Criminal Justice and Mental Health Consensus Project
Groups Seek Proactive Approaches for Offenders with Mental Illness
Mental Health Weekly June 17, 2002
For decades, local police officers, judges and mental health officials have
struggled with the growing phenomenon of people with mental illness cycling
among courtrooms and jails, and psychiatric hospitals, community residences and
the streets.
Last week, some of the nation’s top lawmakers were introduced to the scope of
the problem when the Senate Judiciary Committee convened the first Senate
hearing in memory on the matter.
While lawmakers may disagree about specific solutions, Senate Judiciary
Committee Chairman Patrick J. Leahy (D.-Vt.), said, “We should all agree that it
makes sense to help state and local governments improve the availability of
mental health services, train their law enforcement personnel to recognize the
signs of mental illness in offenders and give prosecutors more tools to deal
appropriately with mentally ill offenders.”
The catalyst for the hearing was a sustained effort involving law enforcement,
mental health, corrections and legal and judicial groups, spearheaded more than
two years ago by Michael Thompson, director of criminal justice programs with
the Council of State Governments (CSG).
Thompson, the CSG and the groups worked tirelessly to produce a 333-page report,
“Criminal Justice/Mental Health Consensus Project.” The public release of the
report last week was timed to coincide with the Senate hearing.
The project brought together more than 100 line-level experts from the mental
health and criminal-justice systems to share their perspective and expertise on
what is happening, as well as to recommend actions.
The report is intended for use in a proactive way to arrive at more measured
responses than, for example, legislation enacted quickly and with unintended
consequences following a community crisis.
Target audiences include legislators and policy-makers; professional
associations; and perhaps most im-portantly, any number of people and groups at
the local level seeking to be change agents,” said Bill Emmet, project director
with the National Association of State Mental Health Program Directors. NASMHPD
was the coordinating agency for the project’s mental health task force, one of
four study tracks.
Meanwhile on the federal level, the report may serve as a foundation for
legislation being considered by Sen. Mike DeWine (R.-Ohio) to provide for grants
to help communities and groups break the cycle by establishing a continuum of
programs, including jail diversion and a host of others.
The initiative, still being crafted as of press time, would reflect the work
and backing of a number of mental health and criminal-justice organizations.
Numbers are telling
The issue of people with mental illness coming in contact with the
criminal-justice system is gaining a bigger spot in the limelight as state
budgets continue to be squeezed, conventional streams of mental health funding
shrink and public-safety issues move to the forefront.
The country’s jails hold disproportionate numbers of people with mental illness.
About 5 percent of the general population — and about 16 percent of the inmate
population — has a serious mental illness, according to a 1999 U.S. Department
of Justice report.
A study conducted in upstate New York and published in 2001 found that men
involved in the public mental health system were four times as likely to be
jailed as men in the general population, while the ratio for women was
six-to-one over a five-year period.
But community attention rarely focuses on the rotation of people with mental
illness through the courts and jails — until tragedy strikes, often in the form
of a deadly encounter between police and a person with a history of untreated
mental illness.
Leahy described in the hearing one such incident in his home state of Vermont.
In December, a man with mental illness interrupted church services in West
Brattleboro, threatened to kill himself and, with a knife, charged three
Brattleboro police officers. The police shot the man, who later died.
The report outlines in themed chapters a total of 23 distinct events
representing junctures where a person with mental illness might encounter the
criminal-justice system.
The events begin with the person’s first contact with police and end with his or
her maintaining contact with the mental health system upon release from jail.
Intervening events include on-scene police response; appointment of counsel;
prosecutorial review of charges; sentencing; intake of sentenced inmates;
release decision; and development of a transition plan.
Each event carries recommendations for implementation, accompanied by sketches
of programs throughout the country that link ser-vices and treatment.
The report draws on the experience and recommendations of a range of experts.
Besides NASMHPD, other project partners in the report are the Police Executive
Research Forum; the Association of State Correctional Administrators; the Judge
David L. Bazelon Center for Mental Health Law; the Center for Behavioral Health,
Justice & Public Policy; and Pretrial Services Resource Center.
Two state legislators — Connecticut Rep. Mike Lawlor, a Democrat, and
Pennsylvania Sen. Robert Thompson, a Republican — co-chaired the project’s
steering committee.
“What’s been so energizing to me,” NASMHPD’s Emmet told MHW, “is that we have
been able to meet with police chiefs and prosecu-tors and judges who are all
basically calling for the same kinds of improvements in the system that we in
the mental health system see are needed.
“We potentially have a great many more allies than at least we knew we had in
the past,” he added.
Need for reform
Just as it was important for mental health experts to hear police, judges,
lawyers and corrections officers express understanding for the challenges facing
the mental health field, “It was important for them to hear we in the mental
health system know we have holes in it,” Emmet said.
“It was an opportunity for us to look in the mirror” and acknowledge that people
wouldn’t be falling into the criminal-justice system, or endlessly cycling
through it, if adequate mental health systems were in place, he said.
The report underscores the importance of making mental health systems more
accountable, and of fostering more effective partnerships between them and
criminal-justice systems, Emmet said.
Melissa Reuland, a senior research associate with the Police Executive Research
Forum, praised participants for their open and honest exchanges during the last
20 months that somehow dispensed of “issues of power.” The process, Reuland told
MHW, proved that “people can cross disciplines and put their own needs behind
what we might consider the greater good, whether the safety of
an officer or the privacy of the individual.”
Indeed, Ron Honberg, legal director at the National Alliance for the Mentally
Ill (NAMI), who participated in the project, suggested that however effective
the report is as an advocacy tool, the process it espouses may be even more
useful. That’s because stakeholders often don’t talk with one another in
productive ways.
“We know now through bitter experience that just because mental health advocates
want something doesn’t mean it’s going to happen,” Honberg told MHW.
Reuland said she hopes smaller jurisdictions can use the report to replicate the
“ability of people from very different backgrounds and incentives and priorities
to come to the table and contribute their expertise in a forthcoming, respectful
way.”
Said NASMHPD’s Emmet, “If that understanding can be replicated in states and
communities around the country, we’ll be light years ahead of where we are
today.” The report, “Criminal Justice/Mental Health Consensus Project,” can be
found at www.consensusproject.org.
Source: Mental Health Weekly is an independent newsletter that
provides the latest information and analysis in public policy, business trends
and treatment issues affecting the field. To subscribe, go to
http://www.bhrpress.com/bookstore/write-ups/news_mhw.htm. NYAPRS-member
agencies can subscribe at the discounted (individual) rate.
The Criminal Justice and Mental Health Consensus Project (excerpts)
Vickie Fox Smith - Madnation
The Criminal Justice and Mental Health Consensus Project has been operating
behind closed doors for two years. A 400+ page report has now been issued. It
promises to be the basis of an increased reliance on force and coercion in
mental health for years to come.
No consumer/survivor/expatient group was invited to the table although a handful
of people were sprinkled onto the advisory committee that met three times. The
Bazelon Center for Mental Health Law was there as a "Project Partner" and
failed--in a spectacular way--to keep the report from supporting a horrific
increase in the amount of coercion that people can expect to face if they catch
the combined attention of criminal justice and mental health.
The report is of particularly importance because it is likely to be considered a
major source document as Bush's New Freedom Commission meets to make policy
recommendations for mental health. It is widely believed that a recommendation
for mental health courts--a tool of forced treatment and coercion-- is a likely
outcome. Only one survivor activist, Dr. Dan Fisher, has been appointed to this
body.
MadNation has consulted with various individuals who participated as consumer
representatives on the Criminal Justice and Mental Health Advisory Board. They
report that they only gradually became aware of their relative powerlessness in
comparison to the small group of people involved in the actual drafting of the
report. They also stated that information and recommendations they provided
supporting less coercive programs were not reflected in the final document. In
addition a promise made that the web site would provide an avenue for additional
information to be brought forth has not yet been fulfilled.
MadNation encourages those people and organizations who either were not given
the opportunity to be heard or whose recommendations were left out of the final
report to speak out. The public (and our elected officials) need to know about
the flawed process that made this possible. More importantly, the information
that was intentionally left out of this report must be made public and
opposition to the policies outlined in the report must be fully articulated and
promoted as widely as is the report itself.
The report (in PDF Format) has been released on the consensus website.
The project is organized around a series of 46 policy statements. They are
summarized in tabular form in the (PDF) Executive Summary.
Policy # 23 is especially frightening: "Ensure that people with mental illness
who are no longer under supervision of the criminal justice system maintain
contact with mental health services and supports for as long as is necessary."
With those few words, the Criminal Justice and Mental Health Consensus Project
has made a commitment to the policy of on-going (perhaps life-long) out patient
commitment.
NOWHERE IN THE EXECUTIVE SUMMARY WILL YOU FIND:
ANY significant mention of protecting the rights of people believed to be
mentally ill; the word "voluntary" when talking about treatment; a recognition
that tracking and publicly documenting incidents of abuse and rights violation
by police and law enforcement is an absolute necessity; any hesitation about
bringing people into the combined criminal justice/mental health system for
nuisance offences and keeping them there--perhaps forever.
Source:
http://www.madnation.cc/issues/force/criminals/index.htm
This "Mental Health E-News" posting is a service of the New York Ass'n of
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Save these dates!
September 10 - 13, 2002
NYAPRS 20th Annual Conference Celebration
'Now More Than Ever: Hope, Healing and Recovery'
at the Nevele Grande Resort, Ellenville New York
contact: Mary McLaughlin, NYAPRS
1 Columbia Place Albany, NY 12207
(518) 436-0008; fax: (518) 436-0044
