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The original ‘plan’ for deinstitutionalization of America's population of persons with severe and persistent mental illness saw community mental health services as providing many of the functions of large mental hospitals in community settings. While substantial effort and resources have been committed to this enterprise, many persons with mental illness encounter significant problems in adjusting to life in the community. Prominent among these problems is the disproportionate involvement in the criminal justice system of persons with psychiatric disorders. This problem, popularly described as the ‘criminalization’ of mental illness, often threatens the clinical stability and safety of persons with mental disorders, and at the same taxes heavily the resources of the criminal justice system. This paper reviews data exploring the relationship between levels and availability of community-based services and the likelihood that persons with mental illness will become involved with the criminal justice system. Finding no relationship, we conjecture that community mental health services are effective with only certain individuals, and move toward a taxonomy of offenders with mental illness. This classification scheme takes into account the relationship between psychiatric disorder, lifestyle and pre-morbid criminal involvement, and is designed to inform system actors with regard to the targeting of these resources.

Large numbers of adults with mental illness detained by police, seen in the courts, and confined in prisons and jails has been a longstanding concern of officials in the mental health and criminal justice systems. Diversion programs represent an important strategy to counteract the criminalization of persons with mental illness. The challenge is to identify and integrate resources in such a way that an organization bridging the police, courts, mental health, substance abuse, homelessness, welfare and entitlements agencies would evolve that would effectively and appropriately serve offenders with mental health issues, keeping them stable in the community and reducing recidivism.