Every year, about 11 million people move through America’s 3,100 local jails, many on low-level, non-violent misdemeanors. Many of the people in county and other local jails have behavioral health conditions that impact their quality of life, including mental illnesses and substance use disorders. Left untreated, these conditions can contribute to homelessness and difficulty with maintaining a steady, sufficient income, which also makes accessing services and getting treatment challenging. Furthermore, the physical health of individuals in jails is often poor, including significantly higher rates of chronic conditions such as hypertension, diabetes and asthma than the general population. 

Some individuals with behavioral and physical health conditions frequently cycle through jails, homeless shelters, emergency rooms and other crisis services. These individuals are often called frequent utilizers. Many places around the country have anecdotes about individuals who are well known to the police or emergency room doctors. Despite the multiple interventions and services that are used in response to frequent utilizers' conditions, fragmented care and a lack of coordination across justice, health and human services systems leads to unhealthy outcomes. Moreover, without alternatives to jails or emergency rooms, police and other first responders have few options for diverting frequent utilizers in crisis to treatment and services.

Focusing efforts on frequent utilizers represent an opportunity for targeted, resource-saving interventions that can improve their health and well-being.

The Data-Driven Justice (DDJ) initiative brings communities together to disrupt the cycle of incarceration and crisis. Communities participating in the initiative develop strategies that promote better outcomes for frequent utilizers by aligning justice, health and human services systems around data. These communities have committed to creating or expanding real-time or near real-time local data exchanges that combine justice, health and/or other system data to identify frequent utilizers of multiple systems. In addition, DDJ communities are identifying the ways and options for diverting frequent utilizers from the justice system to community-based services and treatment providers.