Helping mentally ill criminals: jailing offenders with mental illnesses serves no one, but new policies and funding are bringing about needed changes.

AuthorLyons, Donna
PositionCover story

Fifty-year-old Eddie has spent much of his life in and out of prison for crimes that included drug possession, larceny and burglary. Often homeless, he recalls his stints in jail as a respite from the overwhelming task of taking care of himself. Last fall, Eddie, a grandfather, reached an important turning point in his life. He became the first client discharged from a mental health court in Santa Fe, N.M. Similar to drug courts, the specialized courts are designed to help people like Eddie get mental health treatment, manage their lives and stay out of jail.

"It's amazing to see the changes in some one over a year with the services and supervision of this court," says Lupe Sanchez, program manager for the court in the First Judicial District in Santa Fe. Most clients are probation violators. A tough customer, Eddie spent as much as 20 years behind bars, Sanchez said. "Mental health services and case management can help a guy like him go from having no structure and responsibility to being able to live self-sufficiently. No doubt he otherwise would be in jail."

THE NUMBERS ARE STAGGERING

A recent report by the federal Bureau of Justice Statistics said that more than half of all prison and jail inmates have a mental health problem. That works out to be 705,600 offenders in state prisons and 479,900 in local jails. Mental disorders are increasingly common in the United States, but their prevalence in criminal justice systems is estimated at three times the rate of the general population. Convicts also are more likely to suffer from more than one illness, in particular schizophrenia, bipolar disorder, major depression or acute psychosis "co-occurring" with substance abuse.

The deinstitutionalization of the mentally ill in the 1960s was designed to care for those with acute mental health needs in the community instead of in state-run asylums. But the movement to be more compassionate and cost-effective in treating those with mental illness has had a down side. In the generation since many state mental hospitals closed and treatment approaches shifted to the community, many people with serious mental illnesses have failed to get the treatment they need. For some, that means homelessness and crime, and advocates now decry what they call the "criminalization of the mentally ill."

It is estimated that as many as 40 percent of people in this country with mental illness are not receiving treatment. Some are prone to substance abuse and nuisance or "quality of life" crimes such as trespassing, disorderly conduct and public intoxication. Some drift into property crimes or prostitution, while others may become serious and even dangerous offenders.

Only about one third of offenders with mental health needs receive treatment, according to the Bureau of Justice Statistics survey. Released without care, many such offenders remain in a cycle of crime and incarceration that often starts with juvenile arrests and persists into adulthood.

TRAINING POLICE

Police encounters with the mentally ill are frequent and unpredictable. On a routine basis, police deal with cases of vagrancy and nuisance crimes. They also respond to incidents in which people with mental illness are victims of crime. Officers must make quick determinations of a person's danger to themselves or others, and try to defuse situations that endanger them or escalate into "suicide by cop" or other tragic scenarios.

Training and experience help police officers recognize signs of mental illness and adapt their...

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