Breaking the Mental Health Pipeline to Jail


Police departments have become the front line of mental health treatment, and jails and prisons are the primary caretakers, a New York City conference was told yesterday.

Mental health practitioners told a gathering of more than two dozen journalists that decades of reduced budgets for community mental health programs and state hospitals, paired with “tough on crime” legislation and “War on Drugs” policies, have effectively criminalized mental illness.

Nevertheless, some communities are developing innovative approaches aimed at diverting individuals into alternative treatment or specialized mental health courts before they are trapped in a system that invariably worsens their condition, the journalists were told.

A national initiative to reduce the number of people with mental illnesses in jails was launched this week in a partnership between the National Association of Counties, the Council of State Governments (CSG) Justice Center and the American Psychiatric Foundation.

The initiative is aimed at bringing together many of the best practices underway to develop models that can be emulated by local governments and law enforcement, said Gerard Murphy, deputy director of the CSG's National Initiatives program, told the group meeting at John Jay College of Criminal Justice.

And the federal Excellence in Mental Health Act, passed in March 2014, will provide $25 million to eight states for two-year pilot “certified community behavioral health clinics,” aimed at increasingly local access to intensive care.

For the majority of the justice-involved population struggling with mental illness, however, state and local correctional institutions are the only places where they can expect to receive some form of treatment, however minimal.

“There are now more psychologists working in state prisons than (in) state hospitals in this country,” said Dr. Jeffrey Metzner, a psychiatrist with the University of Colorado Anschutz Medical Center.

The result is an often unsafe mingling of violent offenders with those who suffer from behavioral diseases.

Doris Fuller, whose daughter Natalie recently committed suicide after struggling with psychosis and severe bipolar disorder, said her greatest fear was that her child would become enmeshed in the criminal justice system.

“It is a big statement on the state of treatment of mentally ill inmates that a mother would be worried that her daughter would be in prison because of her symptoms,” said Fuller, who is executive director of the non-profit Treatment Advocacy Center.

“We can't talk about this subject without talking about the state of the mental health system in America in general,” Fuller added. “We wouldn't be having this conference if people could get the help that they need in their communities.”.

Fuller said Natalie was arrested three times after her first psychotic break, because of symptoms of her disease that included, in one instance, voices telling her to sing on someone's doorstep.

Police were familiar with Natalie's case, Fuller said, but at times had no option but to arrest her.

Many police departments struggle to respond to calls involving individuals with mental illness. It's an issue that has drawn federal attention in cities as large as Albuquerque, N.M., and Portland, Ore., both of which are subject to federal consent decrees monitoring police treatment of those with mental illness.

In Albuquerque, the decree came in response to a series of fatal police shootings of troubled young men .

“The (Albuquerque Police Department) really are going to be the last option if you're looking for a peaceful resolution,” said Renetta Torres, whose 27-year-old son Christopher was suffering from schizophrenia when he was killed by police officers in April 2011.

“Christopher was in the backyard, he was home,” Torres said. “The two officers were in plainclothes, they actually looked like 'thugs', that's how a neighbor described them. They jumped a fence and shot him three times while he was on the ground.”

But some police departments have taken steps to safeguard the mentally ill. In Madison, Wis., police have come to accept their role as first responders to mental health crises, said officer Roberta Stellick.

“We look to citations and jail as our last resort,” Stellick said.

Still, Stellick said the scars of years of interactions with untrained officers remain for many of the mentally ill she interacts with. She points to residents of the mental illness program where her wife works as evidence.

“They're like a family, we have our Thanksgivings there, we bring our daughter, but even there they don't want to see me in my uniform, and I think that speaks to some horrible early interventions,” Stellick said.

Graham Kates is deputy managing editor of The Crime Report. He can be found on Twitter, @GrahamKates. He welcomes your comments.

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