Pubdate: Thu, 13 Nov 2003 Source: Ledger, The (FL) Copyright: 2003 The Ledger Contact: http://www.theledger.com/ Details: http://www.mapinc.org/media/795 Author: John Rutherford Bookmark: http://www.mapinc.org/prison.htm (Incarceration) MENTAL HEALTH CASES FALL TO POLICE Florida's law-enforcement and corrections systems are rapidly evolving into the state's de facto mental health treatment providers. More often than not, our law-enforcement officers, prosecutors, defense attorneys, judges and parole officers are being forced to serve as the first responders and overseers of a system ill-equipped to deal with the consequences of an underfunded treatment system that's stretched beyond capacity. While headline-grabbing tragedies often serve to define the problem in the eyes of both the public and our policy-makers, the day-to-day realities for our officers and judges are much different. A more familiar scenario is one in which an officer responds to repeated incidents involving an individual known to have a history of mental illness. With nowhere to take him or her for treatment or crisis intervention, the officer is forced to place the person under arrest, often for such minor infractions as disturbing the peace or making lewd gestures at passing vehicles. Then the process begins. The individual makes a court appearance in which the prosecutor is forced to follow through on what often becomes a neverending cycle of nuisance charges. The person pleads guilty to time served and is released back on the street, without treatment or support. Predictably, they soon cycle back into the system. And the process begins all over again. According to a report recently released by Human Rights Watch, between 200,000 and 300,000 men and women in U.S. prisons have mental disorders, including schizophrenia, bipolar disorder and major depression. An estimated 70,000 are psychotic on any given day. Florida houses about 10,000 of those prisoners who suffer from severe mental illnesses. Yet, many prison mental health services are woefully deficient, crippled by understaffing, insufficient facilities and limited programs. All too often, seriously ill prisoners receive little or no meaningful treatment. Prisons were never intended as facilities for the mentally ill, yet that is one of their primary roles today. Far too many men and women who cannot get mental health treatment in the community are swept into the criminal-justice system after they commit a relatively minor crime. In the United States, there are three times more mentally ill people in prisons than in mental health hospitals and prisoners have rates of mental illness that are two to four times greater than the rates of members of the general public. Outside the corrections system, there is a lack of community-based treatment for people with mental illnesses who were already living in local communities. Funding for community-based care and treatment hasn't kept pace with the need almost anywhere in the country. That means the burden has shifted to the criminal-justice system, in effect criminalizing mental illness and substance abuse. Warehousing people with mental illnesses and substance-abuse problems in our jails and prison systems is a terrible waste of resources, and a major disservice to the families who are urgently seeking treatment for their loved ones -- and to our law-enforcement professionals. Instead of providing care and treatment, it seems policy-makers have fallen into a form of denial about the magnitude of the problem. As a result, millions of taxpayer dollars are being wasted and hundreds of thousands of people who could be helped are left in inappropriate settings. From a point of view of justice, public safety, cost-effectiveness and medical solutions for medical problems, this just should not be. Advocacy organizations, such as Florida Partners in Crisis, unite law- enforcement, medical, state-agency and judicial-system officials in a collaborative effort to work for change in the state's mental health- care system. Florida Partners in Crisis' objective is to foster collaboration and cooperation among the many human service agencies to improve mental health services and processes, and to redirect people with mental illness from the corrections system to the health-care system. This is one step toward change, however more needs to be done. Building more prisons and jail space to accommodate people who need treatment doesn't make sense for our communities, our families or our criminal-justice system. In a time when state and local government funding is stretched thin, we need to be looking for the most cost effective means to address these problems. Ensuring that people have appropriate access to treatment and medications offers the best return on investment for Florida families and Florida taxpayers. - --- John Rutherford, who is the sheriff of the city of Jacksonville/Duval County, is state director of Florida Partners in Crisis. - --- MAP posted-by: Jackl