Jail Based Mental Health

The Jail-Based Mental Health (JBMH) program was developed to provide mental health services to individuals with forensic legal status who are awaiting admission to an IDHS State Operated Psychiatric Hospital (SOPH). The program was designed in response to the growing number of individuals found Unfit to Stand Trial (UST) or Not Guilty by Reason of Insanity (NGRI) who remain in county jails for extended periods while awaiting inpatient placement. Many smaller county jails have limited access or no access to consistent mental health services, which can contribute to worsening psychiatric symptoms, increased behavioral concerns, and challenges for jail staff managing these individuals.

The program was initially developed in partnership with the Kankakee County Jail and was inspired by Kankakee County Sheriff Mike Downey’s interest in collaborating with IDHS to address the growing waitlist for forensic inpatient treatment. The program began with a 12-bed capacity and has since expanded to 20 beds serving both male and female detainees.

The JBMH program is not intended to replace inpatient forensic hospitalization. Rather, it is designed to provide interim mental health treatment and clinical stabilization while individuals remain on the IDHS waitlist for inpatient admission. Participation in the program does not affect an individual’s placement on the waitlist or eligibility for transfer to a State Operated Psychiatric Hospital. However, some participants may improve clinically to the point that they are restored to fitness while in custody and no longer require inpatient hospitalization. 

The program operates through a collaborative model between IDHS, the participating county jail, and a community mental health provider. In the Kankakee County program, Iroquois Mental Health Center provides mental health staffing and services within the jail. Services may include: 

• Comprehensive mental health assessments 
• Psychiatric evaluation and medication management
• Supportive individual counseling
• Group therapy and milieu programming
• Crisis intervention services 
• Clinical monitoring and case management
• Fitness education and psychoeducation
• Discharge planning and coordination with community resources

Psychiatric services are provided through both in-person and telehealth modalities, and treatment participation, including medication treatment, remains voluntary. Mental health staff work collaboratively with IDHS/DBHR Bureau of Forensic and Justice Services and jail personnel to monitor clinical stability and identify individuals who may require a higher level of care. Individuals who are medically complex or demonstrating severe behavioral aggression may not be appropriate for participation in the program. 

The referral and transfer process involves coordination between IDHS, the participating jail, and the individual’s home county jail. IDHS reviews referrals to determine program appropriateness. Once approved, the parties execute a Memorandum of Understanding (MOU) outlining responsibilities related to housing, transportation, medical care, and financial obligations. IDHS currently maintains dozens of MOUs with Illinois county sheriffs in support of the Franklin, Kankakee and McHenry County programs.

The JBMH program provides several system-level benefits, including: 

• Expanding access to mental health services for detainees housed in smaller county jails 
• Supporting clinical stabilization while individuals await inpatient admission 
• Reducing strain on county jails with limited behavioral health resources 
• Increasing opportunities for medication access and fitness education 
• Allowing some individuals to achieve fitness in custody without requiring inpatient hospitalization

IDHS continues to evaluate and expand the program model, including the development of additional partnerships with other Illinois county jails.