Recommendations for Implementation

Despite the prevalence of mental illness and the cost to taxpayers of inadequate mental health treatment, communities have not made access to effective mental health service a priority. Furthermore, when a person with mental illness is involved with the criminal justice system, the public typically assumes, incorrectly, that the person is inherently violent and cannot function in the community.

Indeed, the Surgeon General's recent report on mental health argues that the stigma around mental illness is one of the most significant challenges to the development of effective mental health policy.[1]  This stigma has intensified over recent decades, despite the advancement of scientific knowledge about the causes of mental illness and the effectiveness of certain treatments; studies show that a greater portion of people associated mental illness with violence in the 1990s than the general public did in the 1950s.[2] 

Combating the stigma surrounding mental illness and enlisting broad-based support for improvements to mental health policy requires education.  Until the general public comes to understand mental illness as a disease similar to physical illnesses, public support for improved mental health services is unlikely to increase.  To this end, California's Little Hoover Commission's report Being There suggests the formation of a statewide commission on mental health advocacy to build public support for adequate mental health services.  Changing public opinion about mental illness is a difficult task, but one for which the criminal justice system can be an extremely effective partner.  Criminal justice personnel are charged with ensuring public safety.  They have, therefore, a singular credibility advocating for improved community-based mental health services and dispelling notions that people with mental illness in the community compromise public safety.  Criminal justice officials, who deal with the influx of individuals with mental illness into their system on a daily basis, can help the public and policymakers become aware of the need to improve community-based mental health services.

Example:  Commission on the Status of Mental Health of Iowa's Corrections Population

The Community Corrections Improvement Association, the private foundation arm of the Iowa Sixth Judicial District Department of Correctional Services, formed the Commission on the Status of Mental Health of Iowa's Corrections Population to provide a forum for public discussion about issues at the intersection of mental health and criminal justice.  During November 2001, the commission held a series of eight public hearings, supported by a panel of experts, across the state of Iowa to consider the issues from a local level.  The commission also administered a survey to assess public attitudes and knowledge, developed a video and media relations campaign, and planned a conference to raise awareness about mental health and criminal justice issues.

Consumers and their loved ones often want to cooperate with the criminal justice system - or seek the assistance of officials in the criminal justice system - but lack the knowledge to successfully interact with representatives of the various criminal justice agencies.  Criminal justice agencies can improve consumer awareness and initiate positive relationships through community outreach programs.  Such programs can be important preventative tools, which improve the safety of both criminal justice personnel and consumers during future interactions.[3] Similarly, consumers and families who know whom to call and what to ask for are much more likely to have their needs met at the outset, which will make these interactions less frustrating for both parties.

Example:  Chapel Hill (NC) Police Department

The Chapel Hill Police Department conducts community trainings in conjunction with NAMI and the local clubhouse (an organization that provides support services through a self-help community-based center) to educate family members as to their rights and responsibilities when in contact with the police department. These interactions have also helped increase the level of trust between the community and the police department.

When a person with mental illness becomes involved in the criminal justice system, his or her family, friends, mental health service providers, and other advocates may want to help in a variety of ways.  Family members may want to inform the defense attorney about the defendant's mental health history, to advocate for the defendant's placement in a particular treatment program, or generally to help their loved one navigate the criminal justice system.  Advocates in some communities have developed resources for such situations.

Example:  When a Person with Mental Illness is Arrested: How to Help, A New York City Handbook for Family, Friends, Peer Advocates, and Community Mental Health Workers

Staff at the Urban Justice Center's Mental Health Project developed a practical handbook for supporters of people with mental illness who have become involved in the criminal justice system.  The handbook provides general information about the criminal justice process (arrest, arraignment, meeting with counsel), relevant statutes and advice for advocates on working with defense attorneys, as well as information specific to the New York City criminal justice system.

Example:  Mental Health Services for Mentally Ill Persons in Jail  -  A Manual for Families and Professionals Including Jail Diversion Strategies, NAMI Wisconsin

NAMI Wisconsin, in conjunction with a variety of mental health and criminal justice professionals, developed a manual to help families and professionals better understand the issues that arise when an individual with mental illness becomes involved in the criminal justice system.  This manual includes sections dedicated to the mental health system, the criminal justice system, jail diversion programs, and other relevant issues.  Though originally targeted to families of consumers who are involved in the criminal justice system, the manual has proved useful to professionals throughout the mental health and criminal justice fields.

Family members and other supporters of people with mental illness should also receive information about the prerelease and discharge planning processes from corrections personnel, and receive instruction on how they can participate in helping their spouse or relative make a smooth transition from the jail/prison back to the community.  It is especially important that they know what resources are at their disposal to assist them and their recently released family member when a crisis occurs.

Victim advocates should be informed about mental health services and procedures within correctional facilities and how discharge planning occurs. They should receive orientation, education, and assurances about what services are available for offenders and what supervision the offender will undergo in addition to what protection they can expect from the criminal justice system.  These matters can be included in the overall community education and training curriculum developed by criminal justice agencies.