““Trans-Institutionalization”Trans-Institutionalization”(Criminalization of the Mentally Ill)(Criminalization of the Mentally Ill)

0

50,000

100,000

150,000

200,000

250,000

300,000

350,000

400,000

State hospitalptsMentally illprisoners

Source: US Dept. of Health Human Services & Dept of Justice statistics

Mentally Ill Jail Inmates (Offenses)Mentally Ill Jail Inmates (Offenses)

26%

27%

24%

23%

Violent

Property

Drug

Public-order

Bureau of Justice Statistics ( September 2006):

Mental Health Court: CriteriaMental Health Court: Criteria(GAINS Center for People with Co-Occurring Disorders in the(GAINS Center for People with Co-Occurring Disorders in theJustice System): Justice System):

Most are adult criminal courtsMost are adult criminal courtsHave a separate docket dedicated to persons with mental Have a separate docket dedicated to persons with mental illnessesillnessesDivert criminal defendants from jail into treatment Divert criminal defendants from jail into treatment programsprogramsSome courts monitor the defendants during treatment and Some courts monitor the defendants during treatment and have the ability to impose criminal sanctions for failure to have the ability to impose criminal sanctions for failure to complycomplyFirst such courts established in US were in Marion County, First such courts established in US were in Marion County, IN (January 1997) and Broward County, FL (June 1997)IN (January 1997) and Broward County, FL (June 1997)

3

3

102

1

1

1

3 1

1

1

1

3 2

8

1

11

16

1

1

1

1 17

14

5

2

1 1

11

Hawaii

Alaska

1

US Mental Health Courts (2006)(Redlich AD, et al: Law Hum Behav (2006)

Mental Health Courts-OutcomesMental Health Courts-Outcomes

Clark Co. (WA) Mental Health Court Program Clark Co. (WA) Mental Health Court Program (4/00-4/03)(4/00-4/03)

Herinckx HA, et al: Psych Services (2005)

0

20

40

60

80

100

120

140

160

Casemgt hrs

Inptdays

Outptdays

1yr pre MHC

1 yr post MHC

0

0.5

1

1.5

2

Arrests

Sacramento County Jail:Sacramento County Jail:StatisticsStatistics

Main Jail was built in 1989 to house 1,252 Main Jail was built in 1989 to house 1,252 inmates. Over the years, double bunking inmates. Over the years, double bunking increased the capacity to 2,432 inmates.increased the capacity to 2,432 inmates.

Additional facility: RCCC houses >2,000 Additional facility: RCCC houses >2,000 sentenced and pre-trial inmates.sentenced and pre-trial inmates.

Approximately 57,200 bookings in 2005Approximately 57,200 bookings in 2005

Average inmate length of stay: 37 daysAverage inmate length of stay: 37 days

Approximately 16% (700) of total inmates are Approximately 16% (700) of total inmates are followed by Jail Psychiatric Servicesfollowed by Jail Psychiatric Services

Jail Psychiatric Services (JPS)Jail Psychiatric Services (JPS)

JPS has provided mental health services to JPS has provided mental health services to

inmates since 1978.inmates since 1978.

Contractual agreement between UC Davis Department Contractual agreement between UC Davis Department of Psychiatry and Sacramento County Sheriff’s of Psychiatry and Sacramento County Sheriff’s Department.Department.

Multidisciplinary team which includes Psychiatrists, Multidisciplinary team which includes Psychiatrists, Psychologists, RNs, LCSW, LVNs, and support staffPsychologists, RNs, LCSW, LVNs, and support staff

Services include: acute psychiatric triage, medication Services include: acute psychiatric triage, medication management, inpatient LPS-certified psychiatric unit (18 management, inpatient LPS-certified psychiatric unit (18 beds), group therapy, community re-entry coordinationbeds), group therapy, community re-entry coordination

Jail Psychiatric Services: Inpatient Jail Psychiatric Services: Inpatient (847 admissions to JPS-Inpatient Unit from 9/04-8/05):(847 admissions to JPS-Inpatient Unit from 9/04-8/05):

#admits #admits # admits# admits # admits # admits

nonviolent chargesnonviolent charges misdemeanor chargesmisdemeanor charges prior psych hospitalization prior psych hospitalization

505505 243243 616616

59.6%59.6% 28.7%28.7% 72.8%72.8%