The Sequential Intercept Model (SIM) and Therapeutic Jurisprudence

In this blog Kirk Heilbrun, Patricia Griffin, Edward Mulvey, David DeMatteo, and Carol Schubert explore the Sequential Intercept Model,  how can it be used and it’s relationship with therapeutic jurisprudence (TJ)…

There is now pending legislation in the U.S. Senate and the U.S. House involving the diversion of justice-involved individuals with behavioral health disorders from standard prosecution. Both bills use the Sequential Intercept Model (SIM), developed by Mark Munetz and Patty Griffin, in collaboration with Hank Steadman, as an organizing tool to help structure the proposed law.

It is very challenging to find appropriate and fair dispositions of cases involving individuals with behavioral health problems such as mental illness, substance abuse, or trauma symptoms. Using only standard prosecution does not seem reasonable. It would mean that such individuals, some of whom would not re-offend if provided with appropriate treatment, are instead convicted and perhaps incarcerated. Returning to the community following incarceration, they would face the same challenges they experienced prior to jail or prison. The standard process of arrest, conviction, incarceration, and standard reentry is simply not the best approach for many such individuals. Research support for this conclusion has been growing for years.

TJ describes how the law can act as a therapeutic agent–in this case, to provide appropriate services while simultaneously reducing the risk of re-offending–rather than serving a primarily punitive influence.  Contemporary use of TJ involves auditing and improving the relevant stages of the criminal justice laws and processes to consider how TJ-related practices can be better used—an approach that is very consistent with the SIM.

Indeed, the application of TJ and the SIM to the overall criminal justice process would often yield similar conclusions.  One way of conceptualizing the relationship among the law, TJ, and the SIM is to consider the legal structure to be a bottle and the practices it promotes to be the wine. Certain kinds of practices are consistent with TJ and the SIM; others are not.  A review of this structure at various points of intervention could result in changing law and associated practice when doing so is consistent with rehabilitative, public safety, and fiscal criteria.

Consideration of alternatives for mentally ill individuals in the criminal justice system provides just such a situation.  Treatment in the community is less expensive and less restrictive than incarceration in a jail or prison, or involuntary commitment to a hospital.
Some people really do commit crimes that are basically a public display of behavioral health problems.  Many can be rehabilitated in the community at less cost to society, less loss of liberty, and no increase in the risk of future offending.  For these individuals, being provided with the appropriate treatment in the community can both promote behavioral health and reduce the cost and public safety risk to society.

But how do we decide on where to intervene?  How do we make well-informed decisions about those who are appropriate for non-standard diversion versus those who need prosecution and incarceration as usual?  This is where the SIM can be useful.  The model identifies five points of “interception” that include first contact with police, first appearance, jail incarceration following arrest, reentry planning while incarcerated, and specialized parole after returning from incarceration.  Each of these points can focus efforts to develop alternatives to standard prosecution.

For example, at the first intercept (initial police contact), training police officers in specialized police responding such as Crisis Intervention Team (CIT) provides officers with a better understanding of behavioral health problems and additional tools for dealing with such problems without unnecessarily escalating an already-tense situation.

Another example involves “problem-solving courts” such as drug court, mental health court, or veterans court.  Clients enter problem-solving court because they have the potential to respond to rehabilitation in a way that both improves their lives and reduces the risk that they will commit another crime.

The SIM can help communities consider their current criminal justice and behavioral health system functioning, and decide whether and how they would like to provide alternatives to standard prosecution.  It serves as a method for identifying and implementing appropriate TJ efforts.  It can help practitioners make sense of both systems as well as help administrators and policy-makers to use their available public funding most efficiently.  It can help legislators collaborate in proposing needed legislation that will promote effective practice.  These goals are highly consistent with many advocated by TJ.  It would be useful to explore this relationship in greater detail and to develop methods for integrating the TJ and SIM approaches.

 Click here for the book “The Sequential Intercept Model and Criminal Justice” (Oxford University Press)

About the blog authors…

Patricia A. Griffin and Kirk Heilbrun are two of the editors of The Sequential Intercept Model and Criminal Justice published by Oxford University Press.  Edward Mulvey, David DeMatteo, and Carol Schubert are the other editors.  All five editors are associated with the Pennsylvania Mental Health and Justice Center of Excellence.  Patricia Griffin, PhD, is an independent consultant who is also associated with the Justice Center of Excellence, SAMHSA’s GAINS Center for Behavioral Health and Justice Transformation, and Policy Research Associates.  Kirk Heilbrun and David DeMatteo are on the faculty of the Department of Psychology at Drexel University. Ed Mulvey and Carol Schubert are at the Western Psychiatric Institute and Clinic and the Department of Psychiatry at the University of Pittsburgh.