Experiments in change: pretrial diversion of offenders with mental illness.

OBJECTIVE Our objective was to study the outcomes experienced by 2 communities after implementing pretrial diversion of offenders with mental illness. METHOD The same method of diversion was implemented in a predominately urban and a predominantly rural county. We collected retrospective clinical and offence data from pretrial diversion assessments conducted in court. As well, we measured outcome for the diversion procedure in terms of actual vs expected rates of recidivism. RESULTS Prior psychiatric treatment was associated with the diverted group, and a criminal history was associated with the nondiverted group. In the larger, urban county the diversion option was offered more often to persons with psychoses, mood disorders, and minor offenses. Conversely, in the smaller rural county diversion was offered most often to persons accused of serious offenses. The recidivism found in urban and rural diverted groups after a year of supervised care was only 2% to 3%, but the rate of use of diversion in both counties was low, owing to selection biases. CONCLUSION Pretrial diversion of offenders with mental illness accused of minor crimes is eminently feasible for both urban and rural settings, provided that police, crown, and treatment policies are coordinated to favour the treatment option rather than prosecution.