Friday, January 25, 2008

Mentally ill said to need treatment, not prison

Thursday, January 24, 2008

By Pat Shellenbarger
The Grand Rapids Press

With the state Corrections Department gobbling up more than $2 billion a year -- one-fifth the state's budget -- a statewide coalition of judges, police, social service officials and others say there is a better way to spend taxpayers' money -- treat the mentally ill rather than lock them up.

Citing what it called "a growing statewide crisis," the new group, called the Michigan Partners in Crisis, today released a list of six initiatives it said would improve treatment of the mentally ill, reduce the state's prison population, save money and lower the crime rate.

"It's a wiser investment of state dollars," said Michael Reagan, a member of the coalition's advisory board and president of the nonprofit Proaction Behavioral Health Alliance, based in Grand Rapids.

Besides, he said, "It's the humane thing to do, and it makes our communities safer."

While no recent figures are available, coalition members believe more than half the inmates in Michigan's prisons and jails suffer some form of mental illness, often undiagnosed and untreated. That is a partly due to a decision by state officials over the past few decades to "deinstitutionalize" most mental patients by closing state mental hospitals.

While the coalition is not calling for reopening of the mental hospitals, it said the state failed to provide enough resources to treat the mentally ill in communities. As a result, some commit crimes and end up incarcerated, where they usually do not get proper treatment and often deteriorate.

"We have not deinstitutionalized the mentally ill," said Mark Reinstein, a coalition member and president of the Mental Health Association of Michigan. "We have 'transititutionalized' them," shifting them from hospitals to jails and prisons.

The coalition, asserting that most crimes committed by the mentally ill are nonviolent, called for the creation of mental health courts that would send mentally ill offenders into treatment programs rather than jails and prisons.

Diagnosing and treating mental illness before a crime occurs would be even better, Reinstein said.

For those who still need to be incarcerated, the state should improve treatment programs in the prisons to stem the high recidivism rate for mentally ill inmates, he said.

"These aren't places that fit in with treatment," Reinstein said. "What we have now isn't anywhere near what it ought to be. We have a horrible epidemic problem here."

The group called on state leaders to commission an independent study to determine how common mental disorders are in Michigan's county jails, state prisons and juvenile facilities. Last fall, the state Corrections Department estimated 16 percent of its inmates have been diagnosed with mental health problems.

"I think that's a low number," said C. Patrick Babcock, former director of Michigan's Department of Mental Health.

Deinstitutionalization was a good idea, he said, but, after the state closed most mental hospitals, "too many people fell through the cracks."

He cited the case of Timothy Souders, who died of dehydration while shackled to a bed in a Jackson prison in August 2006. Because of his mental illness, Souders, 21, could not follow prison rules, and his condition deteriorated while he was locked in solitary confinement.

The coalition is calling for an end to solitary confinement as punishment for mentally ill inmates.

Nationally, about 64 percent of county jail inmates and 56 percent of state prison inmates suffer some form of mental illness, the group said, and 75 percent of those in juvenile facilities have emotional disorders.

The current state budget includes $400,000 for a study to determine what portion of the state's 51,000 prison inmates are mentally ill.

The last independent study two decades ago found 40 percent of Michigan's prison inmates had some form of mental illness, including schizophrenia, bipolar disorder and major depression.

A 1998 study by Wayne State University found that 45 percent of Kent County's jail inmates were mentally ill.

State prison officials generally agree with the coalition's goals, Corrections Department spokesman Russ Marlan said.

"We've always said we don't think prison is the best place to treat the mentally ill," he said. "We've said all along we have to take who we get, and we do the best job that we can before releasing them.

Coalition goals

The goals of Michigan Partners in Crisis are:

Inform the public and policy makers about the impact of untreated mental illness.

Spearhead independent analysis of the prevalence of mental disorders in state prisons, jails and juvenile justice facilities; determine treatment needs.

Work with the state to improve mental health diversion services.

Get the state to suspend -- rather than terminate -- Medicaid for incarcerated people with mental illness.

End solitary confinement as punishment for mentally ill inmates.

Give state Department of Community Health greater authority to manage and provide treatment for mentally ill inmates.

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