Equity considerations in mental health diversion in California

Figures & data

Table 1. Findings themes & subthemes.

Theme	Sub-themes
Monitoring the Characteristics of the Mental Health Diversion Population	Many interviewees believed that the demographics of the diversion population was representative of larger demographics of the criminal legal system in the county. However, it was difficult to tell if these perceptions were data-driven or based on anecdotal evidence. Some interviewees felt certain populations (e.g., white individuals, women) were more likely to be diverted. In most counties, it is unclear if data is not being tracked or if data is tracked but some diversion partners are unaware of these efforts.
Cultural Competence and the Selection of Providers	In some counties the services offered may be dictated by the individual’s insurance provider, which means diversion programs have limited control over how providers are selected. Counties using a competitive bid process screen for providers able to offer culturally competent services, and others build requirements for training into county contracts. Providers and diversion partners have differing understanding of cultural competency, and what it means to provide culturally competent services.
Involvement of Community in Program Design	In most counties, community stakeholders and people with lived experience did not play a role in the design or implementation of diversion programming.
Limitations to the Availability of Services	Individuals were eligible to participate in diversion regardless of where they lived. However, external factors may limit the availability of services. Private insurance providers offered less robust coverage for services and do not cover the costs of mandated court drug testing. Individuals who live outside of the county they were charged in may encounter administrative barriers when enrolling in diversion in that county, including difficulty complying with reporting guidelines. In many counties diversion programs and/or the service providers are at or nearing capacity. Some have implemented wait lists. In some counties, clients face barriers finding housing and accessing reliable transportation, impacting their ability to access services.
Diversion as a way to address racial disparities	Some interviewees were hopeful about mental health diversion’s ability to address racial disparities in incarceration. Others emphasized that reliable program data and reporting was needed to determine if mental health diversion effectively reduces racial inequities in the criminal legal system. Some interviewees disagreed with the focus on race and ethnicity and emphasized that all program participants were treated equally regardless of their race or ethnicity.