Leveraging the Sequential Intercept Model to Address Diversity, Equity, and Inclusion

SAMHSA’s GAINS Center is committed to promoting and improving diversity, equity, and inclusion through its research, technical assistance, and training activities. Recently, the GAINS Center finalized a plan that involves implementing a variety of changes to further these efforts. The plan includes changes to how the GAINS Center will approach many of its activities, including Sequential Intercept Model (SIM) Mapping Workshops. SIM Mapping Workshops represent an ongoing area of work that involves many critical criminal justice and behavioral health stakeholders from communities throughout the country.

For the past decade, the GAINS Center has solicited annual applications for SIM Mapping Workshops from jurisdictions interested in better identifying and responding to the needs of adults with mental and substance use disorders who are involved or at risk for involvement in the criminal justice system. SIM Mapping Workshops are designed to bring together local, cross-system, multidisciplinary groups of criminal justice and behavioral health stakeholders from a particular jurisdiction to facilitate collaboration, identify available resources and gaps in services, establish a local set of priorities for change, and engage in strategic planning.

SIM Mapping Workshops present opportunities to educate criminal justice and behavioral health stakeholders about the importance of diversity, equity, and inclusion in the criminal justice and behavioral health systems. In addition, facilitators can work with communities to develop strategies for identifying and addressing a variety of disparities and inequities found across the SIM, including the following:

  • Intercepts 0 and 1: Access to treatment and support services in the community (particularly those that are culturally responsive) disparities, law enforcement contact and arrest rates, and referrals to diversion programs and services.
  • Intercepts 2 and 3: Bail and pre-trial release disparities; higher prevalence of incarceration, financial hardship due to fees, phone calls, and essential items; lower rates of drug court admission and graduation; and longer jail and prison sentences.
  • Intercepts 4 and 5: Reentry planning disparities, higher rates of probation and parole violations, and revocations.

SIM Mapping Workshops are highly interactive, and while the process is facilitated by GAINS Center staff, the work is driven primarily by participants. It is important to have a diverse group of participants to ensure that that work accurately reflects the many different perspectives present in the community.

Diversity refers to the ways in which an individual or group of people are different from one another. It can be expressed in various forms, including race, ethnicity, gender, gender identity, sexual orientation, socioeconomic status, language, culture, national origin, religious affiliation, age, (dis)ability status, etc. The GAINS Center will be providing specific guidance to jurisdictions regarding the need for diversity among participants and will also be looking to increase diversity among staff members that facilitate SIM Mapping Workshops.

Equity refers to fair treatment, access, opportunity, and advancement for all people, while at the same time striving to identify and eliminate barriers that have prevented the engagement of certain groups. SIM Mapping Workshops can have a significant impact on equity in local criminal justice and behavioral health systems, and the GAINS Center will be expanding its efforts in this area and spending more time focusing on equity during SIM Mapping Workshops. Some examples of this enhanced focus include the following:

  • Adding content about diversity, equity, and inclusion to the presentation that is delivered at the beginning of SIM Mapping Workshops
  • Inserting questions and considerations throughout the process regarding equity
  • Encouraging jurisdictions to pursue strategies for identifying inequities and disparities and addressing them through strategic planning

Inclusion refers to authentically bringing traditionally excluded individuals and/or groups into processes, activities, and decision/policy making in a way that shares power and ensures equal access to opportunities and resources. The GAINS Center’s primary foci in this area is amplifying the voices of people with lived experience who have been directly impacted by criminal justice and behavioral health systems and ensuring that their perspectives are valued and help inform planning for systems transformation and improvement.

Many inequities and disparities exist and have always existed for people with mental and substance use disorders who are involved in the criminal justice and behavioral health systems. Identifying intercepts for diversion and treatment to rectify these inequities drove the development of the SIM. Compared to people without mental and substance use disorders, people with mental and substance use disorders are in contact with the criminal justice system at a greater frequency, penetrate deeper into it, and experience worse outcomes. These inequities and disparities are further magnified in Black, Latinx, and Indigenous communities. Due to their unique structure and participatory nature, the SIM and the SIM Mapping Workshops are critical tools to address diversity, equity, and inclusion within the criminal justice and behavioral health systems. Communities can leverage these tools to promote equitable and inclusive systems change.



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GAINS, Sequential Intercept Mapping, Training & Technical Assistance