Remarks of Laurie Robinson, Acting Assistant Attorney General
Office of Justice Programs
Bureau of Justice Assistance National Technical Assistance and Training Event
Smart Responses in Tough Times: Achieving Better Outcomes for People with Mental Illness Involved in the Criminal Justice System
Thursday, July 16, 2009
Thank you, Mike. I appreciate the opportunity to join you all today.
I want to thank Ruby, Jim Burch, and the staff of BJA, as well as all the good folks at the Council of State Governments, for putting this conference together. Let me also thank our other partners – the Center for Mental Health Services, the Center for Substance Abuse Treatment, the National Institute of Corrections, the Pretrial Justice Institute, and the National Association of Counties, all of whom have been so instrumental in calling attention to the issue of mental illness in the justice system.
I also want to thank all of you for taking the time out of your busy schedules to be here.
This is an issue we looked at when I was with the Department of Justice back in the 90s. In fact, it’s almost 10 years to the day that we convened what I think was an important national conference on crime and mental health under Janet Reno. It was something of a landmark gathering that brought together all the stakeholders to talk about how to best address the problem of mental illness within the justice system. I want to tell you that Attorney General Eric Holder, who was the Deputy Attorney General at the time, understands the importance of this issue and remains committed to addressing it.
I’m grateful that so many of you are here to help guide our response.
Before addressing the subject at hand, I want to give you a brief report on Eric Holder’s Department of Justice. I can assure you it is a new day at the Department of Justice and the Office of Justice Programs. It is now 5½ months since he and I came to the Department. OJP was the first component he visited – that says something about how passionately he cares about our issues. And he joins me in setting several priorities for OJP, among them, full engagement with our partners in the field, restoring respect for the science in our criminal and juvenile justice efforts, and strengthening our relationship with our sister agencies.
Shortly, you’ll hear from several directors of mental health and criminal justice agencies about some of the things they’re doing to address mental illness in the justice system. And before I give my remarks, I just want to thank them for all that they’re doing. One of the keys to dealing with this issue will be the leadership that states provide in coordinating services. Many counties and communities are doing wonderful work in this area as well, and ultimately, long-term success will depend on all levels of government – I know this has long been one of the Don Murray’s themes at NaCO – working together to take ownership of the problem and lead us toward greater collaboration and partnership.
Partnership is critical to addressing mental illness in the justice system. This problem is just too complex, and the numbers are just too large for us to expect justice system professionals to handle it alone. We already know that people with mental illness are over-represented in jails and prisons. Now we have the recent report from the Council of State Governments and Policy Research Associates which suggests that almost 17 percent of jail inmates have a serious mental illness. That’s three to six times higher than the general population, and it means that as many as two million bookings of people with serious mental illness may occur every year. We have been hearing for more than a decade – as one corrections official recently summed it up – that “[j]ails are rapidly becoming a core element in the mental health system.”
The problem is, through no fault of their own, justice system professionals are not adequately equipped to handle this problem. Their primary responsibility is public safety – not to provide a mental health assessment. Yet one of the hard lessons we’ve learned over the years is that law enforcement officials are often the first – and sometimes the only – people to respond to mentally ill individuals. In short – and I certainly don’t need to tell the experts in this room – we can’t expect to arrest our way out of this problem.
We’ve seen a lot of great progress in recent years. In many jurisdictions, law enforcement agencies have come to terms with the challenges they face, and they have reached out to the mental health community. In some jurisdictions – Memphis is certainly the pioneer, as you know – law enforcement officers are being trained on how to defuse encounters with mentally ill individuals. In other jurisdictions – like Birmingham and Knoxville – mental health professionals team up with law enforcement to respond to these situations. Still others – Seattle and Hillsborough County, Florida, for example – have mental health centers that can serve as alternatives to jail booking. There are many other innovative examples.
But the law enforcement response is, by no means, the only element to this complex issue. This is an issue that runs the full gamut of the system. It affects law enforcement, but it also affects prosecution and defense, it affects courts, it affects corrections, it affects juvenile justice agencies. It’s an issue at every stage, and it exacts a disproportionate toll on system resources. Failing to address this problem at one stage only compounds the problem at another.
One of the most effective means of addressing individuals with mental illness in the justice system is the mental health court. I’m encouraged by what we’re seeing with the development of mental health courts. Initial research tells us that they appear to be effective in reducing justice system involvement of mentally ill individuals. Although a comparative study of outcomes has yet to be completed, a study in San Francisco that was published in the American Journal of Psychiatry in 2007 showed that mental health court participants recidivate less frequently. Another study of the Broward County, Florida mental health court showed that participants get treatment more often and spend less time in jail than those who go through the traditional system.
Of course we know that a key reason why mental health courts – and other problem-solving courts like drug courts and reentry courts – have been successful is that they leverage the monitoring power of the courts and marry it with treatment. They use the authority of the system to get to the underlying causes of an individual’s involvement in the system. But of course this is tricky with mental illness. It is certainly not an activity like using drugs! This problem-solving approach is particularly useful for persons with mental illness because it can help them connect back to the community and improve their independent functioning as part of the community. This approach succeeds in promoting accountability, which means that both treatment and public safety goals are served.
Judges have a special role to play here, too. There are now somewhere in the neighborhood of 250 mental health courts nationwide, which is encouraging, but it’s not nearly enough to handle the large population of mentally ill people who enter the system. Judges should be encouraged to adapt the problem-solving principles of mental health courts to their regular dockets, and they should ensure that court personnel receive training and that they collaborate with mental health and substance abuse treatment agencies.
BJA has funded a number of mental health courts under its Justice and Mental Health Collaboration Program, including five learning sites that serve as a resource for other jurisdictions.
Let me also just touch on reentry and community corrections. A vast majority of all offenders will eventually be released and return to their communities. We like to underscore that reentry really begins the moment an individual enters the corrections system. This applies doubly to those with mental illness.
Life behind bars can, of course, take an enormous psychological and emotional toll on a person with mental illness. And there are other concerns, too – like termination of federal benefit programs that mentally ill individuals rely on for medication and treatment. When they come out of the system, they have to reapply for those benefits, and that can take weeks or months. In some cases, they aren’t reinstated at all. So returning mentally ill offenders are in a very tough bind. It’s no wonder that they return to prison and jail at such a high rate.
Here again, partnerships are so important. Corrections officials should strive to link mentally ill inmates with appropriate treatment services while in jail or prison, and they should begin looking ahead the moment the offender arrives to start planning for what will happen once they are released. This means reaching out to treatment services, to housing agencies, even to Social Security offices. And probation and parole officials should work to link mentally ill offenders with screening and needs assessment services, as well as with counseling.
BJA is in the process of reviewing applications under the Second Chance Act. A number propose to use funding to provide mental health services to returning offenders, a sign of how important this issue has become. BJA is working hard to award all these grants by September 30th. And speaking of grant awards, I know that many of you applied for funding under the Justice and Mental Health Collaboration Program. We expect to have those awards made by September 30th as well, and I’m very pleased that we have $3.5 million more available this year than last year, which will allow us to almost double the number of awards.
There’s also the issue of juvenile offenders with mental illness. The National Center for Mental Health and Juvenile Justice has found that 70 percent of youth in the juvenile justice system suffer from mental health disorders. That’s staggering. And there are unique challenges to this group that demand increased attention to partnerships – with schools and foster care, for example. Many of our Justice and Mental Health grants over the last three years have gone to support efforts to address juveniles with mental illness.
Finally, there’s the cost. State budgets are shrinking, and the amount that states are spending on mental health treatment is going down. Add to that the fact that some studies show that offenders with serious mental illnesses are incarcerated longer than other inmates and that the daily cost of their incarceration can be significantly higher than the general inmate population. And of course, there are the costs associated with repeated responses to individuals whose mental illnesses continue to go untreated.
BJA is working with the Council of State Governments on a project we call Justice Reinvestment. It is designed to help states figure out how to lower corrections costs and reinvest those savings to other areas – primarily at the prevention end early in the system – to improve public safety. While state spending on mental health treatment has gone down, spending on corrections has gone up faster than just about any other budget item. But as states have discovered – painfully – that’s no longer sustainable. We need to determine a wiser course. Just as we can’t arrest our way out of this problem of mental illness in the justice system, neither can we spend our way out of it. We need to figure out how we can coordinate resources so that we hit the problem head on, at the front end, and that we deal with it at every stage.
I know I’m preaching to the choir. You know all this – otherwise you wouldn’t be here. Our challenge is how to formalize and expand this idea of partnership between the justice system and the mental health community. Many of you are already doing this, and I want to commend you for your foresight. As we move forward, we need your guidance in identifying ways to replicate your efforts, and we need to know what other programs are out there that are working.
The Attorney General has made it a point wherever he goes to emphasize the importance of evidence-based approaches to preventing and reducing crime. This information comes from you, the practitioners in the field. We want to hear from you so that we can facilitate the horizontal transfer of that information to your peers and colleagues in other jurisdictions.
This is not a simple problem with a straight-forward solution, but it’s a problem we can no longer afford to ignore. I am grateful for all your work, and I urge you to stay connected to each other and to us at the Department of Justice. We’ll continue to be your partners, and I’m confident that we can find workable strategies for addressing this issue.