Michael Goforth: Evidence mounts to make changes in mental health and jails

By Michael Goforth (Contact)
Monday, June 15, 2009

“We tend to use a criminal justice model for a disease and it just doesn’t work,” Judge Stephen Leifman told me in a telephone conference earlier this year. “We can’t afford to keep doing what we’re doing.”

Leifman, a special adviser on criminal justice and mental health for the Florida Supreme Court, was talking about the financial and social costs of housing the mentally ill in municipal, county and state jails.

Of an estimated 600,000 Floridians with mental illness, about 125,000 needing immediate treatment are booked into jails or prisons each year. The cost for a mentally healthy inmate is about $40,000 per year. For a person with mental illness in a state-operated psychiatric hospital, the annual cost is about $140,000

In addition, the numbers are increasing and it’s estimated that over the next decade, the state would have to build a new prison each year to keep up with the number of mentally ill inmates.

And, that doesn’t include the costs for expanding county jails for their mentally ill populations, which has been occurring on the Treasure Coast in recent years.

Speaking recently at a briefing on Capitol Hill, Leifman said, “Our criminal justice system was never intended to be the safety net for the public mental health system. Unfortunately, though, that is exactly what it has become. Too often, people land in jail for minor offenses directly related to symptoms of untreated mental illnesses because of inadequate system of community-based services and supports.

“Only through systemwide collaboration and partnerships can we begin to close the revolving door to the criminal justice system which, today, results in increased recidivism, devastation to our families and communities, wasteful government spending, and the shameful warehousing in jails and prisons of some of the most vulnerable and neglected members of our communities.”

Leifman was speaking in conjunction with release of the first significant study of mental health and jails in about two decades. That study by the Council of State Governments Justice Center and Policy Research Associates found that about 17 percent of inmates in the study suffered from “serious” mental illness.

That study, however, looked at only about 20,000 inmates at five jails. Using those figures, it was estimated that about 2 million seriously mentally ill persons are booked into jails in the United States each year.

But, it’s not just those with serious mental illness who are being housed in jails. Based on medications required, about a third of those booked into the St. Lucie County Jail each year suffer from some form of mental illness. The cost for a mentally ill person charged with a misdemeanor averages $35,000 per stay. The cost for a mentally ill person charged with a felony is about $64,000 per stay.

In March, U.S. Sen. Jim Webb, D-Va., introduced the National Criminal Justice Commission Act of 2009, which calls for a national commission to undertake an 18-month study of the impact of putting the mentally ill in jail and how the criminal justice system can be reformed to address the problem.

U.S. Sen. Pat Leahy, D-Vt., has been pushing for reauthorization of the Mentally Ill Offender Treatment and Crime Reduction Act, which would provide federal grants to state and local governments to create or expand mental health courts, offer treatment and training programs to provide support and services to reduce repeat offenders, and to train police in how to react to situations involving persons with mental illness.

In addressing the results of its study, the Council of State Governments Justice Center said, “Too often there are people incarcerated who have serious mental illnesses, oftentimes for minor offenses, who would be better served in the community. Though jails have a constitutional mandate to treat the mental illnesses of individuals under their supervision, they are ill-equipped to meet the needs of those with serious mental illness.

“Policies have relied on outdated data to determine the scope and nature of this problem. As state and local governments face significant budget shortfalls, grapple with growing jail populations, and slash spending for community-based mental health services, there has not been a more critical time for policymakers to consider the implications of this prevalence study.”

Study results are clear. Too many people with mental illness are in jails who should not be there. They can be better served and more cheaply served through community programs.

But, as time goes on without comprehensive actions, those will mentally illness and their families are abused and taxpayers are forced to pay far more than they should for far too little.

michael.goforth@scripps.com