The nation's prisons and jails are filling with mentally ill offenders - an issue that has long plagued corrections agencies and mental health advocates.  But, help for both offenders and the agencies that house them may soon be in sight.  Last week, the congressional House Judiciary Committee held a hearing on "The Mentally Ill Offender Treatment and Crime Reduction Act of 2003" and lawmakers there had a chance to hear about the problem first-hand from people on the front lines of the battle.

"Jails are jails, they are not treatment facilities or hospitals," Tuscaloosa County, Ala. Sheriff Ted Sexton said at last Tuesday's hearing.  "County jails are not equipped to house a large [mentally ill offender population]."

Sexton was one of four witnesses called at the hearing to testify about the importance of "The Mentally Ill Offender Treatment and Crime Reduction Act of 2003," which was passed by unanimous consent in the Senate last October.  The bill, which would provide $100 million a year in funding to criminal justice and mental health agencies in both 2004 and 2005, is now under consideration in the House of Representatives.

The bill, once enacted, would foster collaborations between corrections and law enforcement agencies and mental health and substance abuse treatment providers to promote public safety and community health through planning and implementation grants.

Relying on Research

According to the Mental Health Consensus Project, about 16 percent of the U.S. jail and prison population has a serious mental illness as compared to five percent of the general population.  This overrepresentation of the mentally ill in the country's correctional facilities documents the need for legislation that addresses the problem, according to Dr. John Monahan, a clinical psychologist and professor of law and psychology at the University of Virginia.

"The number of people this act will affect is staggering," said Monahan, who also spoke at the House Judiciary hearing and is Director of the MacArthur Research Network on Mandated Community Treatment.  "At any given day in the U.S. there are over 200,000 prison inmates, 100,000 jail detainees and 700,000 people under the supervision of community corrections - over one million people in all with a serious mental illness."

Monahan pointed to the vast number of communities who have taken it upon themselves to create programs to address this issue as evidence of its wide scope.

"Seven percent of all counties have a police or a court-based program to divert defendants with mental illness from jails," Monahan said. 

This also means that that 93 percent of counties have no program in place to divert mentally ill offenders from incarceration, which is an important function of the bill, he noted.

Programs like mental health courts, which have grown in number from one court in 1997 to nearly 100 today, have been proven successful, said Monahan, whose work with the MacArthur Foundation involves evaluating some of these programs.

"The [MacArthur Research] Network is now working in partnership with the National Institute of Justice to evaluate mental health courts funded by Congress," Monahan said.  "The evidence is that we can make a difference - offenders with a mental illness can, in fact, be dealt with in ways that can reduce crime, save taxpayer money or both."

But these programs can only be successful if agencies work together and pool their resources, Monahan said.

Creating Collaborations

"The evidence is that collaboration is essential to get anything accomplished having to do with mentally ill offenders," Monahan said.  "After five years of intensive study neither mental health [agencies] nor criminal justice [agencies] can do the job alone."

Cheri Nolan, another witness at the hearing, echoed Monahan's thoughts.  As Deputy Assistant Attorney General of the Office of Justice Programs, she testified to the need for treatment for mentally ill offenders so they do not get caught in the criminal justice system's revolving door.

"Recidivism rates for individuals with mental illness are extremely high," Nolan said.  "Individuals with mental illness often are returned to the community, where, without access to appropriate housing and comprehensive mental health care and support services, they are more likely to be picked up for low level crimes once again in a costly and repetitive cycle." 

According to Nolan, connections need to be made to ensure that mentally ill offenders have access to treatment, support services and housing when they are released back into the community from correctional facilities.  "The Mentally Ill Offender Treatment and Crime Reduction Act" will help to make those connections possible by uniting criminal justice and mental health agencies, she said.

"From my work at OJP I have come to believe that the increasing number of people with mental illness in the criminal justice system is one of the most pressing issues facing our police departments, jails, prisons, and courts," Nolan said.  "Increasing collaboration between criminal justice and mental health agencies is essential at the state and local levels, as well as at the federal level."

The witnesses who testified at the hearing are not alone in their desire for "The Mentally Ill Offender and Treatment Act" to be passed.  Other corrections practitioners and people working with the mentally ill offender populations are also behind the bill.

"We feel it is important to find alternatives to incarceration for the mentally ill population," said John Shaffer, Executive Deputy Secretary of the Pennsylvania Department of Corrections.  "We feel that this funding that [the] proposed legislation will provide us [will give us] the necessary resources to provide continuity of care when inmates are released to the community."

Shaffer noted that mentally ill offenders are difficult to parole because of the limited resources in place in the community, have a high likelihood of recidivating and are costly to correctional systems, in terms of staff hours and medication expenses.

For these reasons, he is a strong proponent of the bill.

"We're hopeful that the legislation is passed," Shaffer said.  "[If so], we will be able to apply for those funds to establish more resources in the community to provide treatment alternatives for the mentally ill population."

Different Points of View

But, June Poe, the final witness to testify at last week's hearing, is perhaps even more hopeful.  As the mother of a mentally ill man who has been involved with the criminal justice system, she advocated for the House to pass the bill.

"I want to put a human face on this bill," said Poe, whose son was diagnosed with paranoid schizophrenia in 1974 and has since been incarcerated several times.

According to Poe, her son's condition deteriorated each time he was incarcerated and it was not until he received help from his community's Program of Assertive Community Treatment (PACT) team, which provides comprehensive community treatment, rehabilitation, and support services to consumers in their homes, at work, and in community settings.

Without the PACT team's intervention, Poe says that her son would have been rearrested in 2001.  But, now, because of the team's support, he is living independently in the community.

"I strongly urge passage of a bill that will greatly benefit both people with serious mental illness and entire communities," Poe said.

Resources:

To view the bill, go to http://thomas.loc.gov/cgibin/query/D?c108:4:./temp/~c108r9D40L::