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CRIMINALIZATION OF MENTAL ILLNESS AND THE LAW ENFORCEMENT ROLE

CRIMINALIZATION OF MENTAL ILLNESS AND THE LAW ENFORCEMENT ROLE. Risdon N. Slate, Ph.D. 2010 FBI National Academy Utah Chapter Fall Training – St. George, Utah. Free Association. Mentally Ill. Psycho. Jason in Friday the Thirteenth. Jason on Arsenio Hall Show.

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CRIMINALIZATION OF MENTAL ILLNESS AND THE LAW ENFORCEMENT ROLE

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  1. CRIMINALIZATIONOF MENTAL ILLNESS ANDTHE LAW ENFORCEMENT ROLE Risdon N. Slate, Ph.D. 2010 FBI National Academy Utah Chapter Fall Training – St. George, Utah

  2. Free Association • Mentally Ill

  3. Psycho

  4. Jason in Friday the Thirteenth

  5. Jason on Arsenio Hall Show

  6. Crisis in Mandarin Chinese

  7. Crises Often Drive CJ Policy • Crisis Intervention Team Training • Eugene Gregory and Alan Singletary • Andrew Goldstein • Aaron Wynn • Brad H. • Seung-Hui Cho

  8. Recipe for Failure • Not offering adequate treatment • Providing no follow-up on re-entry into the community

  9. California’s Lanterman-Petris-Short Act • Prompts Abramson to coin the phrase “Criminalization of Mental Illness” • WHY? • Magna Carta of the mentally ill (Abramson).

  10. Each of the following cited for contributing to the criminalization of mental illness • CJ Process viewed by LE as more expeditious than MH Process • Deinstitutionalization • Inadequate community support service • Lack access to intermediate & long-term care

  11. Deinstitutionalization

  12. Patients in State Mental Hospitals 20th Century 21st Century • Beginning roughly 150,000 • 1955 peak = 559,000 • 1960 – 1980 = < 100,000 • Beginning = _______ • Estimated today = _______

  13. . . . The grim statistics - jails and prisons have become the new “psychiatric hospitals”

  14. Harcourt, 2006 Texas Law Review

  15. Penrose finds as prison populations decrease mental hospital populations increase; as prison populations increase mental hospital populations decrease. • Today more persons with mental illnesses in prisons and jails than in psychiatric hospitals. • Transinstitutionalization has take place

  16. Factors Associated with Deinstitutionalization Movement • Inhumane conditions and abuses in state hospitals • Discovery of Thorazine • The anti-psychiatry movement

  17. 2 Cases Set the Deinstitutionalization Movement in Motion in the 1970s • Wyatt v. Stickney (1972) • O’Connor v. Donaldson (1975)

  18. Founders of the Anti-Psychiatry Movement • Michael Foucault • R.D. Laing • Thomas Szasz

  19. Work of Szasz & the anti-psychiatry movement has made it easier to put a person in jail than to secure treatment for them.

  20. L. Ron Hubbard (Scientology Founder) “There is not one institutional psychiatrist alive who could not be arraigned and convicted of extortion, mayhem, and murder” (Rissmiller & Rissmiller).

  21. Scientology • Religious Views • Prominent Members • Views on Formal Education • Views on Psychiatry

  22. Community Mental Health Centers • JFK appropriated $3 billion in 1963 for CMHCs • Never allocated • JFK assassinated • Viet Nam War • NIMBY (Gilligan)

  23. States’ Ways to Shift Costs for the Care of PWMI to the Federal Government • Disability insurance • Housing assistance • Medicaid • Moving persons with mental illnesses from state hospitals to nursing homes • How Shift Costs to County & Local Govt. ?

  24. Managed Psychiatric or Behavioral HealthCare • Has actually resulted in payment of commissions for denial of hospital admissions • May result in cost shifting instead of saving • Limited choices, pre-certification, cut corners

  25. National Alliance on Mental Illness (NAMI) Grading the States Report • Average Grade for the Public Adult Mental Health Care Systems in the U.S. = D ____ UTAH= ?

  26. Medicaid vs. Medicare

  27. Preferred Drug Lists/Restricted Formularies

  28. Hospitals do not have to provide mental health treatment to those unable to pay. • Markowitz found a predominance of private psychiatric hospital beds in cities to be significantly associated with increases in both arrest and crime rates, suggesting that when the mental health system is privatized police have fewer referral options to mental health treatment and are more likely to make an arrest.

  29. “That’s news to us” Whose job is it? MOUs

  30. Homelessness

  31. Military

  32. Daytona Beach Police Chief Michael Chitwood • Greyhound Therapy • Banishment • Cost-shifting

  33. Surgeon General’s Report • The most formidable obstacle to future progress in the arena of mental illness and health is: ________

  34. Violence • Factors linked to violence include: past incidences of violence, substance abuse, lack of treatment, and non-compliance with medication. • “Laws change for a single reason, in reaction to highly publicized incidences of violence. …[And it] may be necessary to capitalize on the fear of violence” (D.J. Jaffee, Treatment Advocacy Center)

  35. Violence & Funding for Mental Health Treatment • Stigma - Otto Wahl • One Flew Over The Cuckoo’s Nest • Negative media portrayals of persons with mental illnesses have reportedly contributed to roughly half of all citizens perceiving persons with mental illnesses as being more violent than persons without mental illnesses. • Famous persons with mental illnesses

  36. One Flew Over the Cuckoo’s Nest

  37. Anosognosia • Xavier Amador • Effects

  38. 3 Largest Inpatient Psychiatric Facilities

  39. People with mental illnesses are incarcerated longer • Riker’s Island (NYC) • Average length of incarceration • All inmates = 42 days • Inmates with SMI = 215 days • Pennsylvania Prisons • Inmates with SMI three times more likely to serve maximum sentences. • Source: www.consensusproject.org

  40. Prevalence of Mental Illness • Ditton Study • James & Glaze • Percentage of PWMI with a substance abuse disorder

  41. THE LAW ENFORCEMENT RESPONSE TO PERSONS WITH MENTAL ILLNESSES IN CRISES

  42. Seth Greenberg • “Mental illness is not a … choice; it is a medical disease.”

  43. VPH vs. SBC

  44. CIT • Memphis PD

  45. Gary Cordner • PWMI more likely to be injured by police and _______ times more likely to be killed by police.

  46. Price • Police have been found to have more empathetic views than the general public toward pwmi in crises.

  47. Ruiz & Miller • Two most common misperceptions held by the police toward pwmi

  48. Experts advise police not to resolve encounters with pwmi in crises quickly • However, most police agencies do not have such specialized training or a formalized policy for such interactions. • Greenberg, in a study of 28 police training academies, found the average amount of training was _____hours.

  49. Law Enforcement Relationship with Mental Health Personnel • Fairly Negative Working Relationship • LE often views arrest and cj process as a more expedient option than referral to the mh system. • Mercy Bookings • “The system that can’t say no.” • MOU

  50. No Mercy

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