By Sherry Levin Wallach, Bloomberg Law
The growing number of Americans with serious mental illness is challenging law enforcement, courts and jails, which have become de facto psychiatric wards
For far too long, America has failed in its promise to provide humane treatment for people living with serious mental illness (SMI). As a result ... many people living with mental illness are left to fend for themselves or with a family member who lacks training and resources to provide care. Far too many more are languishing in jails, which over the years have become de facto psychiatric wards.
The number of inmates living with mental illness is staggering. In the first six years of this century, the number had quadrupled, according to a Federal Bureau of Justice Statistics report.
It keeps climbing today. The National Alliance on Mental Illness (NAMI) reports that 37% of incarcerated adults have a diagnosed mental illness while two million times every year persons with serious mental illness are put behind bars with three out of five never receiving medical treatment.
Recently, a task force of the New York State Bar Association examined all sides of the issue of care and legal representation for people living with mental illness and trauma—not just the need to replace jail with treatment, but also the impact that decades of neglect have had on law enforcement, the court system and attorneys who devote their careers to representing this marginalized population. On Jan. 18, the association brought even more attention to this issue by holding a summit on the intersection of mental illness and the criminal legal system.
Comprehensive reform is needed
Often, when a mentally ill person acts out in public, the police are called rather than trained medical personnel. A court date is soon followed by a trial. People who are living with mental illness regularly end up in prisons and jails that are not equipped to provide the care they need to successfully re-enter and function in society.
To meet the needs of all people living with mental illness, a comprehensive national program of humane care is needed through a network of community-based support centers. Such a program has actually been in place since 1963, when President John F. Kennedy signed into law the Community Mental Health Act, promising that “reliance on the cold mercy of custodial care will be supplanted by the open warmth of community concern and capacity.”
The Community Mental Health Act accelerated the process of deinstitutionalization, but what was supposed to be a comprehensive, community-based health care system didn't materialize. Nearly a decade later, in New York, shocking scenes from inside Willowbrook State School seared in the national consciousness the abuses that plagued large institutions for people with developmental disabilities and those living with mental illness. Willowbrook was graphic proof that society was still warehousing people with disabilities rather than providing the compassionate care Kennedy had envisioned.
Today, while people with developmental disabilities have a range of community residential treatment options, there is still a dearth of supportive community treatment for people with mental illness. A mentally ill person is more likely to end up in jail than in the “warmth of community care.”
Every minute of delay is a minute too long
We have been more inclined to punish people with mental illness than to care for them. Imagine if society were to incarcerate people suffering from dementia or Parkinson’s disease. How long would it take Congress to pass reform legislation?
American scientists took less than a decade to accomplish Kennedy’s challenge to land a man on the moon. It should not take decades longer for society to achieve his other goal of replacing the “cold mercy of custodial isolation” with compassionate community care.
We are determined to keep the focus on the issue at all levels, from Congress to state leaders to reform advocates everywhere.
Sherry Levin Wallach is president of the New York State Bar Association. She also is deputy executive director of the Legal Aid Society of Westchester County in White Plains, N.Y.
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