County jail tests integrated treatment, community re-entry for people with mental illness, addiction

—by Paul M. Kubek

There is a revolving door of incarceration, release, and re-arrest that keeps spinning for some people. Among those caught in the cycle of recidivism are young people with severe mental illness who also have problems related to alcohol or other drugs. Research shows that individuals with these co-occurring disorders are more likely to experience a list of negative outcomes, including unemployment, poverty, homelessness, trauma as victims and as witnesses to violence, hospitalization, chronic health conditions, and, of course, arrest, and incarceration.

Researchers at the Mandel School of Applied Social Sciences have teamed up with policymakers and service organizations in Cuyahoga County, Ohio, to develop and test a research-informed intervention, called "Project RESTORE," to address the complex needs of this population. The intervention and the study is funded by a $750,000 grant from the U.S. Department of Justice, Second Chance Act through the Cuyahoga County Sheriff's Department. 

The Co-Principal Investigators of Project RESTORE are Kathleen J. Farkas, PhD, LISW-S, associate professor of social work at the Mandel School, who has over 20 years of experience developing and evaluating reentry initiatives in Cleveland, and Amy Blank Wilson, PhD, assistant professor of social work, who has over 10 years of experience studying people with mental illness in the criminal-justice system.


The central goal of Project RESTORE is to achieve a long-term measurable reduction of 50 percent or more in the recidivism rate among young-adult felony offenders in Cuyahoga County Jail who are dually diagnosed with severe mental illness and substance use disorders. Eligible mental health diagnoses include Schizophrenia spectrum disorders, bipolar, and major depression.

Project RESTORE is a jail-based intervention that begins soon after participants enter the jail. RESTORE staff utilize research-informed assessment instruments to conduct a rigorous inventory of risks, needs, and services that are aimed at reducing re-incarceration. At the heart of the intervention is an enhanced reentry case management model that uses principles and practices of Integrated Dual Disorder Treatment (IDDT): it will target criminogenic risk factors as well as mental-health and substance-abuse symptoms and recovery. The Mandel School's Center for Evidence-Based Practices will provide consultation and training on IDDT.


Farkas and Wilson explain that the research component of Project RESTORE uses a randomized control design and tests the effectiveness of the intervention upon two groups: 60 individuals who receive the enhanced reentry intervention and 40 individuals who receive services through Cuyahoga County's current reentry best practices.

Researchers will follow-up with participants in the study two weeks, six months, and one year after their release from jail. Farkas and Wilson will compare data from the two groups and focus on service utilization rates, mental health and substance abuse outcomes, and criminal justice recidivism rates. They will also monitor implementation and accommodation of the RESTORE's case management approach and develop recommendations for future jail-based interventions.

RESTORE's community partners include the Cuyahoga County Sheriff's Office; Mental Health Services for Homeless Persons, Inc.; Recovery Resources, Inc.; and Project LEARN, Literacy Cooperative of Greater Cleveland. 

Paul M. Kubek, MA, is director of communications at the Center for Evidence-Based Practices at Case Western Reserve University, a partnership between the Mandel School of Applied Social Sciences and Department of Psychiatry at the Case School of Medicine.