The Criminalization of Mental Illness: Crisis & Opportunity for the Justice System

Risdon N. Slate, Ph.D.Professor of CriminologyFlorida Southern College

Prevalence of Mental Illness in the Criminal Justice System

• Jails and prisons in the U.S. hold three times more persons with mental illness than do psychiatric hospitals in America (Human Rights Watch Report, 2003).

• Jails comprise the 3 largest inpatient psychiatric facilities in the country.

• Estimates are that around 16 percent of jail and prison populations in the U.S. are comprised of persons with mental illness (Ditton, 1999). (Compare to James & Glaze, 2006 BJS/DOJ study).

Deinstitutionalization

• “Mental illness is not a choice. It is a medical disease.” (Greenberg, 2001, p. 43).

Source: Munetz, Mark and Griffin, Patricia. “Use of the Sequential Intercept Model as an Approach to Decriminalization of People With Serious Mental Illness.” (2006) Psychiatric Services 57:544-549.

The Sequential Intercept Model viewed as a series of filters

Criminal Justice System Responses

• Law Enforcement (CIT, CSOs and Mobile Crisis)

• Mental Health Courts

• Discharge Planning: Diversion & Re-entry

The True Solution Lies In More And Better Mental Health Services

• Evidence based practices, including:– Assertive Community Treatment (aka FACT)– Integrated mental health/substance abuse treatment.– Supported Employment– Supportive Housing

• Peer services and supports• Acute care beds and/or crisis stabilization services

Does Diversion Work?

• Does It Save Money?• Does it Reduce Crime?• Does it Help the People Intended to

Benefit?

As noted by Kathryn Power of SAMHSA, Lord Kelvin, a Scottish Mathematician of the 1800s, once said:

“When you can measure what you are speaking about, and express it in numbers, then you know something about it; but when you cannot measure it, when you cannot express it in numbers, your knowledge is of a meager and unsatisfactory kind.”

2007 RAND STUDYAllegheny County, PATotal Cost Savings of

$9,584.00per participant

for a½ Million Dollar Savings

Over 2 Years

Jail/Hospital costs per person

Program # of

Partici-pants

PRIOR to involvement

DURING involvement

(plus program cost)

Cost savings

per person

Thresholds Jail

Program (Cook

County, IL)

30 (two years)

$53, 897 $35,024 $18,873

Project Link

(Monroe County,

NY)

44 (one year)

$73,878 $34,360 $39,518

Source: Criminal Justice Mental Health Consensus Project

Cost Savings

Three County Data (Annualized)

12 Months

Prior to Enrollment

Since Enrollment

Days Homeless 205,992 63,764

Days Incarcerated

60,438 9,287

Days Hospitalized

10,906 2,435

Source – National GAINS Center

California’s AB 2034 Program

Crises Often Drive Policy In The Justice System

• Crisis Intervention Training – Memphis PD• Eugene Gregory & Alan Singletary• Aaron Wynn• Brad H.• Andrew Goldstein• Seung-Hui Cho• Emergency Economic Stabilization Act (Parity)

Crisis in Mandarin Chinese:

Hippocrates

• “A wise man should consider that health is the greatest of human blessings, and learn how by his own thought to derive benefit from his illnesses.”