European states treat mental illness before it becomes prison problem

By DAN EISENSTEIN

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.