Creating New Hope for Mental Illness and the Criminal Justice System

By John P. Docherty, M.D. | Oct. 20, 2017

 

The number of people living with mental illness in America’s jails is alarmingly high. In 44 out of 50 states, prisons and jails hold more individuals with serious mental illness than the largest state hospital. In local jails, 64% of people experience symptoms of a mental health condition, which represents over 7 million people. Additionally, 17% of jail inmates experience a serious mental illness.

As an example: Recent reports from Miami-Dade County in Florida revealed that a small proportion of individuals with mental health conditions were accounting for a disproportionate amount of time in jail, emergency rooms, hospitals and psychiatric facilities. Over the course of five years, 97 individuals were arrested 2,200 times and spent 27,000 days in Dade County jail.

Finding ways to divert such individuals out of criminal justice and into appropriate care—so future incarcerations are reduced or avoided—is vital. A jail diversion program was implemented in Dade County that included mental health training for police officers and 911 dispatchers. In result, jail populations were significantly reduced from over 7,000 to a little over 4,700 over the past five years.

These revealing statistics point to a public health crisis in the care and societal management of mental illness. Across the country, innocent people are cycling through “the system” with repeated arrests, and with a higher likelihood of being incarcerated than hospitalized, simply because they experience a mental health condition. There is an urgent need to address the gaps in the mental health and criminal justice systems. This is not simply an issue of societal compassion—it is a fundamental issue of equity and justice.

Innovative Solutions to a Troubling Problem

One factor that may be contributing to this problem is the lack of information sharing across health, social and criminal justice systems. There is a need to establish integrated data systems to maximize good outcomes and prevent people from falling through “gaps” in the system. Examples of gaps include people being incarcerated without knowledge of the person’s mental health history and treatment plan, people being released from incarceration into the community without any effort to coordinate with the mental health system to ensure follow up services, etc.

In 2012, Otsuka (ODH, Inc.) partnered with IBM and the South Florida Behavioral Health Network in Miami to implement a platform that integrated data from criminal justice and mental health, substance use and social support services. Using this data, the group found that if people living with a mental illness were provided with case management and proper services after a period of incarceration, they experienced a 50% reduction of risk for rearrest.

The collaborative work by ODH, Inc. and IBM has potential to help communities achieve the goals of reducing unnecessary incarceration of people with mental illness and ensure that people receive needed services and supports after they re-enter communities. The White House recently launched the Data-Driven Justice Initiative (DDJ) to help reduce the inappropriate and counterproductive incarceration of those experiencing mental illness. This initiative includes a bipartisan coalition of 67 governments (city, county and state) that will use data-driven strategies to divert low-risk offenders with mental illness from the criminal justice system to appropriate care. The initiative also aims to equip law enforcement officials and first responders with protocols to assess and divert people to service providers rather than the default of the criminal justice system.

The DDJ also includes specific coordination with the Department of Veteran’s Affairs (VA) to help divert veterans cycling through the criminal justice system as well. This is critical, considering that 7% of individuals in local jails are veterans, and over half of these veterans are experiencing a mental illness.

To help implement DDJ strategies, private, nonprofit and philanthropic organizations have partnered with the White House. This partnership includes help with data analytics, research, diversion and coordination of services, among other collaboration. Analytics will be used to identify individuals with mental illness who are at the greatest risk for incarceration, and who would most benefit from mental health care and other services.

The use of technology has the potential to help people experiencing mental illness throughout the country. While it is obviously not a complete solution, the hope is that technology and analytics may help guide individuals living with mental illness into appropriate, humane care—rather than costly, unproductive and harmful incarceration. 

 

John Docherty is the Vice President of Clinical Sciences and Digital Medicine at Otsuka. John has been teaching psychiatry at Weill Cornell Medical College for the past 22 years. He received his M.D. from the University of Pennsylvania.

Comments
Ryan M Davis
I'm hoping to get enough signatures to make changes at a federal level on how to handle people with mental illnesses when looking respond. PLEASE, every signature will help to bring more awareness to the misunderstanding and the mistreatment of people with mental illnesses. Together we can make changes for the better!!

https://www.change.org/p/mark-dayton-keep-nonviolent-mental-health-patients-out-of-the-court-system
12/30/2017 2:46:57 AM

Barbara
This program was launched in the final months of the Obama administration, so doubtful it's being implemented by the Trump administration. https://obamawhitehouse.archives.gov/the-press-office/2016/06/30/fact-sheet-launching-data-driven-justice-initiative-disrupting-cycle

However, there is a federal law which protects the human rights of the mentally disabled in the criminal justice system. It is called the Americans With Disabilities Act. The following info is from the very informative book, CAUGHT IN THE WEB OF THE CRIMINAL JUSTICE SYSTEM: AUTISM, DEVELOPMENTAL DISABILITIES AND SEX OFFENDERS:

"We have a national policy to protect and accommodate those with developmental disabilities, reflected in the Americans with Disabilities Act, and the correlative Rehabilitation Act. This sets a national policy that applies to those in law enforcement and must circumscribe their exercise of discretion.

"In 'Examples and Resources to Support Criminal Justice Entities in Compliance with Title II of the Americans with Disabilities Act.' USDOJ, Civil Rights Division, Technical Assistance Publication, January 11, 2017, p.2:2 Nondiscrimination requirements, such as providing reasonable modifications to policies, practices, and procedures and taking appropriate steps to communicate effectively with people with disabilities, also support the goals of ensuring public safety, promoting public welfare, and avoiding unnecessary criminal justice involvement for people with disabilities."

https://www.ada.gov/cjta.html
12/29/2017 4:57:52 PM

Kathleen Houser
My husband has schizophrenia and bipolar and has been in jail for almost 3 months. His charges are all misdemeanors. He is being held for 50,000 bail. can this agency get him into a jail diversion program. We live in schuylkill County Pennsylvania. He does not belong in jail and is being charged with simple assault. Our neighbor assaulted him and he is currently on parole. I want to know why he is being held on such a large amount of bail when he should be in a jail diversion program, if any at all!
12/14/2017 10:56:54 PM

Kathleen Houser
My husband has schizophrenia and bipolar and has been in jail for almost 3 months. His charges are all misdemeanors. He is being held for 50,000 bail. can this agency get him into a jail diversion program. We live in schuylkill County Pennsylvania. He does not belong in jail and is being charged with simple assault. Our neighbor assaulted him and he is currently on parole. I want to know why he is being held on such a large amount of bail when he should be in a jail diversion program, if any at all!
12/14/2017 10:55:56 PM

Avatar
Nancy
Having the local "pigs" laugh at you while they drag you off to the mental ward MUST BE STOPPED!
11/26/2017 5:49:19 PM

valorie laske
my sister is presently in jail awaiting a hearing.how do i check to see if they have the DDJ system (data driven justice) or that she's on it
10/28/2017 12:01:58 PM

Robin Allgood
My son who had asperger is incarcerated an his public defender lawyer is saying that Asperger is not considered a mental illness.How can I bring awareness to the courts of Virginia beach that it is.
Please help
10/25/2017 11:44:19 PM

Lefford Fate
I gave this TEDxCharleston talk last year, I hope it will shed a little more light on Corrections and Mental Illness

https://www.youtube.com/watch?v=30cyl_E1dbk
10/25/2017 9:07:35 PM

Sharon
It's refreshing to hear good news about mental health care coming out of Florida. Sadly this state is one of the worst in the country for mental health care. I have witnessed this up close with a friend suffering from schizophrenia who nearly ended up on the street last year because of the "stick a band aid on it" approach of the system here. Hopefully the success in Dade County is shared and replicated in other Florida counties such as mine (Volusia) where progress is sorely needed. Are plans to replicate this approach in other counties?
10/23/2017 7:54:33 PM

Lizanne Corbit
So powerful to see articles like this. I think this is an incredibly important topic that needs to be openly discussed. The stats are there and posts like these can do a huge part to create conversation and spark change.
10/23/2017 4:32:37 PM

Jo Lenox
The justice system definately needs to collborate with many area of the community to help ensure that the mentally ill are protected from further abuse, oppression stigma. Handicapping the mentally ill with added abuse through the justice system only compounds the misery to not only the individual but society also.
10/20/2017 3:22:11 PM

Nicole Soucy
New Hampshire hospital isn’t working an state /federal,funded why only to create more issues for capitalizing on how about activity is key to recovery not isolation/seclusion chemical induced for all the great wonderful state services ...meaning adult daycare
10/20/2017 11:45:00 AM

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