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County Characteristics Associated with Implementation Strategies to Reform the Use of Jail for People with Behavioral Health Problems

2025/09/17 by Olzhas Zhorayev, Niloofar Ramezani, Jennifer E. Johnson +4 · 1 voice
Health Professions · Medicine · Social Sciences · #Criminal Justice and Corrections Analysis #Diverse Approaches in Healthcare and Education Studies #Health and Wellbeing Research

paper · doi:10.1177/00938548251370367

openalex publication_date 2025/09/17 · openalex created_date 2025/10/10 · openalex updated_date 2026/08/01

Abstract

Counties engage in various strategies to implement behavioral health services in jail and community settings. National initiatives to reduce the use of jail for those with mental illness emphasize four primary implementation strategies: relationship building among agencies, performance monitoring, integration of care across agencies, and consensus on common goals. Using survey data from 519 U.S. counties, this research employs hierarchical linear modeling (HLM) to examine county characteristics associated with these strategies. We find that higher interagency data capacity, a greater number of grants or initiatives, and a greater number of evidence-based programs are significantly associated with the use of relationship-building, performance monitoring, and integration of care strategies. The availability of data experts is a significant determinant of relationship-building strategies. In contrast, sociodemographic characteristics such as county size and rurality do not significantly predict the use of implementation strategies to reduce the number of individuals in jail with mental illness.

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