Introduction

The number of people with psychiatric disabilities in jails and prisons is on the rise. By the end of 2000, nearly one million adults with mental illnesses were in the criminal justice system.1 Nearly two million new jail admissions were of people with mental illnesses—a rate of 35,000 individuals a week2—mostly for nonviolent offenses.3 The number of youth with mental or emotional disorders entering juvenile detention centers and correctional facilities is also climbing.4

Mental health advocates have been distressed for years about the disproportionate number of people with psychiatric disabilities who are arrested or held in jail or prison. The growing numbers are also raising concern in criminal justice circles. Police express frustration about repeated—and time-consuming—encounters with people in their communities who appear in need of mental health treatment. Those who run jails, prisons and juvenile corrections programs worry about people with psychiatric disabilities in their facilities. They are concerned about these inmates themselves and about staff and other inmates, and outraged because these inmates need help more than—or instead of—punishment.

Equally disturbing—especially for the individuals themselves and their families—is the endless cycle of recidivism that results when people with psychiatric disabilities are released with their needs unmet. In these times of lean state budgets, lawmakers and public officials have raised serious concerns about the financial burden recidivism places on law enforcement, corrections and their community.

The Council of State Governments (CSG) recently completed two years of study and meetings of hundreds of individuals involved in criminal justice or mental health systems at the state and local levels.5 As the CSG found, “individuals with mental illnesses leaving prison without sufficient supplies of medication, connections to mental health and other support services, and housing are almost certain to decompensate, which in turn will likely result in behavior that constitutes a technical violation of release conditions or a new crime.”6 This confirmed a 1991 study finding that within 18 months of release from prison, 64 percent of offenders with mental illnesses were rearrested and 48 percent were hospitalized.7

This cycle can be broken, by ensuring that inmates with psychiatric disabilities have immediate access to the mental health services, housing and other supports they need to avoid rearrest. Building Bridges offers an approach that states can use to afford recently released inmates with psychiatric disabilities a successful transition to community life.
As the CSG recognized, people with psychiatric disabilities rely heavily on federal benefit programs to pay for housing, food and other necessities and to receive health and mental health services. Disability benefits such as Supplemental Security Income (SSI) and Social Security Disability Income (SSDI) provide a cash benefit that is often essential to securing housing. Medicaid provides access to health, mental health care and substance abuse services. Although these are federal programs, states can put in place policies that will enable inmates with psychiatric disabilities to be enrolled or reinstated in these programs, receive needed services speedily and establish connections to the community-based mental health system prior to release. As the CSG noted, access to these services “is the most effective ‘precontact’ diversion from the criminal justice system for people with mental illness.”8 Building Bridges provides a legislative template for enacting such policies.9

How to Use the Model Law

A summary of the model law follows to provide a broad overview. In the succeeding sections, the text of the proposed legislation is paired with a commentary with background and explanation to assist advocates and policymakers in working to adapt the model to their state. The commentary highlights potential issues, explains the choices we made as the language was drafted and provides references to helpful sources and supplementary materials. We have assumed that states will want to enact implementing rules or regulations related to benefit-reinstatement legislation, and accordingly have included suggestions as to what those rules should contain.

Several states are already working with earlier drafts of this template. We hope many more will use Building Bridges to enact legislation that will address a critically important part of the growing crisis of serious mental illnesses. We urge advocates to form or join local task forces to discuss the issues and tailor the model law to fit state or local codes and circumstances. We welcome the opportunity to work with members of such task forces who are interested in adapting the law for enactment in their state.

Next: Summary

Notes

1 Calculated using the respective rates of mental illness reported in Bureau of Justice Statistics Special Report, Mental Health Treatment of Inmates and Probationers (NCJ 174463) and year-end jail and prison population numbers reported in Bureau of Justice Statistics Bulletin, Prisoners in 2000 (August 2001, NCJ 188207) and probationers reported in Bureau of Justice Statistics press release of August 26, 20001.

2 Based on admission rates reported in Bureau of Justice Statistics Bulletin, Census of Jails, 1999 (August 2001, NCJ 186633) multiplied by the percentage of jail inmates with a mental illness (16.3%) reported in Bureau of Justice Statistics Special Report, Mental Health Treatment of Inmates and Probationers (July 1999, NCJ 174463).

3 Bureau of Justice Statistics Special Report, Mental Health Treatment of Inmates and Probationers (NCJ 174463)(citing a figure of 70 percent).

4 Cocozza, Joseph. J., & Skowyra, Kathleen R. Youth with Mental Health Disorders: Issues and Emerging Responses (April 2000). Juvenile Justice, Volume VII(1), Washington DC: Office of Juvenile Justice & Delinquency Prevention.

5 Council of State Governments , Criminal Justice/Mental Health Consensus Project (June 2002), New York: Council of State Governments. The report may be found at www.consensusproject.org.

6 Id. at p. 274.

7 Feder, L., “A profile of mentally ill offenders and their adjustment in the community,” Journal of Psychiatry and the Law, 19:79-98 (1991).

8 Council of State Governments at p. 33; Id at p. 274 (“Linkage with appropriate government benefits in a timely manner can make the difference between success and failure in the community.”).

9 The Bazelon Center for Mental Health Law has authored several publications focusing on individuals with serious mental illnesses in the criminal justice system and their return to the community following incarceration. These include Finding the Key to Successful Transition from Jail to Community (March 2001), an explanation of federal Medicaid and Disability Program (SSI, SSDI) rules; Facts about Federal Benefits for Individuals with Serious Mental Illnesses Who Have Been Incarcerated: Veterans Benefits, Temporary Assistance for Needy Families (TANF) and Food Stamps (January 2002); Fact Sheets for Advocates: People with Serious Mental Illnesses in the Criminal Justice System (May 2002); and A Better Life—A Safer Community: Helping Inmates Access Federal Benefits (February 2003).