A Crack of Light in a Dark Place

Providing Necessary Mental Health Treatment for the Inmates of Cook County Jail

General Overview

Problem: Cook County Jail, the home of 13,000 male and female inmates, has been deemed the largest mental health facility in the country. Unfortunately, most of the inmates with mental illnesses are neither receiving the appropriate treatment or care while awaiting their day in court, and are not receiving treatment once released back into the community.

How We Got Here

Prior to 1975, Judges had the authority to mandate mental health treatment for any individual before the court who demonstrated severe signs of mental illness.

Inmates who were required to receive mental health treatment were sent to State-Run Hospitals whose sole purpose was to house and treat the mentally ill.

Hollywood Lifts the VeilIn the late 1960’s, documentary film makers began investigating the squalid conditions of State-Run Mental Hospitals.

Gross mistreatment, such as forced feedings, lack of bathing and hygiene, sensory deprivation, forced nudity and bullying were common institutional problems that were found at many of these facilities

O’Conner v. DonaldsonFacts: While visiting his parents in Florida, Kenneth Donaldson told his father that he was afraid one of his neighbor’s was attempting to poison his food. His father petitioned the Florida court for a sanity hearing, Kenneth was diagnosed with paranoid schizophrenia, and was civilly committed to a Florida State Mental Hospital.

Supreme Court Ruling: A State cannot constitutionally confine a non-dangerous individual who is capable of surviving safely by themselves or with the help of family and friends.

Two Exceptions: (1) They are an imminent danger to themselves, or (2) They are an imminent danger to others.

The Demise of the State Mental Hospital and the Uprising of Violence

The New Model that Never Was

States planned to use out-patient facilities to treat individuals awaiting trial.

These out-patient facilities never received any State or Federal funding and collapsed.

By 2000, half a million inmates with mental illnesses have been released back on the streets.

Illinois’s Spending Cuts

Since 2009, Illinois has cut 15%, or $168 million dollars from community mental health care.

The National Alliance on Mental Illness has placed Illinois in the top 10 States for slashing funding for mental health care.

Cook County Jail at a Glance

Largest Jail in the Country, housing approximately 13,000 inmates.

Annual costs total approximately $550 million dollars.

20% of inmates housed have a mental illness. (2,800 inmates)

Cook County Jail Health Facilities

Designed to establish fitness for trial, not for the treatment of the mentally ill.

An inmate may wait for months to see a Doctor.

State Hospitals are egregiously underfunded (Elgin Medical Center has roughly 500 beds for mentally ill inmates).

Bill At A Glance

Short Title: Mental Health Crime Prevention Act

Venue: Cook County

Sponsor: Alderman James Cappleman (D-46th Ward)

Purpose of the Bill(1): To increase funding for Public Health Facilities, Outpatient Treatment Centers, and private practitioners in Cook County so that inmates awaiting trial may receive much needed mental health treatment.

(2): To increase the capacity and upgrade the facilities at currently operating State Mental Health Hospitals to better treat and accommodate those inmates who are afflicted with more serious mental illnesses.

(3): To provide alternative sentencing options and treatment programs for Cook County Judges so that first time offenders and non-violent offenders with mental illnesses can receive medical treatment rather than prison sentences.

(4): To provide treatment options for released inmates with mental illness who have served their period of incarceration with a focus on preventing recidivism and providing long term mental healthcare for those with serious mental illness.

(5): To capitalize on newly available funds, resources and programs to treat the mentally ill as provided by the Federal Government.

The Federal Government’s Support

Affordable Care Act

Mental Health First Aid Act

Excellence in Mental Health Act

Mental Health in Schools Act

Behavioral Health IT Act

Affordable Care ActEstimated that 30 Million Americans will get mental health care coverage for the first time.

32 Million more Americans will have more affordable mental health care coverage.

White House pledged $100 Million in additional funding for mental health research.

Mental Health First Aid Act

Sponsored by Sen. Mark Begrich (D-AK)

Also known as S.153

Purpose: To amend Public Service Health Act to authorize grants for mental health first aid training programs.

Bill is currently being referred to a Congressional Committee.

Excellence in Mental Health Act

Sponsored by Senators Debbie Stabenow (D-MI) and Roy Blunt (R-MO).

Also known as S-264.

Purpose: To expand access to community mental health centers and improve the quality of mental health care for all Americans.

This bill was adopted as an amendment to the “doc fix” SGR Bill (bill that reforms how Doctors are paid through Medicare)

Mental Health in Schools Act

Sponsored by Congresswoman Grace Napolitano (D-TX).

Aimed at providing mental health treatment services to students in public schools.

Currently working its’ way through the Senate.

Cost Cutting

Daily Expenses to run Cook County Jail are approximately $1,520,353.00. Annually it is $550 million dollars.

Inmates with mental illnesses cost anywhere from 2 to 3 times the cost of a typical inmate.

Diverting funds from the Cook County Jail to public health facilities would actually alleviate the financial burden on the prison system, while simultaneously treating inmates.

Women’s Health Issue

In most jurisdictions, mental illness amongst women prisoners ranges from one quarter to one half of the total population.

Roughly two to three times the rate as male prisoners.

Lack of treatment forces D.C.F.S. (Illinois Department of Child and Family Services) to take custody of children, place them in temporary custodial care, and in some cases, terminate the parental rights of the mother.

Mental Health and the War on Drugs

There are no definitive statistics on the correlation between drug use and mental health.

One U.S. Bureau of Prisons study estimated that 50% of all mental health inmates were using an illegal narcotic prior to incarceration.

The mentally ill use illegal drugs to self-medicate.

Hurdles to Passing Legislation

Social stigma of helping “criminals”

Inmates have no lobby or representation

Cook County is at an unprecedented level of debt

The State Legislature is voting this April to shut down half of the State Mental Hospitals, bringing the total down from 12 to 6

Potential National Stakeholders

National Association of Police Organizations

National Sheriffs’ Association

American Psychiatric Association

The American Psychological Association

National Alliance on Mental Health

National Council for Behavioral Healthcare

American Foundation for Suicide Prevention

Mental Health America

National Association of Psychiatric Health Systems

Potential Local Stakeholders

Law Office of the Public Defender

Adoption and Child Custody Advocacy

Department of Budget and Management Services

Cermak Health Services

Bureau of Finance

Alderman James Cappleman

B.A. University of Houston

Masters in Social Work University of Illinois-Chicago

Represents the 46th Ward (Uptown Neighborhood)

Strong proponent of Mental Health Reform

Judge Thaddeus Wilson

B.A. University of Notre Dame

J.D. Northern Illinois University

Sitting Judge on the Circuit Court of Cook County (Criminal Division)

Tom Dart

B.A. Providence College

J.D. Loyola University Chicago

Former Illinois State Senator for the 28th District (91-03)

Current Sheriff of Cook County

https://www.youtube.com/watch?feature=player_detailpage&v=UdcPGt8QxZo