House Passes Mental Health Courts Legislation, Next Stop President Clinton's Desk
House passage of S 1865 follows unanimous Senate approval on September 26, and clears the bill to go to the White House where NAMI is hopeful President Clinton will sign it into law. NAMI extends it thanks to key leaders in the House for their work on this important bill: Judiciary Committee Chairman Henry Hyde (R-IL), Crime Subcommittee Chairman Bill McCollum (R-FL), Judiciary Ranking Member John Conyers (D-MI) and Crime Subcommittee Ranking Member Bobby Scott (D-VA).
NAMI would also like to congratulate Representative Ted Strickland (D-OH) and Senator Mike DeWine, the lead sponsors of this bill, for their leadership in moving this measure forward toward final passage. Finally, NAMI would also like to recognize the efforts of Representative Strickland and Senators Pete Domenici (R-NM), Edward Kennedy (D-MA), and Representatives Heather Wilson (R-NM), Marcy Kaptur (D-OH), Steve Horn (R-CA), and Lois Capps (D-CA) for their efforts to push mental health courts as part of their mental illness treatment services enhancement bill (S 2639/HR 5091).
The establishment of mental health courts is one of NAMI's main advocacy strategies to address the stark reality that jails and prisons have become the nation's depository for people with severe mental illnesses. The current rapid downsizing and closure of state psychiatric hospitals without the funding and implementation of evidenced-based community treatment programs has left people with severe mental illnesses with nowhere to turn to access needed treatment and services.
The U.S. Department of Justice reported in 1999 that 16% of all inmates in state and federal jails have a severe mental illness. 283,000 people with serious mental illnesses were in jail or prison - more than four times the number in state mental hospitals. The average daily number of patients in state and county psychiatric hospitals has steadily dropped from 592,853 in 1950 to 71,619 in 1994. It is unconscionable that in an era of unprecedented economic growth and budget surpluses, people with legitimate medical conditions have had their healthcare options cut and removed and are being imprisoned, instead of being provided with access to appropriate treatment and services in the community and, when necessary, hospitalization.
NAMI has been raising the alarm over the unjust imprisonment of people with severe mental illnesses over the last decade. In 1992, NAMI and Public Citizen's Health Research Group released a report, entitled Criminalizing the Seriously Mentally Ill: The Abuse of Jails as Mental Hospitals, which revealed alarmingly high numbers of people with schizophrenia, bipolar disorder and other severe mental illnesses incarcerated in jails across the country. The vast majority of these offenses were relatively minor breaches of the law directly related to the symptoms of untreated mental illness, such as vagrancy, trespassing, disorderly conduct, alcohol-related charges, or failing to pay for a meal. Even though the criminal justice system may recognize this, police and criminal justice systems often lack adequate procedures to divert people with severe mental illnesses into community-based treatment programs. In 1992, less than 5% of the nation's jails had procedures in place to divert petty offenders with severe mental illnesses into community treatment programs. And, most shockingly, because of a lack of availability of community services, 29% of jails reported that they had incarcerated people with severe mental illnesses without filing any criminal charges.
The mental health courts legislation passed today would put the procedures in place to divert non-violent offenders with serious mental illness from jails and place them into appropriate community programs. S 1865 appropriates funds for fiscal years 2000 through 2004 for grants to states and municipalities to establish mental health courts across the nation to hear all cases involving individuals with severe mental illnesses charged with misdemeanors or non-violent felonies with the purpose of diverting as many of these cases as possible away from criminal incarceration into appropriate mental health treatment and services. Grant money would also be used to provide specialized training of law enforcement and judicial personnel to identify and address the unique needs people with serious mental illness that come into contact with the criminal justice system, and for the coordination of all mental health treatment plans and social services, including life skills training, such as housing placement, vocational training, education, job placement, health care, and relapse prevention for each participant who requires such services.
Although conditions in jails may have improved since Dorothea Dix first asked for jail diversion for people with severe mental illness 170 years ago, most jails and prisons still do not provide effective treatment for people with severe mental illnesses. Many correctional facilities do not have qualified mental health professionals on staff to recognize and respond to the needs of inmates experiencing severe psychiatric symptoms. Correctional facilities frequently respond to psychotic inmates by punishing them or placing them in physical restraints or isolation cells, responses that may exacerbate rather than alleviate their symptoms. Inmates with severe mental illnesses usually do not have access to newer, state-of-the-art atypical antipsychotic drugs because of the costs of these medications. Federal and state prisons generally do not have adequate rehabilitative services available for inmates with severe mental illnesses to aid them in their transition back into communities.
The lack of appropriate treatment and services in jails mentioned above often have serious consequences. Suicide is the leading cause of death in our nation's jails and a 1995 study found that 95% of all jail suicides were committed by people with a treatable psychiatric illness. The same study reported that 75% communicate their intent beforehand. Without qualified mental health professionals on staff who can address the inherent risk associated with having a severe mental illness and incarceration, jails and prisons are not only becoming that nation's new mental hospitals, they are tragically putting the lives of people with severe mental illness who are denied access to appropriate treatment at a much greater and unacceptable risk.
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