Sent: Wednesday, October 10, 2001 6:44 AM
Subject: Criminal Justice System Fails Those With Mental Disabilities

http://www.law.com/cgi-bin/nwlink.cgi?ACG=ZZZ71K51LSC

Criminal Justice System Fails Those With Mental Disabilities

James C. Harrington Texas Lawyer October 10, 2001

Two recent federal government reports should give us pause about how inadequately our criminal justice system deals with people with mental disabilities. In July, the Bureau of Justice Statistics reported in "Mental Health Treatment in State Prisons" that about 16 percent of all inmates in state prisons are identified as mentally ill. According to the National Alliance for the Mentally Ill, 5.4 percent of American adults have a serious mental illness. The Department of Justice report also found that only 79 percent of those who are mentally ill received therapy or counseling. This data is only the tip of the iceberg because it didn't include county jails, where people often have more acute mental illnesses and where treatment is minimal.

In August, the U.S. Public Health Service reported that America's minorities face severe economic, cultural and linguistic barriers that prevent thousands from receiving proper treatment for mental illnesses. The study, "Mental Health: Culture, Race and Ethnicity," found that, although minorities are no more likely than whites to have mental illnesses, various factors -- such as mistrust and fear of treatment, racism and discrimination, and differences in language and communication -- keep minorities from getting the help they need and, when they do, the treatment tends to be too little too late.

The Public Health Service attributed the lack of treatment to the fact that 25 percent of African-Americans and 37 percent of Hispanics do not have health insurance. The report said African-Americans are over-represented in populations at high risk for developing mental illnesses -- the homeless, prisoners and children in foster care -- meaning their need for mental health treatment is generally higher. Although overall rates of mental illnesses among Hispanics roughly equal that of whites, young Hispanics have higher rates of depression, anxiety disorders and suicide.

There are some conclusions we can draw. One is that, because Hispanics and African-Americans are disproportionately represented in the prison population, they likely are over-represented among inmates with mental illnesses.

CLEAR CORRELATION

There is a link between incarceration and mental illnesses that we don't care to face: As we have dismantled the large mental health institutions in the last two decades, many people who had been in those institutions or who otherwise are in need of care have ended up in prison.

There are a couple of reasons for this. One is that our society has failed to provide adequate mental health care in alternative facilities, such as group homes, leaving many people to live on the streets or with relatives who don't have the ability to cope with their loved one's mental illness. We shut down the institutions because they had become horrible places of de facto incarceration, but we haven't provided needed alternative care. And now prisons have become mental health facilities.

Another reason more mentally ill end up in prison is that our criminal justice system doesn't know how to deal with people with mental illnesses, who "act out" or commit crimes because they don't have medication or proper supervision other than to lock them up. Similarly, police by and large don't have the slightest idea of how to handle people with mental illnesses in crisis situations. They arrest them, rather than diverting them to medical care, if it exists, and bring them into the criminal justice system.

This does no good for individuals who end up in prison. They don't learn coping skills and don't receive very good treatment compared to what they would get in the community, but they do learn behavior from the inmates around them.

Taxpayers in Texas spend $22,000 per year to keep someone in prison, whereas if individuals were diverted to a group home or other maintenance program, we would spend far less, and they would be able to draw Social Security for their mental disabilities. And, above all, they might be able to learn skills for coping with their mental illnesses and society.

The situation with persons with mental retardation is equally acute. They comprise a disproportionate percentage of minority individuals in jail and prison.

When these reports came out, neither Gov. Rick Perry nor Texas Attorney General John Cornyn uttered a word, suggesting the need for a more pragmatic approach to the problem of mental illness in minority communities and how it disproportionately intersects with jail and prison time and how in the long run this is counterproductive for society.

There is a clear correlation with mental illness, the state's minority populations, poverty and prisons. We need responsible and creative leadership. We know what approaches will work in these situations, but we need leaders who will put them into effect. Texas needs to dedicate itself to handling this complex problem, for the sake of poor people with mental illnesses and for the sake of the state as a whole.

James C. Harrington is the director of the Texas Civil Rights Project, a nonprofit foundation that promotes civil rights.