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A Crack of Light in a Dark Place. Providing Necessary M ental H ealth T reatment for the Inmates of Cook County Jail. General Overview.

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A crack of light in a dark place

A Crack of Light in a Dark Place

Providing Necessary Mental Health Treatment for the Inmates of Cook County Jail


General overview
General Overview

  • Problem: Cook County Jail, the home of 13,000 male and female inmates, has been deemed the largest mental health facility in the country. Unfortunately, most of the inmates with mental illnesses are neither receiving the appropriate treatment or care while awaiting their day in court, and are not receiving treatment once released back into the community.


How we got here
How We Got Here

  • Prior to 1975, Judges had the authority to mandate mental health treatment for any individual before the court who demonstrated severe signs of mental illness.

  • Inmates who were required to receive mental health treatment were sent to State-Run Hospitals whose sole purpose was to house and treat the mentally ill.


Hollywood lifts the veil
Hollywood Lifts the Veil

  • In the late 1960’s, documentary film makers began investigating the squalid conditions of State-Run Mental Hospitals.

  • Gross mistreatment, such as forced feedings, lack of bathing and hygiene, sensory deprivation, forced nudity and bullying were common institutional problems that were found at many of these facilities


O conner v donaldson
O’Conner v. Donaldson

  • Facts: While visiting his parents in Florida, Kenneth Donaldson told his father that he was afraid one of his neighbor’s was attempting to poison his food. His father petitioned the Florida court for a sanity hearing, Kenneth was diagnosed with paranoid schizophrenia, and was civilly committed to a Florida State Mental Hospital.

  • Supreme Court Ruling: A State cannot constitutionally confine a non-dangerous individual who is capable of surviving safely by themselves or with the help of family and friends.

  • Two Exceptions: (1) They are an imminent danger to themselves, or (2) They are an imminent danger to others.



The new model that never was
The New Model that Never Was Violence

  • States planned to use out-patient facilities to treat individuals awaiting trial.

  • These out-patient facilities never received any State or Federal funding and collapsed.

  • By 2000, half a million inmates with mental illnesses have been released back on the streets.


Illinois s spending cuts
Illinois’s Spending Cuts Violence

  • Since 2009, Illinois has cut 15%, or $168 million dollars from community mental health care.

  • The National Alliance on Mental Illness has placed Illinois in the top 10 States for slashing funding for mental health care.


Cook county jail at a glance
Cook County Jail at a Glance Violence

  • Largest Jail in the Country, housing approximately 13,000 inmates.

  • Annual costs total approximately $550 million dollars.

  • 20% of inmates housed have a mental illness. (2,800 inmates)


Cook county jail health facilities
Cook County Jail Health Facilities Violence

  • Designed to establish fitness for trial, not for the treatment of the mentally ill.

  • An inmate may wait for months to see a Doctor.

  • State Hospitals are egregiously underfunded (Elgin Medical Center has roughly 500 beds for mentally ill inmates).


Bill at a glance
Bill At A Glance Violence

  • Short Title: Mental Health Crime Prevention Act

  • Venue: Cook County

  • Sponsor: Alderman James Cappleman (D-46th Ward)


Purpose of the bill
Purpose of the Bill Violence

  • (1): To increase funding for Public Health Facilities, Outpatient Treatment Centers, and private practitioners in Cook County so that inmates awaiting trial may receive much needed mental health treatment.

  • (2): To increase the capacity and upgrade the facilities at currently operating State Mental Health Hospitals to better treat and accommodate those inmates who are afflicted with more serious mental illnesses.

  • (3): To provide alternative sentencing options and treatment programs for Cook County Judges so that first time offenders and non-violent offenders with mental illnesses can receive medical treatment rather than prison sentences.

  • (4): To provide treatment options for released inmates with mental illness who have served their period of incarceration with a focus on preventing recidivism and providing long term mental healthcare for those with serious mental illness.

  • (5): To capitalize on newly available funds, resources and programs to treat the mentally ill as provided by the Federal Government.


The federal government s support
The Federal Government’s Support Violence

  • Affordable Care Act

  • Mental Health First Aid Act

  • Excellence in Mental Health Act

  • Mental Health in Schools Act

  • Behavioral Health IT Act


Affordable care act
Affordable Care Act Violence

  • Estimated that 30 Million Americans will get mental health care coverage for the first time.

  • 32 Million more Americans will have more affordable mental health care coverage.

  • White House pledged $100 Million in additional funding for mental health research.


Mental health first aid act
Mental Health First Aid Act Violence

  • Sponsored by Sen. Mark Begrich (D-AK)

  • Also known as S.153

  • Purpose: To amend Public Service Health Act to authorize grants for mental health first aid training programs.

  • Bill is currently being referred to a Congressional Committee.


Excellence in mental health act
Excellence in Mental Health Act Violence

  • Sponsored by Senators Debbie Stabenow (D-MI) and Roy Blunt (R-MO).

  • Also known as S-264.

  • Purpose: To expand access to community mental health centers and improve the quality of mental health care for all Americans.

  • This bill was adopted as an amendment to the “doc fix” SGR Bill (bill that reforms how Doctors are paid through Medicare)


Mental health in schools act
Mental Health in Schools Act Violence

  • Sponsored by Congresswoman Grace Napolitano (D-TX).

  • Aimed at providing mental health treatment services to students in public schools.

  • Currently working its’ way through the Senate.


Cost cutting
Cost Cutting Violence

  • Daily Expenses to run Cook County Jail are approximately $1,520,353.00. Annually it is $550 million dollars.

  • Inmates with mental illnesses cost anywhere from 2 to 3 times the cost of a typical inmate.

  • Diverting funds from the Cook County Jail to public health facilities would actually alleviate the financial burden on the prison system, while simultaneously treating inmates.


Women s health issue
Women’s Health Issue Violence

  • In most jurisdictions, mental illness amongst women prisoners ranges from one quarter to one half of the total population.

  • Roughly two to three times the rate as male prisoners.

  • Lack of treatment forces D.C.F.S. (Illinois Department of Child and Family Services) to take custody of children, place them in temporary custodial care, and in some cases, terminate the parental rights of the mother.


Mental health and the war on drugs
Mental Health and the War on Drugs Violence

  • There are no definitive statistics on the correlation between drug use and mental health.

  • One U.S. Bureau of Prisons study estimated that 50% of all mental health inmates were using an illegal narcotic prior to incarceration.

  • The mentally ill use illegal drugs to self-medicate.


Hurdles to passing legislation
Hurdles to Passing Legislation Violence

  • Social stigma of helping “criminals”

  • Inmates have no lobby or representation

  • Cook County is at an unprecedented level of debt

  • The State Legislature is voting this April to shut down half of the State Mental Hospitals, bringing the total down from 12 to 6


Potential national stakeholders
Potential National Stakeholders Violence

  • National Association of Police Organizations

  • National Sheriffs’ Association

  • American Psychiatric Association

  • The American Psychological Association

  • National Alliance on Mental Health

  • National Council for Behavioral Healthcare

  • American Foundation for Suicide Prevention

  • Mental Health America

  • National Association of Psychiatric Health Systems


Potential local stakeholders
Potential Local Stakeholders Violence

  • Law Office of the Public Defender

  • Adoption and Child Custody Advocacy

  • Department of Budget and Management Services

  • Cermak Health Services

  • Bureau of Finance


Alderman james cappleman
Alderman James ViolenceCappleman

  • B.A. University of Houston

  • Masters in Social Work University of Illinois-Chicago

  • Represents the 46th Ward (Uptown Neighborhood)

  • Strong proponent of Mental Health Reform


Judge thaddeus wilson
Judge Thaddeus Wilson Violence

  • B.A. University of Notre Dame

  • J.D. Northern Illinois University

  • Sitting Judge on the Circuit Court of Cook County (Criminal Division)


Tom dart
Tom Dart Violence

  • B.A. Providence College

  • J.D. Loyola University Chicago

  • Former Illinois State Senator for the 28th District (91-03)

  • Current Sheriff of Cook County


  • https:// Violencewww.youtube.com/watch?feature=player_detailpage&v=UdcPGt8QxZo


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