Counties across the U.S. are reducing the number of mentally ill inmates through data collection, partnerships with community health care providers and directing certain emergency calls to mental health experts, according to a panel convened by the Council of State Governments Justice Center.

The online event Thursday reviewed the past seven years of the Stepping Up initiative, a national partnership among 550 counties to reduce over-incarceration of people with mental illnesses. The initiative aims to address the lack of community-based resources to support a population with disproportionately higher rates of arrests and recidivism.

During the event, leaders in member counties spoke about their successes in reducing the number of inmates with mental illness.

"We have all come to recognize that we are operating the de facto mental institutions of our country, and that so many folks are entering into our systems on a regular basis," said one of the panelists, Sheriff Kelly S. Rowe of Lubbock County, Texas. "We're seeing that nearly 50% of the individuals coming in under initial intake and booking are being identified as having received some level of mental health client services prior to their arrival in."

Rowe said at the intake level, Lubbock County has implemented tools and processes to better identify newly incarcerated people with mental illnesses. While the county has technology that informs the department if an individual has ever received any mental health services from state agencies, it relies on mental health professionals to conduct assessments.

"We're fortunate where we are here that we contract with our local mental health provider, who provides us 24-hour-a-day assessors," he said. "Having a great relationship with whoever your local mental health authority is key to this."

Lisa Potter, director of diversion initiatives in Fairfax County, Virginia, spoke about implementing pre-arrest measures to help divert mentally ill persons from entering the penal system at all. The county reduces bookings by increasing alternatives like community-based crisis receiving centers, mobile crisis units and outreach teams with public safety contacts.

According to Potter, between 2015 and 2021, Fairfax County has seen a 33% increase in referrals to jail-based behavioral health services and a 35% decrease in the jailed population of individuals with mental illnesses and misdemeanor charges. The county also provides reentry services for freed former inmates, such as housing, peer support and connections to health care providers.

In Franklin County, Ohio, the Stepping Up initiative is also being leveraged as a way to address racial inequalities in the justice system. As one of the first counties to declare racism a public health issue, Ruchelle Pride, director of Justice Policy and Programs with the Franklin County board of commissioners, said the county created broad frameworks that track every detail of how individuals move through the justice system, from length of stay, trends in probation violations, even the time and day a person is released from jail.

The county also implemented triage calls within its 911 dispatch center. It ran a pilot program in 2021 where about 50% were diverted to connect to health resources, freeing up law enforcement officers to deal with true public safety calls.

Pride's advice in implementing such processes is to gather all possible stakeholders.

"If you don't invite people to the table when the table is set, they feel like they're on the menu," she said. "So, in other words, make sure we're inclusive, make sure that you are intentional in making sure every key stakeholder in that justice ecosystem, that will be able to contribute to this work, is a part of the conversation from the beginning. No one likes to feel like they're behind the ball."

Stepping Up is a partnership among the Council of State Governments Justice Center, the National Association of Counties and the American Psychiatric Association Foundation, with funding from the U.S. Department of Justice's Office of Justice Programs' Bureau of Justice Assistance. More than half of the U.S. population lives in a county associated with the Stepping Up initiative.

--Editing by Jill Coffey.