National Alliance on Mental Illness
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(800) 950-NAMI;

APRIL 12, 2002

Chairman Wolf and Representative Serrano, I am Carla Jacobs of Tustin, California. On behalf of the 220,000 members and 1,200 affiliates of the National Alliance for the Mentally Ill (NAMI), I am pleased to offer this testimony on the FY 2003 Commerce-Justice-State and the Judiciary Appropriations bill. NAMI would like to focus its testimony on urging full support for the allocation of $10 million to the federal mental health courts program in FY 2003. As our nation's largest organization representing people with severe mental illnesses and their families, NAMI strongly supports this program and its mission of diverting non-violent offenders with mental illnesses out of the criminal justice system and into treatment.

In addition to serving on the NAMI Board of Directors since 1997, I am a Mental Health Commissioner for the County of Los Angeles and a member of the Los Angeles City Task Force on Police and the Mentally Ill. I was a member of the steering committee for "Finding a Better Way", a California think tank on criminalization and was on the legislative committee for the California Forensic Mental Health Association.

Mr. Chairman, NAMI is extremely grateful for the $4 million allocation for mental health courts that was included in the Commerce-Justice-State Appropriations Conference Report for FY 2002. We appreciate the efforts of you and your colleagues to begin addressing this important issue as a response to the very disturbing trend across our nation of "criminalization" of mental illness. NAMI is hopeful that this $4 million appropriation will be a catalyst in helping local communities deal with the large and growing burden faced by the criminal justice system as a result of untreated mental illness.

As the Subcommittee moves forward with its consideration of the Justice Department's FY 2003 budget request, NAMI would like to urge you to increase the appropriation for the federal mental health courts program (P.L. 106-515) to its full authorization level of $10 million. This increased amount will ensure that more states and localities are able to successfully apply for assistance next year to establish new mental health courts - both in our state and across the nation.

Individuals with Mental Illness and the Criminal Justice System People with serious mental illness are frequently arrested for minor offenses, many times as a result of homelessness, and then they are incarcerated in jails where their mental health needs are not met. There are also significant numbers of persons with serious mental illness who come in contact with the police, but are not arrested.

The U.S. Department of Justice reported in 1999 that 16% of all inmates in state and federal jails have a severe mental illness. 283,000 people with serious mental illnesses were in jail or prison - more than four times the number in state mental hospitals. The average daily number of patients in state and county psychiatric hospitals has steadily dropped from 592,853 in 1950 to 71,619 in 1994.

Recent surveys have indicated that 40% of families of persons with mental illness reported that the individual had been arrested at some point in their lives. Moreover, a recent Department of Justice report found more than three quarters of inmates with mental illness had at least one prior prison, jail, or probation term. Some individuals are incarcerated scores of times. Probation systems are also affected, as 16% of probationers were persons with mental illness.

Mentally ill offenders place a heavy toll on the criminal justice system, draining significant police resources as these encounters take a considerable amount of time. In most communities, law enforcement officers face significant problems when they bring individuals to local community mental health programs. These programs may be reluctant to take the person due to reimbursement issues or previous history with the individual or due to drug and alcohol problems. Hospitals will accept persons deemed dangerous to self or others but only after lengthy assessments. As a result, police can spend hours waiting for resolution on a single case, and the person with mental illness often returns to the street almost immediately.

When incarcerated, mentally ill offenders present problems, particularly when they arrive in a disoriented or psychotic state. Once in jail, they remain longer than others with similar convictions. Often their condition deteriorates and they become a behavior problem. Further, there is little planning when an inmate with a mental illness is released. People leave jail without supplies of needed medications, public benefits to pay their living costs or Medicaid for community-based mental health services. As a result, many simply recycle back into the criminal justice system.

Mental Health Courts As A Solution

The establishment of mental health courts is rapidly emerging as one of the most successful strategies to address the stark reality that jails and prisons have become the nation's depository for people with severe mental illnesses. Mental health courts have already proven successful in Broward County, Florida; King County, Washington; Anchorage, Alaska; and a number of other jurisdictions across the country. Mental health courts have been necessitated by the growing concern among judicial, law enforcement and corrections officials about the disturbing trend of persons with severe mental illness being inappropriately placed in jails for non-violent offenses.

What Are Mental Health Courts?

Congress passed America's Law Enforcement and Mental Health Project (P.L. 106-515) in 2000 in order to begin assisting states and communities across the country nation in putting in place innovative approaches to diverting offenders into treatment programs and easing the growing burden on criminal justice and corrections systems. This law - sponsored by your colleagues Senator Mike DeWine (R-OH) and Representative Ted Strickland (D-OH) - authorizes the Department of Justice to fund up to 100 such courts that involve:

  1. continuing judicial supervision, including periodic review, over offenders with mental illness (or a co-occurring substance abuse disorder) who are charged with non-violent offenses, and
  2. the coordinated delivery of services that includes: a) specialized training of law enforcement and judicial personnel to identify and address the unique needs of offenders with mentally illness, b) outpatient or inpatient treatment that carries with it the possibility of dismissal of charges or reduced sentencing upon successful completion of treatment; c) centralized case management involving the consolidation of all of a defendant's cases (including violations of probation), d) the coordination of all mental health treatment plans and social services, including life skills training, such as housing placement, vocational training, education, job placement, health care, and relapse prevention for each participant who requires such services, and e) continuing supervision of treatment plan compliance and continuity of psychiatric care for up to the maximum term of sentence of the criminal offense.

Why Full Funding of P.L. 106-515 in FY 2003?

NAMI feels strongly that Congress should fully fund the new federal Mental Health Courts program as part of the FY 2003 Commerce-State-Justice Appropriations bill. Mental health courts have proven effective in curbing the growing trend of "criminalization" of mental illness by giving courts and prosecutors the tools needed to divert offenders with severe mental illnesses into treatment programs, rather than jails. It is unacceptable that people with severe mental illnesses - legitimate medical conditions - who are not able to access appropriate treatment, are being imprisoned. In 2000, Congress took a major step forward in helping courts and criminal justice systems at the state and local level to provide access to appropriate treatment and services in the community for non-violent offenders when it passed P.L. 106-515. NAMI strongly urges full funding for this important program in FY 2003.


Thank you, Chairman Wolf, for allowing me to testify on this important subject.