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People with Serious Mental Illnesses in Jail and Prison

Their  Storiestrial, conviction or sentencing. Sentencing
is either to probation or incarceration in
People with mental illnesses often come intojail (generally under a year) or prison.
contact  with  the  criminal  justice system.There  are  3,365  local  jails.
- Steven, 28, has bipolar disorder. He can6
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 him7.9%) 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 medication7 There are 1,558 adult correctional
that had kept him stable. Eventually, he wasfacilities housing state prisoners and 110
found not guilty by reason of insanity andfacilities  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 homelessmental  illness.
was arrested in Florida for shoplifting an
ice-cream sandwich that cost $ 1.16, then8 Probation represents a more moderate
imprisoned because he lacked the $25 bail forsanction than incarceration. It is generally
release. (Sun-Sentinel, Ft. Lauderdale , 11given 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 healthNew Department of Justice data confirm
treatment that he showed up at the courthouseprevious research findings that most
and signed his commitment papers. On the dayindividuals with mental illnesses in the
of his hearing, he packed, ready for acriminal justice system have had extensive
hospital stay, but the hospital couldn't takeexperience with both the criminal justice and
him for two months. "What am I supposed to domental health systems and have a severe
until then," he asked. No other services weremental  disorder  and  poor  functioning.
offered him. Seven weeks later, Roy walked
into the woods, strapped his belt around aAs 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 daysettings-jails, state prisons, federal
his mother got a call that the hospital wasprisons 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 Latino1. Based on admission rates reported in
family called the community mental healthBureau of Justice Statistics Bulletin, Census
crisis line. Nine hours later a mental healthof Jails, 1999 (August 2001, NCJ 186633, p.
professional arrived with police. After a5) multiplied by the percentage of jail
brief exam the mental health worker said theinmates with a mental illness (16.3%)
young man may need hospitalization and thereported in Bureau of Justice Statistics
officers agreed to take him to a mentalSpecial Report, Mental Health Treatment of
health facility. Although they had found himInmates and Probationers (July 1999, NCJ
passively sitting on a sofa, the officers174463).
used physical force, beating him with
nightsticks and ultimately pepper-spraying2. Calculated using the respective rates of
the apartment. The family watched, stunned.mental illness reported in Bureau of Justice
The young man was diagnosed withStatistics Special Report, Mental Health
schizophrenia and more than a year laterTreatment of Inmates and Probationers (NCJ
remains withdrawn and unable to return to his174463) and year-end jail and prison
job. His family is discouraged aboutpopulation numbers reported in Bureau of
accessing any public services. (Report from aJustice 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 fillStatistics press release of August 26, 20001.
the  void.
3. Bureau of Justice Statistics Special
- A man with a history of epilepsy wasReport, Mental Health Treatment of Inmates
arrested after appearing confused andand  Probationers  (NCJ  174463).
disrupting service on a city bus. Upon
release, he was found outside the jail4.  Id.
banging his head on a wall and crying. He was
then admitted to hospital, where he5. Based on self reports by inmates and
threatened people with pencils. Hospitalprobationers and, for severity, on overnight
staff called the police and allowed them toadmissions to a mental hospital or treatment
enter patient areas with firearms. After theprogram.
man became agitated from complications
associated with epileptic seizures, he was6. Bureau of Justice Statistics Bulletin,
shot dead by a police officer. His family hadCensus of Jails, 1999 (August 2001, NCJ
brought his seizure medication to the186633).
hospital the day before, but they spoke only
Spanish and no one could communicate with7. Bureau of Justice Statistics Bulletin,
them. The medicine was set aside. (MentalPrisoners  in 2000 (August 2001, NCJ 188207).
Health  Weekly,  6/01)
8. Bureau of Justice Statistics Special
Once people are in thecriminal justiceReport, Substance Abuse and Treatment of
system, their mental health needs are notAdults on Probation, 1995 (March 1998, NCJ
met.166611).
- An Oregon man with a mental illness gouged9. Bureau of Justice Statistics Special
out his eyes as he waited in a Portland jailReport, Mental Health Treatment of Inmates
cell for a psychiatric hospital bed. (Theand  Probationers  (July  1999,  NCJ 174463).
Oregonian  6/12/02  )
Policy to Address Issues Regarding People
- Romus was arrested and brought to thewith Serious Mental Illnesses in the Criminal
Orange County jail in New York , shoutingJustice  System
gibberish. As a result of budget cuts, no
psychiatrist was on call, so Romus wasImpact
pepper-sprayed and shackled to a restraint
chair, where he sat shouting, twisting andThe increase in the number of individuals
kicking for hours. Eventually, an officerwith serious mental illnesses who come in
draggedcontact with law enforcement officers or are
booked into jail or sentenced to
Romus , in the chair, to the jail's mentalincarceration means that more and more
health unit and pushed him in. (Middletownindividuals 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 inwith  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 jailinvolvement  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 heresult of-and long after-arrest or detention.
tries to hurt himself, the jail locks him in
the medical observation cell. "When I getThe various parts of the criminal justice
locked up like that, all I do is cry, punchsystem  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'tjudicial  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 onlypersonnel (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 behaviorrequiring suicide watch or causing major
was strange. Concerned, the arrestingdisruptions  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 whatwho lack special training or are too few in
to do. While the various organizations arguednumber to work with people with serious
over who should take him, Paul hanged himselfmental  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 onTaking  a  Different  Approach
a misdemeanor charge. Although the charges
were dropped, he remained in the detentionWhat is needed is a new approach to policy
center for two years, lost somewhere betweenthat  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 andjustice 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 beenaccessible;
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 inillnesses out of the criminal justice system
a dangerous cycle, from jail to hospital tomore  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 hasincarcerated  do  not  return.
a single room the group provides for him,
food, money and constant support. It tookGoals  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 andindividual with a mental illness and his or
Prisonher family;a more efficient criminal justice
system;
Data
- greater cost-effectiveness across the
- Nearly two million new jail admissions arecriminal justice and mental health system, as
of people with mental illnesses-35,000mental 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 theMany communities have adopted programs that
criminal  justice  system.will divert people with serious mental
illness from the criminal justice system at
2various  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
3diversion);
- 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 mentalviolate individual rights less and to be less
illnesses were inmates in local jails atcostly to the criminal justice system if it
year-end 2000. Of these, 63,000 had a severeoccurs 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 thatprior history in the criminal justice system,
hold people pending arraignment or awaitingthis may not be feasible.



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