| Their Stories | | | | trial, conviction or sentencing. Sentencing |
| | | | is either to probation or incarceration in |
| People with mental illnesses often come into | | | | jail (generally under a year) or prison. |
| contact with the criminal justice system. | | | | There are 3,365 local jails. |
| | | | |
| - Steven, 28, has bipolar disorder. He can | | | | 6 |
| maintain a normal family life and a job as a | | | | |
| landscaper. He had never had problems with | | | | - In Prisons : 201,000 individuals with |
| the law or any history of violent behavior. | | | | mental illnesses were inmates in state |
| One night while he was driving, the police | | | | (191,000 or 16.2%) and federal (10,000 or |
| pulled him over. He heard voices telling him | | | | 7.9%) prisons at year-end 2000. Of these, |
| to keep going. He did, was shot in the hand, | | | | 132,000 had a severe mental illness. |
| bitten by police dogs and arrested. He spent | | | | |
| four months in jail, without the medication | | | | 7 There are 1,558 adult correctional |
| that had kept him stable. Eventually, he was | | | | facilities housing state prisoners and 110 |
| found not guilty by reason of insanity and | | | | facilities housing federal prisoners. |
| was hospitalized; the charges were dismissed. | | | | |
| (Health Foundation of Greater Cincinnati , 8 | | | | - On Probation : 614,000 individuals (16%) |
| 00) | | | | with mental illnesses were on probation at |
| | | | year-end 2000. Of these, 315,000 had a severe |
| A man with a mental illness who was homeless | | | | mental illness. |
| was arrested in Florida for shoplifting an | | | | |
| ice-cream sandwich that cost $ 1.16, then | | | | 8 Probation represents a more moderate |
| imprisoned because he lacked the $25 bail for | | | | sanction than incarceration. It is generally |
| release. (Sun-Sentinel, Ft. Lauderdale , 11 | | | | given to offenders with few or no prior |
| 98) | | | | convictions or to those guilty of less |
| | | | serious offenses. |
| Many lack access to adequate services through | | | | |
| the public mental health system. | | | | Description of the Population |
| | | | |
| - Roy was so desperate for mental health | | | | New Department of Justice data confirm |
| treatment that he showed up at the courthouse | | | | previous research findings that most |
| and signed his commitment papers. On the day | | | | individuals with mental illnesses in the |
| of his hearing, he packed, ready for a | | | | criminal justice system have had extensive |
| hospital stay, but the hospital couldn't take | | | | experience with both the criminal justice and |
| him for two months. "What am I supposed to do | | | | mental health systems and have a severe |
| until then," he asked. No other services were | | | | mental disorder and poor functioning. |
| offered him. Seven weeks later, Roy walked | | | | |
| into the woods, strapped his belt around a | | | | As seen in this table on offenders with |
| low branch and stepped off a plastic bucket. | | | | mental illnesss, on every item, in all |
| His body was found a week later, on the day | | | | settings-jails, state prisons, federal |
| his mother got a call that the hospital was | | | | prisons and probation-offenders with mental |
| ready for him. (Time, 7/00) | | | | illnesses are more likely than other |
| | | | offenders to have the reported problem. |
| - Seeking help for their 20-year-old son who | | | | |
| was exhibiting unexplained paranoia, a Latino | | | | 1. Based on admission rates reported in |
| family called the community mental health | | | | Bureau of Justice Statistics Bulletin, Census |
| crisis line. Nine hours later a mental health | | | | of Jails, 1999 (August 2001, NCJ 186633, p. |
| professional arrived with police. After a | | | | 5) multiplied by the percentage of jail |
| brief exam the mental health worker said the | | | | inmates with a mental illness (16.3%) |
| young man may need hospitalization and the | | | | reported in Bureau of Justice Statistics |
| officers agreed to take him to a mental | | | | Special Report, Mental Health Treatment of |
| health facility. Although they had found him | | | | Inmates and Probationers (July 1999, NCJ |
| passively sitting on a sofa, the officers | | | | 174463). |
| used physical force, beating him with | | | | |
| nightsticks and ultimately pepper-spraying | | | | 2. Calculated using the respective rates of |
| the apartment. The family watched, stunned. | | | | mental illness reported in Bureau of Justice |
| The young man was diagnosed with | | | | Statistics Special Report, Mental Health |
| schizophrenia and more than a year later | | | | Treatment of Inmates and Probationers (NCJ |
| remains withdrawn and unable to return to his | | | | 174463) and year-end jail and prison |
| job. His family is discouraged about | | | | population numbers reported in Bureau of |
| accessing any public services. (Report from a | | | | Justice Statistics Bulletin, Prisoners in |
| Washington DC suburb, 4/02) | | | | 2000 (August 2001, NCJ 188207) and |
| | | | probationers reported in Bureau of Justice |
| The criminal justice system is used to fill | | | | Statistics press release of August 26, 20001. |
| the void. | | | | |
| | | | 3. Bureau of Justice Statistics Special |
| - A man with a history of epilepsy was | | | | Report, Mental Health Treatment of Inmates |
| arrested after appearing confused and | | | | and Probationers (NCJ 174463). |
| disrupting service on a city bus. Upon | | | | |
| release, he was found outside the jail | | | | 4. Id. |
| banging his head on a wall and crying. He was | | | | |
| then admitted to hospital, where he | | | | 5. Based on self reports by inmates and |
| threatened people with pencils. Hospital | | | | probationers and, for severity, on overnight |
| staff called the police and allowed them to | | | | admissions to a mental hospital or treatment |
| enter patient areas with firearms. After the | | | | program. |
| man became agitated from complications | | | | |
| associated with epileptic seizures, he was | | | | 6. Bureau of Justice Statistics Bulletin, |
| shot dead by a police officer. His family had | | | | Census of Jails, 1999 (August 2001, NCJ |
| brought his seizure medication to the | | | | 186633). |
| hospital the day before, but they spoke only | | | | |
| Spanish and no one could communicate with | | | | 7. Bureau of Justice Statistics Bulletin, |
| them. The medicine was set aside. (Mental | | | | Prisoners in 2000 (August 2001, NCJ 188207). |
| Health Weekly, 6/01) | | | | |
| | | | 8. Bureau of Justice Statistics Special |
| Once people are in thecriminal justice | | | | Report, Substance Abuse and Treatment of |
| system, their mental health needs are not | | | | Adults on Probation, 1995 (March 1998, NCJ |
| met. | | | | 166611). |
| | | | |
| - An Oregon man with a mental illness gouged | | | | 9. Bureau of Justice Statistics Special |
| out his eyes as he waited in a Portland jail | | | | Report, Mental Health Treatment of Inmates |
| cell for a psychiatric hospital bed. (The | | | | and Probationers (July 1999, NCJ 174463). |
| Oregonian 6/12/02 ) | | | | |
| | | | Policy to Address Issues Regarding People |
| - Romus was arrested and brought to the | | | | with Serious Mental Illnesses in the Criminal |
| Orange County jail in New York , shouting | | | | Justice System |
| gibberish. As a result of budget cuts, no | | | | |
| psychiatrist was on call, so Romus was | | | | Impact |
| pepper-sprayed and shackled to a restraint | | | | |
| chair, where he sat shouting, twisting and | | | | The increase in the number of individuals |
| kicking for hours. Eventually, an officer | | | | with serious mental illnesses who come in |
| dragged | | | | contact with law enforcement officers or are |
| | | | booked into jail or sentenced to |
| Romus , in the chair, to the jail's mental | | | | incarceration means that more and more |
| health unit and pushed him in. (Middletown | | | | individuals suffer significant harm. For |
| Times Herald-Record, NY, 7/01) | | | | example: |
| | | | |
| - Shawn, 20, diagnosed with schizophrenia, | | | | - They experience great trauma in connection |
| depression and bipolar disorder, has been in | | | | with arrest, booking or detention. |
| and out of state hospitals. He was arrested | | | | |
| after punching a security guard who tried to | | | | - They are unnecessarily stigmatized by |
| stop him from stealing. While in jail | | | | involvement with criminal justice. |
| awaiting a court hearing, Shawn has tried to | | | | |
| kill himself at least four times. "I use | | | | - They are penalized in their eligibility for |
| razors, floor tiles, nails, screws, glass, | | | | housing, employment and public benefits as a |
| anything," he says, "I want to die." When he | | | | result of-and long after-arrest or detention. |
| tries to hurt himself, the jail locks him in | | | | |
| the medical observation cell. "When I get | | | | The various parts of the criminal justice |
| locked up like that, all I do is cry, punch | | | | system also face major problems, including: |
| myself in the face, bang my head against the | | | | |
| wall." Guards then strap him in a restraint | | | | - repeated use of significant police time and |
| chair. "There is not a day...that I don't | | | | judicial resources; |
| think of killing myself," he told a reporter. | | | | |
| "I just want help. I want this to end. I've | | | | - significant stress among law enforcement |
| come to the conclusion that death is the only | | | | personnel (for example, when individuals with |
| way out." ( Portland Press Herald, 11/01) | | | | depression try to encourage the officer to |
| | | | shoot them); |
| Criminal justice and mental health systems | | | | |
| have not collaborated well. | | | | - occupancy of jail beds needed for more |
| | | | serious offenders; |
| - Paul, 24, was arrested for breaking and | | | | |
| entering. While processing him, police saw | | | | - management problems in jail, often |
| that he was highly agitated and his behavior | | | | requiring suicide watch or causing major |
| was strange. Concerned, the arresting | | | | disruptions for jail staff; |
| officers called the area mental health | | | | |
| center, a hospital, the state police and the | | | | - challenges to probation and parole officers |
| District Attorney's office to find out what | | | | who lack special training or are too few in |
| to do. While the various organizations argued | | | | number to work with people with serious |
| over who should take him, Paul hanged himself | | | | mental illnesses; |
| in his cell. (Health Foundation of Greater | | | | |
| Cincinnati , 8/00) | | | | - a scarcity of financial resources as a |
| | | | result of these and other issues. |
| - Joseph is deaf, has a serious mental | | | | |
| illness and cannot speak. He was arrested on | | | | Taking a Different Approach |
| a misdemeanor charge. Although the charges | | | | |
| were dropped, he remained in the detention | | | | What is needed is a new approach to policy |
| center for two years, lost somewhere between | | | | that will: |
| the city's criminal justice and mental health | | | | |
| bureaucracies. (The Washington Post, 9/01) | | | | - assure that individuals with serious mental |
| | | | illnesses do not end up in the criminal |
| Collaboration between mental health and | | | | justice system when a mental health approach |
| criminal justice can lead to better outcomes. | | | | would be more appropriate or because of prior |
| | | | failures to make mental health services |
| - Richard, 43, has schizophrenia. He has been | | | | accessible; |
| arrested 137 times for petty crimes such as | | | | |
| trespassing and panhandling. Unwilling to | | | | - effectively move people with serious mental |
| take medication on his own, he was caught in | | | | illnesses out of the criminal justice system |
| a dangerous cycle, from jail to hospital to | | | | more expeditiously; and |
| homelessness. Thresholds, a nonprofit | | | | |
| rehabilitation agency, convinced a judge to | | | | - ensure that those who have been arrested or |
| release Richard to their custody. Now he has | | | | incarcerated do not return. |
| a single room the group provides for him, | | | | |
| food, money and constant support. It took | | | | Goals for Policy |
| time, but Richard has been able to break his | | | | |
| cycle of living on the streets or in prison. | | | | Such policies will result in: |
| Over a year later, he remains arrest-free and | | | | |
| says he has never felt happier. Thresholds | | | | - better outcomes for the individual with |
| costs $25 a day, while jail costs $75 a day. | | | | mental illness; |
| (Health Foundation of Greater Cincinnati , 8 | | | | |
| 00) | | | | - greater safety for all-the community, law |
| | | | enforcement officers, correctional staff, the |
| Individuals with Mental Illnesses in Jail and | | | | individual with a mental illness and his or |
| Prison | | | | her family;a more efficient criminal justice |
| | | | system; |
| Data | | | | |
| | | | - greater cost-effectiveness across the |
| - Nearly two million new jail admissions are | | | | criminal justice and mental health system, as |
| of people with mental illnesses-35,000 | | | | mental health issues are addressed earlier |
| individuals a week. | | | | and in a more appropriate forum;a more |
| | | | pleasant community for all. |
| 1 | | | | |
| | | | Approaches That Have Been Tried |
| - At the end of 2000, nearly one million | | | | |
| individuals with mental illnesses were in the | | | | Many communities have adopted programs that |
| criminal justice system. | | | | will divert people with serious mental |
| | | | illness from the criminal justice system at |
| 2 | | | | various stages of the process: |
| | | | |
| - More than 16% of jail inmates have a mental | | | | - time of arrest (pre-booking diversion); |
| illness, according to the United States | | | | |
| Department of Justice. | | | | - as the individual's case is initially |
| | | | processed in the jail (pre-booking |
| 3 | | | | diversion); |
| | | | |
| - Seventy percent of jail inmates with mental | | | | - following booking, but without a trial |
| illnesses are there for nonviolent offenses. | | | | (post-booking diversion); |
| | | | |
| 4 | | | | - at adjudication or the trial stage |
| | | | (court-based diversion); or |
| Offenders with Mental Illness | | | | |
| | | | - following incarceration (re-entry programs) |
| - | | | | |
| | | | Diversion is most likely to succeed, to |
| In Jails : 101,000 individuals with mental | | | | violate individual rights less and to be less |
| illnesses were inmates in local jails at | | | | costly to the criminal justice system if it |
| year-end 2000. Of these, 63,000 had a severe | | | | occurs in the early stages of criminal |
| mental illness. | | | | justice processing. However, depending on the |
| | | | seriousness of the crime or the individual's |
| 5 Jails are locally operated facilities that | | | | prior history in the criminal justice system, |
| hold people pending arraignment or awaiting | | | | this may not be feasible. |