National Alliance on Mental Illness
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The Continuing Struggle: Helping Individuals and Families in the Criminal Justice System 

By Elyssa Finkel, NAMI Policy Intern

Too often, individuals with mental illness fall through the cracks of the mental care health system and end up in jail. Currently, about 16.9 percent of jail inmates and 24 percent of state prisoners live with serious mental illness. In addition, 70 percent of youth in juvenile justice centers lives with one or more psychiatric disorders, with at least 20 percent having a serious mental illness that interferes with everyday life.

This reality is outrageous and due, in large part, to the barriers that people with mental illness face in accessing the services they need. For example, individuals often cannot get treatment because of a highly underfunded and uncoordinated mental health care system. Even if these services are available, many people (especially lower income individuals) lack insurance coverage to pay for them. The unfortunate result is that many individuals living with mental illness come into contact with the criminal justice system, which frequently fails to identify the need for treatment.

This issue is of great concern to NAMI members. NAMI’s HelpLine staff members report that about 200 people a month call regarding criminal justice issues. As Lowell Rudorfer, a volunteer on the NAMI HelpLine’s Legal Center, describes, these calls are heartbreaking. “I hear from individuals and family members who have experienced abuse in prison, been denied mental health care while incarcerated, experienced restraint and seclusion and even suffered the excessive use of a TASER,” says Rudorfer. “The criminal justice community still has a lot to learn about mental illness.”

An individual with an untreated mental illness may become involved with the criminal justice system by exhibiting bizarre or unusual behavior in public or by having a psychiatric crisis, which often results in a call to the police. Police officers who are not trained to recognize the symptoms of mental illness and who believe there is a probable cause to make an arrest may see no other recourse but to take the individual to jail. The individual may then be required to stay in jail until a set trial date.

Individuals with mental illness may also be arrested because of aggressive or violent behavior, (although the link between mental illness and violence has been shown to be relatively weak). The risk for being charged with violent crimes does increase with the use of drugs or alcohol and is greatest for individuals with a dual diagnosis (i.e., those with a mental illness and a substance abuse disorder). A small increase in risk of violence exists for individuals with severe mental disorders such as psychosis, especially if they are not taking medication.  

When individuals who live with mental illness are put in jail or prison, their symptoms tend to worsen due to the stresses of their environment and a lack of access to adequate treatment. Some even develop a mental illness while they are in jail or prison. Consequently, a large proportion of these individuals tend to remain trapped, cycling in and out of the criminal justice system, which creates a situation that is burdensome to law enforcement and corrections facilities, costly for communities and unfair to the individuals who are living with these illnesses.

NAMI has already developed a comprehensive Guide to Mental Illness and the Criminal Justice System as an aid for individuals and families navigating this system. To supplement this guide, NAMI recently developed a Criminal Justice Self-Advocacy FAQ, which answers some of the frequently asked questions members have regarding criminal justice issues. This FAQ is meant to serve as a resource that will help empower members to better advocate for themselves or their loved ones if they become involved with the criminal justice system. It addresses common questions such as, “How do I make sure that my loved one gets his medication in jail?” and “Why won’t my public defender use my loved one’s mental illness in their defense?” It provides information about the individual’s rights in these particular situations, recommendations for appropriate courses of action and links to other helpful websites and resources.

NAMI hopes that the FAQ will help members and their loved ones understand their right and advocate for themselves in these difficult situations.