Stepping Up: A National Initiative to Reduce the Number of People with Mental Illnesses in Jails

The Problem

The number of people with mental illness in U.S. jails has reached crisis levels. In counties across the nation, jails now have more people with mental illnesses than in their psychiatric hospitals.

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The People

The situation is hurting real people. But communities, judges, police officers, mental health professionals and others have already started stepping up to combat the problem.

What You Can Do

Stepping Up asks communities to come together to develop an action plan that can be used to achieve measurable impact in local criminal justice systems of all sizes across the country. Learn More

 

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“Dangerousness” Should Guide Policy–not Mental Illness or Gun Ownership

From Psychiatric News Alert: About 8.9 percent of individuals who self-report as having patterns of impulsive angry behavior own guns, and 1.5 percent carry them outside the house, according to an analysis of the National Comorbidity Study Replication study. The study was posted online April 8 in the journal Behavioral Sciences and the Law.

Among those respondents, said Duke University Professor of Psychiatry and Behavioral Sciences Jeffrey Swanson, Ph.D., and colleagues.

“Persons with impulsive angry behavior who carried guns were significantly more likely to meet diagnostic criteria for a wide range of mental disorders, including depression, bipolar and anxiety disorders, PTSD, intermittent explosive disorder, pathological gambling, eating disorder, alcohol and illicit drug use disorders, and a range of personality disorders.”

However, most of those people are legally entitled to own firearms because they have never been involuntarily committed to a psychiatric hospital. Reorienting public policy away from mental illness and toward dangerousness might reduce injury and death by firearms, the authors note. Current approaches to restricting gun access of people with mental disorders have no impact on most of this group, coauthor Paul Appelbaum, M.D., a professor of psychiatry at Columbia University, told Psychiatric News.

“We need to reorient our firearms policies toward limiting gun possession by people who lack behavioral control—for example, by taking guns away from people who behave in dangerous ways—rather than focusing excessively on people with serious mental illnesses, as we do today.”

For more in Psychiatric News about dangerousness as a standard for firearms policy, see “Violence Risk, Not Mental Illness, Should Guide Gun Access.” Also, see “Screening for Violence Risk in Military Veterans: Predictive Validity of a Brief Clinical Tool” in the American Journal of Psychiatry.

Monday Regular Meeting with Mental Health Court Linkage Supervisor

Lana LaMotte, the Mental Health Court Linkage Supervisor for Service Area 8, will be speaking about the Mental Health Court Linkage Program at the regular monthly meeting on Monday September 15. The Court Linkage Program serves adults with a mental illness who are involved in the criminal justice system. The meeting will be at the First Lutheran Church (for time and address see below)

The Court Liaison Program (CLP) is a collaboration between the Los Angeles County Department of Mental Health (DMH) and the Los Angeles County Superior Court. It is staffed by a team of 14 mental health clinicians who are co-located at 20 courts countywide. This program incorporates the “no wrong door” philosophy by offering the courtroom as an entry point for services. The objectives of the program are to increase coordination and collaboration between the criminal justice and mental health systems, improve access to mental health services and supports, and enhance continuity of care. The CLP further aims to provide ongoing support to families and to educate the court and the community at large regarding the specific needs of these individuals. Participation is voluntary and available to those 18 and above.

Services include:

  • On-site courthouse outreach to defendants
  • Individual service needs assessments
  • Information to consumers and the Court of available treatment options
  • Development of alternative and post-release plans that take into account best fit treatment alternatives and Court stipulations
  • Linking of consumers to treatment programs and expedition of mental health referrals
  • Support and assistance to defendants and families in navigating the court system

Court Liaison Program staff coordinate and integrate services between the courts, Jail Mental Health and community based Service Area Navigators, with particular focus on balancing the needs of individuals and the expectations of the judicial system.  The CLP endorses a culture of collaboration within each courtroom where the CLP staff  are present, and the department core values of HOPE, WELLNESS & RECOVERY to the criminal justice system as a whole.

Court Liaison Directory

  • BELLFLOWER (626) 403-4370
  • BURBANK (626) 403-4370
  • CLARA SHORTRIDGE FOLTZ (CCB) (213) 974-2963
  • COMPTON (310) 603-8077
  • DOWNEY (626) 403-4370
  • EL MONTE (626) 403-4370
  • EAST LOS ANGELES (323) 780-2075
  • GLENDALE (626) 403-4370
  • INGLEWOOD (310) 419-2101
  • LAX (310) 727-6245
  • LONG BEACH (562) 247-2529
  • NEWHALL (818) 898-2490
  • NORWALK (626) 403-4370
  • PASADENA (626) 356-5374
  • POMONA (213) 305-3532
  • SAN FERNANDO (818) 898-2490
  • SANTA MONICA (310) 727-6245
  • TORRANCE (310) 222-4067
  • VAN NUYS (818) 374-2349
  • WEST COVINA (626) 403-4370

Judges and Psychiatrists Discuss Mental Health Treatment in the Judicial System

Speaking at the institute, from left, Leifman, Osher, and former Ohio Supreme Court Justice Evelyn Stratton, J.D.

It is common knowledge that the judicial system sees a disproportionate number of mentally ill persons and that jails are crowded with inmates needing mental health services. The problem has many aspects, including the economic burden it places on the corrections systems within the United States and the ineffectiveness of common criminal penalties and sentences in circumstances where medication, therapy and support services are needed.

Fortunately, change may come. At the recent APA Institute on Psychiatric Services, in Philadelphia, fifty leading judges and psychiatrists from across the country met to begin developing strategies to improve outcomes for individuals with mental health needs in the criminal justice system.

As part of an ongoing collaboration, the Judicial-Psychiatric Leadership Forum was convened by the Judges’ Leadership Initiative for Criminal Justice and Behavioral Health and the Psychiatric Leadership Group for Criminal Justice and was coordinated by the American Psychiatric Foundation and the Council of State Governments Justice Center.

According to Miami-Dade County Judge Steve Leifman, cochair of the Judges Leadership Initiative:

“The progress made at this forum is an important step forward in addressing the needs of people with mental illnesses who become entangled in the criminal justice system. The cost of incarcerating rather than treating people with mental illness both in financial and human terms is exorbitant and unnecessary.”

Psychiatrist Fred Osher, M.D., director of the Center for Health Systems and Services Policy for the Council of State Governments Justice Center, added:

“It is critical that psychiatrists engage judges in a dialogue to identify effective strategies that result in improved public health and safety outcomes. It is a shared set of concerns that require a shared vision and collaboration to have the largest impact.”

An estimated 17% of people admitted to jail have serious mental disorders—more than three times the rate in the general population, and nearly 70% of adults in jails and prisons have a substance use disorder. For more information on this topic, see the Psychiatric News articles “Combined Effort Needed to Prevent Incarceration of Mentally Ill People” and “Judges Get Help Handling Mentally Ill Defendants.”