Monday, April 6, 2009

Early intervention works for mentally ill

OUR OPINION: They belong in treatment facilities, not in jails and prisons
You see them all the time: People who aimlessly wander the streets, obviously homeless and obviously in need of attention for their mental illnesses. Ever wonder what happens to them? Far too many end up in jail or prison, at great and unnecessary expense to taxpayers.

To keep just 1,700 of these people locked up, as Florida currently does, costs $250 million each year. When they are released from prison, as inevitably all of them are, their mental-health conditions have worsened.

There is a better way. Instead of warehousing these people in prisons, the state can diagnose and treat their illnesses. It can use supportive diversion programs in community-based facilities to put them on a path of recovery. This can be done at a fraction of the cost of locking them up.

This is what can be accomplished if state legislators approve HB 7103 and SB 2018. The legislation carries the ponderous title, Community Mental Health & Substance Abuse Treatment & Crime Reduction Act. Yet it represents years of work by a coalition of public and private leaders, including Gov. Charlie Crist, former Florida Chief Supreme Court Chief Judge R. Fred Lewis, Miami-Dade Circuit Court Judge Steve Leifman and others.

A Senate committee considers the bill this week and other committee hearings await before a floor vote is taken. The bills deserve the enthusiastic support of all lawmakers. If it becomes law, the proposal would achieve that legislative rarity of doing a public good while being revenue neutral (meaning it doesn't require new money) at the outset, and save the state hundreds of millions of dollars in the long term.

This would be possible because the state would begin to reverse its extraordinarily wasteful practice of putting mentally ill people who commit crimes in prison instead of treating their illnesses. Florida is not alone in doing this, but it would become the model for other states to emulate.

The law would allow Florida to use community-based mental-health resources to intervene with the mentally ill before they go to jail or prison. This is what typically happens:

A mentally ill person commits a minor offense, say being disorderly. A police officer arrives, and attempts to calm the situation. The person, under emotional duress, is unable to comply, becomes more disruptive and is arrested on a more-serious charge.

This is where the legal insanity begins. Because the mentally ill person is unable to understand the charges, he is sent to a criminal-forensic hospital where, with the help of medications, he is calmed enough to face trial. If convicted, he is sent to prison where there is no treatment for his mental illness. If exonerated, he is released, untreated, and certain to suffer another emotional episode, which starts the process anew.

The proposal would authorize pilot projects in Miami-Dade, Tampa-St. Petersburg, Leon County and the Pensacola area. The programs would use managed-care principles, using appropriate diagnosis and medication, trauma services, drug and alcohol intervention and rehabilitative services such as education and job training. The intervention will give the mentally ill the help they need to everyone's benefit.

Sunday, April 5, 2009

Prison nation

Friday, April 3
There are few industries more recession-proof than prisons, especially in this country.
The United States has the world's highest incarceration rate, with 2.3 million people behind bars. Despite having only 5 percent of the world's population, we have 25 percent of the world's reported prison population.

Ours is a nation that loves retribution. The flip side to "zero tolerance," mandatory sentencing laws and "get tough" policies on crime is that about 1 out of every 31 American adults is either in prison, jail or on supervised release. And all this costs us, as a nation, about $68 billion a year.

The picture is even worse in Vermont. According to data compiled by the Pew Center on the States, between 1996 and 2006,

Vermont's prison population doubled in size -- from 1,058 to 2,123 inmates -- and the corrections budget went up 129 percent -- from $48 million in fiscal year 1996 for $130 million in fiscal year 2006.

The percentage of the state budget devoted to corrections has risen from 4 percent of the general fund in 1990 to 10 percent of the general fund in 2008. Our state's incarceration rate has increased 80 percent over the past decade, compared to a national average of 18 percent.

At the current rate of growth, the state will either have to ship more prisoners to out-of-state facilities -- which would cost about $82 million -- or spend $206 million to build new prisons in Vermont.

In the ongoing budget battle, it has been more or less decided that more prisoners will be shipped out of state to corporate-run private prisons, since it is cheaper. But is that the real solution to the problem of an out-of-control corrections budget?
Vermont has the dubious distinction of being one of five states (Connecticut, Delaware, Michigan and Oregon are the others) that spend more on corrections than on their higher education systems. Is that the kind of state we want to be?

In Parade magazine this week, U.S. Sen. Jim Webb, D-Va., wrote about the urgent need to reform our nation's criminal justice system. With so many of our fellow citizens in jail, Webb wrote that "either we are home to the most evil people on earth or we are doing something different -- and vastly counterproductive. Obviously, the answer is the latter."

Webb believes one of the biggest problems is that we have swamped the criminal justice system with low-level drug offenders.

According to the U.S. Department of Justice, nearly 48 percent of all drug arrests in 2007 were for marijuana offenses and nearly 60 percent of all people in state prison serving sentences for drug offenses had no history of violence or of significant selling activity.

And while blacks comprise 12 percent of the U.S. population, they account for 37 percent of those arrested, 59 percent of those convicted and 74 percent of those sentenced on drug charges.

The other factor driving the increase in the prison population is mental health. The Department of Justice estimates 16 percent of adult inmates -- more than 350,000 -- suffer from mental illness, and the percentage is even higher among juveniles.

That is why Webb says he has introduced legislation to "create a national commission to look at every aspect of our criminal justice system with an eye toward reshaping the process from top to bottom."

He believes it's time for Americans to ask some hard questions. Why are so many of our citizens in jail compared to other nations? What is this costing us in tax dollars and lost opportunities? How can we change our nation's drug policies? How can we better diagnose and treat mental illness? How can we make our prisons a place for rehabilitation rather than violence and hate?

These are questions most politicians would rather not answer. It's easier to pass a gay marriage law in our legislature that it is to pass a law that would decriminalize marijuana possession. It's easier to advocate sending more people to jail for longer stretches in the name of public safety than to honestly deal with all the factors that make the United States the world's No. 1 jailer.

We need more lawmakers at every level of government who are brave enough to deal with a criminal justice system that is a national disgrace, to make the necessary changes and to come up with better ways to keep our nation safe.