# Inner and Outer Contextual Factors Impacting Mental Health and Criminal Legal Cross-Systems Collaborations

## TL;DR

This study explores how inner and outer factors influence mental health and criminal legal collaborations to improve outcomes for people with serious mental illnesses.

## Contribution

The study identifies key contextual and bridging factors affecting the sustainability of cross-systems collaborations.

## Key findings

- Inner and outer factors like leadership, values, funding, and data accessibility are critical for collaboration operations.
- Bridging factors such as technical assistance and cross-training support the sustainability of these collaborations.
- Future research should examine how these factors influence the implementation of new practices and policies.

## Abstract

People with serious mental illnesses continue to be overrepresented within the criminal legal system despite multiple diversion and reentry intervention efforts. Engaging in a coordinated systems-level approach to this problem has increased, as mental health criminal legal cross-systems collaborations, like Stepping Up and Sequential Intercept Mapping, proliferate across the United States. Despite their proliferation, little is known about how these cross-systems collaborations operate, including what factors are present and how these factors help or hinder group effectiveness. Stakeholders engaged in mental health criminal legal cross systems collaboration participated in focus groups and in-depth interviews. Using the Exploration, Preparation, Implementation, and Sustainment framework to guide the analysis, findings showed that inner, outer, and bridging factors feature predominately in cross-systems collaborations. Inner and outer contextual factors like leadership, values, funding, and data accessibility are important to their operations. Additionally, bridging factors of purveyors (engaging in technical assistance) and systems-level collaboration strategies (cross-training, sequential intercept mapping, and data sharing) were important to supporting sustainability. Future research should investigate which systems-level collaboration factors are tied to the implementation of new practices, programs, and policies which in turn may improve the behavioral healthcare system and health outcomes for people with serious mental illnesses.