are also less adversarial and less formal than tradi-
tional criminal court processing. In mental health
courts, often, defendants can approach and speak to
judges directly, and sometimes clients and judges will
hug. Most programs are also lenient, have realistic
expectations, and understand that the population they
are serving is prone to relapse and instability. For
example, if a client in a mental health court misses a
scheduled court hearing, the immediate response is not
to issue a bench warrant but rather to use a gradated list
of sanctions that increase in intensity as noncompli-
ance increases. Expulsion from the program and incar-
ceration, while possible, are usually the last resorts.
Finally, diversion program clients tend to report high
levels of procedural justice, in that they feel they have
a “voice,” are respected, and heard.
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Diversion programs set criteria for who is allowed
entry into the program. Mental health screening and
assessment procedures are important components nec-
essary to diversion. Most programs have both clinical
and criminal eligibility criteria. Clinical criteria can be
specific or broad and can include, for example, accept-
ing only persons diagnosed with Axis I (Diagnostic and
Statistical Manual of Mental Disorders,fourth edition
[DSM-IV]) disorders or requiring a link between the
commission of the crime and the person’s mental health
problem. Criminal criteria can include limiting the pro-
gram to misdemeanants or requiring victims’ assent to
be involved. For the most part, diversion programs
exclude violent felons for public safety reasons. Finally,
some communities have developed women-only diver-
sion programs, recognizing that male and female defen-
dants with mental illness have different treatment needs
(such as trauma-based services) and routes to recovery.
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All diversion programs offer some end benefit,
whether it be avoiding an arrest, avoiding a jail or prison
sentence, and/or having the charges dropped or reduced.
However, in exchange for not being charged or sen-
tenced, the person agrees to go to mental health and sub-
stance abuse treatment in the community, to take
prescribed medications, and sometimes to attend peri-
odical status review hearings before a judge. If the per-
son is not compliant on a repeated basis, the charges or
sentences that were held in abeyance can be instated.
Alternatively, some programs require participants to
plead guilty and only after successful completion reduce
the original charges (e.g., from a felony to a misde-
meanor) or expunge the conviction from their criminal
record. Thus, like drug courts, diversion programs use
this carrot-and-stick approach to induce cooperation and
compliance. As mentioned above, this is generally not
done in a coercive manner but rather with an eye toward
the person’s best interest.
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Almost by definition, diversion programs need to
involve professionals from the criminal justice and
mental health systems who work collaboratively. Very
often, a group of key stakeholders in the community
come together to form the program. These stakehold-
ers can include a judge, state and/or county mental
health and substance use officials, attorneys, pretrial
service personnel, correction officers, advocates for
mental illness, and the police. Elements identified as
being essential to the success of diversion programs
are (a) ongoing and active cross-systems collabora-
tion, (b) written memorandums of understanding
between the systems, (c) strong leadership, and (d) a
“boundary spanner.” A boundary spanner is a staff
member who bridges across the mental health, crimi-
nal justice, and substance abuse systems and who
serves to coordinate cross-systems collaborations.
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Many, but not all, diversion programs can be consid-
ered a form of mandated community treatment, in that
they require the person to go to treatment and to take
prescribed medications and will impose consequences
when the person is nonadherent. Typically, prebooking
diversion does not mandate treatment or have long-term
follow through with divertees. In contrast, mental health
courts, while voluntary to enroll, exemplify the concept
of mandated community treatment.
Effectiveness of Diversion Programs
In regard to the effectiveness of diversion, preliminary
research has shown mixed but promising results. On one
hand, there is research demonstrating that diversion pro-
grams can be successful in achieving their goals of
reducing recidivism and linking clients with treatment.
For example, a research study examining nine pre- and
postbooking diversion programs found that in compari-
son with a group of similar but nondiverted individuals,
712 ———Sentencing Diversion Programs
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