As part of the United States Department of Justice investigation into the pattern and practice of the Chicago Police Department, the DOJ held public forums and welcomed feedback from community members. Several CIC Summer 2016 interns attended the forums as well as wrote letters to the Justice Department with suggestions on how to rectify police and prosecutorial misconduct in Cook County.
To the Department of Justice,
The mentally ill are extremely overrepresented in United States jail and prison populations. According to the National Alliance for the Mentally Ill, between 25 and 40 percent of Americans with a mental illness will spend time in jail or prison. As many as 30 percent of
individuals incarcerated in the Cook County Jail are known to suffer from a mental illness. This makes Cook County jail the largest mental health facility in all of Chicago. Sadly, this is common: there are more people in jails and prisons with mental illness than in psychiatric facilities. To make matters worse, most jails and prisons--as they are now--are antithetical to effective treatment for the mentally ill. Incarceration tends to exacerbate symptoms and even hurt the mental health of those who may have had no previous mental conditions. Not only is the criminalization of mental illness expensive, but it constitutes an injustice and a humanitarian crisis for Cook County and our country at large.
The criminalization of mental illness is intimately tied to the lack of funding for access to mental health care. In 2012, Mayor Rahm Emmanuel decreased the number of Cook County's mental health clinics from twelve to six. This only exacerbated the problem of
overrepresentation of the mentally ill in Cook County's jail population by taking away a vital safety net for many suffering from mental illness. With nowhere to go, many ended up on the streets, where the police are the first to encounter them. For example, needing a place to sleep, an individual with schizophrenia may break into a building. The individual may also self-medicate with heroin to quiet the voices in their head now that they cannot regularly afford their prescribed medicine. If found by the police and put in the Cook County jail, they will most likely be discharged at some point, only for the cycle to begin again. This 'revolving door' phenomenon leads many mentally ill people--particularly non-violent offenders--to spend year after year of their lives rotating in and out of jail, in effect serving unofficial life sentences. Truly solving the epidemic of criminalizing the mentally ill lies largely on breaking this vicious cycle. As the majority of people in Cook County jail--including those who are mentally ill--never actually get sent to prison but are instead stuck going in and out of local jails, much work should be focused on the county level.
In order to address this incarceration cycle in Cook County from the perspective of the Department of Justice, there are two entry points. One is at the first interaction between the police and the mentally ill individual. Officers have the authority to bring these people to jail, but also to other locations, such as a mental health assessment center. Police require Crisis Intervention Training in order to both properly identify someone with a mental illness and know how to successfully interact with them. To his credit, Cook County Sheriff, Tom Dart, has made sure all incoming personnel in Cook County Jail get at least 60 hours of training in relation to mental illness, but this program needs to be expanded and possibly intensified for officers who may end up encountering--and hopefully avoiding the arrest of--someone with a psychiatric illness on the street.
The other access point is once an officer brings a mentally ill individual to the county jail.
At this point, one method of dealing with the issue of the incarcerated mentally ill that has shown great promise nationally is the use of multidisciplinary reintegration programs focusing on keeping people well-adjusted after their release. Different programs offer a variety of aid, such as a psychiatric staff, parole officers, and housing assistance. Many, such as the Dangerous Mentally Ill Offender program (Washington State) and Mental Health Services Continuum Project (California), are focused on a state level for mentally ill prisoners approaching the end of their sentence, but Sheriff Dart and Warden Nneka Jones Tapia have started such a program in Cook County Jail: the Mental Health Transition Center. The Mental Health Transition Center, which is available to non-violent offenders, provides group therapy and skills to manage mental illness, classroom and GED education, and courses on how to get and manage a job. Additionally, Dart and Tapia are working on programs to help provide jobs and community health services on the outside even before inmates discharge.
Though these efforts are recent, the results have been excellent so far. As of last April, 22
participants in the program were discharged. Aside from the 8 who were later found guilty of their original crimes and are serving prison sentences, all of the participants have stayed out of jail since discharge and are keeping up with their mental health and drug abuse resources. Many are employed and/or continuing their education. This positive outcome is not surprising. Different programs nationwide have had different levels of success, but by and large they are successful. Furthermore, these programs, while seeming expensive, can actually be demonstrably cost-effective. For example, as opposed to the current way of dealing with the incarcerated (which is extremely expensive for state and taxpayer) the Dangerous Mentally Ill Offender program saved $21,597 per participant in reduction of felonies.
The main problem with the programs created by Sheriff Dart and Warden Tapia is that
they are underfunded. Though the people who have gone through the program show promise,with the jail's current resources, the vast majority of eligible inmates are unable to get into the program as of now.
Mental health courts are an alternative to the criminal justice system for the mentally ill
and another way of solving the issues of mental illness in the prison system, at least in theory. Instead of being sent to prison, sentences in mental health courts are focused on rehabilitation. Among the treatments available are academic and vocational aid, psychiatric treatment, and both residential and outpatient treatment.
Multiple problems with mental health courts keep them from fulfilling their potential.
One is diagnostic. Different states have different criteria for defining mental illness. But in Cook County, bipolar disorder, schizoaffective disorder, and schizophrenia are represented
disproportionately to other disorders that are taken less seriously in common discourse but are often equally as serious. These groups include the various anxiety disorders, autism, and obsessive compulsive and related disorders. Furthermore, our mental health courts do not include criteria for the cognitively impaired at all. In fact, someone with cognitive impairments may be screened out of the mental health courts as being unable to comply with the program.
Another problem is that mental health courts in Cook County are extremely underfunded. As a result, like the previously mentioned Mental Health Transition Center, limits usually must be set for how many people they can take based on resources, rather than need. In Cook County, mental health courts are currently able to take on only 75 participants which-- given our particularly high concentration of the incarcerated mentally ill--is very small. The average person in Cook County's mental health court has had to commit several dozen nonviolent crimes before becoming admitted. Additionally, our mental health courts require a high success rate to continue getting what little funds and grants they can receive, and so they are strongly incentivized to take only the most promising--instead of the most in need--cases in order to inflate their success rates. Finally, the Cook County mental health court system is generally not available to those who have committed violent crimes. This may leave many of those most in need, and who would likely otherwise stay perpetually locked in the criminal justice system by being sent off to prison, out of mental health courts.
Based on the above information, I suggest a list of steps to help solve the humanitarian
crisis and financial problem of treatment of the mentally ill in Cook County's legal system:
1. Require and fund training of police officers in relation to identifying and appropriately reacting to mentally ill offenders.
2. Increase funding to mental health access and staff (therapists, psychiatrists, etc.) in Cook County jail.
3. Invest in multidisciplinary approaches to rehabilitation such as the Mental Health Transition Center.
4. Expand the diagnostic criteria of eligibility into the mental health court system to include other mental health diagnoses and as well as cognitive impairment.
5. Increase mental health court funding. This will increase the amount of people in need who can access it as well as provide better care for those involved.
6. Expand the eligibility of mental health courts based on severity of crime.
With these steps, I believe we can make great progress in alleviating both the financial
strains and humanitarian issues of preventing the excessive incarceration of the mentally ill in Cook County.
Intern at the Chicago Innocence Center