Initiative Aims to Reduce Number of People With Mental Illness in U.S. Jails
Abstract
Effort calls on county governments to collect data on the status and needs of people with mental illness in local jails, determine treatment capacity, and develop plans to reduce their overrepresentation in the criminal justice system.
Two million people with mental illness cycle through America’s county jail cells every year, creating a strain on county governments that must provide them with treatment. Now, local government officials have been invited to join a national collaboration to reduce the number of people with mental illness in jails across the country.
“The sheer number of people with mental illness in U.S. jails has reached crisis proportions,” said Denise O’Donnell, J.D., M.S.W., director of the Bureau of Justice Assistance in the U.S. Department of Justice, speaking last month at a meeting on Capitol Hill launching the Stepping Up Initiative.
The Stepping Up Initiative—a joint effort of the National Association of Counties, the Council of State Governments Justice Center, and the American Psychiatric Association Foundation—calls on county governments to enact strategies to collect data on the status and needs of people with mental illness in local jails, determine treatment capacity, and develop plans with measurable outcomes to reduce their overrepresentation in the criminal justice system.
How Counties Can ‘Step Up’
The Stepping Up Initiative calls for counties to take the following six actions:
Convene leaders and decision makers committed to safely reducing the number of people with mental illness in jails.
Determine prevalence of adults entering jails with mental illness and assess their needs.
Evaluate treatment and service capacity in counties and identify policy and funding barriers to diversions and community support.
Develop a plan of action with measurable outcomes based on the above.
Implement research-based approaches that advance the plan.
Create systems to track progress and report outcomes.
More information about the Stepping Up Initiative can be accessed here.
According to a recent report, there are now 10 times as many people with mental illness in jails and prisons than in psychiatric hospitals, APA CEO and Medical Director Saul Levin, M.D., M.P.A., said during the event. “We must ensure that every one of our patients, every individual who needs and deserves treatment—particularly in the criminal justice system—receives that treatment.”
The present situation grew out of the failure to develop a truly comprehensive community mental health system, said former Rhode Island Rep. Patrick Kennedy. People with mental illness have been moved out of the old asylums only to find themselves in the new asylums—America’s jails and prisons, Kennedy said.
“We discriminate against people with biologically based illnesses by not treating them and then arrest them because they are not treated,” he said.
Such actions can take a significant toll on local governments, Toni Carter, a commissioner of Ramsey County, Minn., explained during the event. “We know the impact these changes can have on our counties’ budgets, on our public safety, and, most importantly, on individuals with mental illnesses and their families,” Carter said. “But this battle won’t be won in individual counties. We need a national movement to change the way we treat people with mental illnesses.”
In that regard, Sen. Al Franken (D-Minn.) spoke of the need for the Justice and Mental Health Collaboration Act, which would support crisis-intervention training for police and diversion programs for offenders, among other measures. Franken is cosponsoring the legislation with Sen. John Cornyn (R-Texas).
“Mental health in the justice system is not a partisan issue,” said Franken, urging attendees to back the pending legislation.
While some counties have made progress in their efforts to facilitate access to treatment and promote appropriate alternatives to jail, scaling up successful efforts has proven more difficult. As part of its ongoing work in the criminal justice field, the American Psychiatric Association Foundation will convene a national summit meeting on the subject in the spring of 2016.
“We need sweeping change in the overrepresentation of people with mental illness in the criminal justice system,” said O’Donnell. “The current system in which our jails provide mental health services is not affordable, nor is it sustainable or right.” ■
