Wednesday, June 29, 2016

Ideas for diverting people with mental illness from the criminal justice system

With the 85th Texas legislative session fast approaching, the House Select Committee on Mental Health continues to discuss the challenges of meeting growing demand for mental health services in the state.  But any effort to improve Texas's mental health infrastructure means we need to address the problems of people with mental health issues who are incarcerated.

Last year alone, over 55,000 people incarcerated in Texas received treatment in the public mental health system prior to their imprisonment.  Many others entered county jails without ever receiving a diagnosis, let alone treatment, for their persistent mental health issues.

But Texas's jails and prisons are no place for people with mental illness.  These institutions are designed to prioritize security, not treatment.  As a result, justice-involved Texans with mental illness may experience a decline in their mental health status while they are incarcerated -- a decline that can lead to dangerous outcomes, including increased recidivism, self-harm, and even suicide.

The over-incarceration of Texans with mental illness not only needlessly harms individuals' mental health, it also decreases public safety, drains county and state coffers, and strains the resources of jails and law enforcement agencies.  Fortunately, there is a better way forward.

This week, the LBJ School of Public Affairs at the University of Texas released Prioritizing Treatment Over Punishment, a white paper on Texas's current efforts to divert people with mental illness away from the justice system.  This is the second in a series of policy briefs arising from the University of Houston's January symposium on "Police, Jails, and Vulnerable People," and intended to provide guidance to legislators and others looking for recommendations to improve the pretrial process.  (The first brief, released earlier this week, was focused on bail reform and pretrial release.)

This white paper explains the troubling link between our mental health and criminal justice systems.  It also discusses the sequential intercept model that is a best practice framework for thinking about the five different stages at which a person with mental illness can be diverted from the criminal justice system and be directed instead toward more clinically-appropriate services in their communities.  There are some widely praised examples in Texas of counties where these diversion strategies are being employed with great success, and the paper highlights those examples.

Prioritizing Treatment Over Punishment was written by LBJ graduate students Rachel Gandy and Erin Smith, under the supervision of Prof. Michele Deitch (yours truly) and Dr. Lynda Frost from the Hogg Foundation for Mental Health.   The paper is a great place for legislators and local officials to look for tried and tested ways to make better use of diversion strategies to keep people with mental illness out of the criminal justice system.


Anonymous said...

"Justice involved Texans?"……. Can we be just a little more politically correct these days? Good grief...

Bill Habern said...

Our law firm daily deals with Texas prison inmates. The issues of mental illness in our prison system is overwhelming. We now warehouse the mental ill with only limited designated space and programs to deal with their needs. To say that well considered action by the legislature followed with by prompt and meaningful new prison policy and direction is needed is an understatement.

For example, the great number of inmates suffering with bi-polar disorder is substantial. Bi-polar disorder in a prison setting is commonly joined with drug addiction as a result of the afflicted person attempting to self medicate. This is commonly known in the medical community as a "dual diagnosis". I know of prison rehab programs for drug addiction, but none where dual diagnosed bi-polar inmates are given primary treatment for their bi-polar issues (which is the real underlying cause of their drug addiction). Treating the symptoms and not the cause just does not work.

We recently had a case where an enlightened parole board member realized that it was a waste of time to send a dual diagnosed bi polar offender to a prison drug rehab program unless that program seriously addressed the bi-polar issue. The board member nor this lawyer could identify such a program within the prison system. Such holes in the prison mental health system are too common.

Bill Habern
Habern, O'Neil and Associates
Not a partnership
Houston, Texas

Anonymous said...

I hear it is hard to escape the revolving door of mental illness when your head gets banged against the wall in such a way as to conceal the injury from UTMB personnel.

thelawproject said...

Have a SPECIAL court venue, like the Veteran's Courts (in New Jersey) and get them out of the traditional Law Enforcement/local court street to jail fast track. EARLY INTERVENTION !

The Law Project

Anonymous said...

I am well aware of this mess. My grandson is in TDCJ has been there for 10 years and he is autistic, bi-polar, has clonic and tonic seizures. Guess how he has been treated. He has even had his front tooth knocked out because he ask a repeated question. They get a kick out of abusing the mentally ill. That way they can give them a case and themn there is no contact visit.

Anonymous said...

Texas has been ranked 48th in the quality of treatment for persons with mental illness. Improvements should be made in the prison system but more funding and improvements need to be made in the public sector to increase the venues for mental health treatment for persons with serious mental illness. Mental Health courts linked with local Behavioral Health Centers or local mental authorities would be a good start.