Major Projects
Evaluation of Stepping up Efforts to Improve MH Services and Justice Utilization

What is the I.M. Justice and Behavioral Health Project?
The Implementation Mechanisms of Justice and Behavioral Health Project (I.M. Justice BH) will collect survey data on 950 counties to identify the ways counties manage justice-involved people with mental illnesses in the jail and/or community. Our aim is to fill in the black box regarding the type of activities and initiatives (like Stepping Up) that agencies engage in to implement policy change.
The purpose of this study is to:
Identify steps that can impact changes in how people with mental illness who commit crimes are handled.
Examine how reforms are made for counties of various population sizes and resources.
Identify technical assistance facilitate growth and development.
that is needed to facilitate growth and development.
Measure how policy evolves over time.
Develop materials to help counties support their goals, needs, and activities.
Understand the state-local government relationships that foster improvements to better serve justice-involved individuals with mental illness.
What is the National Stepping Up Initiative?
More than 10 million individuals are arrested and enter the U.S. criminal justice system each year. More than half have mental health disorders and two-thirds have substance use disorders. They are disproportionately low-income; 68% are minorities. The justice system has become the mental health care system of last resort. The three largest mental health care institutions in the country are jails.
The Stepping Up Initiative is a national initiative to reduce the number of people with mental illnesses in jails through a better connection to mental health services in the community. The Stepping Up Initiative is led by the National Association of Counties (NACo), the Council of State Governments (CSG), and the American Psychiatric Association Foundation (APAF). More than 500 counties have joined the Stepping Up Initiative. These counties are bringing their jail, probation, and community mental health and substance use agencies together to keep people out of jail and in community treatment.
Webinars
October 27, 2021
Criminal Legal System - Behavioral Heath Evidence-Based Practices
September 15, 2021
Understanding Evidence-Based Treatments for Individuals with Mental Illness
August 4, 2021
The Benefits of Participating in the I.M. Justice BH Study: The Feedback Report
July 14, 2021
County level data resources, measures, and characteristics used in a nation-wide initiative
June 23, 2021
Improving mental health services to reduce jail population
Take Our Survey
We would like to know about your experiences in addressing mental health (and substance abuse) services with individuals in the justice system.
Please contact us at IMJusticeBH@ucf.edu to learn how you can assist with this effort by participating in the Wave 3 survey. We appreciate your contributions to this important study. All information will be confidential.
Latest Findings
What is the Cascade of Care?
This study examines how to implement change in practices in the justice-health nexus (Funded by the National Institute on Mental Health, ROI MH1 18680, MPIs Taxman and Johnson).
Implementation Mechanisms for Justice Behavior Health Study
A study of implementation strategies that are used in the justice-health area. Funded by the National Institute of Mental Health, ROI MH1 18680, MPIs Taxman and Johnson.
Justice Involved Individuals Evidence Based Mental Health Practices (EBP)
We reviewed literature, identified evidence-based mental health practices, and surveyed their use among justice-involved populations (in community or jail) across U.S. counties.
Come Be Part of NACO's Efforts to Reduce the Number of People with Mental Illness in Jails
NACo has partnered with researchers at George Mason University, Michigan State University, and the University of Central Florida to find out what approaches are working nationally to reduce the number of people with mental illness in jails.
Factors that Predict the Readiness for Change and Quality Programming in Providing Behavioral Health and Jail Services
A study of implementation strategies that are used in the justice-health area. Funded by the National Institute of Mental Health, ROI MH1 18680, MPls Taxman and Johnson.
Mackey, B. J., Johnson, J. E., Ramezani, N., Hailemariam, M., Rosen, R. K., Thurman, T., Viglione, J., & Taxman, F. S.* (2024, April). Developing interagency collaboration among criminal justice and behavioral health agencies: Evidence from a nationwide mixed-methods study. Oral presentation given at the 17th Annual Academic Consortium on Criminal Justice Health Conference, Phoenix, AZ.
Mackey, B. J., Taxman, F. S., Ramezani, N., Viglione, J., Thurman, T., & Johnson, J. E. (2022, December). Cross-system implementation scales to measure policy team efforts. Poster presentation given at the 15th Annual Conference on the Science of Dissemination and Implementation in Health, Washington, DC.
Mackey, B. J., Clark, K., Ramezani, N., Moffett, M., Viglione, J., Johnson, J., & Taxman, F. S. (2022, November). Evaluation of Stepping Up efforts to improve mental health services and justice utilization. Oral presentation given at the 2022 American Society of Criminology Conference, Atlanta, GA.
Mackey, B. J., Meyer, L. F., Lee, C., Davis, L., Hartwell, T., Adams, S., Hancock, V., Kushmerick-McCune, B., Moffett, M., Sosorburam, T., & Taxman, F. S. (2021, November). Devolutionary practices and unique bureaucratic structures in community supervision: Examining state-level variation in all 50 United States. Oral presentation given at the 2021 American Society of Criminology Annual Conference, Chicago, IL.
Taxman, F. S., Shukla, N., Ramezani, N., Viglione, J., & Johnson, J. E. (2025). Exploring County-Level Resources Influencing Evidence-Based Practices and Treatment Uptake in Behavioral Health Settings. Corrections, 1–16. https://doi.org/10.1080/23774657.2024.2447693
Mackey, B. J., Ramezani, N., Viglione, J., Thurman, T., Johnson, J. E., & Taxman, F. S. (2024). Implementing reform: Approaches to alter the use of local jail for people with behavioral health conditions. International Journal of Offender Therapy and Comparative Criminology. https://doi.org/10.1177/0306624X241294136 | [PubMed (Free) Link]
Clark, K. J., Viglione, J., Sneed, R., Ramezani, N., Taxman, F. S., & Johnson, J. E. (2024). Cascade of care for substance use and mental health disorders for justice-involved populations. Journal of Substance Use and Addiction Treatment, 167, 209488. https://doi.org/10.1016/j.josat.2024.209488 | [PubMed (Free) Link]
Mackey, B. J., & Taxman, F. S. (2024). Jails: The center of decarceration policy reforms. In D. S. Rudes, K. Kras, T. J. Carter, & G. Armstrong (Eds.), Handbook on prisons and jails (Vol. 8). Routledge.
Johnson, J. E., Ramezani, N., Viglione, J., Hailemariam, M., Taxman, F. S. (2024). Recommended mental health practices for individuals interacting with U.S. police, court, jail, probation, and parole systems. Psychiatric Services, 75(3), 246-257. https://doi.org/10.1176/appi.ps.20230029 | [PubMed (Free) Link]
Mackey, B. J., Johnson, J. E., Ramezani, N., Hailemariam, M., Rosen, R. K., Thurman, T., Viglione, J., & Taxman, F. S. (2024). The who, what, and how of interagency criminal justice-behavioral health teams: Developing and sustaining collaborations. Criminal Justice & Behavior. Advance online publication. https://doi.org/10.1177/0093854824128039 | [PubMed (Free) Link]
Ramezani, N., Hailemariam, M., Breno, A. J., Mackey, B. J., Cuellar, A. E., Johnson, J. E., & Taxman, F. S. (2023). Impact of county-level health infrastructure on participation in a reform effort to reduce the use of jail for individuals with mental health disorders. Health & Justice, 11(1), 27. https://doi.org/10.1186/s40352-023-00226-9 | [PubMed (Free) Link]
Cuellar, A. E., Ramezani, N., Breno, A., Johnson, J. E., & Taxman, F. S. (2022). Drivers of county engagement in criminal justice-behavioral health initiatives. Psychiatric services, 73(6), 709–711. https://doi.org/10.1176/appi.ps.202100485 | [PubMed (Free) Link]
Ramezani, N., Breno, A. J., Mackey, B. J., Viglione, J., Cuellar, A. E., Johnson, J. E., & Taxman, F. S. (2022). The relationship between community public health, behavioral health service accessibility, and mass incarceration. BMC Health Services Research, 22(1), 966. https://doi.org/10.1186/s12913-022-08306-6 | [PubMed (Free) Link]
Johnson, J. E., Viglione, J., Ramezani, N., Cuellar, A. E., Hailemariam, M., Rosen, R., Breno, A., & Taxman, F. S. (2021). Protocol for a quasi-experimental, 950 county study examining implementation outcomes and mechanisms of Stepping Up, a national policy effort to improve mental health and substance use services for justice-involved individuals. Implementation science , 16(1), 31. https://doi.org/10.1186/s13012-021-01095-2 | [PubMed (Free) Link]
Ramezani, N., Breno, A., Mackey, B., Cuellar, A., Viglione, J., Chase, A., Johnson, J., Taxman, F. (2020). Multilevel matching in natural experimental studies: Application to Stepping Up counties. Alexandria, VA: American Statistical Association. JSM Proceedings, 2408-2419. [PubMed (Free) Link]

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Key Staff:
Dr. Faye Taxman of George Mason University (ftaxman@gmu.edu) and Dr. Jennifer Johnson of Michigan State University (jjohns@msu.edu) lead the I.M. Stepping Up study, with help from Dr. Jill Viglione of the University of Central Florida (Jill.Viglione@ucf.edu).
Funding Source: National Institute of Mental Health (R01 MH118680)
Major Goals:
Evaluate multi-system justice and mental health implementation efforts on a national scale
Identify effective strategies for bringing evidence-based practices to vulnerable and underserved populations
Learn how to drive policy and practice changes that will improve mental health and reduce incarceration of individuals with mental illness