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Editorial: Prison a poor place for mentally ill

The Detroit News

Since most of Michigan’s state-run psychiatric hospitals closed in the 1990s, prisons have become the largest holding place for the mentally ill. That’s part of a national trend. The Treatment Advocacy Center reports that 44 states hold more mentally ill people in prisons than hospitals or psychiatric facilities.

It’s a costly way to deal with those with mental illness, and not a very effective one. Too often, mentally ill citizens end up behind bars because the state can’t figure out where else to put them.

“Some people are bad and mentally ill, but a lot of mentally ill people don’t need to be in the criminal justice system,” says Tom Watkins, CEO of the Detroit Wayne Mental Health Authority.

Michigan incarcerates roughly 9,400 mentally ill inmates — about a quarter of the total inmate population, according to the Michigan Department of Corrections. The mentally ill are expensive to lock up. It costs more than $95,000 to keep someone with a serious mental illness — nearly three times more than a mentally stable inmate.

In many cases, mentally ill individuals commit crimes because they lose control over their actions — either their medications fail or they never received treatment in the first place. When the mentally ill commit non-violent or petty crimes and don’t pose a threat to the public, prison is not the best option. It’s too costly to taxpayers and an ineffective way to treat the illness.

Watkins said Michigan should not try to return to a system with state-run psychiatric hospitals because they were expensive to operate and oftentimes inhumane. Instead, he suggested a community-based approach to caring for the mentally ill.

This starts with keeping non-violent, mentally ill people out of jail. Watkins and the Mental Health Authority have created 23 community crisis health teams throughout Wayne County. These teams are composed of doctors and social workers who respond to mental health emergencies.

Watkins said the standard procedure for police when they encounter mentally ill people is to take them to an emergency room or jail. Community crisis health teams try to determine if treatment can be delivered without hospitalization or incarceration.

The program, called Community Outreach for Psychiatric Emergencies, responded to 6,400 calls from March to September last year.

If jail can’t be avoided, the problem becomes more complicated and costly. Inmates lose their Medicaid funding when incarcerated, even if they have not been convicted of a crime, unless they can bond out of jail. And many can’t, placing a huge financial burden on state and local governments to pick up the tab for medical bills.

Watkins said judges are more likely to choose not to send mentally ill people to jail when there are community-based rehabilitation programs available.

“They’re more humane and less costly than prison,” Watkins said.

These programs should be expanded to save taxpayer’s money and provide more effective and humane treatment for the mentally ill.