When The Mentally Ill Meet The Criminal Justice System

When The Mentally Ill Meet The Criminal Justice System

The mentally ill come into contact with the criminal justice system at an alarming rate these days. Often once in the system they return too often until their stay there becomes long term. Experts relate this problem back to the sixties and the deinstitutionalization of the mentally ill. This has caused the problem of police being the vanguard of mental health support for the mentally ill.

In the sixties the plan released patients back into the community. This resulted in a downsizing of mental health hospitals and the development of new drug therapies. The money saved by hospital closing was intended to be put back into the community in outpatient programs. This has not happened.

Policies have reduced both funding levels and federal involvement in providing money to the mental health system. States have taken the savings and used them for other budgets leaving many mentally ill people without the appropriate care and support systems. Some individuals, without monitoring, stop taking their medication, while others continue to take outdated medicine that have severe side effects. The results are many unstable people living in the community with no one to help them or families that are unprepared. Many mentally ill people continue to slip through the cracks of a public mental health system that has been torn down by budget cuts. Deinstitutionalizing the mentally ill did not decrease the need for treatment. It seems to have simply shifted the burden and cost to the criminal justice system. As this trend continues with psychiatric hospitals closing there doors and states cutting their mental health budgets, the front line contact with the mentally ill is increasingly falling on police and the nation's jails and prisons.

Risdon Slate, a professor of criminal justice of Florida Southern University states, "In 1960, there were over 600,000 residents in state hospitals in the United States. Today, there are less than 60,000."

According to the Criminal Justice/Mental Health Consensus Project:

1.There are three times as many people suffering from mental illness in U.S. prisons than in psychiatric hospitals.

2. One out of every six people in prison has a severe mental illness.

3. A study in New York State found that men involved in the public mental health system over a five year period were four times as likely to be incarcerated as men in the general population and women were six times as likely.

4. The Los Angeles County Jail, the Cook County Jail in Chicago, and Riker's Island in New York City each hold more mentally ill people on any given day than any psychiatric facility in the U.S.

5. Nearly half the mentally ill inmates were incarcerated for committing a nonviolent crime.

6. People with mental illness are three times more likely to be victims of violent crime than the rest of the population.

How do they end up in the system? "Thousands of mentally ill are left untreated and not helped until they have deteriorated so greatly that they wind up arrested and prosecuted for crimes they might never have committed had they been able to access therapy, medication, assisted living facilities in the community. Mental health professionals told Human Rights that it is next to impossible to get their clients admitted to hospital or treatment programs until after they have deteriorated to such a point that they have already committed a crime," says the Human Rights Watch. The change has increased the burden on policemen all around the country. Unfortunately, the police have little training on how to deal with people who may be delusional or out of control. They are on the whole unprepared to provide the type of help to people who may be suicidal, paranoid or delusional.

Police need to learn to recognize and look at the mentally ill differently and not be as authoritative as they normally would be. Often shouting orders at an already scared person in this type of situation, Memphis police Major Sam Cochran says, "is the wrong thing to do when a person is in a mental health crisis. It's going to put the individual into even more fear and panic."

Officers are trained to use force in dangerous situations. Other non-lethal methods of subduing a mentally ill person having an episode, brandishing some form of weapon, are already being instituted. One death that brought this issue to the forefront was on January 20, 1999, when Sheryl Ann Seymour was shot by an Houston Police Department officer. Seymour, petite and barely standing at five feet, was a schizophrenic who called paramedics when she realized she was having an episode. When paramedics arrived with police she was fully psychotic and holding a kitchen knife in her hand. She advanced toward the officer when he then shot and killed her.

According to the National Institute of Justice Journal, officers have three choices when encountering an irrational person. They can take them to a mental hospital, arrest them, or take care of the situation informally on site.

Frequently taking one to the hospital, if one is available, is a hassle as of now for most forces. Waiting times impose upon officers and legal obstacles make it hard to obtain a commitment or treatment. Often hospitals won't take people considered dangerous, who have abused substances or had many previous hospitalizations.

For the most part officers see arrest as a more simple way of dealing with a person acting out during a mental health crisis. Since the reduction in services for the mentally ill, the criminal justice system has become a default solution for these individuals because the police cannot turn them away the same as the failing mental health system can. This leads to a bogged down system full of misdemeanors that could be avoided. Experts say this is how mentally ill people end up in the system long term. The police have nowhere to turn. When the mentally ill are released, they miss court dates or appointments with their parole officers winding up back in jail. In jail, and untreated, they have trouble following the rules, on occasion committing more crimes adding on more time to their original sentence.

Jail for anyone can be traumatic. Especially the mentally ill. Isolation becomes a reality. They are often placed in punitive segregation cells where, experts say, their mental illness becomes worse. Their treatment is disrupted making it far more difficult to once again find remission of their symptoms. E. Fuller Torrey, M.D. and Mary T. Zdandowicz, from The American Psychiatric Association state, "Studies suggest that delaying treatment results in permanent harm, including increased treatment resistance, worsening severity of symptoms, increased hospitalizations and delayed remissions of symptoms."

While in jail any kind of federal benefits are lost. They emerge from prison with a 30 day supply of pills and a garbled mental illness run awry.

Fortunately there have been some police forces around the nation joining forces with mental health systems to bring about a better change. The Memphis Police Department has set the norm. The have developed the CIT or crisis intervention team which is staffed by police officers trained specifically to deal with mental disturbance crisis calls.

The officers receive forty hours of training from mental health providers, advocates and consumers. They learn about mental illness, substance abuse, psychotropic medications, civil commitment law, and techniques for intervening in a crisis.

The CIT officer may use de-escalation techniques or verbal crisis intervention. They may contact the case manager or treatment provider of the person, provide a referral to treatment, or transport the person to the psychiatric emergency room of the University of Tennessee Medical Center in Memphis. There the staff work closely to facilitate a smooth transfer of custody and ensure continued communication about the patient. No one is turned away. It has been the effort of both the force and the mental health system there in managing crisis calls in a more effective and sensitive manner.

The officers of the CIT have learned that sometimes reasoning with the person will not solve the problem. Especially in the case when the person may be holding a weapon or threatening suicide. Taser guns have been used along with pepper spray but a person in a full blown psychotic episode can be very powerful and not effected by these methods. The goal of the department is ensuring that the minimum amount of force is used while still accomplishing bringing the situation under control without the officer or the individual being hurt.

They started using the IDS, or Impact Delivery System, to immobilize a person without fatally wounding them. The department declares the visual intimidation factor of the IDS is the reason they have rarely had to use it. It is a 10.6 pound rifle with a large ammunition canister. The cartridge is a 37mm rubber baton that travels at 140 mph.

Since the Memphis CIT program has began the Bureau of Justice Assistance reports these results.

1. Reduced stigma and perception of danger attached to mental illness.

2. Reduced use of deadly force.

3. Fewer injuries to officers and citizens.

4. Greater flexibility in the use of misdemeanor charges.

5. Lower arrest rates.

6. Relief to an overburdened criminal justice system.

The Consensus Project reported a forty percent decrease in injuries suffered by individuals with mental illness caused by police because of the implementation of the Memphis CIT.

A better system of care giving needs to be realized across the country. One designed to reduce the number of persons who fall through the cracks and into the criminal justice system. The public mental health system must rise up and meet the challenges that have occurred since the sixties. Policymakers must increase funding for the mental health services in the community. The public mental health system and the criminal justice system must work together so police have alternatives to arrest when handling a mental health crisis. Police officers should receive adequate training in recognizing and dealing with an individual in crisis so they are taken to the correct facility. The least restrictive alternative should be used when misdemeanor charges are brought against a mentally ill person and they should be treated in a mental health facility.

The mentally ill must be protected while providing treatment in the most humane setting possible. Commitment to funding mental health and modifying policies are vital for the most proper and beneficial treatment.