County-Led Decarceration Through Expanding Behavioral Health Care
Key Takeaways
Counties across the country are working to reduce the number of people in jails through addressing behavioral health resource gaps.
- Improving access to mental health services enables counties to implement non-carceral alternatives.
- A study funded by the National Institute on Mental Health identified factors that predict jail population size including county-level health care services availability and accessibility, demographics, socioeconomic status and criminal legal characteristics. The study observed that greater access to mental health services was associated with significantly lower incarceration rates.
Access and availability of mental health services is crucial in providing a sufficient diversion path for individuals.
- The same study reported that an increased police presence in a community was associated with a higher rate of incarceration. Moreover, while controlling for county size, violent crime rate did not predict incarceration levels.
- Why it matters: This analysis suggests that the traditional crime control model will not be the solution to overincarceration; rather, a focus on availability and accessibility of mental health service may provide an alternative option and may lead to lower utilization of county jail beds.
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- The same study reported that an increased police presence in a community was associated with a higher rate of incarceration. Moreover, while controlling for county size, violent crime rate did not predict incarceration levels
- Why it matters: This analysis suggests that the traditional crime control model will not be the solution to overincarceration; rather, a focus on availability and accessibility of mental health service may provide an alternative option and may lead to lower utilization of county jail beds.
NACo’s Stepping Up initiative is providing support.
- Started in 2015, Stepping Up provides counties with resources and tools to bolster cross-system collaboration and implement data-driven practices. This work aims to reduce the prevalence of individuals with serious mental illness in local criminal legal systems and increase access to care for those with serious mental illness.
- See it in action: Stepping Up counties have seen success since becoming a part of the initiative. For example, Fairfax County operates the Merrifield Crisis Response Center. The Center offers 24-hour emergency services, a mobile crisis team, along with entry, referral and assessment services. Since 2016, over 2,800 people with mental illness have been diverted from potential arrest. For more about the work of Fairfax County to address mental health in jails, click here.
Featured Initiative
The Stepping Up Initiative
The Stepping Up Initiative is a data-driven framework that aims to reduce the overincarceration of people with mental illnesses in jails through training, resources, and support that are tailored to local needs.
County Countdown – June 30, 2025
Every other week, NACo's County Countdown reviews top federal policy advocacy items with an eye towards counties and the intergovernmental partnership. This week features the Senate reconciliation debate, transparency on sanctuary designations and more.
DHS releases list identifying sanctuary jurisdictions; includes nearly 400 counties
NACo, along with the National League of Cities, and the International Municipal Lawyers Association, requested additional clarification on the methodology used to create the list, and noted concerns around the legal challenges that localities face when complying with ICE detainers. As of this time, NACo has yet to hear of a county receiving a formal notification that they were included on the list.
U.S. House of Representatives introduces legislation to expand Medicaid coverage for behavioral health treatment facilities
On June 20, a bipartisan group of lawmakers introduced the Increasing Behavioral Health Treatment Act in the U.S. House of Representative. This bill aims to improve access to behavioral health care nationwide by removing long-standing Medicaid funding restrictions for behavioral health treatment in certain facilities, providing new flexibility for states and counties to meet growing behavioral health needs.
NACo Legal Advocacy: City of Buffalo et al. v. Kia/Hyundai
The question at hand in City of Seattle et al. v. Kia/Hyundai is whether or not the Federal Motor Vehicle Safety Standard preempts state tort claims brought forth by local governments alleging that Kia and Hyundai’s failure to install “reasonable” anti-theft technology constitutes negligence and public nuisance.
NACo Legal Advocacy: Perttu v. Richards
Perttu v. Richards has implications on the Prison Litigation Reform Act (PLRA) and could increase the amount of Section 1983 inmate-initiated cases against county jails that reach federal court, ultimately resulting in counties having to expend resources on frivolous lawsuits.
Ramsey County, Minn. cuts juvenile justice admissions with assessment tool
The county's Risk Assessment Index focuses on the critical window between arrest and first court appearance.