During a Sequential Intercept Mapping, a team of facilitators will guide a group of community stakeholders (representing behavioral health and criminal justice entities from all five intercepts) through a map of the five intercepts of the Sequential Intercept Model. During this process, the community identifies various paths that a person with mental illness or co-occurring disorder may follow, highlighting points for diversion and linkage to services or resources along the way, and gaps and opportunities that are particular to that community.  Although the mapping process remains constant across workshops, the end results are often very different, as each community, their individual systems, and cross-systems relationships are unique. This is especially true when comparing maps between urban and rural communities.

On a visual level, the Sequential Intercept Map developed for an urban community will appear much busier than that of a rural community. This is due to more entities (i.e., several branches of law enforcement, several hospitals, etc.) being represented in an urban community, in addition to the notion that urban communities commonly have more resources or specialized services, programs, or approaches. Urban areas have a higher population, thus more need and demand for these resources, services, programs, and approaches. This “busier” map can provide both gaps and opportunities. While there are diverse resources available in an urban community, the systems and cross-systems paths are much more complex, there are many more persons making contact with the behavioral health and justice systems (daily), and therefore a higher probability that an individual can fall through the cracks unnoticed.

While the Sequential Intercept Map developed for a rural community may appear scarce and underdeveloped in comparison, there are advantages and disadvantages as well. Generally there are less resources and specialized approaches available in rural communities; however, there is often opportunity present with an “everybody knows everybody” community. Relationships between systems and stakeholders often preexist in rural communities, where they would need to be first identified, and then built in urban communities. Of course this can be negative in some cases, c.f., there is only one major treatment provider who provides services for justice populations, and relationships are strained between the provider and justice entities such as courts or community corrections. Advantages in a rural community include a smaller justice population which can be easier to track and engage, and less system complexity. Of course a lack of specialized services or approaches is a major gap for persons with co-occurring disorders who need integrated services, or Veterans with trauma histories who need targeted treatments. Another disadvantage can be the lack of transportation for persons to make court appearances and/or appointments with probation officers and treatment providers.

This blog is in no way meant to generalize either urban or rural behavioral health or justice systems, rather its intent is to note some commonly found trends among these communities, and provide examples of how the SIM workshop can produce very distinct results.