APA President Calls For Enhanced Efforts to Alleviate Mental Health Crisis in U.S. Jails

“The criminalization of mental illness is a national tragedy,” APA President Renée Binder, M.D., told an audience gathered yesterday for a congressional briefing on Capitol Hill.

The event, which was sponsored by APA, aimed to promote awareness of the numerous challenges people who are living with mental illness in U.S. jails and prisons face and highlight possible policy solutions to help meet the needs of this population.

People with mental illness in U.S. jails and prisons often spend more time behind bars than those without such disorders, said Binder, a forensic psychiatrist. They also tend to incur more infractions and are more vulnerable to victimization by other inmates—all in a setting not designed or equipped to provide them with treatment.

Binder, together with other leading experts in psychiatry, mental health, and law enforcement who spoke at the meeting, called for enhanced efforts to change the way that people living with mental illness who have been incarcerated are treated.

“Local and state leaders must join with criminal justice, mental health, and substance use professionals to steer and support long-term efforts to move mental health care from our jails to the community,” said Mary Ann Borgeson, who has served as county commissioner in Douglas County, Neb., for 21 years. “But we can’t do it alone. We need federal leadership and we ask Congress to make the efforts needed to reduce the criminalization of people with mental illness.”

According to the speakers, some of the nation’s 3,069 counties have already started to change the way they treat people with mental illness who intersect with the criminal justice system, including modifications in arrest policies and law enforcement training, the establishment of mental health courts, and the development of re-entry supported housing programs.

“However, we need to give local jurisdictions help to decrease the number of people with mental illness behind bars,” Binder said, noting the array of bills targeting mental health reform already proposed in both the House and Senate.

“Numerous provisions in these bills would give local jurisdictions the support they need to reduce the number of persons with serious mental illnesses who are jailed each year,” Binder wrote today in a blog post. “The APA has taken the lead in collaborating with leaders in Congress toward the furtherance of these goals, but we can’t do it alone. I urge you to get involved with your state and local legislature and communicate to them the unique issues that your community faces in regards to the criminalization of people with mental illness.”

For more about people with mental illness in U.S. jails, see the Psychiatric News article, “Counties Seek Help to Reduce Numbers of Mentally Ill Inmates.”

(Image: David Hathcox)

APF Joins in Initiative to Reduce Numbers of Mentally Ill People in Jails

The American Psychiatric Foundation (APF) joined the National Association of Counties and the Council of State Governments Justice Center on Capitol Hill yesterday to launch the Stepping Up Initiative, a national effort to reduce the number of people with mental illnesses in jails across the country.

The initiative calls on county governments to enact strategies to collect data on the status and needs of people with mental illnesses in local jails, determine treatment capacity, and develop plans with measurable outcomes to reduce their overrepresentation in the criminal justice system.

“We know the impact these changes can have on our counties’ budgets, on our public safety, and most importantly, on individuals with mental illnesses and their families,” said Toni Carter (left), a commissioner of Ramsey County, Minn., during the Hill event. “But this battle won’t be won in individual counties. We need a national movement to change the way we treat people with mental illnesses.”

While some counties have made progress in their efforts to facilitate access to treatment and promote appropriate alternatives to jail, scaling up successful efforts has proven more difficult. As part of its ongoing work in the criminal justice field, APF will convene a national summit meeting on the subject in spring 2016.

A recent report noted that there were now 10 times as many people with mental illness in jails and prisons than in psychiatric hospitals, said APA CEO and Medical Director Saul Levin, M.D., M.P.A. “We must ensure that every one of our patients, every individual who needs and deserves treatment—particularly in the criminal justice system—receives that treatment.”

“We need sweeping change in the overrepresentation of people with mental illness in the criminal justice system,” said Denise O’Donnell, J.D., M.S.W., director of the Bureau of Justice Assistance in the U.S. Department of Justice. “The current system in which our jails provide mental health services is not affordable, nor is it sustainable or right.”

For more in Psychiatric News about the mental health crisis in America’s jails, see “Counties Seek Help to Reduce Numbers of Mentally Ill Inmates.” Also, see the Psychiatric Services in Advance article “Prospective Study of Violence Risk Reduction Among Mental Health Court Participants,” coauthored by APA President-elect Renée Binder, M.D.

-aml  (Image: Aaron Levin/PN)

Inmates File Suit Over Lack of Psychiatric Care

Several federal prisoners with serious mental illness have filed a class-action lawsuit against the Federal Bureau of Prisons charging that counter to regulations, they have been held in one of the country's "supermax" prisons and have not been provided with needed psychiatric care, including psychotropic medications. Four of the prisoners, according to a June 24 Washington Post report, were transferred to the maximum security prison in Florence, Colo., after the District of Columbia's prison in Lorton, Va., was shuttered in 2001. So-called supermax prisons are designed for extreme levels of security to house prisoners considered security threats or who have committed violent crimes while in other prisons. They are usually held in isolation cells and only have an hour or often less for exercise or other activities per day.

Edward Aro, one of the lawyers who filed the suit along with the inmates, is quoted as saying that the Bureau of Prisons "turns a blind eye to the needs of the mentally ill at [the Colorado prison] and to the deplorable conditions of confinement that are inhumane to these prisoner." The Bureau of Prisons declined to comment on the suit, but issued a statement saying it does not send mentally ill prisoners to the supermax facility. However, the Post cited, for example, the case of one of the plaintiffs, a convicted murderer, who was diagnosed with schizophrenia and alleges that he has not received medication for the disorder in his 11 years at the Colorado prison. "Instead, he has access to therapy classes on television and anger-management pamphlets."

To read about how mental illness is dealt with in the criminal justice system, see Psychiatric News here and here.

(image: Max Photo/Shutterstock.com)