Where Mental Health and Criminal Justice Collide: Part Three

In part one of our series about the intersection of criminal justice and mental health, we looked at violent, often deadly altercations between police and the mentally ill. Part two considered the connection between mental illness and substance abuse and how statistically unlikely it is for a person with a dual-disorder to get help for either the mental health issue or the substance abuse issue, and how much less likely it is to receive treatment for both. We examined how the dual nature of mental illness and substance abuse may lead to the high incarceration rates for non-violent drug crimes in Oklahoma. In this segment, we will look at some of the costs associated with relying on police to fill in the gaps for those with mental health issues who cannot or do not receive the treatment they need. [caption id="attachment_4480" align="aligncenter" width="620"]Image Credit: Quinn Hue via https://www.flickr.com/photos/quinnhu/3412898779 Image Credit: Quinn Hue via https://www.flickr.com/photos/quinnhu/3412898779[/caption] Often, law enforcement is called to assist a situation involving a mentally ill person after a family has exhausted all other resources, or if a person who is unable to get the help he or she needs begins to exhibit behavior that is dangerous to either himself or others. Law enforcement was never intended to be given the task of assessing or evaluating those with mental illness, and jails and prisons are penal institutions, designed to punish those convicted of crimes, not offer rehabilitation and treatment to those whose "crimes" result from untreated mental illness. According to a USA Today series, "The Cost of Not Caring," utilizing law enforcement as de facto mental health professionals not only does a disservice to those with mental illness, but it also diverts resources from the public safety roles these officers are intended to hold. The series cites Chicago's Cook County Sheriff as saying that 30% of the 12,000 inmates in the Cook County Jail have some degree of mental illness. One of those inmates, he describes as a "'chronic self-mutilator' who has been arrested more than 100 times, ringing up more than $1 million in repeated arrest- and detention-related costs." Locally, the issue plays out in the requirement of law enforcement officers to transport mentally ill patients across the state in search of beds at facilities equipped to handle them. "The Cost of Not Caring" cites an Oklahoma law that requires police to transport mentally ill patients to mental health treatment facilities around the state--a transportation requirement whose costs include significant man-hours and funds: "In 2013, Oklahoma police agencies traveled nearly 1 million miles with mentally ill patients, according to records maintained by the Oklahoma Department of Mental Health and Substance Abuse Services. The state reimbursed the agencies $519,333 for the mileage, but Lewis and other officials said other related costs, including tens of thousands of dollars in necessary overtime and the loss of police coverage from neighborhoods, are difficult to reconcile." Major Tracie Lewis, transportation manager for the Tulsa Police Department, told USA Today, "It is simply overwhelming. Police should not be involved in this process at all, but nobody else can or wants to do it." Lewis said that while the state reimbursed police agencies $519,333 for nearly one million miles traveled transporting mentally ill individuals in 2013, the mileage reimbursement does not offset other expenses associated with the transportation, "including tens of thousands of dollars in necessary overtime and the loss of police coverage from neighborhoods." Aside from the financial toll for police departments transporting people to mental health facilities is the emotional toll on individuals already suffering from various degrees of mental duress. Oklahoma Department of Mental Health Commissioner Terri White says, "They are put in handcuffs and transported hundreds of miles at a time. It is unconscionable; no other disease gets transported this way." Handcuffs are used to prevent the transported people from harming themselves or police officers en route to a facility or from attempting to jump from the police vehicle. However, no one seems to be willing to foot the bill to transport individuals via ambulance or other appropriate medical transport. But saving the money by saddling police departments with the job comes at a high cost to the departments, the general public, and those suffering from mental illness. Institutionalization of those with mental illness is not always the appropriate response; often, it is the worst response. However, in seeking to de-institutionalize the mentally ill, the government closed state mental health facilities without providing mental health resources that could adequately address the needs of each community. Now, rather than institutionalization in mental health facilities, many of those battling mental health issues are instead warehoused in jails and prisons across the nation. In our fourth and final segment of this series, we will look at the problem of mental illness in the nation's prisons.

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