We need to stop treating mentally ill people like criminals

At a time when homelessness in California has reached a point of crisis, criminal justice leaders need to finally address the way we treat the mentally ill and how our institutions respond to incidents of mental health crisis. 

The criminal justice system needs to better treat people living with mental illness for a wide variety of reasons, as the current system is bad for taxpayers, public safety officers and most importantly, the people struggling with mental health issues.

During a mental health crisis, people are more likely to encounter police than get medical help, and as a result, end up in the criminal justice system, frequently for minor nonviolent offenses. 

And this is usually not a one-time event, as mentally ill people are frequently arrested repeatedly, but are rarely connected to the help they need. Every year, over a million people with serious mental illness are booked into jail.

Once in jail, many individuals don’t receive the treatment they need and often their mental health conditions get worse, not better. After leaving jail, many no longer have access to needed healthcare and benefits because of the consequences associated with having a criminal record. Some people, without access to mental health services and support systems, wind up homeless, in emergency rooms and often re-arrested.

Law enforcement officers frequently aren’t the best people for the job. They typically intervene in situations with mentally ill people when other options have failed, whether it’s therapy, education or medication, and relapses occur. Someone then calls 911 and police officers respond according to their training, which can be at odds with best practices for handling mental health crises.

Even if the interaction between law enforcement and a mentally ill person goes well, the current system is also prohibitively expensive. According to the National Alliance on Mental Illness, housing an inmate with mental illness in jail costs $31,000 annually, while community mental health services cost about $10,000.

This heartbreaking dynamic is something I have personal experience with. Growing up, I had a close family member who struggled with addiction. While she luckily had safe interactions with public safety officers and was able to eventually get sober, I saw firsthand how broken our system is when it comes to the way we treat the addicted and mentally ill.

It’s why I founded and lead the pioneering Criminal Justice Mental Health Project in LA County, which has set priorities for a comprehensive mental-health diversion plan that provides alternatives to incarceration for nonviolent offenders, using input from government agencies and community-based organizations.

Our work culminated in the widely acclaimed “Report from the Mental Health Advisory Board: Blue Print For Change,” which proposed expanding training for law enforcement personnel and adding community-based beds to house and treat individuals with mental illness, particularly those with criminal records. 

Among other accomplishments, the project secured $150 million in funding from the county for emergency mental health resources and opened five mental health urgent care centers as an alternative to jail, with a sixth one coming soon. 

The project also resulted in the creation of a new county office of diversion and re-entry, a dedicated psychiatric emergency response team that gives fearful families another number to call besides 911, and 39 teams across the county staffed with a police officer and a mental health professional acting as “second responders” for cases involving mentally ill people.

Additionally, we also needed to significantly change the way in which we teach public safety officers to respond to incidents of mental health crisis. The DA’s Office now trains hundreds of patrol officers and dispatchers in de-escalation tactics for people undergoing a mental health crisis, and is increasing the number of collaborative courts to divert those who have mental illness, substance abuse, and or post-traumatic stress disorder. This training program, which is attempting to destigmatize mental illness and change the culture of policing, was recognized by the National Association of Counties in 2017.

But despite all the important progress we’ve made in LA County, we have much more work to do to make our system more equipped to respond effectively and compassionately to incidents of mental health crisis. 

It’s why this week, I’m in Italy attending the World Health Organization’s Conference on Promoting Human Rights & Recovery in Mental Health, to learn how municipalities across the globe are addressing this extremely complex problem. It’s incredibly important for other criminal justice leaders to do the same, and continuously do the difficult work of adapting and upgrading our system to be more compassionate and just while ensuring the safety of everyone. 

Jackie Lacey is the district attorney of Los Angeles County, first being elected in 2012. Born and raised in South Central, Lacey is the first woman, and first African-American, to serve as LA District Attorney since the office was created.

Tags Articles Community mental health service Health Mental disorder Mental health Mental health in the United States Mentally ill people in United States jails and prisons National Alliance on Mental Illness Police crisis intervention team Psychiatry

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