AUGUSTA – The largest mental hospitals in Maine and the nation are county jails, according to a national expert on jail diversion programs.

That can change if those who deliver mental health and substance abuse services collaborate with the criminal justice system, David M. Wertheimer of Seattle said Friday at the Maine Sentencing Institute.

More than 400 judges, prosecutors, lawyers, law enforcement officials, substance abuse counselors and mental health workers attended the two-day program, which is held every three years.

“You are well on your way in Maine to creating jail diversion programs that work,” Wertheimer said Friday.

Jail diversion programs are designed to divert people whose crimes stem from mental illness from jail to community-based programs that provide treatment and support.

Portland’s jail diversion program is in its second year. Bangor and Penobscot County are taking steps toward creating a similar program.

In the past, treatment for most mentally ill offenders has been made a condition of probation. Yet suicide attempts by inmates at county jails and incidents with police and the public have demonstrated a need for earlier intervention, law enforcement officials said Friday.

“We have designed systems that make sense to bureaucrats, funders, agency administrators and service providers,” Wertheimer said. “They do not make sense from the perspective of people with multiple problems who need or are seeking our help.”

An integrated approach is needed, according to Wertheimer, because about 75 percent of arrestees exhibit signs of mental illness and substance abuse. They also are likely to be unemployed, homeless and need a variety of services, all cooperating and collaborating.

Some of those services and programs include:

. Mental health services, residential or outpatient.

. Substance abuse services, residential or outpatient.

. Emergency, transitional and permanent housing.

. Vocational or employment services

. Intensive case management and-or supervision.

. Peer support and consumer-operated services.

. Primary care services.

. Access to entitlements.

Portland’s program, “Diverting Offenders to Treatment,” was funded by a grant two years ago. It includes an assertive community treatment team that involves mental health, vocational training and substance abuse professionals, as well as supported living situations and a case manager to link mental health, substance abuse, judicial and criminal justice staff together to reduce recidivism rates.

An essential part of the Portland program has been working cooperatively with pretrial services, according to Elizabeth Simoni, executive director of Maine Pretrial Services.

Pretrial services in the Portland program provide a link between the treatment community and the judicial and criminal justice system by assisting people who have been arrested to find needed services, negotiate the court system and put together a jail diversion plan that can be submitted to a judge for approval.

Since April 2003, 78 people have been released through the program with pretrial contracts. Forty-seven completed the program successfully, without committing new crimes, she said Friday.

That equates to 1,600 bed-days saved at the Cumberland County Jail for an estimated cost savings of $700,000, Simoni said.

“The flip side is that they spend more time in jail than if they had been released on PR [personal recognizance] bail because they were awaiting placement in [community-based] program,” Simoni said. “The average wait was 10 days. Some were longer, and some were as short as two days.”

Law enforcement officers around the state are being trained in handling psychiatric crises in their communities. Portland police officers were trained in the Crisis Intervention Team program three years ago. Bangor police and correction officers at the Penobscot County Jail are to begin training soon, Penobscot County Sheriff Glenn Ross said Friday.

Crisis intervention programs exist in seven other Maine communities and have been shown to reduce arrests and divert people to treatment. Officers learn skills to help them respond successfully to crisis situations, and in many cases prevent hospitalization or arrest of the mentally ill.

Ross said that much of what is happening around the state is the formalization of the informal networking that has gone on for years. The next step for Penobscot County is to create written agreements with providers and reach across barriers to get more service providers involved.

One of the benefits of such collaborations, he said, are that the more diverse the groups involved are, the easier it is to gain access to funding sources and the more likely it is that grants will be awarded.