Saturday, July 19, 2008

European states treat mental illness before it becomes prison problem


Tennessee Voices

If, upon arriving in Maastricht, Netherlands, on July 2 I had shut my eyes, I may have thought I had not left Nashville.

The temperature was in the high 80s with humidity to match, very "un-Holland"-like. But with my eyes open, I knew I was in an old European city.

I attended the 18th Conference of the European Association of Psychology and Law (EAPL), representing the Davidson County Mental Health Court over which I preside as a General Sessions judge. Also participating from Nashville were Dr. Roland Gray, representing the Davidson County Drug Court Residential Treatment Program, and Dr. David Patzer, a psychiatrist who works with both court programs.

At the invitation of EAPL, I presented a symposium with Gray and Patzer about the Mental Health Drug courts and a unique collaborative effort that will provide residential intensive drug therapy and mental health treatment for individuals in the criminal justice system who suffer from both serious mental illness and drug addiction. This program just received a federal grant for implementation. It appears to be the only type of program in the United States where separate courts are working together on these issues.

Seth Norman, judge of Davidson County Criminal Court Division IV, who founded and presides over the Drug Court Residential Treatment Program, was not able to attend the conference but provided a video presentation used at the symposium.

I am proud to report that the conference participants with whom I spoke, mostly European psychologists, university professors and students and some law enforcement personnel, were interested and impressed with the programs. However, a few people were curious as to why so many mentally ill people were in the U.S. criminal justice system.

It appears that a much higher percentage of people incarcerated in the United States suffer from serious mental illness than in some European countries. For example, I learned in one seminar that fewer than 5 percent of people arrested for crimes in The Netherlands suffered from schizophrenia. Yet, according to a 2006 U.S. Justice Department study, 24 percent of local jail inmates reported symptoms of a psychotic disorder.

Why this discrepancy? Certainly, there are many reasons. However, one reason may be access to health care. European countries have universal health-care plans; perhaps because of this access to treatment and medication, fewer people have mental health issues that deteriorate to a level where the police and courts have to become involved.

The Europeans may be attacking this issue on the front end, thus resulting in fewer people with mental illness winding up in jails. Just something to think about.

Tuesday, July 8, 2008

Mentally ill need treatment, not jail

By Darlene Linville, Guest Columnist

Published Sunday, July 6, 2008 5:17 PM


"Treatment not jail'' is the battle cry for Partners in Crisis, a statewide advocacy organization whose members support prevention and early treatment programs designed to keep people with mental illness out of the criminal justice system and get them into treatment. Each year as many as 125,000 people with mental illnesses requiring immediate treatment are arrested and booked into Florida jails.

The National Alliance on Mental Illness in Florida theoretically chose the same battle cry, "treatment not jail," when members statewide chose initiatives for 2007, setting as No. 1 to advocate for more funding for the mental health care system, and No. 2, to work toward improving programs to keep people with mental illness from being involved with the criminal justice system. Florida's jails and prisons house more than 10 times the number of people with mental illness as the number being treated in mental health facilities.

NAMI Hernando shouted that same battle cry in 2007 with a community education seminar titled "Taking Action … Let the Dialogue Begin," at which Judge Ginger Lerner-Wren spoke about her involvement as presiding judge in the establishment of the nation's first Mental Health Court in Broward County. She talked long and hard about how the Mental Health Court in her county saved taxpayer dollars while preserving the human dignity of those living with a treatable mental illness. Treatment not jail!

Hernando County was listening. A task force was formed and with the help of Karen Nicolai, clerk of court, Jean Rags, director of Health and Human Services and Kathleen Lonergan, coordinator for the Drug Court, that same battle cry was soon picked up by others in our county. Many people gathered to discuss the need and the possibilities; from the judges to the jail warden to the State Attorney's Office, to the hospital administrators, all were in agreement: A Mental Health Court was desperately needed.

Too many people with treatable mental illnesses were spending time in a very expensive jail when their crimes were not violent, but rather were directly related to nontreatment of their mental illness. The 2006 Hernando County health needs assessment shows that Baker Act initiations are substantially higher in Hernando County than Florida's average, and have been increasing since 2000.

I am amazed at how quickly our county officials, judges, attorneys and jail personnel came together to make it all happen. The mental health court has begun hearing cases, in Judge Richard Tombrink's courtroom.

Everyone agrees a mental health court is not the final answer, but only a beginning. "Treatment not jail" includes finding the treatment necessary to keep people on essential medication and involved with adequate psychiatric care. The Harbor Behavioral Health Care Institute will do all that it can, but in these troubled times of reduced spending for necessary programs it can only do what current funding levels allow.

"Continuing the Dialogue … Decriminalizing Mental Illness" was the theme for NAMI's most recent community education seminar on May 31 at Nativity Lutheran Church. Approximately 70 people heard a panel of experts discuss the why's and how's of a mental health court. County Commissioner Chris Kingsley read the county proclamation for Mental Health Month.

Sheriff Richard Nugent and several members of the Hernando County Sheriff's Office attended the event, at which the recently graduated members of the Crisis Intervention Team were recognized. These officers form a unique group, a group that has learned through special training to recognize mental health issues and the techniques necessary to de-escalate potentially explosive situations, thus preserving human dignity and community safety. We now have 18 trained members of the Crisis Intervention Team. Once again, "treatment not jail".

The first full week of October will find NAMI on a national level observing Mental Illness Awareness Week. NAMI Hernando will be continuing the dialogue and shouting the battle cry "treatment not jail." Watch for more information in the months ahead.

Thank you for listening, Hernando County. We look forward to continuing this partnership and our fight for adequate care for the mentally ill.

Darlene Linville is president of the board of directors of NAMI Hernando. Guest columnists write their own views on subjects they choose, which do not necessarily reflect the opinions of this newspaper.

Saturday, July 5, 2008


"The death penalty is about revenge and hate, and revenge and hate is why my daughter and those 167 other people are dead today."

Bud Welch, father of Julie Marie Welch,
victim in the Oklahoma City bombing

"I have come to believe that the death penalty is not what will help me heal. Responding to one killing with another killing does not honor my daughter, nor does it help create the kind of society I want to live in, where human life and human rights are valued. I know that an execution creates another grieving family, and causing pain to another family does not lessen my own pain."

MVFHR board member, Vicki Schieber, testifying to the Subcommittee on the Constitution,
Civil Rights and Property Rights; Committee on the Judiciary; US Senate, February 2006