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A matrix is proposed to characterize mental health diversion programs and standardize the reporting of program context, outputs, outcomes, and community settings. Data collection for program reporting is challenging because individual programs report on what is relevant to local conditions and may omit or overlook important contextual or structural factors that are key to programmatic success or failure. This limits generalizability and comparability. Using a standard matrix reporting framework clearly lists the constructs of the program, context, and community systems. Two diversion programs are reported demonstrating the use of the matrix. Although different jurisdictions have a wide spectrum of agencies and resources available to support diversion, and may approach the concept differently, standardizing and streamlining reporting will assist with evaluation of diversion and the creation of sustainable programs. [ABSTRACT FROM AUTHOR]

There is a distinct lack of a normative theory for diversion of justice-involved individuals with mental illness at the intersection of the criminal justice and health care systems. The nexus where the criminal justice and health care systems are supposed to connect during diversion is not conceptually framed in a measurable way. The paper proposes a potential systems theory of diversion that explicates the overlapping boundaries within and between the criminal justice and health care systems. From a systems perspective, diversion is operationalized differently depending on the entry of an individual with justice involvement and mental illness into one of the systems. The criminal justice and health care systems have multiple levels (micro-, meso-, and macro-), but individuals enter both systems at the respective systems intersection of the micro- and meso-levels. The theoretical disconnect may fail to consider the impact of criminal justice diversion on the health care system. We propose a unified systems theory of diversion to improve evaluation, comparability, sustainability, resource allocation, and outcomes of diversion programs. [ABSTRACT FROM AUTHOR]

Introduction: Homeless individuals lack resources for primary healthcare and as a result use the emergency department (ED) as a social safety net. Our primary objective in this study was to identify the differences between features of visits to United States (US) EDs made by patients without a home and patients who live in a private residence presenting with mental health symptoms or no mental health symptoms at triage. Methods: Data for this study come from the 2009-2017 National Health and Ambulatory Medical Care Survey, a nationally representative cross-sectional survey of ED visits in the US. We examined differences in waiting time, length of visit, and triage score among homeless patients, and privately housed and nursing home residents. We used logistic regression to determine the odds of receiving a mental health diagnosis. Residence, age, gender, race, urgency, and whether the person was seen in the ED in the previous 72 hours were controlled. Results: Homeless individuals made up less than 1% of all ED visits during this period. Of these visits, 47.2% resulted in a mental health diagnosis compared to those who live in a private residence. Adjusting for age, race, gender, triage score, and whether the person had been seen in the prior 72 hours, homeless individuals were still six times more likely to receive a mental health diagnosis despite reporting no mental health symptoms compared to individuals who lived in a private residence. Homeless individuals reporting mental health symptoms were two times more likely to receive a mental health diagnosis compared to privately housed and nursing home residents. Conclusions: Homeless individuals are more likely to receive a mental health diagnosis in the ED whether or not they present with mental health symptoms at triage. This study suggests that homelessness as a status impacts how these individuals receive care in the ED. Community coordination is needed to expand treatment options for individuals experiencing emergent mental health symptoms. [ABSTRACT FROM AUTHOR]

This conclusion provides a brief synopsis of the research articles presented in this special edition of The Journal of Contemporary Justice. The research findings clearly demonstrate that when the objective of diversion is sought by diversion-based programs where the criminal justice and health care systems intersect, processes and services frequently break down. As this collection of articles highlights, our collective understanding of diversion is siloed by academic discipline; thus, the broader picture of diversion remains muddled. It remains muddled because the reporting of diversion is scattered across disciplinary journals where a more robust understanding of diversion becomes unwieldy if not impossible for researchers and practitioners alike without sifting through multiple books, journals, manuscripts, and websites. Therefore, diversion will continue to elude efficacy without the coordination and cooperation of numerous disciplines spanning both the criminal justice and health care systems diversion. As this collection of articles strongly suggests, there is a need to create a transdisciplinary understanding of diversion as well as publication outlets so best practices can be developed and shared in one place. [ABSTRACT FROM AUTHOR]

This introduction offers a primer for this special edition of the Journal of Contemporary Criminal Justice. The purpose is to provide an interdisciplinary platform for scholars and practitioners to communicate perspectives of criminal justice, criminology, and law; public policy and administration, economics and political science; social work and sociology; behavioral health, counseling and psychology; public health, emergency medicine, and psychiatry around diversion. While disciplines share objectives of diversion as (1) rehabilitation, (2) efficient case processing, and (3) reducing resources, the defining and reporting of diversion differs. Justice-involved individuals with mental health issues making successful re-entry into the civil society, however, becomes convoluted. Diversion in practice has taken many shapes. Diversion in theory has taken many meanings. This special edition offers a variety of empirical and theoretical articles that attempt to provide clarity to an often implemented and understudied area of criminal justice and health care. Interviews with street-level officials, quantitative analyses of programs, and philosophical challenges to innate assumptions about individuals and systems are seen from a wide variety of scholars. The authors showcase their varied backgrounds with graduate students, university faculty, and practitioners, offering the fields of criminal justice and health care insight into diversion at all levels. [ABSTRACT FROM AUTHOR]

Introduction: Benefits, risks, and the increasing popularity of yoga use warrant assessing yoga practice prevalence and users' profiles. This study describes trends in yoga practice exclusively among American adults from 2002 to 2017, compares the profile of yoga users, and identifies factors related to yoga use over time. Materials and Methods: This study is a secondary analysis done in 2019 and 2020 using the National Health Interview Survey (NHIS) 2002, 2007, 2012, and 2017 data. Population weights were used to obtain statistically accurate estimates of yoga use prevalence for the U.S. population. Descriptive statistics were used to profile the sociodemographic and health-related characteristics of yoga users. Multivariable logistic regression was used to identify factors associated with yoga use in each cohort defined by the NHIS year. Results: Yoga practice prevalence nearly tripled from 5.1% in 2002 to 13.7% in 2017 (weighted estimate 10,386,456 and 32,761,194 American adults, respectively). Typical yoga users were young non-Hispanic single white female adults with bachelor or higher education and health insurance, and resided in the west region of the United States. Yoga use pattern change over time was significantly related to only younger age (p < 0.001) but not to other sociodemographic or health-related factors. Conclusions: Yoga has gained increasing popularity in the past two decades among American adults, with younger adults being the driving force. Yoga appears to be adopted for general well-being or prevention more than for specific disease treatment. Future research should evaluate how yoga can be effectively and safely integrated into preventive medicine strategies. [ABSTRACT FROM AUTHOR]