County Examples & Solutions

Reducing Mental Illness in Rural Jails Case Study: Johnson County, Iowa

  • Document

    Reducing Mental Illness in Rural Jails Case Study: Johnson County, Iowa

    Johnson County, Iowa

    • population (142,287)[1]
    • average daily jail population (66)[2]
    • jail capacity (92)[3]

    The Opportunity for Change

    Johnson County, Iowa is located in eastern Iowa and home to the University of Iowa. In 2005, despite the jail being at more than twice its capacity, Johnson County voters denied a proposal to build a new one. Instead, residents called for improvements to how the county addresses the treatment needs of individuals with mental illnesses and substance use disorders in the jail. To meet these demands, the Jail Alternatives Program was created in 2006.

    Johnson County’s Model

    The Jail Alternatives Program is funded through the Sheriff’s Office at $180,000 per year as part of the county general funds. It is staffed by two Licensed Independent Social Workers (Jail Alternatives Coordinators) who work with cross-system community stakeholders to improve service delivery and access to justice-involved individuals with behavioral health disorders. Stakeholders include law enforcement, the jail, prison, probation/parole, hospitals, mental health and substance use treatment providers, homeless services providers, the local Veterans Administration, advocacy groups and individuals with behavioral health disorders and their families.

    Following the Sequential Intercept Model,[4] Johnson County has developed interventions at key intercept points with the ultimate goal of diverting individuals before they become involved in the justice system and identifying and intervening with those who are already involved in the system.

    To start, questions were added to the jail booking process that inquire about current or previous mental health or substance use disorders, medication and treatment. Jail Alternatives Coordinators review all the booking sheets to determine potential eligibility for the program and attend initial court appearances and weekly jail population meetings to review the jail census to identify potential participants. Referrals can also be made by jail staff, inmates, probation officers, attorneys, judges, community providers, as well as friends and family of individuals.

    Once a potential client is identified, coordinators meet with the individual to assess their symptoms, determine treatment needs, explore funding streams and determine eligibility for the program. If they are eligible, coordinators will make referrals to appropriate community-based treatment services and will follow the individual as they transition out of the jail. Coordinators remain involved while the individual gets stabilized in the community and while legal charges are pending.

    Successes and Outcomes

    “The Jail Alternatives Program here in Johnson County has not completely alleviated our need for more jail beds, but it has alleviated a lot of the need and more importantly, people are now being served in a much more appropriate way,” notes Johnson County Supervisor Rod Sullivan. “We on the County Board are 100 percent bought in to jail alternatives. They work. Not only do they work in terms of keeping people out of the jails, but it’s the way that people should be treated. It’s a total win-win and we are very much supportive of further similar things we can do, because we’ve seen the results here and they are very good.”

    The Jail Alternatives Program has seen significant positive outcomes since it started in 2006.[5]

    • It has served 1,378 unduplicated individuals, 94 percent of whom were referred from the jail.[6]
    • The County estimates that they have saved 35,018 jail bed days for a total savings of $2,486,278 since the program started.
    • From FY13 to FY15, the average daily jail census fell 15 percent from 135 to 114.
    • While not quantifiable at this point, the county notes that they have prevented law violations, victimizations, lawsuits, psychiatric hospitalizations and committals since implementing their programs.
    • The program promotes public health, community wellness and public safety and enhances individuals’ quality of life.

    Johnson County passed a resolution to participate in the Stepping Up initiative in August 2015 and has since been engaged in technical assistance resources and opportunities through the initiative. One of their next steps is to develop a plan for working with residents who are the most frequent users of their services.


    Jessica Peckover, LISW, CCDP-D
    Johnson County Jail Alternatives Coordinator
    Office: 319-688-5819


    [1] U.S. Census Bureau, State & County QuickFacts. Accessed November 24, 2015.

    [2] Includes inmates housed in the Johnson County Jail only. Weekly Jail Population Statistics, November 2015. Accessed November 24, 2015.

    [3] Sheriff, Accessed November 24, 2015.

    [4] For more information on the Sequential Intercept Model For more information on the Sequential Intercept Model, visit

    [5] All outcomes are from the Johnson County Jail Alternatives Program Update FY15

    [6] Individuals can also be referred by the Sixth Judicial District Department of Correctional Services, hospitals, providers, individuals and their families and reentry.

    Johnson County, Iowa population (142,287)[1] average daily jail population (66)[2]
    County Examples & Solutions

Related News

Related Resources

Upcoming Events

More From