At this point, there’s probably somewhere in the neighborhood of 300,000-400,000 people in our jails and prisons in this country who have mental illness. In addition, there are probably double that on parole or probation, close to a million people maybe. If you don’t meet the needs of serving their mental illness, you cannot serve them in the criminal justice system.
What can the courts do better? There’s a new and growing model called mental health courts. These mental health courts focus on dealing with defendants who have mental illness differently from how they deal with other defendants. They’ve developed more of a guiding role.
Stigma is a much bigger issue than just the criminal justice population. We all know that most people with mental illness never seek treatment or if they do, it’s well after the onset of the symptoms. Only about 50% of people with major depression, for instance, ever seek treatment. Of those people who do, 70% seek and receive treatment only from their primary care doctor.
The reality is most of my patients that I see are not in trouble because they committed violent crimes, they’re in trouble because they committed relatively minor crimes. Minor assaults that didn’t result in an injury, the so-called misdemeanor assaults, theft under $500, things related to their inability to cope with life related to their mental illness, not related to violence.
The research shows that people who are mentally ill are far more likely to commit a violent crime when they are using substances and the inadequacy of competent, integrated mental health and substance abuse treatment in our country is the cause, in my view, of most of these problems. If we had treatment on demand for substance abuse, we would go along way to solving this issue.