Each day the Gold Room in the Rayburn House Office Building hosts events
designed to educate and inform members of Congress and their staffs. September
27 was no different, but the room was especially full that Wednesday.
For several years now APA and NAMI—the National Alliance on Mental
Illness—have joined to sponsor a congressional luncheon to preview
Mental Illness Awareness Week (MIAW), which, as you know, is an annual
observance to raise awareness of mental disorders and their treatments.
This year's symposium in the historic Gold Room brought needed attention to
a dire situation: that our nation's jails and prisons have become the primary
mental health care facilities in the United States today (Psychiatric
News, October 20).
Psychiatrists and patient advocates know that this is a function these
institutions are neither designed nor equipped to handle. Furthermore, we know
firsthand that people with mental illness are one of the most vulnerable and
treatable populations in our society, yet they are being housed in punitive
Clearly, a great deal of education is needed to solve the problem of
inappropriate incarcerations. APA's Department of Government Relations, led by
Nicholas Meyers, is on the job. In addition, APA's Committee on Jails and
Prisons, chaired by Henry Weinstein, M.D., provided valuable leadership for
MIAW activities, as well as fact sheets and statistics to help illuminate this
vital issue. Our Office of Communications and Public Affairs lent key support
through news releases, “talking points” on the topic, and other
This year's MIAW theme, “The Criminalization of the Mentally
Ill,” was covered from different angles. The standingroom-only crowd
heard from three noted speakers: Richard Nakamura, Ph.D., deputy director of
the National Institute of Mental Health; Wilson Compton, M.D., M.P.E.,
director of the Division of Epidemiology, Services, and Prevention Research at
the National Institute on Drug Abuse; and Tom Hamilton, Ph.D., former
president of NAMI-Texas and NAMI's liaison to APA's Committee on Jails and
I was also pleased to see a good friend of APA's in attendance: Rep. Grace
Napolitano (D-Calif.), who founded and co-chairs the Congressional Mental
Health Caucus, which now boasts more than 70 members from both parties.
By the end of the two-hour event, the Capitol Hill audience was clearly
impressed that the crisis of incarcerating people with mental illness amounts
to a true national tragedy and must be reversed.
They heard data from the new report by the U.S. Department of Justice
titled “Mental Health Problems of Prison and Jail Inmates,” which
stated that more than half of all inmates had a mental health problem. Many of
these people suffer from very treatable disorders like major depression,
bipolar disorder and substance abuse.
Moreover, attendees at the MIAW lunch came to understand the vicious cycle
in which some people with mental illness, if left untreated, develop symptoms
and behaviors that can lead to their arrest and incarceration. Most
importantly, the members of Congress and their staffers took away the message
that appropriate treatment for people with mental illness— and funding
for it—is urgently needed.
APA presented a message bound to resonate with members of Congress: the
current practice of incarcerating mentally ill people hurts the correctional
system, tax-payers, and people who could be helped by being diverted
to appropriate care and treatment. Indeed, there are medical, social, and
fiscal issues that all need to be addressed to change the unacceptable status
quo. It is imperative that members of Congress support increased funding for
community-based mental health services and jail-diversion programs.
While this congressional event is an opportunity to preview MIAW, it is an
occasion for the mental health community from coast to coast to observe MIAW.
led by NAMI, the overarching theme of the week-long focus, this year from
October 1 to 7, was “Building Community, Taking Action.”
This year we took action by using our MIAW symposium to put a human face on
those with mental illnesses who have become ensnared in the criminal-justice
system. One day in the very near future, we hope that the criminal-justice
system will be a just system. A key way to accomplish this is to
divert people with mental illness to a setting in which they can receive
appropriate treatment—treatment that we know can work. ▪
James H. Scully Jr., M.D., is medical director and CEO of APA.