, and assist in keeping key policymakers, the media, and the community-at-large
informed of initiative costs, developments, and
progress.
To overcome challenges inherent in crosssystem collaboration, including staff turnover
and leadership changes, policies and procedures
should be institutionalized to the greatest extent
possible. Interagency memoranda of understanding (MOUs) can be developed to address
key issues such as which resources each organization will commit and what information can be
shared through identified mechanisms.

7. For example, a jail policy of providing only three days’
worth of an individual’s medications upon release might be
inconsistent with a program goal of ensuring continuity of
care from incarceration to community supervision.

2

Improving Responses to People with Mental Illnesses

2

defining, identifying, and
assessing a target population
Criminal justice and mental health agencies jointly define legal and clinical eligibility
criteria to select a subset of individuals whose placement in limited specialized probation
supervision slots will have the biggest impact on public safety, spending, and health.
Potential participants are identified at intake to a jail facility and/or upon transition
to probation supervision by staff qualified to administer standardized and validated
screening instruments, followed by standardized and validated clinical and risk
assessment procedures.

Specialized probation responses can accommodate only a small percentage of people with
mental illnesses involved in the criminal justice system; they are one intervention within a
comprehensive set of strategies to provide law
enforcement, court, and corrections systems with
options other than arrest, detention, and sentenced
supervision for this population. Understood in
this broader context, careful consideration must
be given to determining eligibility to participate
in such initiatives.
Individuals with mental illnesses under
community corrections supervision are a heterogeneous group. They pose different degrees
of criminogenic risk, determined by the nature
of their offense; dynamic factors associated with
their attitudes, circumstances, and patterns of
thinking; and public safety concerns. These
individuals also have a wide range of functional
impairments determined in part by diagnoses,
disabilities, and circumstances. Criminogenic risk
and functional impairment are core components
in the design of traditional supervision and treatment strategies, respectively. As such, it follows

that the range of specialized supervision and
treatment options for this population should be
derived from an assessment of these two basic
dimensions, and the planning committee must
carefully choose a subset of individuals who will
be eligible for participation in the specialized
probation initiative based on these factors.8
Figure 1 illustrates this concept.9 The chart,
derived from similar efforts to organize responses
to people with co-occurring mental illnesses and
substance use disorders,10 highlights the central considerations that drive criminal justice
and mental health system responses. Although it
has not been validated, it provides a conceptual
approach for matching supervision and treatment
options to varying degrees of criminogenic risk
and functional impairment, both of which can
range from low (nominal) to high (severe). Figure
1 proposes that the level of response intensity and
the degree of coordination/integration between
probation and mental health agencies should
increase as both criminogenic risk and functional impairment increase.11 The chart suggests
reserving the most resource-intensive specialized

8. This paragraph is adapted from Prins, S. J., and Draper, L.
Improving Outcomes For People With Mental Illnesses Under
Community Corrections Supervision: A Guide To ResearchInformed Policy And Practice (New York: Council of State
Governments Justice Center, 2009).
9. Ibid.

10. National Association of State Mental Health Program
Directors and National Association of State Alcohol and Drug
Abuse Directors. National Dialogue on Co-occurring Mental and
Substance Abuse Disorders (Alexandria, VA and Washington,
DC: NASMHPD/NASADAD, 1999).
11. Coordination exists when each agency is aware of the other’s
activities and occasionally shares clinical or legal information

The Essential Elements of Specialized Probation Initiatives

3

probation packages for those individuals with
the highest levels of risk and impairment (that
is, the highest risk of recidivism). The chart also
assumes that relevant criminal justice and mental health agencies can collect and track data on
the different subsets of individuals in their systems to determine which group to focus on based
on community-relevant factors (see Elements 3
and 10 for discussions on data collection).
When defining a target population, key considerations should be the availability of treatments
and support services in the community, the
state’s definition of its “priority population” for

publicly funded mental health services, and the
capacities and competencies of relevant agency
staff. These factors help narrow the focus of the
initiative to a subgroup of individuals who, when
provided effective treatment and supervision,
can achieve the greatest public safety and public
health outcomes.
Determining which subgroups to include
will inevitably be informed by addressing questions about which subgroups to exclude from the
initiative. These questions, the importance of
which should not be underestimated, can take a
number of forms: “Is there a certain threshold

Fig. 1: Identifying target populations by criminogenic risk and functional impairment

HIGH

Intensive treatment
in collaboration with
supervision

CRIMINOGENIC RISK

IMPAIRMENT

Treatment and supervision
coordinated as needed

HIGH

FUNCTIONAL

LOW

Integrated supervision and
treatment strategies

Intensive supervision
in collaboration with
treatment

LOW

about particular individuals in contact with both agencies.
Integration exists when community corrections and mental
health agencies develop and implement a single supervision
and treatment plan, share responsibility for this supervision
and treatment, share staff and other resources, and participate
in each other’s case staffing. Adapted from Center for

4

Substance Abuse Treatment. Definitions and Terms Relating
to Co-occurring Disorders: COCE Overview Paper 1, DHHS
Publication No. SMA 06-4163 (Rockville, MD: Substance
Abuse and Mental Health Services Administration, Center
for Mental Health Services, 2006).

Improving Responses to People with Mental Illnesses

of criminogenic risk and functional impairment
at which community resources can no longer be
effective, or at which political support will evaporate?” “Are there specific charges (for example,
sexual offenses) or circumstances (for example, citizenship status) that require different responses?”
The planning committee must carefully deliberate about these issues.
Once the planning committee defines the
target population based on the key dimensions
above, it should ensure that this definition
is communicated to the court, jail, probation
agency, and community treatment providers—
which may have different classification systems,
diagnostic categories, and treatment priorities—
to encourage collaboration based on a common
understanding of the program’s goals and who
would benefit most from the specialized initiative. Policies and interagency protocols should
be in place to ensure all relevant agencies are
using similar standardized, validated, and easyto-administer screening instruments to identify
individuals who fit the eligibility criteria.12
Instruments such as the Brief Jail Mental Health
Screen and the Correctional Mental Health Screen
are short and accurate and can replace outdated
instruments—or be incorporated into existing
procedures—with relative ease.13 Qualified personnel must then use standardized and validated
clinical and risk assessment procedures to determine the specific needs of people who “screen
positive,” and identify the subset of people who
meet the initiative’s eligibility criteria.

This is not to say that standardized screening and assessment processes create a rigid
“scoring rubric” for inclusion or exclusion in the
specialized probation initiative. The processes
are the objective filters used to identify potential
participants. Participation will ultimately be at
the discretion of prosecutors, public defenders,
judges, probation officials, and community-based
treatment providers.
In addition to its obvious impact on the
specialized probation initiative’s design and
implementation, eligibility criteria also play a
central role in determining whether the initiative,
once operational, is meeting its stated goals and
objectives. Focusing on individuals with certain
needs and risks can have a differential impact on
public safety, public spending, and public health
outcomes. For example, using intensive supervision and treatment strategies to target low-risk,
low-impairment individuals who have committed
minor offenses may actually increase recidivism
rates for this population as officers observe
minor technical violations that would otherwise
go unnoticed.14 This increased scrutiny may mitigate potential cost savings to the community as
supervisees are returned to expensive jail beds;
in fact, a focus on a target population with these
characteristics may be more expensive than the
status quo.15 In contrast, supervising individuals
charged with more serious offenses may avert a
larger number of jail stays, but may also require
more concerted political will to assuage the perceived—but not validated—increase in risk to
public safety.

12. Ideally, jurisdictions would employ electronic jail information
systems that can be adapted to code screening categories for
mental illnesses and provide monthly reports on the number
of people screened into these different groups. This is critical
in determining whether adequate resources are available
for the specialized probation intervention, and if they are
not, determining how to re-focus on a particular group. The
probation agency should also ideally have an electronic case
tracking system in which key data elements can be captured
to identify individuals who have participated in the specialized
probation intervention and those who have not. This will allow
for process and outcome research to refine the initiative. For
many jurisdictions, however, obtaining and implementing
advanced electronic information systems is not currently
feasible.

13. Goldberg, A. L., and B. R. Higgins. “Brief Mental Health
Screening for Corrections Intake,” Corrections Today August,
2006, http://www.ncjrs.gov/pdffiles1/nij/215592.pdf.
14. Lowenkamp, C., and E. J. Latessa. “The Risk Principle in
Action: What Have We Learned from 13,676 Offenders and
97 Correctional Programs?” Crime and Delinquency 51 (2006):
1–17, as cited in The Public Safety Performance Project of
the Pew Center on the States. Policy Framework to Strengthen
Community Correction. (Washington: The Pew Charitable
Trusts, 2008).
15. Ridgely, M. S., J. Engberg, M. D. Greenberg, S. Turner,
C. DeMartini, and J. W. Dembosky. Justice, treatment, and cost:
An evaluation of the fiscal impact of Allegheny County Mental
Health Court (Santa Monica: Rand Corporation, 2007),
http://www.rand.org/pubs/technical_reports/TR439/.

The Essential Elements of Specialized Probation Initiatives

5

3

designing the initiative and
matching individuals to supervision
and treatment options
The design of the specialized probation initiative is informed by analyses of the target
population; the policies and procedures of relevant agencies; and available resources,
services, and other supports. The planning committee and initiative administrators
identify agency- and systems-level obstacles to effective probation supervision of people
with mental illnesses and design the specialized initiative to address these issues.

Participant eligibility criteria should be consistent with the specialized probation initiative’s
design. There are two broad and related sets of
issues that planners and administrators should
consider. First, they should determine the most
effective combination of treatment and supervision for the criminogenic risks and functional
impairments of the initiative’s intended target
population. Second, they should determine the
initiative’s participant capacity, that is, its ideal
scale, which will largely depend on the fiscal
realities and availability of resources in a given
community. Decisions regarding these two sets
of issues should be well-documented, and limitations should be openly acknowledged.

The first set of issues includes the type and
intensity of supervision and treatment that participants will receive, the degree to which probation
and mental health agencies coordinate or integrate their responses, and the setting in which
supervision and treatment is provided.16 Systemlevel obstacles such as the availability of case
management, integrated substance use and mental health treatment, trauma-specific services,
and housing should also be considered as most
individuals under probation supervision have
multiple issues that require a response including
co-occurring disorders,17 a history of victimization and other trauma,18 and limited access to
stable housing.19

16. For example, participants with low criminogenic risk and low
functional impairment may require little (or no) supervision
and less intensive outpatient mental health treatment.
Community corrections and mental health staff may not need
to coordinate extensively, dedicate additional resources, or
change the setting in which supervision and treatment are
provided if both systems are implementing good, routine
practices. People with low risk/high impairments or high risk/
low impairments may require coordination between probation
and mental health staff, but not full-fledged integration. These
groups may also require mental health agencies to take the
lead and coordinate with probation, or probation agencies to
take the lead and coordinate with mental health treatment
providers, respectively. Intensive, integrated interventions
should be reserved for those with high criminogenic risk and
high functional impairment.

17. Lurigio, A. J., I. C. Young, J. A. Swartz, T. P. Johnson, I. Graf,
and L. Pickup. “Standardized Assessment of Substancerelated, Other Psychiatric, and Comorbid Disorders among
Probationers,” International Journal of Offender Therapy
and Comparative Criminology 47 (2003): 630–52; Skeem, J.,
E. Nicholson, and C. Kregg. March 2008. “Understanding
Barriers to Re-entry for Parolees with Mental Disorder. In
D. Kroner (Chair), Mentally disordered offenders: A special
population requiring special attention (Jacksonville: Symposium
conducted at the meeting of the American Psychology-Law
Society, https://webfiles.uci.edu:443/skeem/Downloads.html.
18. Ditton, P. M. Mental health and treatment of inmates and
probationers (Washington: Bureau of Justice Statistics, 1999).
19. Ibid.

6

Improving Responses to People with Mental Illnesses

The planning committee should also review
agency-level policy and procedural obstacles to participants’ supervision and/or treatment, such as
inadequate information-sharing protocols (see
Element 9), if they present barriers to appropriate coordination or integration. Furthermore, in
some jurisdictions, pre-sentence investigations,
level of charge or offense, plea agreements, strict
sentencing guidelines, victims’ rights statutes,
or other laws may dictate specific conditions of
supervision, the duration of community supervision, and the impact of successful completion of
a community sentence. Planners and administrators should work with relevant officials to adjust
these restrictions where appropriate and be clear
on issues around which there can be little flexibility for the specialized initiative. If officials cannot
be persuaded to remove or modify these sorts of
policy and procedural obstacles for the specialized initiative, planners and administrators may
need to redefine the initiative’s objectives.
The second set of issues, determined in large
part by probation and mental health agencies’
policies and resources, includes the specialized
initiative’s capacity—that is, caseload size and
composition. The American Probation and Parole
Association has explored caseload standards for
individuals under probation supervision (but not
explicitly for individuals with mental illnesses).20
In general, the number of individuals an officer
supervises should decrease as the overall “case
priority” of their roster increases. Furthermore,
a national survey found that “specialized caseloads” for people with mental illnesses are smaller
than traditional caseloads, averaging fewer than
50 people per probation officer (as compared to

more than 100 for traditional caseloads).21 That
said, there is no ideal caseload size. The quality
of contacts between probation officers and supervisees has shown to be more important than the
quantity of contacts.22
Planners need to consider whether caseload
composition should be limited only to people
with mental illnesses. Officers with smaller caseloads dedicated exclusively to people with mental
illnesses can better monitor their supervisees’
treatment progress.23 This is important because
recovery from mental illnesses is often a cyclical
process; for example, individuals on psychotropic medications who display low criminogenic
risk and low functional impairment may become
higher risk and more impaired if they stop taking
their medications. Officers with small, dedicated
caseloads will be better able to detect these sorts
of fluctuations and respond in a more targeted,
flexible manner than officers with large, mixed
caseloads.
If planners do not feel they can design an
initiative with appropriate scope and scale due
to agency- and systems-level obstacles such as
those described above, or general funding and
workforce capacity issues, they should reconsider the initiative’s eligibility criteria or restrict
the number of participants to a pilot project
with expansion dependent on outcomes and
future resources. All too often a perceived lack
of resources can forestall creative planning and
problem solving that considers such issues as
blending funding sources, sharing staff, identifying in-kind contributions, and public/private/
academic partnerships. Planners and administrators are encouraged to be realistic and open about

20. See Burrell, B. Caseload Standards for Probation and Parole
(Lexington: American Probation and Parole Association,
2006), http://nicic.gov/Library/021896); DeMichele, M. T.
Probation and Parole’s Growing Caseloads and Work Allocation:
Strategies for Managerial Decision Making (Lexington: American
Probation and Parole Association, 2007), http://www.appa-net.
org/eweb/docs/appa/pubs/SMDM.pdf).
21. Skeem, J. L., Paula Emke-Francis, and Jennifer Eno Louden.
“Probation, Mental Health, And Mandated Treatment: A
National Survey,” Criminal Justice and Behavior 33 (2006):
158–84.

22. The Public Safety Performance Project of the Pew Center
on the States. Policy Framework to Strengthen Community
Corrections (Washington: The Pew Charitable Trusts, 2008).
23. In small jurisdictions, however, dedicated caseloads may not
be practical or feasible. Under these circumstances, the central
objective is providing officers with small enough caseloads to
dedicate adequate time to people with mental illnesses under
their supervision.

The Essential Elements of Specialized Probation Initiatives

7

resource limitations, but not allow them to hinder exploration of all possible options. Starting
small and building on success can be a useful
approach.
Although the basic structure of the initiative should be informed by research on effective
probation interventions for people with mental
illnesses, administrators (with advice from the
planning committee) will likely need to make
decisions about the integration of treatment and
supervision, caseload size and composition, and
the duration and intensity of supervision and treatment without the benefit of jurisdiction-specific

24. For more information on systems mapping, please see
Munetz, M. R., and P. Griffin. “Use of the Sequential Intercept
Model as an Approach to Decriminalization of People with

8

research. A “systems mapping” process can complement any available research and help identify
how people with mental illnesses move through
the criminal justice system (arrest, adjudication,
incarceration, and reentry), where “bottlenecks”
occur, which types of people receive which types
of existing treatment/supervision, and where
gaps need to be filled.24 Planners and administrators should assess the jurisdiction’s ability to
collect and track new data and revise this systems
map once the initiative is operational. This information will be critical to initiative sustainability.

Serious Mental Illness,” Psychiatric Services 57 (2006): 544–49
or the National GAINS Center at http://gainscenter.samhsa.
gov/pdfs/integrating/GAINS_Sequential_Intercept.pdf.

Improving Responses to People with Mental Illnesses

4

setting conditions of community
supervision
Conditions of community supervision are commensurate with specific criminal charges
and offenses, promote public safety, and are clearly enumerated and accurately conveyed
to supervisees. Conditions facilitate supervisees’ engagement in treatment, are flexible
over changing circumstances, and are individualized according to assessments of public
safety risk and clinical needs.

Conditions of community supervision are the
guideposts for maintaining a law-abiding life and
define individuals’ responsibilities for successful
participation in the specialized probation initiative. During the design process, including the
selection of a target population, the planning
committee should resolve any of the traditional
factors that determine conditions of community supervision (for example, pre-sentence
investigations, level of charge or offense, plea
agreements, sentencing guidelines, or victims’
rights statutes) that conflict with initiative goals.
Within the parameters that are ultimately established, the conditions of community supervision
should be individualized for each supervisee, and
signed by potential participants before they enter
the initiative. They should also be made aware of
the consequences of noncompliance with these
conditions (see Element 7).
Conditions of supervision will likely include
adherence to a case plan (that is, a treatment and
services plan developed for individuals’ transition from jail to the community or upon being
sentenced to probation). In many jurisdictions,
a judge or prosecutor may make little distinction
between supervision conditions and case plans
and set both at the same time, without involving
probation officers, community-based treatment
providers, or other social services personnel.

Although conditions of supervision and case plans
should inform one another and may ultimately
be packaged together for participants, it is vital
that any personnel involved in “case staffing” be
included in developing each component. Because
case plan design must consider the complex and
multi-systemic social, economic, and clinical
challenges facing people with mental illnesses
involved in the criminal justice system, Element
5 is dedicated to a more complete discussion of
these issues.
Regardless of whether a jurisdiction makes
clear distinctions between supervision conditions
and case plans or treats them synonymously,
a number of general issues should be considered. First, conditions of supervision should
be the least restrictive necessary and reasonably calculated to prevent recidivism or further
involvement in the criminal justice system.25
This is especially true for individuals who pose
low risk of future criminal activity; have fewer
service or treatment needs; and have been convicted of misdemeanors, ordinance offenses, or
other nonviolent crimes. Unlike individuals with
higher criminogenic risk, these individuals may
require less frequent (or no) contacts with their
probation officer. For individuals who have been
convicted of more serious offenses, are at greater
risk of future criminal activity, and have more

25. Council of State Governments Justice Center. Criminal Justice/
Mental Health Consensus Project Report (New York: Council of
State Governments Justice Center, 2002).

The Essential Elements of Specialized Probation Initiatives

9

significant clinical needs, their more restrictive
conditions might be relaxed after a predetermined period of successful adherence. For all
individuals, increases in functionality, decreases
in psychiatric symptoms, and reductions in risk
behaviors should prompt less intensive supervision regimens, while clinical decompensation
or increases in risk behaviors should trigger
more intensive regimens.
The ability to adjust the restrictiveness and
intensity of supervision conditions depends not
only on their flexibility and individualization but
also on probation officers or other probation officials having the discretion to modify them based
on their best judgment and special training (see
Element 8). In some jurisdictions, probation officers are able to make these modifications without
involving the courts; in other jurisdictions, consultation with judges may be required.
Second, the development of supervision
conditions should be informed by individuals’
ability to understand the responsibilities and
expectations that these conditions carry. There
are important distinctions between the requisite competency to stand trial and the need to
ensure competency to comply with conditions of
community supervision. Individuals with a high
level of clinical disability and functional impairment may need clear, written descriptions and
repetitive discussions to fully understand their
obligations.

10

Third, regardless of their charges, public safety
risks, or functional impairments, participants
should be aware of the sanctions they will incur
for violating their supervision conditions and the
incentives for ongoing progress (see Element 7).
The parameters for these graduated sanctions
and incentives should be part of the documentation that individuals sign before they participate
in the initiative. Particularly important are any
distinctions the specialized probation initiative
makes regarding its tolerance for violations of
“control conditions” versus “treatment conditions.” Control conditions may dictate a very low
tolerance for violations, (for example, a supervisee attempts to visit a former spouse despite a
condition of supervision that prohibits such an
action), whereas treatment conditions may allow
for infractions without triggering a violation
report to the courts (for example, a supervisee fails
to take some of his or her medication or misses an
appointment with a treatment provider).
Finally, because many supervisees are adjudicated and granted participation in a specialized
probation initiative after, or in lieu of, a jail term,
it may not be possible to reduce charges or
expunge convictions upon successful completion
of a community sentence; however, when appropriate, such options should be considered. In
either case, supervisees’ length of participation
in the initiative should not exceed the maximum
sentence they could have received under traditional circumstances.

Improving Responses to People with Mental Illnesses

5

developing an individualized case plan
The specialized probation initiative, working with jail discharge planners and communitybased treatment providers, collaboratively develops a treatment and services plan for
individuals transitioning to probation supervision. The case plan is developed as soon as
possible after individuals’ initial contact with the criminal justice system and considers
their criminal charges; public safety risk and functional impairments; treatment, service,
and housing needs; and the resources of both the community corrections agency and
community-based treatment and service providers.

Although case plans will likely be developed in
conjunction with conditions of community supervision (as suggested above), they are explored here
as a separate element because they represent a
traditional function of the mental health system,
whose expertise and experience should inform
this aspect of collaboration between the probation agency and community-based treatment
providers. Furthermore, case plan development
involves multiple agencies beyond the criminal
justice system and should respond to supervisees’ wide-ranging social, economic, and clinical
circumstances. Despite the fact that lengths of
stay in jail can be relatively short compared to
prison terms,26 the time people with mental
illnesses spend in jail after arrest presents a critical public safety and public health opportunity.
Nearly all of the 13 million people booked into
jails each year will be released,27 many of them
under the supervision of probation agencies.
Within hours of arrest, individuals should be
screened and assessed for mental illnesses and cooccurring substance use disorders, perhaps for the
first time. Based on the results of screening and
assessment, a judge or team of criminal justice/

mental health staff should determine whether
individuals should be considered for some type
of specialized response, such as pre-trial release
(with or without conditions), a mental health
court or docket, or a specialized probation initiative. In other cases, judges may decide simply to
place individuals under probation supervision,
and then probation officials may determine who
should become part of their specialized initiative.
Other individuals may serve sentences of less
than a year (although as prisons become more
crowded, jails may hold people for increasingly
longer periods of time).28 Rapid, collaborative
planning among jail, probation, and community
treatment staff is essential to ensure that people
who are entering jail at a high risk of crisis do not
return to the community for supervision in days,
weeks, or months in the same condition—or
worse—to the detriment of any specialized probation initiative.29
One best-practice model for jail case planning, “Assess, Plan, Identify, and Coordinate”
(APIC), is practical and research-based.30 It can
be applied to all individuals with mental illnesses
and co-occurring substance use disorders who

26. Even if people who will eventually be supervised by probation
agencies were never detained or incarcerated, the period
between their initial contact with the criminal justice system
and their community supervision is equally important. This
element refers to jail transition planning in the interest of
brevity, but still applies to these alternative scenarios.
27. Sabol W. J., and T. D. Minton. Jail Inmates at Midyear 2007
(Washington: Bureau of Justice Statistics, 2008).

28. Osher, F. C., H. J. Steadman, and H. Barr. A Best Practice
Approach to Community Re-entry from Jails for Inmates with
Co-occurring Disorders: The APIC Model (New York: The
National GAINS Center, 2002), http://gainscenter.samhsa.
gov/pdfs/reentry/apic.pdf.
29. Ibid.
30. Ibid.

The Essential Elements of Specialized Probation Initiatives

11

spend time in jail, and can be used to develop
plans for the subset of people who are eligible to
participate in the specialized probation initiative.
According to the APIC model, screening and
assessment conducted at intake should be the
first step in developing individualized treatment
and community supervision plans for people with
mental illnesses. Assessment should include
cataloging individuals’ criminogenic risks and
functional impairments; gathering information
from law enforcement, courts, corrections, family members, and community providers to fully
inform the case plan; understanding issues of
cultural identity, language, gender, and age that
should be addressed in the plan; actively engaging individuals in identifying their own needs;
and detecting barriers to accessing and paying
for treatment and services in the community.31
After this assessment, staff should develop a
plan that covers the critical period immediately
following individuals’ supervision assignment
and their long-term needs. There are a range of
issues that should be considered and addressed
in different ways depending on the level of criminogenic risks and functional impairments of the
initiative’s intended target population. These
include housing, food, clothing, transportation,
and childcare; optimal medication regimens,
including sufficient medication to last until individuals’ first appointments and consistent jail
and community treatment agency formularies;
integrated treatment for individuals with cooccurring substance use disorders; and benefits applications/reinstatements for SSI/SSDI,
Medicaid, and other entitlements.32
As the case plan is developed, staff should
identify the community-based providers who
will be responsible for treatment, make referrals, ensure that information-sharing protocols
are in place according to confidentiality statutes

(see Element 9), ensure that victim notification
procedures are followed, and determine treatment and service agencies’ level of coordination/
integration with the probation officer monitoring
the conditions of supervision.33 The role of probation agencies may differ depending on where
these individuals fall in terms of their risks to
public safety and clinical needs.
After responsibilities for community-based
services and supervision are identified, staff
from all relevant agencies should coordinate
their efforts. This involves establishing a team
of caseworkers, including probation officers,
treatment providers, court personnel, and others
who meet regularly in “case staffings,” to modify
treatment plans, monitor adherence to the terms
of release, and make changes to these conditions
as appropriate.
Supervisees should be involved in developing
their case plans to the greatest extent possible;
such involvement is thought to increase their
engagement in treatment and supervision and
ultimately their success in the community. The
degree to which supervisees’ preferences are
incorporated into their case plans, however,
should be weighed against the nature of their
criminal charges, criminogenic risks, and functional impairments. These preferences also
should be balanced against the concerns of
prosecutors, defense attorneys, and judges. For
example, a district attorney or probation official
may not be comfortable allowing an individual
charged with a serious violent crime to provide
as much input into his or her case plan as an
individual charged with a minor misdemeanor.
Issues such as these underscore the importance
of clearly defined initiative parameters that are
the product of collaborative planning and design
processes.

31. Ibid.
32. Program planners and administrators should work with
courts, jails, and probation departments to ensure that
these benefits are suspended—and not terminated—during
individuals’ relatively short stays in jail and immediately
reinstated upon release.

33. Osher, F. C., H. J. Steadman, and H. Barr. A Best Practice
Approach to Community Re-entry from Jails for Inmates with
Co-Occurring Disorders: The APIC Model (Delmar, NY: The
National GAINS Center, 2002), http://gainscenter.samhsa.gov/
pdfs/reentry/apic.pdf.

12

Improving Responses to People with Mental Illnesses

6

providing or linking to treatment
and services
Probation agencies connect their supervisees to comprehensive, individualized, and
evidence-based treatment and services in the community, and work with communitybased providers to coordinate and integrate the services that the probation agency and
the public health and social service systems can provide.

People with mental illnesses under probation supervision require an array of services and supports,
including medication; counseling; behavioral therapy;
substance use treatment; halfway, transitional, or
supportive housing; public benefits; crisis intervention services; peer supports; vocational training; and family counseling. Specialized probation
initiatives should anticipate the needs of their
target population and work with community
providers to ensure that appropriate services—
particularly those required to carry out desired
case plans—will be available to participants during community supervision.
Parameters for the type, intensity, setting,
and degree of coordination or integration of services should be determined by the initiative’s
intended target population and refined according
to participants’ unique criminogenic risks and
functional impairments. Individuals with low risk/
low impairment can be supervised and treated
with little or no coordination. Individuals with
high risk/high impairment need integrated strategies. These strategies can include co-location,
where services and treatment are delivered in the
supervision setting or supervision is provided in
a service and treatment setting; staff sharing,
where staff is hired by or “loaned” among collaborating agencies; and joint initiative administration

in which supervision and case plans are developed and reviewed.
The menu of treatments and services that are
provided by the probation agency or community
providers will vary across jurisdictions. For example, probation agencies may contract for their own
transitional housing programs, monitor drug
abstinence requirements by conducting urinalyses, and contract with community providers to
deliver treatments and services on premises. In
other jurisdictions, community treatment agencies may have probation officers as part of their
case management team. In some communities,
probation agencies may have in-house staff that
provides cognitive-behavioral treatments such as
Moral Reconation Therapy to address participants’
criminogenic risks.34 In still other jurisdictions,
these treatment modalities may be part of an integrated behavioral health approach provided by a
community mental health center that is treating
other psychiatric or substance use disorders.
Regardless of whether probation agencies
directly provide treatments and services or broker their delivery, the specialized probation initiative should work to ensure that evidence-based
practices (EBPs) and promising approaches
for mental health treatment are provided to
supervisees.35 If community treatment providers

34. For more information on Moral Reconation Therapy, see the
Substance Abuse and Mental Health Services Administration’s
National Registry of Evidence-based Programs and Practices at
http://www.nrepp.samhsa.gov/programfulldetails.asp?
PROGRAM_ID=181.

35. The Substance Abuse and Mental Health Services
Administration defines EBPs as “the use of current and best
research evidence in making clinical and programmatic
decisions about the care of the client.” Center for Substance
Abuse Treatment. Understanding Evidence-Based Practices

The Essential Elements of Specialized Probation Initiatives

13

do not have the capacity or training to implement
these practices—or more broadly, any necessary
treatments or supports—the specialized probation
initiative should advocate to increase the availability of these services.
A number of EBPs and promising approaches
have been shown to improve clinical functioning
for people with mental illnesses and may be applicable for people with mental illnesses involved
with the criminal justice system. First, given
the high prevalence of co-occurring substance
use disorders among individuals with mental
illnesses, it is particularly important for specialized probation initiatives to access integrated
treatment for mental illnesses and substance
use disorders. Comprehensive, integrated efforts
help people with co-occurring disorders attain
remission and reduce substance use, hospital
utilization, psychiatric symptoms, and rearrest.36
Second, access to housing is essential to any case
plan or treatment regimen, and supported housing is a promising practice for the successful
community reintegration of people with mental illnesses.37 Third, trauma-informed services,
another promising practice, are also critical given
the high rates of trauma among people with
mental illnesses.38 Finally, individuals with mental illnesses frequently require some form of case
management services. One form, assertive community treatment (ACT), is an EBP associated
with reductions in psychiatric hospitalizations

and increases in functionality. Without modification, ACT has demonstrated a mixed impact
on recidivism. To address this, forensic assertive
community treatment (FACT) teams have been
developed, often integrating probation officers,
and have shown promise in positively impacting
clinical outcomes and recidivism.39
In addition to linking individuals to evidence-based treatments and services, probation
and mental health agency staff should develop
protocols for ensuring supervisees’ continuity
of care (i.e., transitioning from various settings without changing treatment providers) in
two critical situations. First, participants may
be returned to jail for violating conditions of
supervision or for committing a new offense.
Probation officers and treatment providers
should ensure that information about supervisees’ treatment progress, medications, and other
key information is transferred to jail staff so they
can create a case plan based on this information.
Second, participants will eventually complete
their term of community supervision; probation
officers and treatment providers should ensure
they have sustained access to these treatments
and other supports when supervision ends. This
means that probation agencies and community providers should ensure that participation in their
initiative (and more broadly, the criminal justice
system) is not the sole mechanism for access to
these services.

for Co-Occurring Disorders: COCE Overview Paper 5. DHHS
Publication No. SMA 07-4278 (Rockville, MD: Substance
Abuse and Mental Health Services Administration, Center
for Mental Health Services, 2007).
36. Osher, F. C., H. J. Steadman, and H. Barr. A Best Practice
Approach to Community Re-entry from Jails for Inmates with
Co-Occurring Disorders: The APIC Model (Delmar, NY: The
National GAINS Center, 2002), http://gainscenter.samhsa.gov/
pdfs/reentry/apic.pdf.
37. Ibid.

38. Other EBPs for mental health treatment include illness
self-management and recovery, supported employment,
psychopharmacology, and family psychoeducation. For more
information on EBPs and promising practices, see the GAINS
Center web site at http://gainscenter.samhsa.gov.
39. Osher, F. C., and H. Steadman. “Adapting Evidence-based
Practices for Persons with Mental Illness Involved with
the Criminal Justice System,” Psychiatric Services 58 (2007):
1472–79.

14

Improving Responses to People with Mental Illnesses

7

supporting adherence to conditions
of community supervision and
case plans
Probation officers—in coordination with community-based treatment providers—support
individuals’ adherence to the terms of their probation with a “firm but fair” relationship
style and employ problem-solving strategies and graduated sanctions and incentives to
encourage compliance, promote public safety, and improve treatment outcomes.

Once individualized conditions of supervision,
a case plan, and specific treatment regimens
are established, probation officers—in collaboration with community providers—are responsible
for ensuring that their supervisees comply with
the terms of their participation in the specialized
probation initiative. The supervision strategies
and techniques that officers employ can have
a direct impact on whether their supervisees
become further entrenched in the criminal justice system or successfully transition to their
communities. Probation officials should ensure
that their supervision methods are consistent
with the objectives of the specialized probation
initiative.
Probation agencies should view their role as
more than monitors of compliance and consider
their supervisees’ complex treatment and service
needs as integral to maintaining public safety and
reducing recidivism. Probation officers should
be provided incentives to keep individuals with
mental illnesses on their caseloads,40 with the
knowledge that “closing a case” may result in
missed opportunities to link individuals to appropriate treatment. Likewise, community-based
treatment providers should not avoid working

with individuals with criminal charges or convictions. These providers should view jails and
community corrections agencies as part of a continuum of intervention settings, and mental health
officials should create incentives for providers to
implement treatments that target criminogenic
risks.
Collaborative planning and cross-training
can help ensure that probation agencies and
community treatment providers have the workforce capacity to implement these practices and
close existing gaps in resources or competencies; however, planning and training should be
supported by strong leadership within probation
and mental health agencies. In fact, probation
administrators across the country have changed
the culture of their agencies by articulating a
mission—and incentivizing practices—that go
beyond law enforcement and consider probation
as part of a larger constellation of services that
advance public safety and health and strengthen
communities. At the same time, many mental
health administrators have recognized their role
in improving the safety of their communities
and embraced this shared mission within their
agencies.

40. The Public Safety Performance Project of the Pew Center
on the States. Policy Framework to Strengthen Community
Corrections. (Washington: The Pew Charitable Trusts, 2008).

The Essential Elements of Specialized Probation Initiatives

15

Although all responses to supervisees’ behavior, whether positive or negative, should be
individualized, there are general proven supervision strategies and techniques that can reduce
probation violations for all people under community supervision.41 Specialized probation
initiatives should ensure that the following
strategies are incorporated into their efforts.42
Officers should apply risk-needs-responsivity
principles43 and establish “firm but fair” relationships with their supervisees that are authoritative
(not authoritarian) and characterized by caring,
fairness, and trust. Officers should use problem-solving strategies (as opposed to relying on
threats of incarceration or other negative pressures) to address compliance issues. For example,
if a supervisee has functional impairments that
make it difficult to adhere to standard conditions
of release, such as transporting him- or herself
to appointments, the probation officer should
meet with the supervisee to identify and resolve
these obstacles to compliance or make necessary
adjustments to supervision or case plan conditions. In general, officers should conduct field
supervision rather than monitor individuals
remotely from a central location.
It is also important that probation officers
working on a team with mental health and
substance use treatment providers develop a
shared understanding of behaviors that constitute a violation of the conditions of supervision.
For example, substance use relapse is common
early in the recovery process and should not

necessarily be grounds for probation revocation.
On the other hand, depending on an individual’s
level of public safety risk, functional impairment,
and/or history of dangerous behavior when
intoxicated, the response to relapse may include
a technical violation. An individual whose past
crimes were clearly related to intoxication might
warrant less tolerance. The important principle is
that responses to an individual’s behavior should
be consistent with an individual’s supervision
and case plans and reflect the team’s short- and
long-term objectives with each supervisee.
When supervisees’ behavior does constitute
a violation of their supervision conditions, the
specialized probation initiative should employ
a menu of graduated sanctions (that is, the severity of sanctions increases with the frequency or
severity of violations) that are individualized to
maximize compliance. The manner in which
these sanctions will be applied should be explained
to supervisees before they begin participating in the specialized initiative. Sanctions should
encourage pro-social choices and adherence to
treatment recommendations. They should avoid
disengaging individuals from community treatment. Specific protocols should govern the use
of jail as a consequence for serious noncompliance. In general, jail should be used only as a last
resort, and probation agencies should explore
alternatives such as intermediate-sanction facilities or day-reporting centers, staffed by probation
officers and community treatment providers, to

41. These strategies and techniques have been explored in depth
in the literature on evidence-based and promising community
corrections practices. These community corrections EBPs and
promising practices should be distinguished from the mental
health treatment EBPs described in element 6. For more
on community corrections EBPs and promising practices,
see Crime and Justice Institute. Implementing EvidenceBased Practice in Community Corrections: The Principles of
Effective Intervention (National Institute of Corrections, 2004),
http://www.nicic.org/pubs/2004/019342.pdf. For information
on incorporating general community corrections EBPs
into broader statewide policy efforts, see The Public Safety
Performance Project of the Pew Center on the States. Policy
Framework to Strengthen Community Corrections (Washington:
The Pew Charitable Trusts, 2008).

42. Skeem, J., and J. E. Louden. “Toward Evidence-based Practice
for Probationers and Parolees Mandated to Mental Health
Treatment,” Psychiatric Services 57 (2006): 333–42.
43. Several meta-analyses of existing evaluations show that
supervisees are less likely to recidivate when programs focus
on higher risk cases, matching the intensity of supervision
and treatment services to their level of risk for recidivism (risk
principle), match modes of service to their abilities and styles
(responsivity principle), and target a greater number of their
criminogenic needs, or changeable risk factors for recidivism
(need principle). For more information, see Andrews, D. A.,
et al. “Does Correctional Treatment Work? Clinically Relevant
and Psychologically Informed Meta-analysis,” Criminology
28 (1990): 369–404 and Andrews, D. A., and J. Bonta.
The Psychology of Criminal Conduct, third ed. (Cincinnati:
Anderson, 2003).

16

Improving Responses to People with Mental Illnesses

ensure continuity of care and prevent further
involvement with the criminal justice system.44
Probation officers should also have a menu
of incentives for sustained adherence to the conditions of community supervision. These might
include less frequent contacts with probation
officers and treatment providers, certificates
of compliance, non-cash rewards, and in some
cases, reductions in the length of the probation sentence. Policymakers and practitioners
involved with specialized probation initiatives
generally agree that incentives are as critical as
sanctions to supervisees’ success.
It is also important for probation and treatment staff to recognize that, with reduced caseload
size and greater coordination and integration
between community corrections and mental

health agencies, it may be far more likely for a
team member to detect behaviors that constitute
technical violations of supervision conditions.
Treatment providers who have not historically
provided services to justice-involved individuals may experience the “treater-turned-monitor
dilemma” in which they may be tempted to engage
in so-called “benevolent coercion” and use return
to jail as a threat to get individuals to comply
with treatment.45 Such strategies undermine the
potential benefits of collaboration between probation agencies and community-based treatment
providers.46 The specialized probation initiative
should have clear protocols for mitigating these
phenomena in a manner that is consistent with
the initiative’s objectives.

44. For detailed suggestions on developing state statutes that
grant officers the authority to implement graduated sanctions
for all people under probation supervision (not just those with
mental illnesses), see The Public Safety Performance Project
of the Pew Center on the States. Policy Framework to Strengthen
Community Corrections (Washington: The Pew Charitable
Trusts, 2008).

45. For example, see Solomon, P. Response to “A Model Program
for the Treatment of Mentally Ill Offenders in the Community,”
Community Mental Health Journal 35 (1999) and Solomon, P.,
and Jeffrey Draine. “One-Year Outcomes of a Randomized
Trial of Case Management with Seriously Mentally Ill Clients
Leaving Jail,” Evaluation Review 19 (1995): 256.
46. Ibid.

The Essential Elements of Specialized Probation Initiatives

17

8

providing specialized training and
cross-training
Probation officers who supervise individuals with mental illnesses receive substantial
and sustained training on mental health issues, co-occurring substance use disorders,
and effective supervision strategies for this population. Community-based treatment
and service providers receive training on jail and probation policies and procedures, court
reporting requirements, and the scope of behavioral health services provided by jail and
community corrections staff. When possible, staff from probation and community-based
treatment agencies cross-train each other on these issues.

Training should be provided to probation officers
and community-based treatment providers to
improve both systems’ responses to people with
mental illnesses under probation supervision.
Probation agencies and community providers
should work together to plan and implement a
training regimen that supports the specialized
probation initiative. Multi-disciplinary, multisystem collaboration ensures that training reflects
an appropriate range of perspectives. This effort
should be coordinated by initiative administrators who choose training content and techniques,
select trainers, ensure the training is culturally
competent, and evaluate the effectiveness of
training.
Initiative administrators should consider a
number of other training issues as well. First,
they should weigh the costs and benefits of both
centralized and local training, as the former can
create efficient and uniform training for larger
jurisdictions and the latter can create opportunities for building strong, local relationships.
Second, initiative administrators should determine how they will select probation officers and
mental health treatment providers to receive training. Soliciting volunteers, rather than assigning
staff to receive training, may make it less likely
that officers who have no desire to work with this

18

population will feel forced to do so. Recruiting
new staff who have already received training on
mental illnesses or criminal justice issues, or
who have a special interest in working with this
population, is preferable for the same reasons.
Nevertheless, probation agencies can incentivize this type of training as a form of professional
development for staff who may not have strong
preferences either way. Third, to the greatest
extent possible, former supervisees with mental illnesses, their family members, and peers
should be involved in training.
All probation officers, regardless of whether
they are involved with a specialized initiative,
should receive basic training on mental illness
and its impact on individuals, families, and communities; signs and symptoms of mental
illnesses; stabilization and de-escalation techniques; and legal issues such as confidentiality,
victim notification, and other related procedures.
Most importantly, probation staff should learn
what treatment and services are available in the
community and how to access them.
Officers involved with specialized probation initiatives should receive more significant
and sustained training. In a survey of officers
with specialized probation caseloads dedicated
exclusively to people with mental illnesses,

Improving Responses to People with Mental Illnesses

officers received 20 to 40 hours of training
per year.47 These officers should be trained to
employ problem-solving strategies, apply riskneeds-responsivity principles, and use graduated
sanctions in response to noncompliance. They
should also be trained to act as boundary spanners with the mental health and service systems
in order to actively coordinate treatments and
services with supervision.
Community-based mental health providers
working with the specialized probation initiative
should be trained in the workings of the criminal
justice system and the impact of arrest and incarceration on individuals with mental illnesses.
They should understand legal terminology, jail
and court processes, correctional classification
systems, screening and assessment procedures,
and the range of treatments and services
provided by jail-based or specialty probation clinicians. Treatment providers should also receive
training on when and how to report violations of
supervision conditions to probation authorities,

47. Skeem, J. L., Paula Emke-Francis, and Jennifer Eno Louden.
“Probation, Mental Health, and Mandated Treatment: A

their role and responsibilities when warrants are
issued, and how to provide information during
court hearings. To the greatest extent possible,
mental health agencies should also receive training on assessing and treating issues around
criminogenic risk and incorporating these practices into their traditional behavioral health
treatment packages.
Initiative administrators and collaborating
agencies should recognize and acknowledge that
the criminal justice and mental health systems
have traditionally had different missions, and
that cultural differences exist between their agencies. They should understand that cross-training
is necessary, but not sufficient, for reconciling
these differences, meeting shared goals, and
achieving desired outcomes. Structural supports,
policies, procedures, agency leadership, and program and performance evaluations discussed
in the preceding and subsequent elements are
crucial for enabling specialized training to be
absorbed and implemented.

National Survey,” Criminal Justice and Behavior 33 (2006):
158–84.

The Essential Elements of Specialized Probation Initiatives

19

9

sharing information and maintaining
confidentiality
Probation agencies and community-based treatment providers standardize a protocol for
sharing health and legal information about individuals within their shared target population, and ensure that this procedure is understood and implemented by all relevant staff.
The information-sharing protocol is consistent with local, state, and federal privacy regulations and facilitates the exchange of information among all components of the criminal
justice system and between the criminal justice and community-based treatment systems.

Information exchange among jails, probation agencies, and community-based treatment providers is
a prerequisite for developing case plans, linking
individuals to treatment and services, ensuring
continuity of care after periods of incarceration,
and determining appropriate supervision strategies. In short, the success of specialized probation responses to people with mental illnesses
can hinge on whether crucial information about
diagnoses, medications, criminogenic risk assessments, substance use, public assistance, and other
relevant details of personal history follows people
across systems.
All information sharing must, of course,
comply with local, state, and federal statutes on
the confidentiality of mental health and/or substance use records, such as the federal Health
Insurance Portability and Accountability Act
(HIPAA); however, HIPAA is often erroneously
cited as the reason why information crucial to
the success of specialized initiatives cannot be
shared. Planners and administrators should recognize the widely held misconceptions about
HIPAA restrictions and work with all relevant
staff to clarify these issues.48

48. For more information, see Petrila, J. Dispelling Myths about
Information Sharing between the Mental Health and Criminal
Justice Systems (Delmar, NY: National GAINS Center, 2007),

20

Information should be shared in a way that
protects and maintains individuals’ confidentiality rights as consumers of mental health services
and their constitutional rights as defendants.
It is paramount that supervisees are educated
about and involved in addressing these issues.
Probation officers and treatment providers
should establish trusting relationships that can
mitigate information-sharing barriers. Informed
consent leading to supervisees’ signed release of
information is the most effective way to honor
confidentiality rights and create effective supervision and treatment responses.
Planners and administrators should determine which personnel have the authority to
request and provide information about individuals’ mental health and criminal histories.
Information exchanges should be limited strictly
to what is needed to inform appropriate supervision and case plans. To that end, release or
consent forms should become standard interagency procedures. They should be developed in
consultation with legal counsel; adhere to local,
state, and federal laws; and specify what information will be released, to whom, and over what

http://gainscenter.samhsa.gov/text/integrated/Dispelling_
Myths.asp.

Improving Responses to People with Mental Illnesses

period of time. Potential participants in the specialized probation initiative should review these
forms with the advice of defense counsel and
treatment providers. To the greatest extent possible, and especially when competency may be
at issue, staff must ensure that potential participants understand how information will and will
not be used. Potential participants should not be
asked to sign release forms until all competency
issues are resolved.
Planners and administrators must carefully
consider the type of information needed and
existing barriers to its exchange, and then develop
procedures and memoranda of understanding
(MOUs) to ensure appropriate sharing. These
protocols should be emphasized in cross-training sessions. Planners and administrators may
also want to consider ways to share information
electronically, by linking different agencies’ information management systems on an ongoing or
one-time basis.49 Such arrangements, which can be
part of a broader electronic data collection system,
are expedient and efficient and can be designed to
grant and deny access to appropriate staff.
The exchange of information facilitates
communication and collaboration among law
enforcement agencies, courts, jails, community
corrections agencies, and the community-based
treatment system. For example, jail staff can
inform the courts when an individual with mental illness is identified at intake so a judge can
determine if the person should be considered
for participation in a specialized intervention.

49. The Bureau of Justice Assistance supports the electronic
exchange of information between agencies. To learn more
about these and other national policies, practices, and

It is essential that information exchanges flow
in both directions—that is, criminal justice
agencies further along the continuum and community providers should also be prepared to
send information upstream, such as when community treatment information-sharing protocols
ensure relevant information follows an individual back into the corrections system if probation
is revoked.
Planners and administrators should acknowledge that although the clearly defined policies and
procedures described above are essential, they
cannot replace trusting inter-system relationships
among staff at agencies that have historically
had very different goals and cultures. Probation
officers should understand that some types of
clinical information cannot (and should not) be
shared, just as treatment providers should understand that other types of clinical information
must be shared with probation officers to ensure
successful community supervision. The development of these sorts of relationships is arguably as
important as the establishment of any protocols
or electronic data collection systems.
In addition to collecting and sharing data
about individual participants to improve their clinical and legal outcomes, there is also tremendous
value in sharing aggregate data. As discussed in
Element 10, aggregate data are required to measure the impact of the specialized initiative and
ensure its sustainability. Therefore, procedures
and MOUs that explicitly cover the exchange of
aggregate data should also be developed.

technology capabilities that support effective and efficient
information sharing, see www.it.ojp.gov.

The Essential Elements of Specialized Probation Initiatives

21

10

conducting evaluations and
ensuring sustainability
Data are collected and analyzed that demonstrate the impact of the
specialized probation initiative on revocation rates, engagement in
treatment, and the prevalence of mental illnesses in jails and prisons.
These data inform a quality improvement process that results in
modifications to the initiative. In addition, the evaluation of initiative
effectiveness is used to sustain support for the initiative.

The planning committee and initiative administrators should take steps early in the design
process to ensure that they can determine the
effectiveness of the initiative and maintain its
long-term sustainability. To this end, planners
and administrators should identify performance
measures based on initiative goals and objectives. These measures can include process data
on key aspects of initiative operations; qualitative
data on officers’, supervisees’, and community
members’ perceptions of the initiative; and outcome data including initiative costs and cost
offsets. Where possible, the planning committee
should also include program evaluators in the
initial planning and design processes outlined
in the preceding elements. This can be achieved
by establishing early partnerships with local universities or identifying consultants if no in-house
researchers or evaluators are available.
The specialized probation initiative should
collect data that focus on questions most critical to
the initiative’s success. Process data include such
items as the number of people who screen positive
for mental illness, the number of people who have
attended and completed treatment programs, or
the number of contacts with probation or clinical
staff. Qualitative data could include such measures
as officers’ impressions of how time consuming,
easy, or difficult it is to supervise people with mental illnesses, and supervisees’ impressions of the
quality of supervision and treatment they receive.
22

Outcome data include rates of technical violations,
revocations, and rearrest; trends in the overall
growth of the jail population; number of hospital days and emergency room costs avoided; as
well as information about participants’ functional
improvements and symptom reductions. Initiative
funders frequently request data about cost effectiveness; therefore, this information is of critical
concern for continued support. However, cost
effectiveness methodology is quite complex, and
if the data are not collected correctly or reported
clearly, they may not be compelling. Ideally,
data on appropriate comparison groups are also
collected to demonstrate outcomes that might have
occurred in the absence of the specialized initiative. A feedback loop should be established that
allows these data to inform initiative refinement.
As discussed in Element 1, formalizing the
initiative’s policies and procedures is an important component of sustaining the initiative.
Compiling information about the initiative’s history, goals, screening and assessment protocols,
eligibility criteria, information-sharing protocols,
supervision strategies, sanctions, and incentives helps ensure consistency and mitigates the
impact of staff turnover. It also informs ongoing
quality improvement processes and enables initiative administrators to make adjustments when
appropriate.
Planners and administrators should also garner both external and internal support. Initiative

Improving Responses to People with Mental Illnesses

leaders should reach out to community leaders and the media to educate them about the
public safety goals and other objectives of the
specialized probation initiative. They should also
involve key elected and appointed officials and
other policymakers as early as possible in the
initiative’s design and implementation, and keep
them involved to promote supportive legislation
and/or funding opportunities. Probation officers,
mental health treatment providers, and other personnel—involved with the effort or not—should
also be surveyed so initiative partners can better
assess its impact and ideally develop a base of
support from within the ranks of collaborating
agencies.
Planners and administrators should also
develop a crisis communication plan that builds
on the positive relationships they forge between
the specialized initiative and the community at
large, the media, and policymakers. Plan implementers communicate that sometimes there
will be incidents involving initiative participants,
but that these rare—though often highly publicized—events should not undermine the broader
benefits of the initiative.

In addition to calling on policymakers to
advance financial support for an initiative,
diverse funding options are key to long-term sustainability. Although in-kind contributions from
multiple agencies can accomplish a great deal in
offsetting initiative costs, planners and administrators should identify and cultivate additional
resources. Requests for funding should be tied
to clearly articulated initiative goals and incorporate data that demonstrate positive outcomes.
Funding should include support for the process and outcome research mentioned above. In
general, most local probation departments and
other local agencies participating in the initiative do not have the expertise or staff to set up
the data collection and analysis suggested in this
document. With some outside expert assistance,
however, agency personnel may effectively be
guided to design and implement the data collection mechanisms that consultants (for example,
graduate students supervised by an experienced
researcher from a local university) can then
analyze and report to initiative stakeholders at
appropriate intervals.

The Essential Elements of Specialized Probation Initiatives

23

Conclusion
Probation agencies across the country are seeing increasing numbers of people with serious
mental illnesses on their caseloads. Traditional
community supervision strategies are associated with poor outcomes for these individuals;
they are twice as likely as people without mental illnesses to have their probation revoked and
become further entrenched in the criminal justice system. As a group, they can be challenging
to supervise. They have broad treatment and service needs and require supervision strategies that
traditional probation agencies were not designed
to provide.
Recognizing the need for innovative
approaches, probation agencies and communitybased treatment providers across the country are
working to develop creative interventions that
address the unique needs of their overlapping
target populations. These agencies are engaged
in problem solving with an array of partners
from a range of disciplines. Together they are
utilizing a growing knowledge base about what
works, for whom, and under what circumstances.
What the field has lacked is a concise construct
of the essential elements of successful specialized probation responses to people with mental

24

illnesses. This publication draws on the broad
accumulation of information and the experiences of probation agencies and mental health
treatment providers to fill that gap. It is hoped
that these elements will help guide policymakers
and practitioners who are initiating or enhancing their own initiatives.
The tone of this document may suggest
that the changes recommended above are easy
to make. They are not. There are many challenges, including complex politics, turf battles,
competition for limited funding, and scarce probation and community mental health resources.
Despite these obstacles, probation agencies and
their community partners have demonstrated a
willingness to coalesce around shared goals and
purposes to address these difficult issues. These
essential elements are written for such innovators and those who will follow in their footsteps,
all of whom work tirelessly to make communities safer and healthier, use public resources
and tax dollars efficiently and effectively, and
improve outcomes for people with mental illnesses who become involved with the criminal
justice system.

Improving Responses to People with Mental Illnesses

Council of State Governments
Justice Center
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tel: 212-482-2320
fax: 212-482-2344

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www.justicecenter.csg.org

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