---
title: Mental Health Diversion Program Referral Form Template | Paperform
description: Refer individuals with mental illness from criminal justice settings to community treatment alternatives. Streamline diversion program referrals for jail, court, and community-based services.
url: "https://paperform.co/templates/corrections-mental-health-diversion-program-referral-form"
type: static
generatedAt: "2026-03-28T00:43:31.035Z"
---

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### Support Better Outcomes with Mental Health Diversion Referrals

When mental illness drives criminal justice involvement, diversion programs offer a proven alternative to incarceration—connecting individuals with community-based treatment that addresses root causes while improving public safety and reducing recidivism.

This **Corrections Mental Health Diversion Program Referral Form** streamlines the referral process for law enforcement, court staff, probation officers, mental health professionals, and case managers working to redirect individuals from the criminal justice system into appropriate care.

#### Why Mental Health Diversion Programs Matter

Mental health diversion programs recognize that incarceration often fails to address the underlying psychiatric needs driving criminal behavior. Research consistently shows that connecting individuals to treatment in the community leads to better clinical outcomes, lower reoffense rates, and significant cost savings compared to continued cycling through jails and prisons.

Whether you're managing a pre-booking diversion program, post-booking jail diversion initiative, or specialty mental health court, having a clear and comprehensive referral process ensures eligible individuals receive timely access to services that can transform their trajectory.

#### What This Referral Form Captures

This template collects the essential information diversion program coordinators need to assess eligibility and match individuals with appropriate community resources:

 - **Referral source and urgency** to prioritize cases and coordinate follow-up
 - **Demographic and contact information** for case management and outreach
 - **Current legal status** including charges, court dates, and custody status
 - **Mental health history** covering diagnoses, medications, previous treatment, and hospitalizations
 - **Substance use assessment** to identify co-occurring disorders
 - **Criminal justice history** to evaluate program eligibility criteria
 - **Risk and safety factors** including violence history, housing stability, and support systems
 - **Treatment readiness and willingness** to participate in community-based alternatives
 - **Recommended treatment level** and service needs
 - **Supporting documentation** uploads for clinical records and assessments

The form uses conditional logic to reveal relevant follow-up questions based on mental health symptoms, substance use patterns, and risk factors, ensuring you gather complete information without overwhelming referral sources with unnecessary fields.

#### How Criminal Justice and Mental Health Teams Use This Form

**Law Enforcement Diversion Officers** use this form during crisis intervention contacts to quickly refer individuals to pre-booking diversion programs, avoiding arrest and jail booking entirely when appropriate.

**Jail Mental Health Staff** complete referrals for inmates identified during intake mental health screening, connecting them to post-booking diversion programs that can secure release with community treatment linkage.

**Public Defenders and Court Staff** submit referrals on behalf of clients with mental illness who may benefit from specialty mental health courts or other treatment-focused court programs.

**Probation and Parole Officers** refer supervisees whose mental health needs aren't being met through standard supervision, seeking diversion to intensive community treatment programs.

**Community Mental Health Providers** initiate referrals for clients currently involved in the criminal justice system who would benefit from coordinated diversion services and legal advocacy.

**Case Managers and Social Workers** working in emergency departments, homeless outreach programs, or crisis centers can refer individuals at high risk of justice involvement to preventive diversion services.

#### Streamline Diversion with Paperform and Stepper

This template helps mental health and criminal justice professionals move quickly when opportunities for diversion arise—often during narrow windows between arrest and court proceedings.

**Paperform's conditional logic** ensures referral sources only see questions relevant to each individual's situation, while required fields guarantee program coordinators receive the information needed for eligibility decisions.

**File upload fields** let referrers attach psychiatric evaluations, arrest reports, medication lists, and other supporting documentation that strengthens the case for community treatment alternatives.

**Email notifications** can alert diversion program staff immediately when urgent referrals are submitted, enabling rapid response during critical decision points like arraignment or bail hearings.

For programs managing complex intake and assessment workflows, **[Stepper](https://stepper.io)** can automate next steps after referral submission—assigning cases to specific clinicians, scheduling eligibility assessments, triggering background checks, updating case management systems, and coordinating with courts and treatment providers. This automation ensures no referral falls through the cracks during busy periods.

#### Supporting Justice-Involved Individuals with Dignity

Mental health diversion programs represent a critical shift toward treating mental illness as a health issue rather than a criminal justice problem. By using this structured referral form, your program can efficiently identify appropriate candidates, gather necessary clinical and legal information, and connect vulnerable individuals to treatment that can prevent further justice involvement while supporting recovery and community reintegration.

Whether you're launching a new diversion initiative or strengthening an established program, Paperform gives you a professional, secure, and mobile-friendly solution that works across law enforcement, courts, jails, and community providers—ensuring seamless referrals that keep people moving toward treatment instead of incarceration.

---

**Trusted by healthcare and social services organizations** requiring GDPR and SOC 2 Type II compliant solutions for sensitive case information, Paperform provides the security, conditional logic, and workflow automation diversion programs need to serve justice-involved individuals effectively.
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