CRIMINALIZATIONOF MENTAL ILLNESS ANDTHE LAW ENFORCEMENT ROLE Risdon N. Slate, Ph.D. 2010 FBI National Academy Utah Chapter Fall Training – St. George, Utah
Free Association • Mentally Ill
Crises Often Drive CJ Policy • Crisis Intervention Team Training • Eugene Gregory and Alan Singletary • Andrew Goldstein • Aaron Wynn • Brad H. • Seung-Hui Cho
Recipe for Failure • Not offering adequate treatment • Providing no follow-up on re-entry into the community
California’s Lanterman-Petris-Short Act • Prompts Abramson to coin the phrase “Criminalization of Mental Illness” • WHY? • Magna Carta of the mentally ill (Abramson).
Each of the following cited for contributing to the criminalization of mental illness • CJ Process viewed by LE as more expeditious than MH Process • Deinstitutionalization • Inadequate community support service • Lack access to intermediate & long-term care
Patients in State Mental Hospitals 20th Century 21st Century • Beginning roughly 150,000 • 1955 peak = 559,000 • 1960 – 1980 = < 100,000 • Beginning = _______ • Estimated today = _______
. . . The grim statistics - jails and prisons have become the new “psychiatric hospitals”
Penrose finds as prison populations decrease mental hospital populations increase; as prison populations increase mental hospital populations decrease. • Today more persons with mental illnesses in prisons and jails than in psychiatric hospitals. • Transinstitutionalization has take place
Factors Associated with Deinstitutionalization Movement • Inhumane conditions and abuses in state hospitals • Discovery of Thorazine • The anti-psychiatry movement
2 Cases Set the Deinstitutionalization Movement in Motion in the 1970s • Wyatt v. Stickney (1972) • O’Connor v. Donaldson (1975)
Founders of the Anti-Psychiatry Movement • Michael Foucault • R.D. Laing • Thomas Szasz
Work of Szasz & the anti-psychiatry movement has made it easier to put a person in jail than to secure treatment for them.
L. Ron Hubbard (Scientology Founder) “There is not one institutional psychiatrist alive who could not be arraigned and convicted of extortion, mayhem, and murder” (Rissmiller & Rissmiller).
Scientology • Religious Views • Prominent Members • Views on Formal Education • Views on Psychiatry
Community Mental Health Centers • JFK appropriated $3 billion in 1963 for CMHCs • Never allocated • JFK assassinated • Viet Nam War • NIMBY (Gilligan)
States’ Ways to Shift Costs for the Care of PWMI to the Federal Government • Disability insurance • Housing assistance • Medicaid • Moving persons with mental illnesses from state hospitals to nursing homes • How Shift Costs to County & Local Govt. ?
Managed Psychiatric or Behavioral HealthCare • Has actually resulted in payment of commissions for denial of hospital admissions • May result in cost shifting instead of saving • Limited choices, pre-certification, cut corners
National Alliance on Mental Illness (NAMI) Grading the States Report • Average Grade for the Public Adult Mental Health Care Systems in the U.S. = D ____ UTAH= ?
Hospitals do not have to provide mental health treatment to those unable to pay. • Markowitz found a predominance of private psychiatric hospital beds in cities to be significantly associated with increases in both arrest and crime rates, suggesting that when the mental health system is privatized police have fewer referral options to mental health treatment and are more likely to make an arrest.
“That’s news to us” Whose job is it? MOUs
Daytona Beach Police Chief Michael Chitwood • Greyhound Therapy • Banishment • Cost-shifting
Surgeon General’s Report • The most formidable obstacle to future progress in the arena of mental illness and health is: ________
Violence • Factors linked to violence include: past incidences of violence, substance abuse, lack of treatment, and non-compliance with medication. • “Laws change for a single reason, in reaction to highly publicized incidences of violence. …[And it] may be necessary to capitalize on the fear of violence” (D.J. Jaffee, Treatment Advocacy Center)
Violence & Funding for Mental Health Treatment • Stigma - Otto Wahl • One Flew Over The Cuckoo’s Nest • Negative media portrayals of persons with mental illnesses have reportedly contributed to roughly half of all citizens perceiving persons with mental illnesses as being more violent than persons without mental illnesses. • Famous persons with mental illnesses
Anosognosia • Xavier Amador • Effects
People with mental illnesses are incarcerated longer • Riker’s Island (NYC) • Average length of incarceration • All inmates = 42 days • Inmates with SMI = 215 days • Pennsylvania Prisons • Inmates with SMI three times more likely to serve maximum sentences. • Source: www.consensusproject.org
Prevalence of Mental Illness • Ditton Study • James & Glaze • Percentage of PWMI with a substance abuse disorder
THE LAW ENFORCEMENT RESPONSE TO PERSONS WITH MENTAL ILLNESSES IN CRISES
Seth Greenberg • “Mental illness is not a … choice; it is a medical disease.”
CIT • Memphis PD
Gary Cordner • PWMI more likely to be injured by police and _______ times more likely to be killed by police.
Price • Police have been found to have more empathetic views than the general public toward pwmi in crises.
Ruiz & Miller • Two most common misperceptions held by the police toward pwmi
Experts advise police not to resolve encounters with pwmi in crises quickly • However, most police agencies do not have such specialized training or a formalized policy for such interactions. • Greenberg, in a study of 28 police training academies, found the average amount of training was _____hours.
Law Enforcement Relationship with Mental Health Personnel • Fairly Negative Working Relationship • LE often views arrest and cj process as a more expedient option than referral to the mh system. • Mercy Bookings • “The system that can’t say no.” • MOU