The Sequential Intercept Model was developed by Mark Munetz and Patricia Griffin (2006) to help communities understand the way people with mental health issues interact with the criminal justice system and to target interventions to prevent people from getting deeper involved in the system.
The Sequential Intercept Model is usually focused around 5 broad target points, or areas where people with mental health issues may find themselves in contact with police or legal officials.
The five Intercepts are:
- Law Enforcement
- Initial Detention / Court Hearings
- Jail / Court
- Community Corrections
The model was based on ensuring that people with mental health issues are not forced into the criminal justice system at greater rates than people without mental health issues.
Law Enforcement and Emergency Services
Noting that up to 10% of police calls by patrol officers involve mental health issues (Cordner, 2006), the first interception point is front-line police and emergency services workers. Munetz & Griffin (2006) describe several strategies to help intervene at this point:
- Mobile Crisis Teams of mental health workers
- Employing mental health workers as civilians in the Police Service
- Pairing police officers with mental health workers to go on patrol calls
- Specially trained mental health police officers
All of these approaches involve combining front-line policing with mental health support to ensure that sensitivity is respected. Emergency services may also respond to mental health issues where individuals are psychotic or otherwise struggling with a connection to reality, which can put these staff in danger.
Initial Detention / Court Hearings
After an individual has been arrested, the next interception point of the sequential intercept model is initial detention and hearings post-arrest. Individuals may be diverted at this point to programs for non-violent, low level crime (such as petty theft or trespassing) based on the symptoms of their mental illness.
Diverting this individual to mental health treatment can avoid exacerbating their mental health issues. Additionally the court may “employ mental health workers to assess individuals after arrest in the jail or the courthouse and advise the court about the possible presence of mental illness and options for assessment and treatment, which could include diversion alternatives or treatment as a condition of probation.”
Jail / Court
Individuals who have mental illnesses and get involved in the criminal justice system are likely to spend a significantly longer jail term than individuals with the same charges who do not have mental illnesses. (Hoke, 2015) For this reason, the third intercept point is the jail or court system, where many individuals with mental illness are managed.
One important opportunity is the establishment of Mental Health Courts set up specifically for people with diagnosed mental illnesses relevant to their crimes.
After an individual has exited the court system (if on probation) or jail (if sentenced to serve time), it is time for them to re-enter society. Transition points like this are times where an individual may be feeling the least supported and at greatest risk of suicide (Pease, Billera & Gerard, 2016) or of reoffending. (Caudill & Trulson, 2016) Discharge planning is common in hospitals but not in jail, which can make continuing care difficult for clients who are released from jail.
One potential model for solving this noted by Munetz & Griffin is the APIC (Assess, Plan, Identify, and Coordinate) Model by Osher, Steadman & Barr (2003). This plan “highlights the importance of collaboration among multi-sectoral community partners to ensure that the community is committed to the transition process.” (Evidence Exchange Network, 2014)
The final intercept in the Sequential Intercept Model is community corrections, which is probation or parole. Since mental health treatment is often a condition of staying out of jail, these individuals represent an excellent opportunity to help those in the criminal justice system continue to access care, despite the adversarial nature of the parole/probation relationship.
Evidence Exchange Network for Mental Health and Addictions. (2014). “The Assess, Plan, Identify, and Coordinate (APIC) Model.” Retrieved on March 15, 2017 from http://eenet.ca/wp-content/uploads/2014/04/APIC-summary-addendum_March2014.pdf
Caudill, J. W., & Trulson, C. R. (2016). The hazards of premature release: Recidivism outcomes of blended-sentenced juvenile homicide offenders. Journal Of Criminal Justice, 46219-227. doi:10.1016/j.jcrimjus.2016.05.009
Cordner, G. (2006) “People with Mental Illness”. Center for Problem-Oriented Policing. No 4. Retrieved on March 17, 2017 from http://www.popcenter.org/problems/mental_illness/print/
Pease, J. L., Billera, M., & Gerard, G. (2016). Military Culture and the Transition to Civilian Life: Suicide Risk and Other Considerations. Social Work, 61(1), 83-86. doi:10.1093/sw/swv050
Hoke, S. (2015). Mental Illness and Prisoners: Concerns for Communities and Healthcare Providers. Online Journal Of Issues In Nursing, 20(1), 1. doi:10.3912/OJIN.Vol20No01Man03
Osher, F., Steadman, H. J., & Barr, H. (2003). A Best Practice Approach to Community Reentry From Jails for Inmates With Co-Occuring Disorders: The APIC Model. Crime & Delinquency, 49(1), 79.
Munetz, M.R. & Griffin, P.A. (2006) Use of the Sequential Intercept Model as an Approach to Decriminalization of People With Serious Mental Illness. Psychiatric Services. 57(4) Accessed electronically on March 25, 2016 from http://ps.psychiatryonline.org/doi/pdf/10.1176/ps.2006.57.4.544