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NOTHING that is done to address mental illness outside of prison will work without instituting Assisted Outpatient Treatment Programs (AOTs).  These programs combine subsistence assistance with MANDATORY psychiatric treatment. That is why mentally ill offenders who are taken through mental health court only experienced  a 20 to 25% rate of improvement.  Although any decrease in imprisonment among the country's most vulnerable citizens is valuable to the mentally ill, their families, and taxpayers, the rate of improvement could easily and inexpensively triple under AOTs.

Mentally ill people who exit hospitals and jails usually stop taking their meds and keeping psychiatric appointments very quickly due to a condition that makes it impossible for them to know that they are even sick, called  "anosognosia."  As a result, they lapse back into psychosis and eventually do something worthy of incarceration.  Homelessness, arrests, hospitalizations, and incarcerations drop up to 90% among the mentally ill who are in AOT programs compared to their experiences of three years prior to participating in the AOT.  It is cheaper than prison by far (imprisoning the mentally ill costs the normal $50,000 per year PLUS up to another $100,000 for special needs.) 

Frequently, released psychiatric patients quit their treatment upon release from jails and hospitals because of anosognosia and commit crimes ranging from simple vagrancy to murder, like 32-year-old Na Yong Pak, a woman who was released from a mental health facility in Georgia last year despite her family's protests, and she promptly murdered her mom - burned her to death.  See this family's tragic story here:
http://www.ajc.com/metro/content/metro/gwinnett/stories/2009/02/11/burned_woman_mental.html

There has been ZERO reduction in costs to taxpayers on behalf of the indigent mentally ill resulting from closing hospitals and reducing services in the communities. In fact, there was a significant increase in shifting the sick from hospitals and community care to the prison system.  The mentally ill are not going to jails instead of into treatment to save money or to save sick people from institutionalization.  The difference is WHO gets the money - private prison profiteers rather than hospital and outpatient treatment providers.

Methods and reasons for decriminalizing mental illness are explained in the article HUMAN RIGHTS FOR PRISONERS MARCH, as well as an explanation as to why the inexpensive, highly effective, lifesaving approach is not more broadly applied.  See the article at this link:
http://my.nowpublic.com/world/human-rights-prisoners-march-was-postponed-weather 

COMMENT CONTINUES AFTER THE VALUABLE ARTICLE BY DR. GROHOL.

Mary Neal
Assistance to the Incarcerated Mentally Ill
Http://www.Care2.com/c2c/group/AIMI

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Imprisoning People with Mental Illness
By John M Grohol PsyD
July 18, 2009

People with mental illness are increasingly ending up being imprisoned, rather than in the mental health care system where many of them belong. With the down economy, states and counties — who are primarily responsible for the health of the indigent — cut social services first. And with most public psychiatric hospitals long-since closed, people who have a mental disorder end up being warehoused not in hospitals, but in prisons.

Yes, we succeeded in closing down the state mental hospitals. But we moved the population not to outpatient facilities, but to our prisons.

Now, finally, people are realizing the short-sightedness of locking people with mental illness up, as the spiraling prison costs of doing so become a burden to cash-strapped local governments.

In Philadelphia, a new mental health court has just started, meant to divert people away from prison and into mental health treatment. By doing so, the hope is that they can reduce the incidence of mental illness within prisons, and provide better care for people with a mental disorder in the process.

The new court is part of an approach called “sequential interception,” which includes programs designed to intervene so that people with mental illness don’t get caught up in the criminal justice system - or even killed by it. [...]

The court and the CIT are responses to a complex problem that began decades ago when the closing of state hospitals released mentally ill people into the community without adequate support or services.

Decades later, the high numbers of mentally ill people occupying prisons - some reports put the number at 30 percent of the inmate population - suggests that in too many cases, prisons have replaced state hospitals.

Imagine that — up to 30 percent of prisoners could have a treatable mental disorder. And guess what kind of mental health care most prison systems offer? Limited, if any (federal prisons tend to do a better job in this area than state-run prisons, but none come close to offering the kinds of services one would typically find in their local community).

Human Rights Watch has called out the U.S. prison system for its warehousing of the mentally ill and giving them inadequate care:

In 1998, the Bureau of Justice Statistics reported there were an estimated 283,000 prison and jail inmates who suffered from mental health problems. That number is now estimated to be 1.25 million. The rate of reported mental health disorders in the state prison population is five times greater (56.2 percent) than in the general adult population (11 percent).

Women prisoners have an even higher rate of mental health problems than men: almost three quarters (73 percent) of all women in state prison have mental health problems, compared to 55 percent of men.

“While the number of mentally ill inmates surges, prisons remain dangerous and damaging places for them,” said Jamie Fellner, director of Human Rights Watch’s U.S. Program and co-author of a 2003 report, “Ill-Equipped: U.S. Prisons and Offenders with Mental Illness.” “Prisons are woefully ill-equipped for their current role as the nation’s primary mental health facilities.”

Prison systems are horrifying places to be in the first place. They are even more so for someone who is suffering from schizophrenia or bipolar disorder and doesn’t have access to standard treatments for them. The previous Human Rights Watch report noted:

Inmates with mental illness are often punished for their symptoms. Being disruptive, refusing to obey orders, and engaging in acts of self-mutilation and attempted suicide can all result in punitive action. As a result, the report noted, prisoners with mental illness often have extensive disciplinary histories.

Frequently, the prisoners end up in isolation units. “In the most extreme cases, conditions are truly horrific,” the report stated, adding:

Mentally ill prisoners locked in segregation with no treatment at all; confined in filthy and beastly hot cells; left for days covered in feces they have smeared over their bodies; taunted, abused, or ignored by prison staff; given so little water during summer heat waves that they drink from their toilet bowls. … Suicidal prisoners are left naked and unattended for days on end in barren, cold observation cells. Poorly trained correctional officers have accidentally asphyxiated mentally ill prisoners whom they were trying to restrain.

These are conditions one would expect in a third-world country. Not in the U.S. And not for people who are often most in need of compassion and care.

What research is there to show such mental health courts help? On Friday, a study was released that showed a 20 to 25 percent improvement in offender outcomes under the mental health court system in Minnesota.

Those who did not go through the specialized court got arrested again in less than three weeks.

Sociologist Henry Steadman, who heads the New York-based policy research group, said it’s important to view those numbers in context.

“Taking a hard-core, challenging population that has failed repeatedly in all three systems: criminal justice, substance abuse and mental health,” Steadman said, “and has cycled and is a particularly challenging group, and have come up with an intervention that is a 20 to 25 percent improvement on almost all the measures. My evaluation is that’s pretty damn good in today’s world.”

Indeed. While mental health courts don’t result in immediate cost savings, after about a year and a half, the savings start to add up. And of course, those 20 to 25 percent of people who go through such programs are leading far better lives than if they were stuck behind bars in prison.

But in the end, it’s not really about costs, is it? It’s about treating humans with basic dignity and respect, and taking care of those who need treatment and care. A society is judged in part by how they take care of their most vulnerable and sick citizens. Today, our society just got a little bit better.

Dr. John Grohol is the CEO and founder of Psych Central. He has been writing about online behavior, mental health and psychology issues, and the intersection of technology and psychology since 1992.

http://psychcentral.com/blog/archives/2009/07/18/imprisoning-people-with-mental-illness/

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THERE IS NO MYSTERY AS TO WHY 1.25 MILLION MENTALLY ILL AMERICANS ARE IN PRISON.  IT HAS TO DO WITH MONEY, AS DR. GROHOL SAID, BUT NOT SAVING TAXPAYERS MONEY. 

IT HAS TO DO WITH PRISON PROFITEERING AT THE EXPENSE OF SACRIFICING THE WEAKEST MEMBERS OF OUR SOCIETY. 

CRIMINALIZING MENTAL ILLNESS IS DONE TO BENEFIT PRISON PROFITEERS, LIKE EXCESSIVE SENTENCING, DENIAL OF DNA TESTING RIGHTS, DENIAL OF NEW TRIALS WITH SUBSTANTIAL EVIDENCE OF DOUBT, MANDATORY THREE-STRIKES LAWS, AND MANY WRONGFUL CONVICTIONS, WHICH RESULT MOST OFTEN FROM INADEQUATE DEFENSE BY PUBLIC DEFENDERS. 

SOME BELIEVE THAT PUBLIC DEFENDERS OFFICES HAVE LIMITED RESOURCES BECAUSE OF THE LACK OF CAPITAL.  THE OPPOSIT IS TRUE.  EVERY INMATE, WHETHER INNOCENT OR GUILTY, COSTS TAXPAYERS AROUND $50,000 PER YEAR TO INCARCERATE.  THEREFORE, PROVIDING POOR LEGAL DEFENSE ACTUALLY COSTS MORE MONEY TO THE TAXPAYERS WHEN INNOCENT PEOPLE GO TO PRISON.  A 30-YEAR-OLD MAN WHO IS SENTENCED TO LIFE IN PRISON COSTS TAXPAYERS AROUND $3.5 MILLION DOLLARS. THAT AMOUNT CAN BE MORE THAN DOUBLED IF THE INMATE IS OR BECOMES CHRONICALLY MENTALLY OR PHYSICALLY ILL.  THEREFORE, PROVIDING INADEQUATE LEGAL SERVICES IS TERRIBLY EXPENSIVE EVEN IF IT RESULTS IN JUST ONE WRONGFUL CONVICTION, NOT TO MENTION THE UNJUST HUMAN SUFFERING.

MOST INSTANCES OF IMPRISONING MENTAL PATIENTS ARE VIOLATIONS AGAINST THEIR CIVIL RIGHTS, BECAUSE SO MANY OF THEM LACKED AN UNDERSTANDING OF THEIR MIRANDA LAW (GIVING ACCUSED PERSONS THE RIGHT TO REMAIN SILENT WITH THE UNDERSTANDING THAT WHAT THEY SAY CAN AND WILL BE USED AGAINST THEM).  ACUTE MENTAL PATIENTS ALSO USUALLY LACK THE ABILITY TO CONTRIBUTE TO THEIR OWN DEFENSE AT TRIAL.  NA YONG PAK'S BROTHER REPORTED THAT AFTER SHE BURNED THEIR MOTHER TO DEATH WITHIN 12 DAYS OF RELEASE FROM THE MENTAL HOSPITAL, NA YONG HAD NO IDEA WHATSOEVER WHY SHE WAS IN PRISON.  WHAT GOOD IS IT THAT TAXPAYERS SPEND MILLIONS OF DOLLARS "PUNISHING" PEOPLE LIKE NA YONG.  THEY RECOGNIZE THEY ARE BEING TORTURED IN SOLITARY CONFINEMENT, COLD AND NAKED, BUT MANY OF THEM HAVE NO IDEA WHY THEY ARE MADE TO SUFFER. 

PRISONS ARE CALLED "CORRECTIONAL INSTITUTIONS," AND THE PRIMARY OBJECTIVE IS PUNISHMENT FOR WRONGDOING. PRISONS ARE ALSO SUPPOSED TO BE REHABILITATION FACILITIES, EVEN THOUGH PRECIOUS LITTLE IS DONE TO REHABILITATE INMATES.  IN ANY CASE, ACUTE MENTAL ILLNESS CANNOT BE "CORRECTED" BY PUNISHING SICK PEOPLE, AND IT CANNOT BE "REHABILITATED."  MENTAL ILLNESS IS A HEALTH CONDITION AND MUST BE TREATED, NOT PUNISHED.  THE VICTIMS OF THE DEVASTATING ILLNESS NEED CARE, LIKE VICTIMS OF HEART DISEASE, DIABETES, OR ANY OTHER CHRONIC ILLNESS. TREATMENT OF MENTAL ILLNESS CERTAINLY DOES NOT RISE TO THE COST OF OVER $3.5 MILLION REQUIRED FOR LIFETIME IMPRISONMENT AFTER EXPENSIVE TRIALS THAT SICK PEOPLE MAY NOT EVEN UNDERSTAND. 

NATIONWIDE APPLICATION OF KENDRA'S LAW FOR NON-VIOLENT MENTALLY ILL OFFENDERS AND HOSPITALIZATION FOR VIOLENT SICK PEOPLE WOULD SAVE BILLIONS ANNUALLY OFF AMERICA'S PRISON BUDGET AND RESTORE 1.25 MILLION AMERICANS TO A MORE WHOLESOME EXISTENCE.  AOT PROGRAMS HAVE THE CAPACITY TO FACILITATE MOVING MANY MENTALLY ILL OFFENDERS FROM BEING A TAXPAYER BURDEN TO BECOMING TAXPAYERS, THEMSELVES. 

   WHENEVER THERE IS A SOCIAL ILL, LOOK AT THE MONEY TRAIL AND SEE WHERE IT LEADS.  THERE IS ALWAYS A MONETARY CAUSE FOR EVERY SOCIAL PROBLEM.  ( link: 1 Timothy 6:10 )

WHATEVER THE PROBLEM, CHECK AND SEE WHO PROFITS, whether it is a matter of war and peace; poor prison rehab programs; withholding treatment from the mentally ill unless they have the wherewithal to seek psychiatric services (reserving them for prison); environmental injustice; equipping all police officers with Tasers that they do not recognize as being merely less lethal, not "non-lethal"; inadequate public school education (keeping people ignorant); ousting God from public everything (so the Government will be the highest authority in the minds of the people), the proposal of forcing all U.S. citizens to choose between accepting a potentially harmful or deadly H1N1 vaccine or be incarcerated in FEMA camps, etc.  Someone profits from every social problem.

Whoever loves money never has money enough; whoever loves wealth is never satisfied with his income. This too is meaningless. ~Ecclesiastes 5:10
http://www.biblegateway.com/quicksearch/?quicksearch=LOVE+OF+MONEY&qs_version=31

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