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Co-Occurring Disorders in Criminal Justice Settings

Overcoming Challenges for Integrated Screening and Assessment

There are many challenges to integrated screening and assessment of co-occurring disorders in the justice system. This page discusses several strategies to address common challenges.

Challenge: Identify individuals with co-occurring disorders in a criminal justice setting where people are held for only a short time.


  • Jail transition planners can implement fast-track strategies for individuals with positive screens for co-occurring disorders, such as those who will be released within 72 hours of intake. A full assessment for co-occurring disorders is not possible within that time frame, but transition planners can establish linkages to behavioral health and other needed services.
  • In Connecticut, the Department of Mental Health and Addiction Services has placed licensed mental health practitioners in each court in the state. These practitioners screen defendants in the court lock-up who are awaiting arraignment, provide referrals to community or correctional behavioral health services, and make recommendations for entry into specialized diversion programs.
  • In a model proposed by the Pretrial Justice Institute, assessment takes place a few hours after screening. Pretrial services staff prepare a plan based on the assessment and collateral information received from other sources. The plan is presented to the judge prior to the initial court appearance or to the prosecutor following the appearance.

Challenge: Inform the screening and assessment process with knowledge from other criminal justice and behavioral health agencies.


  • A criminal justice agency and the local behavioral health authority establish a one-way information-sharing link. Authorized behavioral health practitioners review the daily intake logs for individuals who have received services from the authority as a supplement to screening activities. Arrangements like this have been established using information systems (Maricopa and Pima counties in Arizona) and by facsimile (Travis County, TX).
  • Written consent is obtained through a release of protected health information. Criminal justice agencies use uniform releases that are compliant with Federal and state regulations. In this way, a new release is not necessary each time an individual comes into contact with an agency within the criminal justice system. The release form specifies its purpose, the data elements to be shared, persons and agencies that health information may be provided to or obtained from, and the release's expiration date.

Challenge: Engage the individual with co-occurring disorders in the screening and assessment process.


  • Criminal justice agencies conduct screening in a private setting where the individual may be more willing to discuss sensitive information. Settings may include an interview room in jail or a court's side conference room.
  • Behavioral health practitioners administering assessments use motivational interviewing as part of the process.
  • When discussing histories of trauma, resources are available if the individual needs support.

Resources and Links

  • Recommendations for the adaptation of specialty courts for working with people with co-occurring disorders. This monograph provides recommendations for specialty court programs to meet the needs of defendants with co-occurring disorders. Guidelines for the modification and enhancement of specialty court programs are included.

  • This article reviews the value of motivational interviewing for probation officers when providing supervision and services. Training procedures and the content of the motivational interviewing process are examined.

  • A guide on motivational interviewing for probation and parole officers. This guide reviews motivational interviewing for probation and parole officers. In addition to reviewing the principles of motivational interviewing, the guide offers implementation strategies and practical tips.