Mental Health and the Criminal Justice System
By William King Self, Jr., CELA
There are large numbers of underserved individuals with mental illness in communities across the U.S.–largely due the federal government’s failure to fund community programs in the wake of deinstitutionalization. A disproportionate number of these individuals become embroiled with the criminal justice system. It’s been reported that the number of prison inmates being treated for mental illness tops the total being served by hospitals and treatment centers.
Too often, first responders are unaware that they are witnessing a mental health crisis. They may misinterpret someone’s behavioral tics or failure to respond to questions, and quickly escalating tensions can lead to violence. It was just such a tragedy that led the City of Memphis in 1988 to partner with NAMI (National Alliance on Mental Illness) and two local universities to teach specialized police units (Crisis Intervention Teams), to defuse explosive situations and to connect individuals with mental health services rather than arrest them. With the passage of the Americans with Disabilities Act in 1990 came increased focus on law enforcement’s obligations to the disability community. Subsequently, police departments throughout the country (more than 40 states) have developed Crisis Intervention Team (CIT) programs based upon what has become known as the Memphis Model.
Roughly 25 percent of the Memphis police force−both emergency dispatchers and patrol officers−has been trained as CIT officers. The CIT officers receive 40 hours of training from mental health providers and advocates. A key element of the Memphis CIT program is that it consists of volunteers who are already trained officers, not new recruits. The volunteers are taught to recognize signs of autism, schizophrenia, OCD, drug-related psychosis, and other mental illness and to employ a variety of de-escalation techniques in order to increase the safety of all parties. They are counseled, for instance, to seek assistance from caretakers and family members, to speak softly and to repeat and rephrase requests for information.
CIT officers are patrol officers stationed in every precinct of the city, and 911 calls that may involve individuals with mental illness, including the elderly with dementia, are routed to them for response. If appropriate, they convey individuals to a central “triage” treatment unit at the emergency room of the Regional Medical Center.
The results have been dramatic—fewer arrests, less use of force and a decrease in violent emergency room incidents. With fewer prisoners requiring care for mental illness and lower injury rates among officers, the program more than pays for itself.
A related initiative, also developed in Memphis, is the Jericho Project, a jail diversion program developed by the Shelby County Public Defender’s office. Jericho seeks to provide integrated treatment and community supports to individuals with severe, untreated mental illness. The program has been embraced by prosecutors and judges alike, who regularly refer individuals to Jericho as part of conditional release or probation strategies. The Jericho project, like the Memphis Model, has impressive successes to its credit. Over 50 percent of its participants have broken free of the re-arrest cycle.
These models are encouraging, but they’re only a beginning. Far too few police officers are aware of the needs of people with mental illness. The potential for heartbreaking and traumatic misunderstandings is huge. Individuals with mental illness need understanding, not jail sentences.
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I have a 31 year old son who is conserved. He has tuberous sclerosis, mental retardation, and autism. His behavior has been elevating in the last year to levels that are out of the norm. One of the main manifestations of Tuberous Sclerosis is that tubers are in and around the different areas of the brain. This causes seizures, mental retardation, and can also cause tumors,. With all this abnormality in the brain behavior issues are common. As stated before, my sons behavior has been elevating in the last year. A few weeks ago he woke up at the care home he lives at around 5 AM and went into a fit and started throwing boulders into 5 of the home windows. Trying to make this as condensed as possible, he was arrested, held overnight, with the help of the Regional Center lawyers, felony charges dropped, and sent to a mental hospital in LA, California. We feel an MRI needs to be done to rule out any type of tumor. We can not get the psychologist to agree to it a write an order, and have not been previous neurologist to respond to our phone or e-mails. He is stuck in a horrible pysciatric hospital without any benefit. Can you help. This is not the correct treatment and we don’t know who to turn to for help for our son. We are happy to answer what ever questions you may have in order to fill in the blanks. Thank you.
Margaret – unfortunately this is all too common. This is a national list so I want to make sure that readers in other state understand that in California we have what is called a Regional Center system that is unique to our state.
First – you probably need to continue to press regional center. I would immediately ask for an emergency IPP. I would also contact my local Area Board and maybe even Disability Rights California. If you need assistance finding these groups – feel free to contact me offlist [email protected] . This is a systemic issue and not only needs to be addressed for your situation – it needs to be addressed for others as well.
This has been a focus of many organizations including the ARC and the ASA. I will try to solicit another professional I work with to make further comments.
Steve Dale
The local police keep filing retaliation on my son. They been knowing him for seven years and they still don’t take him to the hospital. They always put him in jail. Also for no probable cause reasons. After I filed complaints they have sort out my whole family and everything about me.
I forgot to add he is non violent.
My boyfriend has autism and alots of other disorders. He has a yellow card that was state issued to him to show the police if something where to happen and they just ignored it and threw it on the hood of his truck and wouldn’t call his mom and went on and arrested him. He wants to take legal action against them for this.