Coalition Seeks To Reduce Inappropriate Incarceration

By Rebecca A. Clay

A store manager calls the police to report a woman out front shouting obscenities at shoppers. A police officer on patrol sees an unkempt man urinating in public. A frightened family asks police to intervene with a family member struggling with mental illness.

Scenarios such as these can sometimes end in violence, when the police officer or the individual responds with force to a perceived threat. But more often, such encounters lead to the needless incarceration of a disproportionately large number of people with untreated mental illness.

Recently, the Criminal Justice/Mental Health Consensus Project published a report aimed at improving the criminal justice system's response to people with mental illness. The report was produced by a broad-based coalition funded by SAMHSA within the U.S. Department of Health and Human Services, and the Office of Justice Programs within the U.S. Department of Justice, together with private sector sources. The coalition spent 2 years developing the recommendations, presented to a congressional committee in June.

Led by the Council of State Governments, the Criminal Justice/Mental Health Consensus Project includes the Association of State Correctional Administrators; the Bazelon Center for Mental Health Law; the Center for Behavioral Health, Justice, & Public Policy; the National Association of State Mental Health Program Directors; the Police Executive Research Forum; and the Pretrial Services Resource Center.

These partners began by seeking information from a group of bipartisan experts in criminal justice and mental health. More than 100 clinicians, state mental health directors, mental health advocates, substance abuse treatment experts, law enforcement officials, policymakers, judges, corrections officials, victims' advocates, consumers of mental health services, family members, and others shared their ideas. Supplementing that input with surveys and literature reviews, the partners then developed a consensus from these sometimes opposing viewpoints.

The result is a comprehensive plan that local, state, and Federal policymakers, criminal justice and mental health professionals, and advocates can use as a guideline to develop the supports that keep people with mental illness out of the already overburdened criminal justice system. The report features 46 policy statements that address the entire criminal justice continuum—from the time someone calls the police for help to an offender's release from prison. Following each policy statement are specific recommendations for putting the statement into practice, plus examples of programs and policies that some jurisdictions are already using.

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"The consensus report and recommendations are a testament to a commitment to create a new future for people who find themselves at the intersection of the mental health and criminal justice systems," said SAMHSA Administrator Charles G. Curie, M.A., A.C.S.W. "Consistent with SAMHSA's own policy directions, the report supports a community-based treatment philosophy for people with mental illness."

The first half of the report focuses on opportunities for identifying people with mental illness and reacting in ways that recognize their needs and civil liberties while simultaneously protecting the public. For example, when a person in need of mental health services comes into contact with the criminal justice system, there are a variety of options available. The report recommends training police dispatchers and officers to determine whether mental illness may be a factor in an incident, establishing protocols to help officers respond appropriately, promoting accountability by documenting interactions between officers and people with mental illness, and collaborating with mental health professionals to reduce the need for subsequent interactions.

The second half of the report discusses the broad, systemic changes necessary for achieving the coalition's specific recommendations. These changes include:

• Promoting extensive collaboration. Neither the criminal justice system nor the mental health system can bring about change by taking action alone, the report emphasizes.

• Educating all involved. Training can help law enforcement personnel, court officials, corrections staff, and mental health professionals respond appropriately. Community education can raise the public's awareness.

• Developing an effective, accessible mental health system. The report calls for mental health services that are accessible, user-friendly, evidence-based, culturally competent, and integrated with other service systems.

• Measuring and evaluating outcomes. Evaluation can determine whether programs and policies are successful and help build continued support for changes.

For more information about the project, go to www.consensusproject.org.

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