Berrien County might look seriously at this issue if they care about improving an antiquated system with a statewide reputation. (not good)
By Mark Reinstein
Michigan, like the country, has a tremendous problem with persons who have mental illness entering adult and juvenile justice systems. Gov. Granholm has proposed one promising remedial step in her fiscal year 2009 executive budget - i.e., $3.4 million for five pilot mental health courts in the state. We strongly encourage the Legislature to approve this recommendation.
How bad is the problem? The U.S. Bureau of Justice Statistics reported in 2006 that nationwide, 64 percent of jail inmates and 56 percent of state prison inmates had mental illness. More than 75 percent of jail inmates with mental illness - and more than 50 percent of state prisoners with mental illness - had committed nonviolent offenses. More than 75 percent of both jail and prison inmates with mental illness had been incarcerated previously.
In Michigan, the last time county jails were independently studied was 1998-99, when the Department of Community Health sent contracted clinicians into the Wayne, Kent and Clinton county jails. Their diagnostic interviews found that the prevalence of mental illness (exclusive of substance abuse) was 51 percent, and the prevalence of the three most serious diagnoses was 34 percent.
The last time Michigan prisons were independently studied was in the mid-1980s, by two state universities. A mental illness rate of 40 percent (exclusive of substance abuse) was found. For the three most serious diagnoses, the rate was 24 percent. This was before Michigan subsequently closed a dozen state-operated psychiatric hospitals.
The term "deinstitutionalization'' is often used to represent the downsizing of state-operated psychiatric hospitals. But we have not deinstitutionalized mental illness; we have trans-institutionalized it to prisons, jails and juvenile justice facilities.
Michigan and the country are experiencing an epidemic of persons who have mental illness winding up in justice systems, which are not therapeutic settings and often can't provide needed care. In many cases, offenses by persons with mental illness are relatively minor and may not have occurred if the individual had been connected with community treatment.
Multi-faceted responses are needed for this problem. But one thing we can do now is establish some specialized mental health courts, as much of the country has done. There are approximately 150 such courts nationally; Michigan has one fledgling mental health court begun last October.
Communities with mental health courts make local determinations of types of offenses that, if committed by someone with mental illness, are eligible for treatment in lieu of incarceration. These programs do not set free individuals whose offenses exceed the local community's standards as to what is and isn't acceptable for consideration of mental health court eligibility. Typically, completion of a recommended treatment regimen by those who are eligible is required to avoid incarceration, and successful completion of the treatment erases the offense from an individual's record.
There are numerous citations from other states of this approach saving substantial amounts of money, as it is less expensive to treat mental illness in the community than to house (and treat) someone in a justice facility.
For example, the Akron (Ohio) Mental Health Court in its first three years dramatically reduced program participants' time in county jail, state prison and state psychiatric hospitals.
And in San Francisco, to provide one other illustration, a large-scale university study found mental health court participants much less likely than others charged with crimes to commit new offenses generally or violent offenses specifically.
It is also far more humane for persons and families experiencing mental illness to receive community treatment rather than incarceration. That is among the reasons the Governor's Mental Health Commission recommended in 2004 that Michigan must establish some mental health courts.
Mental health courts won't solve all problems relating to incarceration of individuals with mental illness. But it's time we caught up with most other states in making use of this tool to help fight the problem. We hope the state Legislature will see the wisdom of doing so for what is a minuscule amount of money in the total state budget picture.
About the writer: Mark Reinstein is president and CEO of the Mental Health Association in Michigan, a statewide advocacy headquartered in Southfield and partly funded by United Way.
3/2/08, Ann Arbor News
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