Jails: A Less Restrictive Alternative?
by Jim Gottstein
The March 8, 1999, Final Draft of the Alaska Department of Correction's (Jails & Prisons) Strategic Plan for Trust Beneficiaries in the Alaska Department of Corrections states:
Alaska is mirroring a national trend where state psychiatric hospitals downsize, and the numbers of mentally ill in correctional facilities rise. . . . The primary cause of this criminalization of the mentally ill is generally believed to be a lack of adequate community-based programs, including assisted housing, support staff, and an emergency response system of mental health care that includes alternatives to incarceration. . . . Many of the mentally ill now in Alaska's correctional facilities would have been treated at the Alaska Psychiatric Institute (API) in the past. . . . The current plan to further reduce API to 54 beds requires an effective, well-funded community based system to prevent even more beneficiaries entering the correctional system. (pp. 1-2)
The Strategic Plan says that on the day the sample was taken, Corrections had 373 seriously mentally ill in its jails and that on the same day there were 79 people at API (while housing 373 people with serious mental illness, the Dep't of Corrections reports it only has 31 (overutilized) treatment beds). (p.8) As the whole purpose of the "de-institutionalization" of people with mental illness is to provide a less restrictive alternative to the hospital, it seems entirely appropriate to ask: Is jail a less restrictive alternative to hospitalization?
It is also clear that not only are people that used to go to API ending up in the jails, but that people who wouldn't have wound up in API in the past are also going to jail. In addition to the 373 inmates with serious mental illness, there were 490 people with less severe mental illness who were also housed in jail that day. (p. 8) The Olmstead Case, currently on appeal to the United States Supreme Court, held that it was a violation of the following regulation under the Americans with Disabilities Act, for a state to keep a person with mental illness in a hospital when the person could be treated in a community setting:
A public entity shall administer services, programs, and activities in the most integrated setting appropriate to the needs of qualified individuals with disabilities. 28 C.F.R.§ 35.130(d).
The same could be said to be true of jailing people with mental illness. In other words, why isn't it just as much of a violation to jail a person who should have been treated in the community as it is to hospitalize a person who should be treated in the community? A consumer was recently awarded $5.4 million for being placed in solitary confinement as a violation of his civil rights (this is likely to be appealed, but an appeals court already ruled in favor of the consumer once) and it is not a long stretch to see how incarcerating people suffering from mental illness could be a violation of the ADA in many, many instances.
In any event, the problem of people with mental illness being incarcerated because they are not getting appropriate services has been recognized. The Alaska Mental Health Trust Authority, the Alaska Mental Health Board and the Alaska Court System are all working to address these problems. For example, the Alaska Mental Health Trust Authority has funded a pilot project called Jail Alternative Servises to provide specialized sentencing, diversion and monitoring for misdemeanants in Anchorage with mental illness. The Alaska Court System court system has also established a Mental Health Court in Anchorage so that when people with mental illness get in trouble with the law, the case gets handled by people who have experience in dealing with these issues. On a more system-wide basis a Decriminalizing the Mentally Ill Subcommittee has been formed to explore ways to not only deal with people entering the criminal system, but also to keep them out of the system altogether. As more information about these programs is gained, this page will be updated.
Jim Gottstein is a recovered mental health consumer who was appointed to the Alaska Mental Health Board in December of 1998. Jim has also written an article on recovery, entitled "The Mental Health System: Recovery Should be the Goal and Consumer Employment." In addition, Jim worked as one of the lead plaintiffs' attorneys in the Mental Health Trust Litigation, which created the The Alaska Mental Health Trust Authority. The views expressed here are the the author's only.
last modified 4/2/1999