STATEMENT
OF
CHERI NOLAN
DEPUTY ASSISTANT ATTORNEY GENERAL
OFFICE OF JUSTICE PROGRAMS
BEFORE THE
SUBCOMMITTEE ON CRIME, TERRORISM, AND
HOMELAND SECURITY
COMMITTEE ON THE JUDICIARY
Mr. Chairman, Mr. Scott, and Members of the Subcommittee, I am Cheri Nolan, Deputy Assistant Attorney General of the Office of Justice Programs. I am pleased to be here this afternoon on behalf of the U.S. Department of Justice (DOJ) and especially the Office of Justice Programs to discuss how the criminal justice system responds to individuals with mental illness who are involved with the system.
This is an issue that cuts across federal, state, and local boundaries, with mentally ill individuals being held everywhere from city lockups to federal prison facilities.
It is becoming clear that the increasing number of people with mental illness in the criminal justice system is one of the most pressing problems facing law enforcement and corrections today. This issue has both major public safety and fiscal implications.
To understand the policy implications facing us, I would like to highlight some data about what prisons and jails are doing, and what has become a more and more common profile among offenders. According to a special report by the Office of Justice Programs’ Bureau of Justice Statistics (BJS), in 2000, nearly all (95 percent) state adult confinement facilities screened inmates for mental health problems. Of the nation’s 1,558 state public and private adult correctional facilities, 1,394 reported they provided mental health services to their inmates. Nearly 70 percent of facilities housing state prison inmates reported that as a matter of policy they screened inmates at intake, 13 percent of state prisoners were receiving some mental health therapy or counseling services at midyear 2000, and nearly 10 percent of state prisoners were receiving psychotropic medications. BJS’s report was based on the “2000 Census of State and Federal Adult Correctional Facilities,” which included—for the first time—items related to facility policies on mental health screening and treatment.
Another BJS report
found that 16 percent of correctional detainees self-reported they had a mental
illness. We all recognize that the accuracy of this estimate depended on the
ability and willingness of inmates to report such problems, which makes a
strong argument for using uniform, proven assessment and screening tools.
However, if this prevalence rate of mental illnesses among correctional detainees
were used as the actual rate for program planning, there would be approximately
2 million individuals with serious mental illnesses admitted to
I’m sure that we agree that all individuals who are found guilty of committing crimes must be held accountable. If the crime is serious, incarceration is the appropriate response, regardless of whether the perpetrator has a mental illness. Our policy is clear: we will not absolve someone of any responsibility for committing a crime simply because he or she has a mental illness.
At the same time, police, prosecutors, judges, and corrections administrators regularly voice their frustrations about existing responses to people with mental illness who commit low-level, less-serious crimes. When incarceration is not the answer, individuals with mental illness often are returned to the community, where, without access to appropriate housing and comprehensive mental health care and support services, they are more likely to be picked up for low level crimes once again in a costly and repetitive cycle.
Yet, even for those with mental illness who spend time in jail, the criminal justice system is a “revolving door.” Recidivism rates for individuals with mental illness are extremely high. Let me cite two examples: first, according to an October 1998 article in Psychiatric Services, more than 70 percent of inmates with mental illness released from the Lucas County, Ohio jail were re-arrested over the course of 3 years, and second, according to the Los Angeles County Board of Supervisors’ Task Force on Incarcerated Mentally Ill, about 90 percent of Los Angeles County jail inmates with mental illness are repeat offenders, and almost one-third of the inmates have been incarcerated 10 or more times.
These figures are a testament to the difficulty of ensuring that people with mental illness leaving correctional facilities are connected to needed treatment, support services, and housing. Without those connections, these individuals will continue to re-offend and public safety will continue to be jeopardized.
The involvement of people with mental illness in the justice system also is
extremely expensive. County jails are forced to use huge portions of their
pharmacy budgets for mental health treatment. According to
Managing individuals with mental illness in prison is no less costly. The Pennsylvania Department of Corrections estimates that an inmate with serious mental illness costs $140 per day to incarcerate, nearly twice as much as an inmate without serious mental illness.
In response to the need to address the combined problems of offender management and increasing costs, state and local governments across the country are developing programs and policies unique to their jurisdiction’s criminal justice systems that aim to improve the response to people with mental illness from the initial contact with law enforcement through the offender’s re-entry to the community from prison.
For example, state and local governments have encouraged police departments to form crisis intervention teams, developed pretrial screening for defendants with mental illness, established mental health courts, specialized caseloads for probation officers, introduced new instruments to screen newly admitted inmates for mental illness, implemented therapeutic communities in jails and prisons for offenders with co-occurring substance abuse and mental health disorders, and formed multidisciplinary teams to work on inmates’ re-entry planning.
At the heart of each of these emerging strategies is collaboration between the criminal justice and mental health systems, the crucial involvement of substance abuse treatment providers and other social service providers, and the need for affordable housing and employment. As we have demonstrated in the cross-agency Serious and Violent Offender Re-entry Initiative in which DOJ has partnered with the Department of Labor and the Department of Health and Human Services, no one sector or agency can solve this problem working alone. Together, they can make a difference.
Today, however, this collaboration is the exception, not the rule. As we have learned, even those leaders in the criminal justice and mental health systems who are interested in working together are unsure of what they can do, and, despite the possibility of generating significant savings to the state and county, the limited budgets in most jurisdictions make it very difficult to experiment with new ideas.
Yet, I believe that OJP can be a valuable resource to state and local governments. By promoting promising practices, providing technical assistance, and working with other DOJ agencies as well as with both the Substance Abuse and Mental Health Services Administration (“SAMHSA”) (in the Department of Health and Human Services) and NIMH to conduct research, we can stimulate the development and replication of programs and policies that will increase public safety and make the justice system more efficient.
For instance, the Bureau of Justice Assistance (BJA) has supported the investigation and implementation of mental health courts. In 2000, BJA published the first in-depth examination of mental health courts, “Emerging Judicial Strategies for the Mentally Ill in the Criminal Caseload.” This monograph described the organization and operation of four of the earliest mental health courts and has helped guide communities in developing their own mental health courts.
In
the Fiscal Year 2003 appropriation, BJA received funding for mental health
courts, which we have administered according to the parameters established in
P.L. 106-515, “
Beyond direct
grant funding, it is our responsibility to the field to provide information and
technical assistance grounded in research and representing sound criminal
justice practice, regardless of whether the project receives OJP funding. That is why, in addition to the grant
funding, OJP promotes technical assistance. Through this technical assistance,
BJA sponsored the first-ever national meeting of mental health court
practitioners in
Later this year, BJA will publish guides for implementing and operating mental health courts. As with all of our programs, we are working with the field to collect outcome data, which will further inform our policy decisions in this area. OJP’s National Institute of Justice (NIJ), is one of BJA’s partners in these endeavors. NIJ plans to publish the results of its examination of the referral and decision-making processes of seven BJA-funded mental health courts.
While mental health courts can be a component of addressing the problems associated with offenders with mental illness, other approaches are needed as well. That is why BJA has supported the Criminal Justice/Mental Health Consensus Project, which is coordinated by the Council of State Governments. The landmark Consensus Project Report provides hundreds of recommendations that policymakers and practitioners agree will improve the response to people with mental illness who come in contact with the criminal justice system.
In recent months, we have taken several steps at BJA to help state and local governments think about this issue from arrest through re-entry.
First, the Director of BJA has appointed a senior policy advisor for criminal justice and mental health issues. This is the first time the agency has had such a position. It demonstrates our recognition that the involvement of people with mental illness in the justice system is becoming one of the most important issues facing local and state criminal justice agencies and that BJA must be responsive to their needs.
Second, some grantees are using Serious and Violent Offender Re-Entry Initiative funds, better known as “re-entry,” to improve the transition that people with mental illness make from prison to the community.
Third, BJA is currently developing a strategic plan to support the efforts of law enforcement, corrections, and courts in dealing with individuals with mental illness. In fact, earlier this month, a group of court and mental health experts met to develop recommendations to BJA on what activities we and our federal partners could undertake to support court-based efforts to better address defendants with mental illness.
Increasing collaboration between criminal justice and mental health agencies is essential at the state and local levels, as well as at the federal level. We are coordinating our efforts with SAMHSA, particularly with regard to their Targeted Capacity Expansion (TCE) Grants for Jail Diversion Programs. While the programs are similar in nature, SAMHSA is providing grants for pre- and post-booking diversions that do not involve continuous judicial oversight, treatment, and case disposition. BJA is funding models that provide continuous judicial oversight and intensive case management, ensuring that offenders remain accountable throughout the process. Our cooperative efforts with SAMHSA will also help ensure that the federal government does not fund overlapping grant programs.
In addition, the
technical assistance providers for both agencies’ programs, the Council of
State Governments and the
This coordination helps us maximize the value of each agency’s grant program. Furthermore, this collaboration enables us to leverage each agency’s resources, expertise, and credibility with our respective constituencies in state and local governments. Most important, it allows us to demonstrate to state and local governments that the collaboration between mental health and criminal justice agencies is not only possible, but extremely valuable.
And, BJA is working with SAMHSA to implement the policies identified in the July 2003 report of the President’s New Freedom Commission on Mental Health to maximize the utility of existing resources, improve coordination of treatments and services, and promote successful community integration for adults with a serious mental illness.
Mr. Chairman, from my work at OJP I have come to believe that the increasing number of people with mental illness in the criminal justice system is one of the most pressing issues facing our police departments, jails, prisons, and courts. State and county governments have demonstrated that thoughtful policies and programs can be developed to address this problem. The federal partners are committed to doing all we can to support practitioners through our grant programs and technical assistance.
We very much appreciate the interest you and your colleagues have shown in this critical issue. I welcome the opportunity to answer any questions that you may have.