Monday, May 26, 2008

Lacking treatment options, mentally ill go to jail


SANDPOINT - In Idaho, as in Bonner County, the fastest way to land in jail without committing a crime is to suffer from mental illness.

And it's not because of any shortcomings on the part of local law enforcement officials - they already go above and beyond the call of duty when responding to situations where a mentally ill person is “in crisis.”

Where the system falls apart is after the event takes place - particularly in rural communities with limited resources. Faced with a severe lack of secure facilities, law enforcement personnel often have no choice but to incarcerate the individual, further exacerbating a shortage of space needed to house those people who actually have committed a crime.

The same holds true for the Idaho prison system, which has a markedly higher percentage of inmates with mental illness - 44 percent for juveniles; 28 percent for adults, according to the Partnership for Safety and Justice - than the national average for adults of 16 percent.

“Many people with mental illness are in the state's correctional system,” said Dr. Ann Wimberley, president of NAMI Far North - the regional chapter for the National Alliance on Mental Illness. “Some of them are there because they actually committed a crime, but some are there because of a lack of resources in their own community.”

The gap is not surprising, since Idaho ranks 49th in the nation for spending on mental health, earning the state a grade of “F” for mental health services from NAMI's national office. Although Kootenai County has a 10-bed facility that provides a temporary solution, as many as eight of those beds are used by the state at any given time, Wimberley said, which leaves Kootenai County with a shortage of its own.

“Having a safe place to take a person who's having a crisis is a big problem for law enforcement,” she added. “This is a situation that needs to be addressed by leaders of the community.”

With that in mind, NAMI Far North hosted a luncheon in Sandpoint on May 21, bringing together about 70 people representing the mental health

See NAMI, Page 3

and medical communities, elected officials from the city and county, law enforcement, the judicial system and the state Legislature. The speaker at that gathering, District Judge John Mitchell, highlighted a program that shows promise in those cases where crimes have taken place - a Mental Health Drug Court.

“In my courtroom, I began seeing a correlation between crimes of addiction and mental illness,” Mitchell said. “And if you talk to any district judge in the state, they would tell you the same thing.

“There are 5,000 inmates in the Idaho prison system and about 70 percent of that population is there for a crime of addiction,” he continued. “Almost half of them - about 1,750 people - also have a mental illness.”

Started about four years ago, the Mental Health Drug Court program in North Idaho began with five participants and has climbed to nearly 40.

“Most of our participants come to us when they are close to rock bottom - they're homeless, they're jobless,” Mitchell said. “We have saved more than a quarter-million dollars in jail costs and about $129,000 in hospital costs.”

Those figures are calculated by summing up how much these same individuals - most of whom were “return customers” to the judicial system, according to Mitchell - racked up in emergency room fees and jail time during the previous year, compared with their financial impact after joining the program. Routing people with mental illness into this group provides a network of support, education and treatment, the judge pointed out.

“This is a system-wide problem,” he said. “We have had a tendency to simply incarcerate and think that's going to solve the problem. But you need treatment.”

Mitchell also introduced a course called Crisis Intervention Training (CIT), which started in Memphis in 1988, after the fatal shooting of a mentally ill person during a response call by law enforcement.

“The program is in use in all but 10 states - and we're one of them where it isn't,” the judge said. “I'm here to start that dialog.

“Quite simply, what CIT involves is law enforcement walking a mile in health care's shoes and the other way around,” he added. “That way, when you're at somebody's house and they're unstable, you have a lot better idea of what you're getting into and a lot more options to work with, based on the knowledge the CIT program can give.”

Local law enforcement officials are on board regarding the need for training, but express frustration that they are often placed in the role of first responder to incidents that might be avoided or, at the very least, defused, before their help is needed.

“Law enforcement is ill-equipped to deal with this and we have zero options,” said Sandpoint Police Chief Mark Lockwood. “I think the hospitals look at us and say, ‘They've got the handcuffs and they take people into custody all the time,' so we get the calls. The biggest issue is that we lack facilities and a way to get these individuals the help they need.”

Lockwood applauds NAMI Far North's efforts to pull the community together in search of solutions for an issue that, by all accounts, has no easy answers.

“As a coalition - working together with NAMI, law enforcement and the judicial system - we can lobby the legislature for funds to build regional treatment facilities,” the police chief said.

“That's something we talk about every year with our lawmakers,” said Bonner County Sheriff Elaine Savage, “but this year, the legislature was not kind to North Idaho as far as treatment facilities. We have people in jail who shouldn't be there. These people don't need to be incarcerated, they need help.”

Wimberley said the Idaho Legislature already has approved funding a secure, 300-bed facility in a former warehouse on state prison property, with about 250 beds set aside for people with mental illness who have been sentenced for a crime. The other 50 beds at that prison facility, however, will be used to hold mentally ill individuals who have not committed an offense.

Like the sheriff and the police chief, the NAMI Far North president believes handling the matter at the local level would be a better direction.

“It's the right thing to do,” Wimberley said. “Rather than placing people in the correctional system, it's not only more humane to treat them in the community, it's also more cost-effective.”

NAMI Far North provides support, education and advocacy for people with mental illness, their families and friends. The group meets on the third Wednesday of every month from 6-8 p.m. at the Bonner General Hospital classroom.


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