Article from 9/23/2015 Washington Post by Justin Volpe on the treatment of the mentally ill in the criminal justice system.
Jails are no place for the mentally ill. I was lucky to get out.
Housing people with serious mental illness in prison is dangerous, expensive and ineffective.
By Justin Volpe September 23
Justin Volpe is a Certified Recovery Peer Specialist living in Miami.
Twelve years ago, after a long struggle with drug addiction and mental illness, I packed my bags and left my home in New Jersey, bound for Miami and determined to make a fresh start. My brother had convinced me it would be a chance to get clean, to restore my mental health.
But the move unraveled me. My illness and addiction caused me to lose job after job, and I was becoming delusional, hearing voices and seeing hallucinations. I sold my TV and computer because I believed they were sending satellite signals to control me. I thought people were following me, coming to break into my apartment at night. My paranoia kept me up for weeks, wandering the streets in bad neighborhoods, constantly looking over my shoulder. Because I didn’t understand my illness, I never sought the treatment I needed. Looking back, I suppose I shouldn’t have been shocked when I found myself staring into the lens of a booking camera, arrested on petty theft charges after the voices told me to steal.
I know I am responsible for the actions that landed me in jail, but I also know they were the result of a disease that spiraled out of control due to lack of proper treatment. That day was the first and only time I’ve been charged with a crime. I also know that my stint in the Miami-Dade County Jail was anything but rehabilitative. I was locked up on the jail’s ninth floor — infamous as the “Forgotten Floor,” where the jail kept its inmates with serious mental illnesses. The conditions were so bad that I had trouble believing I was still in the United States. The lights were on day and night; it was always 60 degrees. You could smell the mold in the air. I’m still haunted by the screams of the inmates round-the-clock. I remember one guy begging for his life while I prayed the officers wouldn’t take their wrath out on me. Amid the chaos of the jail, my mental health worsened, and the possibility of rejoining the outside world seemed further out of reach.
Today, I’ve been clean from drugs for eight years and from alcohol for three. For the past six years, I’ve been happily married, and my wife and I have a 4-year-old son. We recently bought a home, and I’ve found deeply meaningful work as a peer support specialist working with the 11th Judicial Circuit Criminal Mental Health Project in Miami-Dade — the jail diversion program that saved my life.
My story is the exception. I’m one of the lucky few offered support and treatment after a brush with the law. I went to jail in 2007, around the time that Miami-Dade County Judge Steven Leifman succeeded in encouraging more comprehensive coordination between law enforcement and behavioral health treatment centers. After 46 days in jail, the resident psychiatrist identified me as having a mental illness and transferred me to a hospital. Case workers there deemed me eligible for the program, which puts people who aren’t considered a public safety threat into community-based treatment and offers mental health and drug addiction services. Without that program, I’m not sure where I would have ended up. I certainly wouldn’t have had the chance to help more than 600 people through jail diversion and treatment after getting my own life on track.
Jails have become warehouses for those struggling with mental illness as well as drug addiction. Serious mental illness now affects about one in six men and almost one-third of women in jails, rates four to six times higher than in the general population. For people with serious mental illnesses, stigma often keeps them from seeking treatment, which is how they wind up in the criminal justice system. There are currently 10 times more mentally ill people in jails and prisons than in state mental health institutions; the vast majority of these people are in jail for non-serious offenses.
The results are tragic. Jamycheal Mitchell, a young man who, his family says, suffered from bipolar disorder and schizophrenia, was found dead in a Virginia jail cell in August. His death came four months after his arrest for stealing a Mountain Dew and a few dollars’ worth of snacks. His family believes he starved after refusing to take meals. Earlier this month, three jail deputies in Santa Clara County, Calif., were arrested under suspicion of murder in the death of Michael James Tyree, another young man with a history of mental illness. Tyree, who died of internal bleeding due to trauma, was being held on misdemeanor drug and theft charges.
Mental illness doesn’t excuse anyone from accountability. But the purpose of our justice system is not just to punish but to rehabilitate. And yet research shows that even a brief stay in jail, as short as a few days, can hamper rehabilitation: It reduces job opportunities, harms physical and mental health and increases the likelihood of committing another crime. Especially for people struggling with mental illness, the system can perpetuate a vicious cycle of arrest, detention, release and re-arrest. Of about 500 people in New York City who were jailed more than 18 times between 2008 and 2013, more than 20 percent had a serious mental illness.
This is a community problem that requires alternatives to incarceration as well as partnerships with health providers and reintegration programs. We can start by directing more resources to the most promising models: greater coordination between police and mental health services, innovations like mobile crisis units, mental health courts and pretrial diversion programs like the one that helped me. These programs offer road maps for others across the country to follow.
As a peer recovery specialist in Miami-Dade County, I work with people who are facing similar challenges. I’m one of the first people whom participants in the program see after getting out of jail. I help them find the resources for clothing, food and other essentials. Because of my personal experience, I can relate to people in the program on a level that a judge, attorney or treatment provider might not be able to. Building this relationship is a vital part of what community-based programs do to ensure that people receive treatment in the community and don’t come back through the criminal justice system. Even after their cases are closed, I often stay in touch and continue to provide counsel.
Miami-Dade County has found that recidivism among people with diagnosed mental health issues arrested on misdemeanor offenses declined dramatically after the program’s launch, dropping from 72 percent to 20 percent. And studies show that diversion programs are cost-effective: Those that steer people struggling with drug addiction toward treatment rather than incarceration save $2 for every dollar spent. But too often, communities don’t invest in these programs, and the result is skyrocketing incarceration.
We’re seeing signs of progress. I was part of the launch of the MacArthur Foundation’s Safety and Justice Challenge, which is working with New York City, Chicago and Philadelphia as well as smaller counties like Pennington County in South Dakota and Multnomah County in Oregon to create plans that will reduce incarceration while prioritizing public safety.
People shouldn’t have to go to jail to get the treatment they need to get back on track, and incarceration is not a safe or cost-effective way to deal with our mentally ill population. My story shows both sides of the local criminal justice system: how it can fail, but also how it can work — when it holds people accountable while providing the resources for them to turn their lives around and rejoin society. Everyone who struggles with mental illness and drug addiction should have that same opportunity, and our communities will be stronger and safer if they do. Treating people like me should mean more than putting us inside a cell.