Is avoiding jail better for addicts or mentally ill people who commit crimes?

Hear Lisa Bernard-Kuhn discuss overcrowding at the Hamilton County Justice Center in the podcast player above starting at 32:30

CINCINNATI -- A spike in drug-addicted inmates. Growing medical costs. Overcrowding.

The mounting, complicated problems facing Hamilton County’s Justice Center are poised to reach a breaking point this year, leaders say, as the opioid crisis continues to stretch public resources and strain local jail space.

The challenges aren’t new, said Tom Fallon, commander of Hamilton County’s Heroin Task Force. They're just increasingly getting worse.

In his 30 years in law enforcement, “it’s always been an issue,” he said.

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As leaders scramble for solutions, Fallon is among those eager to try a new approach: Keeping people out of jail in the first the place -- especially those whose crimes are connected to their addiction or mental health issues.

In the coming months the county is expected to hire a contractor to explore the creation of a pre-arrest diversion initiative. Such programs offer addiction treatment and behavioral and mental health services to low-level offenders in lieu of any jail time.

“Drug and alcohol abuse and mental illness occupy most of the court cases in any given area,” Fallon said. "I can remember (an example) that has happened hundreds of times in my career: Maybe it’s that guy with an open container. The underlying problem is he has a severe alcohol problem or mental illness. Citing him to court or arresting him is not doing any good.”

Kelly Firesheets, a senior program officer at Norwood-based Interactive for Health agrees. The nonprofit she works for is tapping into a $100,000 local grant to launch the exploratory phase of a pre-arrest program for the county.

“The fundamental idea of it is to get people into the right systems to deal with the problems they have,” Firesheets said. “The benefit to the county … is that keeping people out of the courts and keeping people out of jails and moving them into treatment not only saves the taxpayers money, but it also gives us the ability to use the jail and use the courts for people who are committing serious crimes.”

Last June, the number of inmates housed at the Hamilton County’s Justice Center hit an all-time high of more than 1,600. That’s in spite of the county allowing more than 8,000 inmates to be released last year alone under a variety of early release programs that the county has adopted to alleviate the local jail space woes.

Officials are also pursuing other avenues to get more offenders battling addiction the help they need. The county has asked the state for $3 million to retrofit the jail with 80 drug treatment beds. The design has been done and it's ready to go as soon as the state signs off, Commissioner Denise Driehaus said.

Without access to mental health and addiction treatment services, those who are released often become repeat offenders, recycling in and out of the criminal justice system.

"We are working on strategies to keep folks out of the jail to begin with or to treat them differently in a different space," said Driehaus.

‘They don’t look at you like you’re a waste of money’

Examples of pre-arrest programs are popping up across the U.S., with cities including Seattle, New York City, and Albany, New York among the early adopters.

Some programs place the emphasis on first-time offenders. Others use it to redirect those involved in prostitution or those with severe mental health issues from the jail system.

“Everyone knows what our problem is now,” Fallon said. “But we don’t know what the next one is going to be."

Early results from other communities show the initiatives can have a number of upsides, including:

Reducing the number of repeat offenders. A pre-arrest diversion program in Seattle led to 60 percent less recidivism in the first six months of the effort, according to research by John Hopkins Bloomberg School of Public Health.

Potential cost savings. In Bexar County, Texas, a police-based crisis intervention team has helped redirect low-level offenders with substance abuse issues to mental health services. The program reported a $2.4 million savings in jail costs tied to public intoxication, $1.5 million in mental health services, and $1 million in emergency room costs.

Improved police/community relations: Participants involved in Seattle's LEAD program self-reported positive experiences with police and the other community organizations involved in their care. “They don’t look at you like you’re a waste of money, and they don’t look at you like you’re a crazy crackhead that needs to go somewhere," one participant said in a survey. "They actually look at you like you’re a person.”

Local paramedics respond to an overdose.

Locally, leaders began to seek out more details on pre-arrest efforts after they saw the impact being made by Quick Response Teams in Colerain Township and Norwood. The teams include local law enforcement and an addiction specialist, who seek out residents who were recently revived from an overdose and work to connect them with treatment.

But the teams were eager to get to people at risk of overdosing sooner.

“Overdosing is essentially dying. We’d like to move upstream, and intervene before they die,” Firesheets said. “As we started to work on and support that model… we learned that there are actually a wide variety of these pre-arrest diversion interventions that we can do.”

Already, some of the teams have started to “look more proactively for people who are probably at risk of overdosing,” Firesheets said.

“Those teams started to reach out and interact with people who maybe had a theft that was drug related,” she said. “Or maybe they were caught with paraphernalia. They’re not waiting until the person overdoses, but being a little bit more proactive and finding people who are at risk and connecting them to services.”

‘There’s a lot more to life than drugs’

Mason resident Stephanie Schaffner knows first-hand the risks and crimes someone is willing to pursue when their addiction takes over.

The 30-year-old was booked into the Hamilton County Justice Center in January 2017 after she was charged with stealing thousands of dollars from her employer. At the time, she managed a Downtown restaurant. She used the cash she stole to cover the costs of her $200 daily heroin and crystal meth habit.

Stephanie Schaffner and her mother after entering a local treatment program.

“Everything I had went to drugs,” she said. “I never thought that there would be a day when I wasn’t going to be using drugs.”

As her addiction had evolved during the previous eight years, Schaffner said she's regularly agree to drive friends to local stores, knowing they we’re going to steal merchandise that they could later sell or trade for drugs.

“We did it all the time,” she said. “I wasn’t bold enough to go in, but I was used for my car a lot.”

Eventually, she was court-ordered into an outpatient treatment program -- one that she now credits for saving her life.

“It wasn’t until I got into treatment and got sober that I realized, OK there is a lot more to life than drugs,” she said.

Post-arrest diversion programs, like those Schaffner was ordere into, continue to play a big role getting local residents into treatment, said Fallon.

Adding pre-arrest programs would give local law enforcement "another tool to problem solve, without clogging up the court system." 

For now, however, officials say it’s too soon to know just how a local pre-arrest program might operate here.

A first step is creating a county-wide Quick Response Team that leaders say could tie in with efforts to build out other pre-arrest programs.

Figuring out the program’s costs, design and what agencies will oversee it will be the bigger steps ahead, said Fallon.

“There’s a lot of interest," he said. "It’s just a lot of people to get involved."

Getting buy-in from the county's more than 40 municipalities and their respective law enforcement agencies will also be key.  

"With anything like this, there's always going to be concerns that we get the right people to the right places," said Firesheets. "Pragmatically, you can't send everyone to jail. I think we all know and accept that now."

Know someone who is struggling with addiction?

Here's a list of helpful resources:

  • Addiction Services Council of Cincinnati hotline: Staffed all hours, seven days a week. Greater Cincinnati: 513-281-7880. Kentucky: 859-415-9280
  • Clermont County Crisis hotline: 513-528-7283 or visit
  • Centers for Chemical Addictions Treatment: 513-381-6672 or visit
  • Substance Abuse and Mental Health Services Administration hotline: 1-800-662-HELP (4357). Also known as the Treatment Referral Routing Service, the line is a confidential, free, 24-hour-a-day, 365-day-a-year, information service, in English and Spanish, for individuals and family members facing mental and/or substance use disorders. This service provides referrals to local treatment facilities, support groups, and community-based organizations. Callers can also order free publications and other information.
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