Lessons in "Slow" Engagement From Staff and Administrators at a Prebooking Jail Diversion Program.

ABSTRACT

Objective: In this study, the authors elicited the perspectives of criminal justice and mental health stakeholders about a prebooking jail diversion program, the Judge Ed Emmett Mental Health Diversion Center, serving primarily individuals experiencing chronic homelessness and diagnosed as having a serious mental illness. Methods: The authors analyzed semistructured interviews with 19 participants and observational fieldnotes from 60 hours of ethnographic fieldwork, conducted from January to July 2020 and including five administrative-level meetings. They used qualitative coding to develop themes. Administrative data were also reviewed. Results: Engagement of clients in the program was a major theme. Barriers to engagement included clients' fear of police involvement and strict rules around smoking. Facilitators to engagement included "slow" engagement, or gradual, gentle microengagements over time and across multiple visits, ideally with peer counselors. Conclusions: To promote client use of services at this critical point of care, jail diversion programs might consider ongoing negotiations with clients to balance expectations between the criminal justice and mental health systems of care by using "slow" client engagement, limiting police involvement, and adopting trauma-informed and harm-reduction approaches.