Shift the Responsibility of Untreated Mental Illness out of the Criminal Justice System
Faust, Thomas N., Corrections Today
As executive director of the National Sheriffs' Association and also a long-time member of the American Correctional Association, it is a privilege to have this forum as a "guest editorial" author in Corrections Today. My thanks to ACA Executive Director James Gondles, Jr. for this opportunity.
In the December 2002 issue of Corrections Today, Gondles spoke of alternatives to incarceration. A serious issue for sheriffs and jail administrators is the incarceration of severely mentally ill offenders. Our jails and prisons have started to become psychiatric hospitals. According to the U.S. Department of Justice, 16 percent of inmates are severely mentally ill. There is a critical need for alternatives regarding mental illness and the need to shift the responsibility of untreated mental illness out of the criminal justice system.
The diversion of the mentally ill from the criminal justice system needs a systemwide/communitywide approach Early intervention and treatment of the mentally ill are critical to diversion from the criminal justice system and back to mental health professionals. The three largest de facto psychiatric facilities in the United States are now the Los Angeles County Jail, Rikers Island Jail in New York City and Cook County Jail in Chicago. There are twice as many mentally ill people in the Miami-Dade County Jail than the South Florida Evaluation and Treatment Center. In many jurisdictions in the nation the county's jail holds more people with severe psychiatric illnesses than any psychiatric facility in that county.
The problem continues to escalate--it is a major quality of life issue for severely mentally ill inmates because they are more likely to be beaten, victimized or commit suicide than those who are not sick. The handling and control of these inmates pose a serious safety threat to staff. It is also a major expense for jail systems--the L.A. County Jail spends about $10 million per year on psychiatric medication.
Failure to treat people before they enter the criminal justice system is a major reason for the increase in jail populations. Jail diversion programs and mental health courts are positive steps but do not address the fundamental problem: treating people before problems occur. Today, the Treatment Advocacy Center reports, there are nearly five times more mentally ill people in the nation's jails and prisons (nearly 300,000) than there are in all the state psychiatric hospitals (about 60,000). The problem is untreated mental illness.
The National Institute of Mental Health reports that there are 4.5 million Americans with schizophrenia and manic-depression. And at any given time, 40 percent, or 1.8 million people, are not receiving adequate treatment, according to Archives of General Psychiatry. Legal reforms in the 1970s contributed significantly to the criminalization of mentally ill people. Treatment laws were changed to require that individuals be a danger to themselves or others before they could be treated involuntarily. So what typically happens? A family whose child stops taking medication calls county mental health professionals who tell the family they cannot do anything until the child becomes "dangerous," When the child deteriorates to the point at which he or she is dangerous, the mental health professionals are no longer the ones who respond; it becomes sheriffs and police. …