Treatment Online

Mental Health Courts Lower Recidivism Rates
> 10/15/2007 11:04:44 AM

The United States' prison population has nearly quadrupled in the last 25 years alone. America incarcerates more of its citizens, by both number and percentage, than any other industrialized country, with more than 7 million citizens now incarcerated, paroled or on probation (1 in 136 Americans currently resides in a "correctional facility"). And prison is an inevitable desination for far too many mentally ill Americans; they make up more than 15% of the incarcerated population One of the reasons for these alarming numbers stems from yet another: at least 1in 5 American inmates have been incarcerated for drug charges, and the comorbid relationship between substance abuse and mental illness is well established.

The question must be raised: are mentally ill mid-level criminals and the American public in general better served by policies leaning toward incarceration or reformation? Is the "lock 'em up and throw away the key" philosophy actually working, especially in a prison system as overcrowded as ours? How can we best balance punishment and treatment for those who clearly need both? In Virginia, for example, more mentally ill individuals reside in prison than in state and private hospital wards combined, and many are indeed destined to cycle through the system repeatedly, burning through exhaustible public funds and leaving innocent victims in their wakes. A proposed solution for these dispiriting trends lies in a still-contentious idea: courts specifically designed to process mentally ill offenders.

Amid near-universal assertions that the American prison system continues to fail both the inmates it houses and the citizens who suffer as the objects of their crimes, calls for increased anti-recidivism efforts for the 95 percent of inmates who eventually leave prison find particular resonance among those concerned about the treatment of the mentally ill. These concerns do not amount to a misplaced sense of sympathy for convicted felons, and the program should not apply to the most extreme murderers and those deemed beyond hope of reform. But many jails do not provide mental health services and even in those that do, procedures often fail to meet standards set for civilians who are not behind bars. Why should we intensify efforts to treat mentally ill inmates? To help them better balance themselves as individuals with the ultimate goal of preventing their return to the correctional system and the chronic criminality implied by rearrest.

Among the features of the mental health court system: more voluntary in/outpatient treatment plans that carry the potential for reduced sentences if completed; more specific tracking of the legal status and behaviors of� mentally ill inmates/patients; increased efforts toward life-skills training programs, housing and employment assistance, education, health care and, most importantly, relapse prevention. Do these measures add up to the coddling of dangerous criminals who happen to qualify for mental illness diagnoses? Hardly. We can better prepare the individuals in question for life outside prison and help them learn to live with their conditions and resist the urge to return to lives of crime by offering them treatments they most likely would not seek (or receive) on their own - and this approach can save time, money, and the lives and property of those who would become victims. In the mental health systems considered in the current study, some offenders were able to volunteer for treatment in the mental health community; they "graduated" after being deemed stable for a preset period of time. The proof of the system's efficiency is in statistics: 18 months after treatment, the percentage of mental health court "graduates" who had been rearrested was less than half that of the group of patients who'd gone through the standard criminal justice system. The numbers only got better with time.

This system is designed for severely ill individuals who frequently cycle through the criminal system for small crimes rather than convicted murderers who may very likely qualify for some form of mood or personality disorder diagnosis. It may prove particularly useful in cases of mentally ill juvenile offenders destined for lives lived in and out of confinement - those who complain about the cost of treating lawbreakers need only consider the degree to which those numbers would decline if the proper approach can turn� early offenders away from lives of crime. Even the most resistant criminals deserve some form of treatment, and the mental health court system could make for near-miraculous reforms when instituted on a larger scale.

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