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Future Health

STOP Treating Mental Illness like it's a Crime!

January 21, 2016 

Here are two unfortunate things we know: 1. Jails and prisons are where too many people with mental illness are receiving, or rather not receiving, treatment. 2. A jail cell is unlikely to be a place of healing.

Here's one more thing we're starting to realize: There's a better way.

Our most vulnerable people are better served if they can be diverted from jails, and states' bottom lines will benefit as well. It's less expensive, more efficient and more humane to treat mental illness like it's not a crime.

In our home state of Texas, as in the rest of the nation, our communities don't have the capacity to meet the demand for mental health services for all those in need, leaving jails and prisons to serve as de facto asylums. This leads to a vicious cycle in which people with mental illness are re-traumatized, released and then re-incarcerated.

Consider the Houston area. According to an article in the Texas Tribune, it "has a list of about 900 people ... who were in and out of jail at least five times in 2011 and 2012. Some had 30 or more visits, the sheriff said. From that list, 538 had been diagnosed with mental health issues that required treatment."

This is bad math from almost every direction.

Community-based professionals and institutions whose priority is mental health are better equipped to provide care than institutions that exist primarily to incarcerate. Imprisonment can compound the trauma that many people with mental illness have already suffered. It's more expensive to imprison someone than to treat that person. And it distracts from the core mission of law enforcement and correctional officers when they're asked to act as social service providers of last resort. They are not trained or funded to properly provide the care needed.

Without question, some people with mental illness need to be incarcerated. But for low-level nonviolent offenders, we should look to measures that can divert people from jails and into community-based mental health treatment programs.

The sequential intercept model, an approach developed by forensic experts Mark Munetz and Patty Griffin, highlights how this process of diversion can happen at every point along the criminal justice continuum -- from the moment the 9-1-1 call is placed all the way to re-entry into the community after incarceration.

What's required are common-sense reforms such as targeted training for police and 911 dispatchers, screening for behavioral health conditions at the early stages of the process, and improved coordination between the justice system and social service agencies in advance of re-entry.

For example, re-entry peer support, in which a recently released person is paired with a trained mentor who's been through the same experience, has been tested in Pennsylvania with promising results. In Texas, the legislature approved up to  million in funding last session for two pilot sites. Scaling of such a program, if the pilots prove successful, could make an enormous difference.

We should take these steps because it's the right thing to do, and because the time is right. The evidence base for diversion programs has matured to the point where we can have confidence that the money will be well spent. Law enforcement officials across the country are coming together in support of such measures. And advocates, experts and policymakers are recognizing that systemic change is needed to address systemic problems.

Crisis can create opportunity. In the case of our mental health system, the current host of problems creates fertile conditions for the kind of creative problem solving and collaboration that can make "jail diversion" more than a trendy phrase. We all know the way we've been doing things isn't working. And we're beginning to realize there's a better way. What better time than now to do what we know is right and make our nation a healthier, more compassionate and more sensible place for all its people.


Octavio Martinez

Lynda Frost

Huffington Post