Artwork by Monica Garwood for Anxy magazine

“We don’t throw people in jail for having cancer. We don’t put people in prison for having diabetes. And yet, too often, our response to people with mental illness or addiction is to lock them up.”

- Patrick Kennedy

Why This Matters

Facilities that were designed to house people convicted of crimes have become de facto “treatment” locations for a lot of people exhibiting the symptoms of a mental health condition. Every year, approximately 2 million people with a mental illness are admitted into jails in the United States. Cook County Jail in Chicago is regularly called “America’s largest mental hospital”. Youth are impacted to an even greater degree: 65-70% of children in the juvenile justice system have a diagnosable mental health condition. The majority of them are not violent criminals and have not even gone to trial, so they have not been convicted of a crime.

States with less access to mental health care have more adults in the criminal justice system. Low-income people and communities of color are disproportionately affected.

“That is a sad state of affairs in our society, that only when you get locked up does it become a priority to get you treatment.”

Jackie Lacey
Los Angeles District Attorney

Jails are not appropriate for people who are suffering from a mental health condition. People do not get better while locked up. In fact, the experience of incarceration itself can inflict trauma on individuals and further compound the symptoms of mental illness.

Once incarcerated, many do not receive the treatment they need. Even among those who were medicated for mental health conditions at admission into jail, 50% did not receive pharmacotherapy in prison. Those exhibiting the most severe mental health conditions are more often placed in isolation, which has been shown to cause psychological harm, especially for individuals who already have a serious mental illness.

Source: National Alliance for Mental Illness

When a person with mental illness is incarcerated, they tend to stay in jail longer and, upon release, recidivate back to jail at a much higher rate than those without a mental health condition. They also may lose their healthcare and benefits and struggle to find housing and employment as a result of their incarceration.

Not only is this human toll unacceptable, but it is also expensive. Jails usually spend two to three times more money on those inmates who receive mental health treatment than those who do not. And federal law prohibits the use of Medicaid dollars for those who are in correctional facilities, thus the costs fall entirely on the state and locality. These larger investments often do not yield improvements to public safety nor improvements to the health of the individuals.

If we prioritize mental health with earlier and more effective intervention, we will decrease the number of people with mental illness cycling through the criminal justice system. Instead, they will receive the treatment they need and their mental health will improve. We will be more efficiently spending funds in the criminal justice system, removing a stream of work they shoulder for which they are not well suited.

Our Approach

Diversion from the criminal justice system for non-violent offenders with mental health conditions is crucial to reduce the human and fiscal costs of incarceration. This means ensuring treatment alternatives to incarceration are available in the community, engaging law enforcement to become part of the solution, and ramping up de-escalation models for crisis situations. Battery Powered seeks opportunities to fund work that embeds additional resources in low-income areas and communities of color given the disproportionate impact of mass incarceration on these populations.

Diversion from incarceration is not only possible, it works! Diverting those suffering from a mental health condition who are accused of misdemeanor crimes into appropriate, community-based treatment programs yields better long-term results. Such programs reduce arrests, jail days, hospital stays and total criminal justice expenditures. If criminal behavior is addressed by the jails and mental illness is left to professionals in the community, we will be more appropriately using their talents and our resources; we will be using the right tool for the job.

Crisis Intervention Teams

One nationally recognized model is called the Crisis Intervention Team. This model includes training law enforcement to recognize the signs of mental illness and substance use and to de-escalate situations with these populations. Training also includes cultural competency to avoid the unequal treatment of racial and cultural groups. The model typically includes a mobile team that provides support to police and the individual and includes transportation to a community-based treatment program rather than to jail. Today, there are approximately 2,800 such programs around the country, but they represent only 15% of police jurisdictions.

It is important to note that the success of crisis intervention teams depends in part on the availability of quality community-based mental health programs, a topic discussed earlier in this issue brief.

Youth-Focused Diversion Programs

The most effective models for youth living with mental health conditions are community-based and deal with youth behaviors as a family. Youth Service Centers, which include different models of family therapy in the community and home, are one example. Crisis Receiving Homes are another example. They provide respite to caregivers and youth to prevent or ameliorate a mental health crisis and provide a safe environment for care and recovery outside of a hospital setting.

The School Youth Responder Model is one example of diverting youth from the justice system by handling school infractions through a behavioral health response instead of law enforcement. Youth with a school infraction are assessed by professionals and connected to behavioral health support. Appropriate school discipline is also determined based on a restorative justice framework. In this way, schools can reduce the use of suspension and expulsion, which are often the first step towards involvement with the juvenile justice system.

“Discipline is not a treatment for trauma.”

shawn Ginwright
Flourish Agenda

Adult Diversion Programs

Partnerships between community mental health programs and the criminal justice system are critical to ensure that individuals who struggle with mental health who become involved in the criminal justice system can be brought to appropriate care. Individuals are sometimes referred to these programs by the court or district attorney. The goals are to improve social and emotional functioning and independent living skills while increasing educational and employment opportunities. Peer services, therapy, psychiatry, skill-building, and case management are provided with the shared goals of stabilizing the individual in the community and bridging resources to support the individual in building a meaningful life. Having enough of these programs with qualified staff and peer partners available in the community is a critical piece in the system of care.

RESOURCES

Divert Incarceration

Why This Matters

Our Approach