Thursday, 24 January 2013

Mental health not a certain catalyst for criminal activity

Mentally ill people make the news every day.

Many believe those who suffer from schizophrenia, bipolar disorder and other mental illnesses are dangerous criminals in training
Although violent crimes make headlines, most mentally ill offenders are charged with petty, nonviolent offenses like trespassing and loitering, said police officer Nicholas Soriano. And, although many end up in jail, this is not a lasting solution.

Some of the biggest psychiatric facilities in the country are jails,” Soriano, the homeland security coordinator for the Athens-Clarke County Police Department, said.

Soriano serves as a liaison between the police and the Treatment and Accountability Court, which offers an alternative to jail for those whose committal of nonviolent crime is informed by an untreated mental illness or disability. TAC participants agree to follow a treatment plan and check in with the court while complying with probation orders.

Soriano said after deinstitutionalization measures, which began in the ‘60s, released mentally ill patients from long-term treatment facilities, many were not met with the necessary support and were left to fend for themselves.

“The homeless population exploded,” he said. “You’ve got folks that were let out of institutions who everyday had a strict regimen. And now they’re out on the streets on their own. What happened because of that is law enforcement became frontline mental health workers. We had to transition to that.”

Soriano prepares officers for this responsibility by teaching the 40-hour crisis intervention course every officer must undergo before entering the field. Advantage Behavioral Health Systems works with the police in this initiative, teaching officers to recognize signs of mental illness. ABHS also works with TAC as the mental health provider for offenders with severe and persistent mental illness.

“We don’t believe that [mental illness] excuses that behavior,” ABHS Clinic Coordinator Laurie Wilburn Bailey said. “It’s just that we know that incarceration isn’t going to fix anything for when they come back out. And let me tell you, treatment court is longer for a lot of these people than any amount of time they would spend in jail.”

Elisa Zarate, court coordinator for TAC, said the partnership between the court and ABHS aims to reduce recidivism rates by addressing the underlying issues of mentally ill offenders.

“It’s our belief that if we, you know, catch these individuals early and get them connected to mental health treatment, then they’re less likely to be a repeat offender,” she said.

Zarate said the court tries to connect indigent participants to resources they may not ordinarily be able to access. These include mental health services, but also others, to address the larger problem of poverty.

Bailey said the relationship between mental illness and poverty is cyclical.

“Many of our folks, their symptoms are so severe that they’re not able to work,” she said. “It can impact their ability to earn a living wage. So maybe they’re on SSI or on disability and you know, living in Athens on $670 a month — you live in poverty. If they don’t have even disability, then that means that they don’t have Medicaid, and so they’re having to figure out how to get their meds covered. And those meds are expensive.”

Mental health medications can cost upwards of $800 a month, Bailey said. The cost of medication is one reason many indigent offenders don’t seek treatment until after they end up in a police car. Another is the actual symptoms of mental illness.

“If someone has any of the forms of mental illness that can have a psychotic component or a paranoid component to it, the system can be scary,” she said. “It can be, you know, ‘The police are out to get me’ or ‘Those people at the mental health center are giving me poison.’ The actual symptoms of the psychosis can impede their ability to be willing to accept the treatment — because they just don’t trust very well yet.”

Bailey said symptoms of mental illness can also make communicating with doctors a challenge, as patients have difficulty expressing their needs and comprehending what they hear when their minds are racing. This difficulty also affects their interactions with others in society.

In fact, Bailey said, sometimes the mentally ill are perceived as threatening when they aren’t doing much at all. That is often when the police get called.

“Maybe they have an odd presentation,” she said. “Maybe they don’t have a real good understanding of personal space, and so they’re making people uncomfortable downtown because they seem intimidating, or they seem like they might hurt you. If that happens enough times, they might get a charge of loitering or something that they wouldn’t have gotten had people not been uncomfortable. So it’s not necessarily that they’re more prone to criminal activity. But I think that sometimes, their symptoms might result in more police interaction.”

But that interaction doesn’t have to be negative. If someone commits a misdemeanor offense and appears to have a mental illness, an officer has the option to take the offender into custody but transport him or her to a hospital instead of jail.

“If you had someone who has an altered state of reality, and they’re criminally trespassing, and they refuse to leave somewhere, and you know they have a mental illness, yeah, you could arrest them for criminal trespassing,” Soriano said. “You could put them in jail on a misdemeanor — and, you know, tie up the system. Or you can transport them to the hospital and hopefully get them evaluated.”

Soriano said although it may be impossible to help everyone, there is still reason to try.
“I know the cops and even mental health workers, they get a bad rap,” he said. “But we really care. We’re actually out here to try and help people. If we didn’t care, we wouldn’t be trying so hard to get people into treatment. It’s just sad that you can’t get to everybody.”

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