About the Issues
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Click a quadrant of the diagram to learn about the issues related to the respective components of the criminal justice and mental health systems.
Material in this section is adapted from The Consensus Project Report.
About Corrections
The Issue: The extraordinary growth of jail, prison, probation, and parole populations in recent years has presented enormous challenges to the corrections system and has put a significant financial strain on local and state budgets across the country. Many people who are incarcerated have mental illnesses: the prevalence of mental illness is higher in prisons and jails than it is in the general population (16 percent versus 5 percent, according to a 1999 Department of Justice study). These individuals must be adequately assessed and provided treatment consistent with community standards. These individuals stay incarcerated longer than the general corrections population and are more likely to recidivate.
The Response: To address these issues, jail officials and community mental health providers have established collaborative programs to treat people while incarcerated and link individuals to treatment and services in the community upon release. Prison officials and state mental health authorities have jointly funded transition planning programs to develop treatment plans for individuals with mental illnesses prior to their release. Probation and parole officials are partnering with community mental health providers to coordinate supervision and treatment, often using specialized case management models.
About Courts
The Issue: Many people with mental illnesses are familiar faces in courtrooms across the country, and they are often brought in on low-level charges resulting from the public display of an untreated mental illness. Many are held pre-trial, or sentenced to short stays in jail, where the stresses of crowding, isolation, and the threat of violence exacerbate their mental illnesses. Prior to release into the community, most will have not received the comprehensive re-entry planning needed to ensure linkages to treatment and other services. Consequently, individuals with mental illnesses all too often cycle through the nation’s court systems.
The Response: Court officials, mental health advocates, treatment providers, consumers of mental health services, and representatives from other criminal justice agencies are partnering to develop initiatives—including mental health courts—to respond to the needs of defendants with mental illnesses while protecting public safety and ensuring the integrity of the legal process.
About Law Enforcement
The Issue: Law enforcement officers are all too familiar with calls for service that repeatedly bring them into contact with people whose mental illnesses are not being adequately addressed. Officers often find themselves in the difficult position of determining whether to resolve such incidents informally or to take the person into custody, either under arrest or for an emergency evaluation. Although these incidents are generally resolved safely, on rare but highly publicized occasions, they have involved the use of force, and the police officer, the person with a mental illness, or both, can be seriously injured or killed. Without adequate training and access to community services, officers face tremendous obstacles in managing these incidents.
The Response: Law enforcement officials are partnering with local mental health service providers and mental health advocates to develop innovative strategies that increase safety and make it easier for officers to connect people with mental illnesses to much needed services.
About Community Supports and Services
The Issue: Few systems have undergone a transformation over the past 40 years as comprehensive as the nation’s approach to delivering mental health services. Once based exclusively on institutional care and segregation, the system has shifted its emphasis almost entirely to the provision of community-based support for individuals with mental illnesses. This shift—driven in part by fiscal reality, political and philosophical realignment, and medical advances—has resulted in successful community integration for many clients who receive services.
There is agreement between the mental health and criminal justice communities that the best way to prevent people with mental illnesses from coming into contact with the criminal justice system is to provide them with treatment and other services in the community. The problem comes, however, in connecting all individuals who would benefit from community-based care to these services. In addition to limited capacity, stigma and discrimination often create barriers to care for many potential clients. This problem is exacerbated by the fact this clientele requires a range of services including housing, substance abuse treatment, employment services, and income supports, which are also in short supply. It is against this backdrop that officials in the criminal justice system encounter people with mental illnesses with increasing frequency.
The Response: Across the country, state departments of mental health have examined the services they offer, their funding mechanisms, and administrative systems, and found ways to partner with their counterpart criminal justice agencies to prevent individuals with mental illnesses from becoming involved in the criminal justice system. At the community level where mental health services are delivered, agencies are exploring ways to make services more effective and accessible for all, including individuals involved with the criminal justice system, by partnering with local criminal justice agencies to increase opportunities for diversion to community treatment and other services and to improve continuity of services from justice-involvement to community re-entry.