The mentally ill offender: a brighter tomorrow through the eyes of the Mentally Ill Offender Treatment and Crime Reduction Act of 2004.

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The mentally ill offender: a brighter tomorrow through the eyes of the Mentally Ill Offender Treatment and Crime Reduction Act of 2004.

I. INTRODUCTION II. DUTY TO PROVIDE OR THE RIGHT TO RECEIVE HEALTH CARE SERVICES III. EXCEPTIONS TO THE GENERAL RULE THAT THE STATE HAS NO DUTY TO PROVIDE HEALTH CARE: PERSONS UNDER STATE CUSTODY A. Rights to Health Care for Children in State Custody B. Rights to Health Care for Persons in Mental Institutions C. Rights to Health Care for Prison Inmates, Pretrial Detainees, and Arrestees IV. THE LANDMARK DECISION OF ESTELLE V. GAMBLE: INMATES ACCESS TO HEALTH CARE A. The Deliberate Indifference and Serious Medical Needs Test V. RIGHTS TO MENTAL HEALTH CARE TREATMENT A. Rights to Mental Health Care Treatment in State Treatment Facilities B. Rights to Mental Health Care Treatment in Correctional Facilities VI. BARRIERS TO EFFECTIVE AND EFFICIENT TREATMENT FOR MENTALLY ILL OFFENDERS A. Correctional Facilities Must Implement Screening Procedures B. Correctional Facilities Must Staff Adequately Trained Mental Health Care Professionals C. Results of the Lack of Training for Law Enforcement Officers VII. PROBLEMS THAT RESULT FOR THE FAILURE TO PROPERLY TREAT MENTALLY ILL OFFENDERS A. Lack of Treatment in Correctional Facilities for Mentally Ill Offenders B. Recidivism Rates Among Mentally Ill Offenders VIII. PUBLIC POLICY DEMANDS THAT MENTALLY ILL OFFENDERS RECEIVE THE NECESSARY MENTAL HEALTH CARE TREATMENT WHILE INCARCERATED A. The Mentally Ill Offender and Crime Reduction Act B. Properly Implemented Treatment Programs in Correctional Facilities Can Lower Recidivism Rates Among Mentally Ill Offenders C. Collaboration Between Systems to Combat the Barriers Affecting the Mentally Ill Offender D. Law Enforcement Agencies Must Be Trained to Deal with the Mentally Ill Offender E. Alternatives to Incarceration for Mentally Ill Offenders IX. CONCLUSION I. INTRODUCTION

Rhonda Atkins poured her heart out when she testified to Congress, in the summer of 2004, about her concerns that this country faces in combating the problem of obtaining the necessary treatment for mentally ill offenders. This problem is especially close to her heart because her daughter Reese was diagnosed with bipolar disorder, a severe mental disorder, when she was fifteen years old. (1) For years, Reese's conditions went untreated and she began to slowly deteriorate. Reese tried to control her conditions by abusing various substances, like so many other individuals suffering from mental illnesses. Reese's behavior would range from severe mania, to extreme irrationality, to paranoia. When her daughter's behavior became uncontrollable, Rhonda's only resource was to call the police. (2)

Through the countless times that the police were called to her residence because of her daughter's behavior, some police officers were compassionate to her illness, while others were rough. Sometimes, the officers escalated Reese's conditions where she or the officers could have been injured. One officer stated, "if you were my daughter, I would knock you across the room." (3) The officer's behavior exemplifies the growing problem that the criminal justice system is ill-equipped to properly handle mentally ill offenders.

At the time of Reese's first arrest for trespassing, there were no resources available to give her daughter the necessary treatment she required. Even after she was later diverted into a drug court, following a drug charge, her daughter was still left without the necessary treatment. One social worker even discouraged the integration of substance abuse treatment and mental health treatment. (4) The reality of Reese Atkins is a sad but true story. The Atkins family is not alone in this fight.

Beginning in the early 1950s and '60s, states began to close their public mental health hospitals. This process was known as "deinstitutionalization." In recent years, following the massive wave of deinstitutionalization, a substantial number of institutionalized persons with mental disabilities were relocated from civil mental hospitals into jails and prisons. (5) Despite this shift in population, correctional facilities remain ill-equipped to handle and deal with offenders with mental disabilities. One study found that approximately 6.5-10% of inmates suffered from a serious mental illness, while another 15-40% suffered from a moderate mental illness. (6) Another study done by the Bureau of Justice Statistics indicated that 16% or an estimated 283,800 inmates were identified as being mentally ill by mid-year 1998. (7) Cheri Nolan, Deputy Assistant Attorney General of the Office of Justice Programs, testified to Congress that "the increasing number of people with mental illnesses in the criminal justice system is one of the most pressing issues facing our police departments, jails, prisons, and courts. (8)

Despite such statistics, offenders' rights to mental health treatment have been slow to reach many of incarcerated inmates who require treatment. The landm...

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