In Depth: Legal System Struggles to Divert—Not Punish—Those with Mental Illness
About half of all Americans in prison have a severe mental illness, according to the American Psychiatric Association. The numbers are even higher for those in local jails. On the front lines, New Hampshire police say they've tried to become more knowledgeable about mental health.
More training has helped, along with public awareness and the state's mental health court system. Still, it's a complex interaction. Too often, says Strafford County Attorney Tom Velardi, people with mental illness and substance abuse end up incarcerated.
"In our local jail, we estimate about 70 percent of the people have a co-occurring disorder. How do you deal with folks that have these diagnoses? First, it's to not force them into a criminal justice system that's not designed to deal with their issues, " he said on The Exchange.
"What we've designed in Strafford County are some systems to try to help identify mental health issues, to not criminalize or escalate mental health issues, and to get people diverted out of the system."
See highlights from the conversation below (edited slightly for length and clarity). For audio of the full Exchange conversation, as well as additional reading and resource materials, visit here.
How do police officers figure out whether someone is causing trouble because of mental illness? Give us an example?
David Goldstein, Chief of Police in Franklin: One comes to mind almost immediately -- a high school student who was diagnosed with Oppositional Defiance Disorder, and it took my School Resource Officer and myself to restrain her and get her to the hospital. She was in a full-blown episode, where every other word out of her mouth was an obscenity. In the old days we would have probably just restrained her with handcuffs and maybe even leg cuffs and hobbled her and gone from there. But we're dealing with this a lot better now.
How often do these incidents occur?
"In our local jail, we estimate about 70 percent of the people have a co-occurring disorder." Strafford County Attorney Tom Velardi
Goldstein: More often than not it's going to be a police officer that encounters these individuals initially. If it's a call to a home where someone is out of control, if it's something that's going on in a commercial establishment in the city or any community, whether somebody out on the street is just having a conversation with themselves, it is going to be a law enforcement officer that does interact with that individual.
If a person is exhibiting violent behavior, how do you deal with that?
Goldstein: There are a number of considerations we have to take into account and those are the safety of the public and the safety of the officers themselves. So while we are certainly training officers to be sensitive to the issues that are going on, we're certainly not training them to diagnose or treat these people.
We are training and educating ourselves on how to best deescalate these situations. And sometimes that does not work. And that's where law enforcement will catch a lot of criticism: Why didn't you use a taser? Why didn't you use pepper spray? People have to understand that we will do the best we can given what we have to work with. But there is kind of an unwritten rule that we still have to protect ourselves as well as the public. And sometimes that does require us to go physical or to use some of our tools. If we have to use lethal force we will use lethal force but we have to be able to justify that as well. That's when the Attorney General gets involved.
What are some of the challenges of talking about mental illness in the context of criminal justice? Is there the danger of stigmatizing people?
Donna Brown, attorney and former public defender: The vast overwhelming majority of people with mental illnesses contribute to the society in amazing ways. There's always that challenge of talking about mental illness connected to criminal justice without creating a stigma towards people who have mental illness. They don't want that stigma that they're criminals, that they're bad people, that they're dangerous and not employable.
What are some of the new ways in which police departments are dealing with mental health issues?
David Goldstein: Franklin has a fledgling critical incident team that deals with these incidents, and we're starting a program asking individuals in the community to let us know if they have a family member or friend who has a problem. So when we respond to a residence we're not going in blind. For example autism is one of the conditions we deal with, and we know that individuals deal with situations differently than most. Now we know if an individual does not respond immediately to an order, that's part of the condition.
What are some of the circumstances that can land someone in jail?
Donna Brown: Many times people end up in jail not because they're considered dangerous to the community but the court may consider them dangerous to themselves -- and if we don't put this person in jail, they might hurt themselves. That person is already in a crisis situation and they're more likely to maybe resist. We always talk about the triple charges: disorderly conduct, simple assault, resisting arrest. These all can happen when a person is in mental distress.
Amy from Durham explains how her son's illness kept him from following through on some routine court requirements, eventually leading to his first arrest at the age of 18.
He just couldn't get himself there. They would reschedule it, arrest him, he'd get bail, or pay the bail person, and never actually go to the jail, and then have another date. And then finally the judge just threw him in jail and you know all over a marijuana cigarette, which I think is insane. But I think it has to do also with your socio-economic state, whether you get thrown in jail or not. So that was a rough period. It was my first time ever having to deal with anything like that.
How does the mental health court system compare with the drug court system?
Tom Velardi, Strafford County Attorney: Mental health -- and mental health courts -- in general, don't get the attention that the drug courts get. I applaud the legislature for passing enabling legislation to start drug courts and actually give some incentive to fund drug courts in places that don't have them. But if you were to map mental health courts across the state, you'd see how sporadic it is. There are huge catchment areas where people need these services if they get forced into the criminal justice system and they will not have them.
What do you say to someone who might think that the mental health courts let people off the hook, when they should be paying a price for their crime?
Velardi: That's a general misnomer about specialty courts altogether. You have to think about it from the perspective of the participant. These are coercive programs, when you cut right down to it. People are not necessarily doing this totally voluntarily but because they have a judge telling them to do it. That is hard work. Victims of crime seem to be very forgiving -- they want them to get better and also they understand that it's going to be hard work. It's not a get-out-of-jail-free card.
What do you want people to really understand about these situations?
Taunya Jarzyniecki - Mental health counselor and court liaison in the Community Connections program at the Mental Health Center of Greater Manchester: I want them to come away with a sense of hope, that there are options out there for your sons, daughters, family members who are struggling with mental illness and also have some criminal charges. There are options. One of the gentleman I worked with said to me that he was able to learn to accept himself and that he learned personal responsibility.