A Justice Challenge for Trump: Mental Health & Drugs

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Photo by Gage Skidmore via Flickr

It’s a common lament of the nation’s police officers and prison wardens alike: A large proportion of the crime suspects and inmates they find themselves dealing with suffer from mental illness, substance-abuse issues, or both.

Today, a coalition of organizations spanning justice and health interests are launching a new campaign to focus on what they call “behavioral health issues in the criminal justice system.”

At a meeting in Washington, D.C., the groups are issuing what they termed consensus recommendations to the next Congress and Donald Trump’s incoming administration on what should be done about the complex, intertwined issues.

“Mental illness is not a strong predictor of criminal or violent behavior,” the coalition says. “Yet left untreated, it can lead to behaviors that cause too many individuals to wind up in the criminal justice system.”

The unintended result is that jails and prisons around the nation “have become de facto behavioral health care providers.”

The effort is led by two groups that aren’t often seen in the forefront of justice reform: the American Psychological Association and the National Association of Social Workers.

Initial supporters are: the American Psychiatric Association, the Equitas Foundation, the National Alliance on Mental Illness, the National Association for Rural Mental Health, the National Association of Counties, and the National Association of County Behavioral Health and Developmental Disability Directors.

Other members of the coalition are: the National Association of State Mental Health Program Directors, the National Criminal Justice Association, the National Health Care for the Homeless Council and the Police Foundation.

The full extent of the problems isn’t known, but a U.S. Bureau of Justice Statistics report in 2006 said that the percentage of prison and jail inmates reporting impairment during the previous year because of a mental health problem ranged from about 45 percent in federal prisons to 56 percent in state prisons to 64 percent in local jails.

When it came to “drug dependence, abuse, or both,” the range was 45.5 percent of federal inmates, 53.4 percent of state inmates and 68 percent of those held in local jails.

The situation is even worse in the juvenile justice system, where 70 percent of youths detained have “diagnosable symptoms of a mental health disorder,” which is three and a half times the rate among everyone under 18 years old, said another 2006 study.

On the substance abuse front, 61.2 percent of youths in the justice system screened positive for a substance use disorder, found a 2014 study.

The coalition acknowledged that many elements of the justice and health fields have been trying to address what it termed a “crisis” for many years.

In 2002, the Council of State Governments Justice Center issued a 450-page report titled the Criminal Justice/Mental Health Consensus Project that was based on three years of study by 100 experts and practitioners.

For example, many agencies who employ the first responders to trouble have formed “crisis intervention teams,” and problem-solving courts have been created to give special attention to the needs of both mentally ill defendants and drug abusers.

Back in 2002, the Council of State Governments Justice Center issued a similar report titled the Criminal Justice/Mental Health Consensus Project that issued a 450-page report based on three years of study by 100 experts and practitioners.

Since then, many government agencies around the U.S. have improved their responses to mentally ill and drug-impaired people, but these efforts tend to be fragmented among the wide array of law enforcement and health service providers.

“The time has come to address behavioral health issues in a coordinated, comprehensive fashion,” says a “consensus work group” of the coalition.

The group is seeking “immediate action” by Congress and the Trump administration on a long list of suggestions.

Among them:

  • More federal aid, training, and technical assistance to state and local government, including a clearinghouse on best practices for handling those in the justice system with mental health and substance abuse disorders.
  • Instead of cutting off Medicaid to cover services for those in jail who haven’t been convicted, letting coverage continue so that inmates don’t suffer setbacks in their conditions.
  • Providing “integrated treatment” for those who suffer from both mental health and substance abuse issues, which are termed “co-occurring disorders.” Now, they tend to get help through separate federal grant programs.
  • Creation of a national center to coordinate training of police and corrections officers who must deal with troubled suspects and inmates.
  • A focus on local jails, which have particular challenges because inmates have “unpredictable release dates,” some staying for a few days, and others for weeks, months, or years. The coalition noted that the suicide rate in jails is about four times higher than that in the general population.
  • Harder work on improving prisoner re-entry services, including better information sharing between justice agencies and community health service providers.

The groups didn’t offer an estimated price tag for these and many other recommendations, which is sure to be an issue in a Washington environment in which budget-cutting Republicans will hold dominant positions in both the legislative and executive branches as of mid-January.

Some Democrats have spoken out already. Today, a gathering of coalition members is hearing from Sen. Al Franken (D-MN), who has been pushing for a “Comprehensive Justice and Mental Health Act” that he says would provide federal support for “more mental health courts (including special courts for veterans), more crisis intervention teams, more corrections-based services for people with mental illness, and more training for law enforcement officers to help them recognize and respond to mental health crises safely.”

Sen. John Cornyn (R-TX) offered his own bill on federal aid for mental health services, but the measure has been held up in a dispute over guns.

When a veteran is diagnosed with a mental illness, the Veterans Administration may appoint a “representative payee” to handle the veteran’s benefits. In those cases, the veteran’s name is added to the National Instant Criminal Background Check System (NICS) as a “prohibited person due to mental health issues,” which bars the veteran from buying a gun.

The National Rifle Association backs Cornyn’s attempt to end the prohibition on veterans’ guy-buying, but many Democrats won’t accept it.

Will President-elect Donald Trump pay attention to the mental health-criminal justice issue? Reform advocates hope he does, amid a long list of pressing economic, foreign affairs, and other challenges.

They note that in position papers during this year’s presidential campaign, Trump made a point of running on a “law and order” platform that give particular attention to the Second Amendment right to bear arms, which earned him the endorsement of the National Rifle Association.

It was in the Second Amendment section of his policy proposals that Trump said the U..S. should “Fix our broken mental health system.”

He contended that, “All of the tragic mass murders that occurred in the past several years have something in common – there were red flags that were ignored. We can’t allow that to continue.

“We must expand treatment programs, and reform the laws to make it easier to take preventive action to save innocent lives. Most people with mental health problems are not violent, but just need help, and these reforms will help everyone.”

Members of the coalition will be working to add other organizations to their list of supporters to help in what could be a long battle to get significant action.

Ted Gest is president of Criminal Justice Journalists and Washington Bureau Chief of The Crime Report. Readers’ comments are welcomed.

2 thoughts on “A Justice Challenge for Trump: Mental Health & Drugs

  1. There is no treatment in the USA for mental illness and drug addiction/alcoholism…it’s all absolutely worthless “How do you feel?” circle group therapy nonsense, handfuls of toxic meds that don’t work, and mandatory “Jesus Saves” & 12-Step religious AA/NA cult insanity….

    • Unless you want help you cant be helped but the groups do have a lot to offer and I believe we should focus on that type of thing along with love and more positive attitudes. Those work for a lot of people so we cannot rule those out. We must add to. Talk to addicts in recovery. That’s where most of your best information is lying in. -Daphne D. Wallis Mississippi mental health advocate -AngelWater Solutions …The Company Founder is a recovering drug addict, striving mom of 4 and mental health specialist.

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