Blind Advocacy of Offender Rehabilitation Programs Hurts All

Highlights Offender recidivism after prison is horrendous. Programs have little to no effect. We need a research initiative similar to cancer. It should be a national priority. What we don’t need is blind advocacy. If you are going to criticize the President, at least be honest with your data. Author Leonard Adam Sipes, Jr. Retired […]

The post Blind Advocacy of Offender Rehabilitation Programs Hurts All appeared first on Crime in America.Net.

Highlights Offender recidivism after prison is horrendous. Programs have little to no effect. We need a research initiative similar to cancer. It should be a national priority. What we don’t need is blind advocacy. If you are going to criticize the President, at least be honest with your data. Author Leonard Adam Sipes, Jr. Retired […]

The post Blind Advocacy of Offender Rehabilitation Programs Hurts All appeared first on Crime in America.Net.

from https://www.crimeinamerica.net

Violence, School Achievement and Future Criminality

Observations Schoolchildren exposed to violence have a tougher time learning. Violence also affects the success of people caught up in the criminal justice system. If students exposed to violence affect school test scores, then the state of education will be stalled unless we impact multiple forms of violence and abuse. If you were wondering why […]

The post Violence, School Achievement and Future Criminality appeared first on Crime in America.Net.

Observations Schoolchildren exposed to violence have a tougher time learning. Violence also affects the success of people caught up in the criminal justice system. If students exposed to violence affect school test scores, then the state of education will be stalled unless we impact multiple forms of violence and abuse. If you were wondering why […]

The post Violence, School Achievement and Future Criminality appeared first on Crime in America.Net.

from https://www.crimeinamerica.net

Thinking Outside the Cell: Software Cuts Recidivism Among Texas’ Mentally Ill

In Dallas County, the main outlet of psychiatric care for those with mental illness is no longer the corrections system. A five-year initiative using predictive technology is helping to divert justice-involved mentally ill individuals into effective treatment programs.

In Dallas County, Texas, the main outlet of psychiatric care for those with mental illness is no longer the corrections system.

A five-year initiative aimed at bridging the gap between the legal and medical communities is successfully diverting justice-involved mentally ill individuals to effective treatment programs.

The key to the program is technology. The initiative uses software created by HarrisLogic, a Missouri-based technology and clinical services company that allows information about mentally ill individuals who fall afoul of the law to be shared among law enforcement, courts and health care providers.

Experts say such a tech-based approach could be critical to reducing overcrowding in U.S. jails.

There are now nearly ten times the number of mentally ill patients behind bars than those residing in the remaining state hospitals, according to a 2014 report by the Treatment Advocacy Center, an Arlington, Va.-based national nonprofit focused on mental illness issues.

A prime example is the Dallas County Jail, whose jurisdiction stretches from the cities of Carrollton to Mesquite, to just outside of Arlington. Dallas County’s major detention center, the Lew Sterrett Justice Center, is the second largest mental health facility in Texas, according to the County Sheriff’s Office.

In 2014, the county received a $7 million grant from the W.W. Caruth, Jr. Foundation for a “Smart Justice Initiative” to provide alternatives to jail for individuals with mental health problems who come into contact with the justice system. The county partnered with the Meadows Mental Health Policy Institute (MMHPI), a research and development organization that helps Texans connect to mental health care.

Now in its fourth year, the jail diversion program has reduced recidivism from 31 percent in 2014 to 26 percent in 2017, according to the National Association of Counties.

It’s “an impressive example of how local jurisdictions can implement data-driven innovations that enhance public safety, reduce jail costs to taxpayers, and provide effective and humane interventions for people with mental illness,” said Marc Levin, vice president of criminal justice at the Texas Public Policy Foundation.

Alternatives to Punishment

Relieving jails of the burden of providing mental health services is only a first step towards the goal of developing alternative and non-punitive options for treatment. It doesn’t address the decisions that bring mentally ill individuals into the justice system in the first place, mental health advocates say.

The Dallas County initiative uses technology to assist in the decision-making by police, courts and health providers.

Following a 911 call, if it is determined that jail is an initially appropriate response to a troubled individual, data from the standard mental health and suicide screening tests (as per Texas standards) is automatically integrated with any other data related to the individual’s medical history contained in police or emergency response records as well as hospital data.

Traditionally, such data was kept in separate silos, but the software implemented through the Jail Diversion Platform, created by Harris Logic, integrates all the personal information critical to determining a defendant’s immediate needs and subsequent care.

That includes information such as previous arrests or incarcerations, previous mental health rehabilitation, and current medication, Hudson Harris, chief engagement officer of HarrisLogic, said in an interview with The Crime Report.

This data is entered in the County Adult Information System, a “master index,” which is used to share information in a manner that allows for access by court and jail authorities, clinicians, legal professionals, and pretrial staff.

Privacy Protection

No mental health assessment is conducted without the prior permission of a defendant’s attorney—likely a public defender. Further privacy protections require that each agency using the data can only view what is authorized to them through a data usage agreement.

By involving multiple agencies, the combined knowledge and expertise allows future treatment to be tailored to an individual’s needs─better than simply checking a box during a mandatory evaluation, authorities say.

This step is arguably the most crucial. Without accurate and swift identification, issues stemming from an individual’s illness can make it more difficult for persons to follow jail rules, increasing the likelihood they will face harsh disciplinary measures, or be subjected to violence from other inmates or from guards.

The second intercept in the initiative is through pretrial release, providing an escape from being trapped in the justice system.

“Mental health patients often spend more time in jail waiting for their case to be resolved than that of a mentally healthy convict,” observed Alisa Roth, author of Insane: America’s Criminal Treatment of Mental Illness, in a recent article.

This may be due to the requirement in many states that inmates with serious mental illness undergo additional evaluations or be restored to competency before standing trial.

According to a survey of 40 state hospital officials by the Treatment Advocacy Center, 78 percent of the respondents were wait-listing pretrial inmates for hospital services. Often, mentally ill inmates spend more time behind bars waiting for their case to be heard than they would serve if they were convicted of the offense.

To remedy this delay, the comprehensive technology utilized in the Smart Justice program increases the likelihood of a pretrial release by allowing officials to determine if the person is a flight risk, or a danger to the public.

Using this complete data, a judge is more likely to issue a pretrial release, but with conditions for connection to treatment.

An evaluation of the Smart Justice Initiative from April 2017 to January 2018 showed that of the individuals presented before the magistrate for a release decision, 89 percent were successful in being granted a pretrial release bond. Of those granted bond, 100 percent were “released, connected to treatment, and supervised on bond with monitored treatment for the Court,” reports Dallas County.

Need for Coordinated Care

So why are mentally ill offenders more prone to getting re-arrested and re-booked than the general population, even with increased treatment availability?

The main reason, explains Hudson Harris, is the lack of coordinated care. This refers to the absence of follow-up treatment or supervision of mentally ill persons after they have been released from jail, typically back to the same environment that caused them to get arrested in the first place.

It’s here that the third intercept comes into play.

The software directly assigns an individual to a treatment program based on the data provided. Normally it takes weeks to find a person eligible for mental health care programs, but with this technology it takes an estimated 15 minutes or less.

Inadequate coordination is not only a problem within the jail system, but also in an individual’s contact with hospitals.

When dealing with an individual with a mental health illness, a hospital’s main goal is only to focus on the individuals’ current state of health─stabilize them, get them locked down, and then out the door as quickly as possible—with little to no coordination of care, says Harris.

There is no link between simply going to the hospital and getting better when you have a psychiatric condition.

In fact, a 2018 study from the American Psychological Association found that hospitalization has an iatrogenic effect on mental health, meaning the treatment causes a worsening of the condition.

 Follow-up Care Crucial

Connecting mentally ill persons with the care and follow-up that they require will ensure they are less likely to become involved in the justice system, said Levin.

“The initiative has resulted in rapid screening and diversion to appropriate treatment programs for thousands of individuals arrested for conducted related to a serious mental illness,” he said.

Providing access to treatment and follow-up care can also help authorities save money on their corrections budgets.

When mentally ill inmates do not receive consistent treatment, they frequently cycle in and out of the jails, forcing the facility (and taxpayers) to spend additional money on health professional staff, medication needed for certain mental illnesses, and simply housing them behind bars for longer periods of time.

A 2003 study reports that in Texas prisons, “the average prisoner costs the state about $22,000 a year compared to the cost of prisoners with mental illness, which ranges from $30,000 to $50,000 a year.”

Also at a state level, Texas spends $1.4 billion in emergency room costs and $650 million in local justice system costs annually to address mental illness and substance use disorders that are not otherwise being adequately treated, according to MMHPI.

The operation of increased treatment may seem like a burden to the jail’s budget, but simply by providing individuals with the appropriate care that they need, the cost of doing so declines; breaking the high-utilizer cycle and reducing contact of the mentally ill with the corrections system.

According to HarrisLogic, the Smart Justice Initiative will be able to trim over $30 million in these expenses over the five-year implementation period.

While the initiative has resulted in significant savings to Dallas County on jail costs and indigent defense costs, and helped reduce overcrowding in the courts system, Levin notes the challenge is to replicate it in other jurisdictions.

Laura Binczewski

Laura Binczewski

While Dallas received a large grant, other jurisdictions would have to provide upfront funding or use a pay-for-performance model in order to get similar initiatives off the ground, which may prove difficult for less-fortunate counties, he said.

However, the prospects for similar programs elsewhere have brightened thanks to the increased interest of private funders, and a call to action by the Stepping Up Initiative, a national effort to divert people with mental illness from jails by asking state and local officials to pass mental health legislation.

Noting that 451 counties across the nation have already passed motions calling for reforms to the justice system’s treatment of mentally ill, the initiative organizers said a nationwide consensus for change was crucial.

“Without change, large numbers of people with mental illnesses will continue to cycle through the criminal justice system,” the organization declared on its website, “often resulting in tragic outcomes for these individuals and their families, missed opportunities for connections to treatment, inefficient use of funding, and a failure to improve public safety.”

Laura Binczewski is a TCR news intern. She welcomes comments from readers.

from https://thecrimereport.org

Thinking Outside the Cell: Software Cuts Recidivism Among Texas’ Mentally Ill

In Dallas County, the main outlet of psychiatric care for those with mental illness is no longer the corrections system. A five-year initiative using predictive technology is helping to divert justice-involved mentally ill individuals into effective treatment programs.

In Dallas County, Texas, the main outlet of psychiatric care for those with mental illness is no longer the corrections system.

A five-year initiative aimed at bridging the gap between the legal and medical communities is successfully diverting justice-involved mentally ill individuals to effective treatment programs.

The key to the program is technology. The initiative uses software created by HarrisLogic, a Missouri-based technology and clinical services company that allows information about mentally ill individuals who fall afoul of the law to be shared among law enforcement, courts and health care providers.

Experts say such a tech-based approach could be critical to reducing overcrowding in U.S. jails.

There are now nearly ten times the number of mentally ill patients behind bars than those residing in the remaining state hospitals, according to a 2014 report by the Treatment Advocacy Center, an Arlington, Va.-based national nonprofit focused on mental illness issues.

A prime example is the Dallas County Jail, whose jurisdiction stretches from the cities of Carrollton to Mesquite, to just outside of Arlington. Dallas County’s major detention center, the Lew Sterrett Justice Center, is the second largest mental health facility in Texas, according to the County Sheriff’s Office.

In 2014, the county received a $7 million grant from the W.W. Caruth, Jr. Foundation for a “Smart Justice Initiative” to provide alternatives to jail for individuals with mental health problems who come into contact with the justice system. The county partnered with the Meadows Mental Health Policy Institute (MMHPI), a research and development organization that helps Texans connect to mental health care.

Now in its fourth year, the jail diversion program has reduced recidivism from 31 percent in 2014 to 26 percent in 2017, according to the National Association of Counties.

It’s “an impressive example of how local jurisdictions can implement data-driven innovations that enhance public safety, reduce jail costs to taxpayers, and provide effective and humane interventions for people with mental illness,” said Marc Levin, vice president of criminal justice at the Texas Public Policy Foundation.

Alternatives to Punishment

Relieving jails of the burden of providing mental health services is only a first step towards the goal of developing alternative and non-punitive options for treatment. It doesn’t address the decisions that bring mentally ill individuals into the justice system in the first place, mental health advocates say.

The Dallas County initiative uses technology to assist in the decision-making by police, courts and health providers.

Following a 911 call, if it is determined that jail is an initially appropriate response to a troubled individual, data from the standard mental health and suicide screening tests (as per Texas standards) is automatically integrated with any other data related to the individual’s medical history contained in police or emergency response records as well as hospital data.

Traditionally, such data was kept in separate silos, but the software implemented through the Jail Diversion Platform, created by Harris Logic, integrates all the personal information critical to determining a defendant’s immediate needs and subsequent care.

That includes information such as previous arrests or incarcerations, previous mental health rehabilitation, and current medication, Hudson Harris, chief engagement officer of HarrisLogic, said in an interview with The Crime Report.

This data is entered in the County Adult Information System, a “master index,” which is used to share information in a manner that allows for access by court and jail authorities, clinicians, legal professionals, and pretrial staff.

Privacy Protection

No mental health assessment is conducted without the prior permission of a defendant’s attorney—likely a public defender. Further privacy protections require that each agency using the data can only view what is authorized to them through a data usage agreement.

By involving multiple agencies, the combined knowledge and expertise allows future treatment to be tailored to an individual’s needs─better than simply checking a box during a mandatory evaluation, authorities say.

This step is arguably the most crucial. Without accurate and swift identification, issues stemming from an individual’s illness can make it more difficult for persons to follow jail rules, increasing the likelihood they will face harsh disciplinary measures, or be subjected to violence from other inmates or from guards.

The second intercept in the initiative is through pretrial release, providing an escape from being trapped in the justice system.

“Mental health patients often spend more time in jail waiting for their case to be resolved than that of a mentally healthy convict,” observed Alisa Roth, author of Insane: America’s Criminal Treatment of Mental Illness, in a recent article.

This may be due to the requirement in many states that inmates with serious mental illness undergo additional evaluations or be restored to competency before standing trial.

According to a survey of 40 state hospital officials by the Treatment Advocacy Center, 78 percent of the respondents were wait-listing pretrial inmates for hospital services. Often, mentally ill inmates spend more time behind bars waiting for their case to be heard than they would serve if they were convicted of the offense.

To remedy this delay, the comprehensive technology utilized in the Smart Justice program increases the likelihood of a pretrial release by allowing officials to determine if the person is a flight risk, or a danger to the public.

Using this complete data, a judge is more likely to issue a pretrial release, but with conditions for connection to treatment.

An evaluation of the Smart Justice Initiative from April 2017 to January 2018 showed that of the individuals presented before the magistrate for a release decision, 89 percent were successful in being granted a pretrial release bond. Of those granted bond, 100 percent were “released, connected to treatment, and supervised on bond with monitored treatment for the Court,” reports Dallas County.

Need for Coordinated Care

So why are mentally ill offenders more prone to getting re-arrested and re-booked than the general population, even with increased treatment availability?

The main reason, explains Hudson Harris, is the lack of coordinated care. This refers to the absence of follow-up treatment or supervision of mentally ill persons after they have been released from jail, typically back to the same environment that caused them to get arrested in the first place.

It’s here that the third intercept comes into play.

The software directly assigns an individual to a treatment program based on the data provided. Normally it takes weeks to find a person eligible for mental health care programs, but with this technology it takes an estimated 15 minutes or less.

Inadequate coordination is not only a problem within the jail system, but also in an individual’s contact with hospitals.

When dealing with an individual with a mental health illness, a hospital’s main goal is only to focus on the individuals’ current state of health─stabilize them, get them locked down, and then out the door as quickly as possible—with little to no coordination of care, says Harris.

There is no link between simply going to the hospital and getting better when you have a psychiatric condition.

In fact, a 2018 study from the American Psychological Association found that hospitalization has an iatrogenic effect on mental health, meaning the treatment causes a worsening of the condition.

 Follow-up Care Crucial

Connecting mentally ill persons with the care and follow-up that they require will ensure they are less likely to become involved in the justice system, said Levin.

“The initiative has resulted in rapid screening and diversion to appropriate treatment programs for thousands of individuals arrested for conducted related to a serious mental illness,” he said.

Providing access to treatment and follow-up care can also help authorities save money on their corrections budgets.

When mentally ill inmates do not receive consistent treatment, they frequently cycle in and out of the jails, forcing the facility (and taxpayers) to spend additional money on health professional staff, medication needed for certain mental illnesses, and simply housing them behind bars for longer periods of time.

A 2003 study reports that in Texas prisons, “the average prisoner costs the state about $22,000 a year compared to the cost of prisoners with mental illness, which ranges from $30,000 to $50,000 a year.”

Also at a state level, Texas spends $1.4 billion in emergency room costs and $650 million in local justice system costs annually to address mental illness and substance use disorders that are not otherwise being adequately treated, according to MMHPI.

The operation of increased treatment may seem like a burden to the jail’s budget, but simply by providing individuals with the appropriate care that they need, the cost of doing so declines; breaking the high-utilizer cycle and reducing contact of the mentally ill with the corrections system.

According to HarrisLogic, the Smart Justice Initiative will be able to trim over $30 million in these expenses over the five-year implementation period.

While the initiative has resulted in significant savings to Dallas County on jail costs and indigent defense costs, and helped reduce overcrowding in the courts system, Levin notes the challenge is to replicate it in other jurisdictions.

Laura Binczewski

Laura Binczewski

While Dallas received a large grant, other jurisdictions would have to provide upfront funding or use a pay-for-performance model in order to get similar initiatives off the ground, which may prove difficult for less-fortunate counties, he said.

However, the prospects for similar programs elsewhere have brightened thanks to the increased interest of private funders, and a call to action by the Stepping Up Initiative, a national effort to divert people with mental illness from jails by asking state and local officials to pass mental health legislation.

Noting that 451 counties across the nation have already passed motions calling for reforms to the justice system’s treatment of mentally ill, the initiative organizers said a nationwide consensus for change was crucial.

“Without change, large numbers of people with mental illnesses will continue to cycle through the criminal justice system,” the organization declared on its website, “often resulting in tragic outcomes for these individuals and their families, missed opportunities for connections to treatment, inefficient use of funding, and a failure to improve public safety.”

Laura Binczewski is a TCR news intern. She welcomes comments from readers.

from https://thecrimereport.org

Most Offender Rehabilitation Programs Don’t Work-A Path Forward? New Federal Report

Observations Most offender rehabilitation and treatment programs don’t work. But a new federal report suggests that mental health efforts could reduce recidivism by approximately 21 percent. “Many want programs for offenders as a compassionate response to perceived inequities among the offender population. These programs routinely produce marginal results. Failure is not compassion. Failure is the […]

The post Most Offender Rehabilitation Programs Don’t Work-A Path Forward? New Federal Report appeared first on Crime in America.Net.

Observations Most offender rehabilitation and treatment programs don’t work. But a new federal report suggests that mental health efforts could reduce recidivism by approximately 21 percent. “Many want programs for offenders as a compassionate response to perceived inequities among the offender population. These programs routinely produce marginal results. Failure is not compassion. Failure is the […]

The post Most Offender Rehabilitation Programs Don’t Work-A Path Forward? New Federal Report appeared first on Crime in America.Net.

from https://www.crimeinamerica.net

Brain Injuries, Mental Health, PTSD and Substance Abuse Explain Criminal Behavior

Observations You can explain dysfunctional criminal behavior by looking at the data on traumatic brain injuries, mental health, PTSD and substance abuse. Author Leonard Adam Sipes, Jr. Retired. Thirty-five years of public relations for national and state criminal justice agencies. Interviewed multiple times by every national news outlet. Former Senior Specialist for Crime Prevention for […]

The post Brain Injuries, Mental Health, PTSD and Substance Abuse Explain Criminal Behavior appeared first on Crime in America.Net.

Observations You can explain dysfunctional criminal behavior by looking at the data on traumatic brain injuries, mental health, PTSD and substance abuse. Author Leonard Adam Sipes, Jr. Retired. Thirty-five years of public relations for national and state criminal justice agencies. Interviewed multiple times by every national news outlet. Former Senior Specialist for Crime Prevention for […]

The post Brain Injuries, Mental Health, PTSD and Substance Abuse Explain Criminal Behavior appeared first on Crime in America.Net.

from https://www.crimeinamerica.net

Judges Called ‘Last Line of Defense’ for Mentally Ill in Justice System

The lack of adequate alternatives to jail or prison to help mentally troubled individuals who run afoul of the law is a “horrible American tragedy,” judges and prosecutors from around the country were told at a New York University School of Law conference.

When police and prosecutors are unable to act, judges must be the “last line of defense” for mentally troubled individuals who run afoul of the law.

That was one of the conclusions at a conference of leading prosecutors and jurists at New York University’s School of Law examining the plight of the seriously mentally ill who are trapped in the justice system.

The use of jails and prisons as frontline treatment facilities for individuals with serious mental illness—for lack of adequate alternatives—is a “horrible American tragedy,”  Judge Steven Leifman of the Eleventh Judicial Circuit Court of Florida said.

Christina Klineman, a Superior Court Judge in Indianapolis, added that if local authorities fail to provide diversion programs that police or prosecutors can use, judges should still try to find ways of ensuring the mentally ill are kept out of jail.

They are “the last line of defense” for protecting the mentally ill, she said.

The two judges spoke during a panel Friday at NYU’s Tenth Annual Conference on the administration of criminal law. They joined other speakers, including advocates, in calling for greater attention to diversion programs for the mentally ill.

“The criminal justice system should be the last resort for the mentally ill, not the first,”  Leifman said, arguing that the lack of alternatives too often places the burden of care on prosecutors, judges and police officers, who lack the proper resources, training and funding to help mentally ill patients. 

Participants in the conference cited studies showing that 40 percent of individuals with a mental illness will come in contact with the criminal justice system at some point in their lives—usually because family members call 911, not knowing what else to do. 

Police receive 250 million calls each year, but only 25 percent of those calls are connected with an actual crime, said Rebecca Neuster of the Vera Institute of Justice. Ten percent of those calls are made because someone with a mental illness is experiencing a manic episode.

See also: Why Jail is No Place for the Mentally Troubled.

But when the police become involved, the individual is handed over to the justice system.

According to Ronal Serpas, a professor of Criminology at Loyola University of New Orleans, if police officers had an alternative to arrest, they would take it.

But all they have to offer mentally ill patients “is the back of their car,” Serpas said.

That, he added, was a solution for no one.

The police role as first responders puts them in a difficult position, but at the same time makes it critical for officers to know where to take people suffering from mental illness other than jail, said Travis Parker, senior project associate at Policy Research Associates.

“Officers need an answer to the question: ‘divert the mentally ill to what?'”

He noted that in some cities, police have been given iPads to contact mental health professionals, instead of taking troubled individuals to jail.

See also: How iPads Changed a Police Force’s Response to Mental Illness.

Once an individual with mental illness is arraigned, however, prosecutors can step in to ensure mentally ill defendants are diverted to counseling and social services, the panel was told.

“Public safety is not defined by convictions and arrests — people need to feel safe and secure, they need housing and a job—and the criminal justice system removes that for so many people,” said Vermont Attorney General T.J Donovan,  who argued prosecutors should use “restraint” in deciding whether to seek convictions.

Klineman brought up the case of a homeless man urinating in the street and raised the question, “what do I sentence him to?”

“If I put him on probation, I set him up for failure and we have more problems. If I release him, he doesn’t get any help,” Klineman said.

In Florida’s Miami-Dade County, home to the largest percentage of people with serious mental illnesses, decarcerating jails and providing an alternative for the mentally ill is a top priority for court officials.

Authorities there created the Criminal Mental Health Project to provide community-based treatment and support services to defendants suffering from serious mental illness and substance abuse disorders.

The program provides two types of services: pre-booking diversion training for law enforcement officers, and post-booking diversion to help individuals in jail and awaiting adjudication. 

Justin Volpe, a young man who suffered from paranoia and substance abuse, said he was able to avoid prison though the program. His sentence was tossed out, and instead he was offered a job by the courts.

“That’s what people need,” Volpe told the conference. “I went from having no insight of my mental illness to working with other people in same situation. I assist people in community and get them help. I also have opportunity to train law enforcement and share my recovery story.”

In fact, Volpe was able to train the police officer who first arrested him. The officer told Volpe, “I’m surprised you’re still alive.”

Volpe takes participants in the program to out to lunch, or coffee, or even to play basketball.

“People don’t need another person telling them about their court dates and doctors appointments- giving them a list of things to do,” he said. “I give them a person-to-person feel,” he said.

Laura Usher, senior manager at the National Alliance on Mental Illness, commented that Volpe’s point was critical.

“The only way to treat someone with a mental illness… is like a person,” she said. 

Megan Hadley is a reporter for The Crime Report. Readers’ comments are welcome.

from https://thecrimereport.org

Cops, Violence, Stress and PTSD

Police Motorcycles Observations If society wants us to have compassion and understanding for people in high crime communities affected by violence, or those vicariously experiencing school shootings, why doesn’t the same apply to police officers? If the close proximity to violence affects students or residents, how could it not impact cops? The data below says it […]

The post Cops, Violence, Stress and PTSD appeared first on Crime in America.Net.

Police Motorcycles Observations If society wants us to have compassion and understanding for people in high crime communities affected by violence, or those vicariously experiencing school shootings, why doesn’t the same apply to police officers? If the close proximity to violence affects students or residents, how could it not impact cops? The data below says it […]

The post Cops, Violence, Stress and PTSD appeared first on Crime in America.Net.

from https://www.crimeinamerica.net

Why Jail is No Place for the Mentally Troubled

For lack of alternatives, thousands of mentally ill individuals are trapped in the justice system. In a conversation with TCR, Alisa Roth, author of “Insane: America’s Criminal Treatment of Mental Illness,” says change will only happen when we reexamine our attitudes towards mental illness.

In her career as a journalist, Alisa Roth has written about people in what she calls “forgotten communities,” such as immigrants and the poor. But when she began focusing on the mentally ill trapped in the U.S. justice system, after a friend’s brother was locked up, Roth discovered what she came to realize was the most forgotten community of all.

“I can’t think of a group that’s more reviled and more misunderstood,” she told TCR. In a discussion with staff writer Isidoro Rodriguez about her new book, “Insane: America’s Criminal Treatment of Mental Illness,” Roth, a former Soros Justice Fellow, describes how jails and prisons have become the nation’s principal institutions for treating mentally troubled individuals, and suggests that strategies for developing more humane, treatment-oriented alternatives have to begin at the state and local levels.

The Crime Report: What was the catalyst for writing this book?

insane

Courtesy Basic Books

Alisa Roth: I can’t think of a group that’s more reviled and more misunderstood than people with mental illness who are in the criminal justice system. We talk about the issue of race in the criminal justice system, we talk about the issue of poverty in the criminal justice system, but we don’t talk about mental illness. These three intersect and overlap, but we can’t think about global reform without addressing the mental health question.

As I mention in the book, I have a friend whose brother developed a severe mental illness and committed a horrible crime. As I was thinking about this whole system, it kept coming back to him. If we as a society can allow him to see an alternative outcome, and not spend the rest of his life in prison, we can allow that for other people who have done less morally or criminally complicated things.

TCR: Through the process of this book, what hurdles did you have to overcome?

AR: I chose two of the most closed systems to look into. The criminal justice system is extremely closed in terms of access, in terms of data, and in terms of information. Likewise, the mental health care system is bureaucratic and complicated. So just figuring out where treatment is being provided, and who should be providing that treatment is difficult.

Then there’s the whole health care aspect. People are not allowed to, or are unwilling to, share information about treatment. And there’s the stigma question in both systems. There is still shame attached to having a mental illness or having a family member with mental illness. We march for breast cancer or AIDS, but we don’t want to talk about mental illness and we don’t want to admit it. So, getting people to open up and say “yes, I do have this issue” or “yes, my child does have this issue and these are the struggles we are going through,” is very difficult. I am very grateful to all the people who were willing to share their stories with me.

TCR: How did dealing with this affect you, and how do you move forward after seeing what you have seen?

AR: I feel a great responsibility and duty to share these stories and spread them. I have the means to tell the world about these horrible situations, whether it’s the really awful abuses or just the day-to-day low-level abuses of being locked up with a mental illness. So, I feel privileged to share that.

Keeping that in mind was a way to mitigate the awfulness of it, but it’s traumatic reporting. I had a lot of nightmares about jail and prisons. I have a lot of friends who work in this universe, so it was great to be able to compare notes and talk about what we have seen. It is traumatizing and exhausting, but I kept thinking that I got to walk out of there at the end of the day, and I needed to take advantage of that to tell the world about how bad the problem is.

TCR: One of the subjects in your book is the practice of solitary, and you note that it is still in effect despite being considered a form of torture by the United Nations. Why do you think it is still being practiced in the U.S.?

AR: There are a lot of pieces that go into this answer. Unfortunately, we have abandoned the notion of reform and rehabilitation in our criminal justice system. We’ve moved back to the punitive notion. In some measure we think that people who are locked up in jail or prison deserve what they get. There is a dehumanizing aspect to the whole criminal justice system, and solitary confinement is part of that. If we don’t think of somebody as a full human being, then it becomes easier to do something really awful to them. If you think of this person as your brother, or our uncle, or your husband, it’s much harder to lock them in a box 23/7.

There’s also the fact that so many of us don’t know what goes on in the criminal justice system. The system as a whole is so abstract for such a large portion of our population, that we just don’t think or know about it. People have no idea that there are tens of thousands of people locked in solitary confinement on any given day. In a lot of places and for a very long time it’s just been how it’s done. It’s a very easy solution to put someone who is being unruly or difficult out of sight and out of mind. I think it speaks to a larger issue: We take people with mental illness, we lock them away, someplace we don’t need to see them. If we put them in jail or prison we don’t need to see them or step over them on our way to Starbucks in the morning. Solitary confinement is a reflection of that. But it makes everything so much worse.

Alisa Roth

Alisa Roth. Photo by Matthew Spence

TCR: Your book also criticizes the dangerous mistakes made by judges, and attorneys, who have no experience with the mentally ill. One example is your story of Jamie Wallace, a young boy suffering from mental illness and multiple physical disabilities, who eventually killed himself in prison due, in part, to a judge’s inability to understand his circumstances. How do we increase awareness and understanding of mental illness so that we may better avoid tragedies such as this?

AR: As awareness of the problem of large numbers of the mentally ill in the criminal justice system grows, judges and attorneys are more attuned to it. It’s not that people don’t know it’s there, but it’s as much as about changing attitudes as anything else. I talk to a lot of judges and I’ve said “Hey, in a lot of cases you’re being asked to make what’s effectively a medical decision and you’re not a doctor; you’re a judge. ‘

The best answer I heard, and it makes sense to me to a degree, is the judge who that’s what he does all the time. He takes the best information he can get and makes a decision based on that. So, he’s not making a medical judgement, per se; he’s taking the information that the psychiatrist, the therapist, and the attorneys give him and using that to make a decision. Jamie Wallace’s case was particularly egregious. He was so young, so sick, and had a developmental disability on top of it. I found it heartbreaking to think that the judge couldn’t see a way to understand. And the judge was playing very much by the rules.

Jamie Wallace was failed by the system at every level, over and over again. A forensic psychiatrist who read about him said he should never have been declared competent or even been standing in that courtroom. The judge made an awful decision, but he also made a mistake in letting him even be in that courtroom that day. You have to wonder how it would have been different if he had been wealthier, or his parents had been more educated, or if he had been in a different state.

TCR: Jamie Wallace’s story is an example of the mistakes that can be made as a result of the disorganized bureaucracy of the criminal justice system. At a time when so many are pushing for better training within that system to fix the problem, and others are fighting to keep the mentally ill out of that system entirely, which do you feel is the better option?

AR: In an ideal world, we would be able to keep everybody with a serious mental illness out of the criminal justice system. In an ideal world, we’d be able to keep a lot of people without a mental illness out of the criminal justice system. We lock up a lot of people very easily. I think that diversion is absolutely critical, but in order to make wide scale diversion possible, we can’t just look at this little tiny piece of the problem. We have to remember that we are operating in a very large ecosystem, not just of criminal justice but also of mental healthcare. We need to see wide-scale reform of both these systems so that people aren’t getting to the point where they’re so sick.

You see people in jail and prison who are sicker than a lot of people you see in psychiatric hospitals. We need to be catching the diseases earlier and treating them earlier. It’s great to train the cops to not arrest people, but if you don’t have some place for the cops to take them that’s not jail, they’re still going to wind up in jail. That’s what happened in San Antonio when they created their crisis center system. [They realized] you can train cops as much as you want, but they’re still going to take people to jail if there’s no other option. The other part of it is, as long as we are going to have people that end up in the criminal justice system, we have to make sure that when they’re there, they’re getting the treatment that they need and not just being warehoused in prisons.

TCR:A popular talking point now is de-institutionalization, starting when the majority of state-run mental health hospitals were closed during the 1960s. However, your book insists that there were other, more important, causes for the problem. Can you expand on that?

AR: De-institutionalization is a fabulous talking point. It has this very neat narrative: Dorothy Dix found people locked up in jail; realized this was not the place for them; they weren’t getting the treatment they needed; wardens were saying they couldn’t handle this; she pushed for the creation of the asylum system; everything was great until it all went to hell and we had to open up the doors and let everyone out. Then, without treatment, people were ending up in the criminal justice system. And it has a very neat solution: if this is how we got there, then all we have to do is treat the mental illness and we’ll get people out of the criminal justice system.

Unfortunately, it’s way more complicated than that. Even when you look at the heyday of institutionalization, during the middle of the last century, there were a lot of people in institutions, but it was not the majority. There were still a lot of people living at home or elsewhere, or getting treatment in the community. The population in institutions tended to be older, white, female, and very heavy on people with a diagnosis of schizophrenia. The people now locked in the criminal justice system are overwhelmingly young, male, and not white.

I think we also have to look at the story of mass incarceration. We’ve started locking up way more people than we ever did…and when you cast such a big net, of course you’re going to pull in a lot of people with mental illness. When you break it down even further and look at co-occurring substance use disorders, a very large majority of people with mental illness in the criminal justice system have a co-occurring substance use disorder. So, if we’re arresting tons of people for drug possession, drug use, drug selling, drug dealing, it makes perfect sense that we’ll pick up people with mental illness.

Using policing tactics such as “broken windows” and “stop and frisk,” allowed us to lock up huge amounts of people [and] made it easier to arrest people with mental illness. I think that the story of mental illness in the criminal justice system is as much a story of mass incarceration as it is of de-institutionalization. The one piece of the story that is important, even if we don’t quite tell it right, is that we do have a severe lack of mental health care in the community and we have made it extremely difficult to get treatment for mental illness. But it’s not that everybody was getting treatment in a hospital and now they can’t get it, we just don’t have that and we’ve never had it.

TCR: How can we get people to start viewing mental illness seriously?

AR: I think we’re starting to move in that direction, very slowly. We’re seeing more people acknowledging an issue with depression or anxiety. We’re still not seeing a lot of actors come up at the Oscars and mention that they have schizophrenia, but I think it’s becoming more socially acceptable to talk about these things. We know that people can change, and society can change. There was a time that people didn’t talk about HIV or cancer, and now we wave flags for it. We need to get over the fear and stigma [attached to] mental illness in our society. The narrative in the media and in politics that links mental illness and violence is very damaging. And it’s hard to get over that stigma when every time something bad happens somebody is out there pointing a finger at mental illness.

TCR: Are tools such as Crisis Intervention Teams (CIT), deescalation and community policing having a positive effect on the problem?

AR: Like so many things in criminal justice, there is not a ton of data or evidence-based research to show one way or another. The data in places such as Miami or San Antonio show that these things work. Miami says that it’s cut the number of officer-involved shootings. In San Antonio, the system has prevented them from expanding the jail. People who study policing say that CIT is just good policing—-going back to the kind of policing we had before “professionalized” law enforcement. It was the cop walking the beat who knew the people in the community. There’s no reason to run into every situation like it’s a battleground. Police officers always talk about how they see people on the worst day of their lives. That narrative is used sometimes as a reason why you need to be on your guard. But I’ve also heard it used as a reason to be gentle, kind, and thoughtful because they’re there to help.

Getting police to respond in a more thoughtful, more community/medically oriented way, instead of the tough, warrior way, is terrific. The big caveat is that if you don’t have the whole system set up to accommodate this it can only get you so far. You might deescalate a particular situation, but if you don’t have any longer-term solutions, you’re going to be back picking up the same person with no place to go. Often communities think CIT will be a step to solving the problem, but you have to think about how you’re going to divert, what’s the mental health treatment going to be, and how do we make sure we’re not picking people up again next week or next month.

TCR: Does change need to start at a federal level?  And do you see potential for change under the current administration?

AR: The thing about criminal justice is that so much of it happens on such a local level that, on the flip side, a lot of reform can also happen on a local level. If I’m in Manhattan, and get arrested, it could potentially be a different outcome then if I’m in the Bronx or New Jersey. Because it’s so local, I think the federal question is almost irrelevant. Even the laws of involuntary commitment are handled at a local level.  I think with a lot of laws, particularly with HIPAA (the Health Insurance Portability and Accountability Act) and involuntary commitment, it really comes down to a very narrow line of navigating between civil liberties and safety for the person and the public.

We obviously don’t want to go back to the time when somebody could have a child committed to a hospital for not being religious enough or dating the wrong person.  On the other hand, I think we’ve made it so difficult to get somebody hospitalized that we’re in this perpetual crisis management mode.  The way it’s set up now is that you really have to be at a crisis point in order to make involuntary commitment possible.  Likewise, with HIPAA, I don’t want my business broadcast all over the place.  On the other hand, the very nature of mental illness means that the person is not, necessarily, capable of making decisions for himself, or even providing the information that the doctors need.  I’ve heard families talk about managing to get their adult child hospitalized, but then not being able to convince the doctor to talk to them about what has or hasn’t worked in the past.  As with any other illness, the more information the clinician has, the better they can treat the problem.

Isidoro Rodririguez

HIPAA is also widely misunderstood. It’s used as an excuse for stonewalling families and other people trying to get information.  I think the more important question, is how do we figure out how to loosen these laws a little bit to make things easier and more effective without throwing all the civil liberties out with it.  As for the current administration, I think this is a big wildcard.  It doesn’t seem to be a big priority except on those occasions when something awful happens and suddenly there’s talk of bringing back asylums and more mental health care.  Between seeing real change at a local level or at a federal level, I have a little bit of hope that at the local level there is potential for reform.

Isidoro Rodriguez, a staff writer for The Crime Report, covers policing and mental health issues. He welcomes comments from readers.

from https://thecrimereport.org

Public Opinion on School Shootings and Violence

Police Vehicle Observations For school shootings and violence, by 56 to 41 percent, Americans think we should change laws related to “school security and mental health system” rather than the “laws on the sales of guns and ammunition.” Author Leonard Adam Sipes, Jr. Thirty-five years of speaking for national and state criminal justice agencies. Interviewed […]

The post Public Opinion on School Shootings and Violence appeared first on Crime in America.Net.

Police Vehicle Observations For school shootings and violence, by 56 to 41 percent, Americans think we should change laws related to “school security and mental health system” rather than the “laws on the sales of guns and ammunition.” Author Leonard Adam Sipes, Jr. Thirty-five years of speaking for national and state criminal justice agencies. Interviewed […]

The post Public Opinion on School Shootings and Violence appeared first on Crime in America.Net.

from https://www.crimeinamerica.net