Marshall County, population 34,318 according to the 2020 census, sits about an hour south of Nashville. The county seat is the charming small town of Lewisburg, which has some big ideas on addressing the rural mental health crisis. In 2024, District Attorney General Robert Carter and General Sessions Judge Lee Bussart collaborated with the Marshall County Recovery Foundation to create the SHIELD (Supportive Help for Individuals Experiencing Life-Threatening Distress) Program. Funding for this program was made possible by a community grant from the State Opioid Abatement Committee. The goal of the SHIELD program is to minimize the personal cost of individuals experiencing crisis while also minimizing the expense to the community.

Marshall County Courthouse (Lewisburg, Tennessee) by cmh2315fl via flickr, Creative Commons BY-NC 2.0

The Sequential Intercept Model

The Sequential Intercept Model outlines six points at which individuals with mental and substance use disorders come into contact with the criminal justice system.¹

Intercept 0 encompasses community services, which will ideally reach those who are struggling with mental and substance use disorders before they are charged with a crime by law enforcement. Intercept 1 includes any responses by emergency services or law enforcement to those with mental health and substance abuse disorders that result in the individual being arrested or diverted into treatment. At Intercept 2, the person has been arrested and is moving through intake, booking and their initial hearing with a judge or magistrate. At Intercept 3, court-based diversion programs are implemented to treat those suffering from mental illness and addiction who are being held in pretrial detention. Intercept 4 involves reentry into society, and the services that support individuals at this stage provide transition planning and support to people with mental and substance use disorders who are returning back to the community after incarceration. Finally, Intercept 5 involves individuals at the community corrections stage, usually on parole or probation. Services at this stage work to strengthen the knowledge and ability of community corrections officers to serve people with mental and substance use disorders, address the individuals’ risks and needs, and support partnerships between criminal justice agencies and community-based behavioral health, mental health or social service programs.

Programs intersecting at Intercept 3, such as recovery court and mental health courts, are gaining popularity across the state and the country. For instance, one study found that within a two-year follow-up period, the felony re-arrest rate decreased from 40% before the drug court to 12% after the drug court started in one county, and the felony re-arrest rate decreased from 50% to 35% in another county.²

Marshall County has both a recovery and mental health court; however, in most circumstances, these very successful programs are available only to individuals assessed as “high risk and high need” according to the Tennessee Risk Assessment System (TNRAS). In rural communities with limited access to behavioral health, law enforcement and emergency rooms are left to handle those suffering acute crises with inadequate training and resources. Emergency crisis response is available, but only in cases presenting suicidal or homicidal threat. If the chronic low risk need is ignored, the suffering of the individual and the cost to the community is amplified.

The Role of a Crisis Prevention Prosecutor

Judge Bussart recognized the need for earlier intervention to avoid catastrophic results, relieve the burden on local law enforcement and reduce the cost to the community. “In a small town, people call the police when they are in trouble,” she says. “Sometimes there is no crime, and the police need the resources to respond.” Alternative treatment courts have taught us that incarceration often does more harm than good when working with those suffering mental health crises or substance abuse disorders. Captain Lonny Cook of the Lewisburg Police Department sees the cost savings to the municipality and the relief provided to officers, stating, “Very often, officers spend countless hours responding to non-emergency and sometimes non-criminal matters. Now, SHIELD provides a solution.”

To prevent those who are assessed as being low-risk/high-need from becoming high-risk/high-need, the SHIELD Program was introduced in 2024. The SHIELD program incentivizes people who need help to get the help they need. The goal of SHIELD is to  push people down the intercept model toward community services rather than pushing them up toward incarceration. Other pretrial diversion programs like SHIELD are being introduced throughout the country; however, SHIELD is unique in that the team includes a crisis prevention prosecutor.

The role of the crisis prevention prosecutor is to collaborate with law enforcement and community resources, utilize early intervention strategies, engage in pre-arrest diversion and deflection strategies whenever possible, and invoke purposeful — rather than punitive — remedies for the accused. This full-time prosecutor responds to inquiries from law enforcement and connects those in need with available resources. The crisis prevention prosecutor acts as a filter, scouring the docket for eligible candidates and sorting people according to their need. For communities who cannot afford 24 hour behavioral health services, the use of a crisis prevention prosecutor intersecting with immediate help at Intercept 1 and Intercept 2 offers a practical, economical solution.

The Marshall County SHIELD Program

The purpose of the SHIELD Program is to send low-risk participants to the services they need and use the court system to hold them accountable. The focus of SHIELD is not specifically on substance abuse or mental health, though the two often go hand-in-hand. A low-level, nonviolent offender can be referred to the SHIELD program by anyone working in the criminal justice system, most often law enforcement officers. Once the referral is made, the crisis prevention prosecutor negotiates with the individual or their counsel. The crisis prevention prosecutor offers the accused a clinical screening with a qualified therapist. During these screenings, the therapist uses clinical assessments to identify the childhood trauma, childhood protective factors, mental health diagnoses and substance abuse severity level of the participant. From there the crisis prevention prosecutor and therapist work together to develop an individualized treatment plan, which may involve psychoeducation, cognitive behavioral therapy, inpatient therapy or further psychological evaluation. This individualized treatment plan is written into a court order, often in the form of a pretrial or judicial diversion. The SHIELD case manager monitors compliance and assists the individual in navigating barriers to completing the treatment plan.

Conclusion

In 2024, the Marshall County Jail Budget was $2,156,605.³ For reference, the total cost of food for the Marshall County jail population was $326,444 of the budget, and the cost of medical and dental services for the jail population was $291,000. On average, the Marshall County Jail houses 100 inmates, making the average cost of incarceration $59 per day. This heavy cost of incarceration is often owed to “frequent fliers” within the criminal justice system, as 68% of released prisoners are rearrested within three years, 79% within six years and 83% within nine years.⁴ Therefore, reduction in recidivism leads to lower costs to the taxpayer.

By comparison, the 2024 SHIELD budget was $284,000. From November  2024 through August 2025, 95 referrals have been made to the program, and only 27 of those referrals resulted in court involvement. By diverting some of these individuals away from jail and to treatment can reduce the jail budget while improving the individual’s quality of life. The success of this program demonstrates that rural communities can reduce crime and reduce costs at the same time. The goal of the SHIELD program is to move down the Sequential Intercept Model and intersect with individuals at an earlier stage of crisis, resulting in less trauma for the individual and less cost to the community. |||

JUDGE LEE BUSSART serves as General Sessions and Juvenile Court judge in Marshall County. Judge Bussart is a graduate of the University of Tennessee Winston College of Law and has served in the TBA House of Delegates and as the Young Lawyers Division Delegate to the American Bar Association (ABA) House of Delegates.

JILLIAN MCGAULEY participated in the TBA Rural Judicial Fellowship Program as a fellow with Judge Lee Bussart. She studied Marshall County’s innovative approach to mental health and substance abuse issues in a rural community.

NOTES
1. Substance Abuse and Mental Health Services Administration, The Sequential Intercept Model (SIM), www.samhsa.gov/communities/criminal-juvenile-justice/sequential-intercept-model, last accessed Dec. 22, 2025.
2. National Institute of Justice, “Do Drug Courts Work? Findings From Drug Court Research,” May 11, 2008, nij.ojp.gov/topics/articles/do-drug-courts-work-findings-drug-court-research.
3. Annual Financial Report Summary, Marshall County, Tennessee, June 30, 2024, comptroller.tn.gov/content/dam/cot/la/advanced-search/2024/county/FY24MarshallHotSheet.pdf.
4. 2018 Update on Prisoner Recidivism: A 9-Year Follow-up Period (2005-2014), May 23, 2018, bjs.ojp.gov/library/publications/2018-update-prisoner-recidivism-9-year-follow-period-2005-2014#0-0.