America's Mental Health Crisis Hidden Behind Bars

Eric Westervelt & Liz Baker
npr.org
Originally posted 25 Feb 20

Here is an excerpt:

It's a culmination of decades of policies affecting those with a mental illness. Many of the nation's asylums and hospitals were closed over the past 60-plus years — some horrific places that needed to be shuttered, others emptied to cut costs.

The idea was that they'd be replaced with community-based mental health care and supportive services. That didn't happen. Ensuing decades saw tougher sentencing under aggressive "war on drugs and crime" policies as well as cuts to subsidized housing and mental health. It all created a perfect storm of failed policies driving more of the mentally ill into the nation's jails and prisons.

Many were left to fend for themselves. Substance abuse and homelessness sometimes followed, as did encounters with police, who often are called first to help deal with the effects of or related to mental crises.

It has put the jails in an awkward position. Today the three biggest mental health centers in America are jails: LA County, Cook County, Ill. (Chicago) and New York City's Rikers Island jail. Without the support needed, conditions have created new asylums, advocates say, that can resemble the very places they vowed to shut down.

"Local jails and prisons have become the de facto mental health institutions," says Elizabeth Hancq, director of research at the Treatment Advocacy Center, a national nonprofit that works to eliminate barriers to treatment for people with severe mental illness. "It's really a humanitarian crisis that if you suffer from a severe mental illness in this country, you almost need to commit a crime in order to get into the system."

The info is here.

Identifying mentally ill 'frequent fliers' first step to reducing police contact

Press Release
Oregon State University
Originally published February 11, 2015

Identifying the population of people with mental illness who have frequent contact with police could help law enforcement officials and community agencies allocate limited resources to those with the highest needs, new research from Oregon State University indicates.

These individuals, often referred to as “frequent fliers” because of their repeated interaction with law enforcement, can consume a large amount of police time and resources, according to researchers in the School of Public Policy in OSU’s College of Liberal Arts.

Identifying and understanding the population can aid policymakers as they work to reduce the frequent and time-consuming interactions, sociologists Scott Akins and Brett Burkhardt said.

“This contact is rarely criminal in nature at the outset,” said Burkhardt, an assistant professor of sociology. “It’s usually a peace officer custody arrest, which is a type of arrest that occurs because a person is believed to be a danger to themselves or others due to a suspected mental illness. But there’s a limited amount of resources, so if we identify people with the highest needs, we can focus resources on those folks.”

Once a local region has identified its population of frequent fliers, community agencies and policy-makers can use the information to change or implement policies to assist those with the highest needs, the researchers said.

“It’s a strategic way to create a more cost-effective and humane way to assist the mentally ill,” said Akins, an associate professor of sociology.

The entire press release is here.

Decarceration of u.s. Jails and prisons: where will persons with serious mental illness go?

By H.R. Lamb and L.E. Weinberger
J Am Acad Psychiatry Law. 2014;42(4):489-94.

Abstract

Decarceration (decreasing the number of persons incarcerated in U.S. jails and prisons) has begun. It is estimated that more than 350,000 persons with serious mental illness (SMI) are among those incarcerated in the United States and that many thousands of them will probably be among those released. Currently, the prison population in general is being reduced as a consequence of concerns about overcrowding and of policies and programs such as reclassification of drug possession, which would affect many persons with mental illness. Court-ordered diversion and changes in sentencing guidelines are also serving to reduce prison populations. In recent years, the mental health system did not have to manage as large a number of persons with SMI, especially those who were among the most difficult and expensive to treat, because many of them were incarcerated in jails and prisons. Now, with decarceration and the release of many such persons, the mental health system may be expected to assume more responsibility for them and should be prepared and funded to meet their needs. This population of persons with SMI needs structure and treatment that, depending upon their individual needs, may include 24-hour supportive housing, ACT and FACT teams, assisted outpatient treatment, psychiatric medication, and psychiatric hospitalization.

The article is here.