Introduction
This paper discusses access to federal benefit programs for adults with
serious mental illnesses and juveniles with serious mental or emotional
disorders leaving jail, prison, juvenile detention or other correctional
institutions (hereafter the term 'serious mental disorders' is used for
both groups). It is based in part on material presented at a symposium
during the 2002 Conference on Expanding Access to Community-Based Services
for People with Co-Occurring Disorders in Contact with the Criminal Justice
System, sponsored by the National GAINS Center. Presenters there, listed
on page 17, had expertise in federal benefit-program rules and experience
in the correctional system (including as a jail administrator) and with
the needs of people who are homeless. The report also includes information
collected by the Bazelon Center on state and local initiatives to deal
with this issue.
Problem
Growing numbers of people with serious mental disorders are in jails
or prison. Many cycle through corrections facilities repeatedly, costing
both criminal justice systems and communities significant resources and
resulting in great pain to themselves and their families. Access to mental
health and substance abuse services, food stamps and the income support
that can pay for housing and other necessities is generally available
to these individuals through federal entitlement programs. Yet many jail
and prison inmates with serious mental disorders either have lost or never
had these essential federal entitlements.
Individuals released from correctional facilities without benefits face
many of the same problems that led to their original arrest. Without income
support, either through federal or state programs or from employment,
adults will not be able to access housing and will have no resources to
meet critical needs. Many will then become homeless.
Once homeless, individuals with serious mental disorders are particularly
at risk of being victimized or arrested. Often they are not accepted at
shelters, or are asked to leave following an incident. Without access
to mental health services--in part the result of not having Medicaid coverage--the
psychiatric symptoms of individuals with serious mental disorders may
worsen and they may fail to respond appropriately when approached by a
law enforcement officer. Their homelessness increases the likelihood of
such approaches. If they are trying to survive on the street they encounter
communities that are increasingly enacting and rigorously enforcing laws
that define quality-of-life crimes. Moreover, many communities are adopting
policies that lead people into violating local ordinances. For example,
redesigning bus or subway seats so that it is not possible to lie down
forces homeless people to sleep out in the open, where they may be arrested.
Often the result is their arrest for an incident where others may just
be encouraged to move on.
It is important to break this cycle of no-supports/arrest/incarceration/
release-without-supports/arrest. When policies are adopted to accomplish
this, everyone benefits--the homeless individuals, their families, the
community and all taxpayers. A recent initiative in California to address
the needs of homeless people with mental illnesses reduced total days
of incarceration for those served from more than 60,000 days in the previous
year to 11,609 since enrollment. A one-year investment of $14.2 million
produced an estimated savings of $7.3 million, of which $3.07 million
was the result of reduced criminal justice system costs.(1)
This California program provides comprehensive services to help people
move off the street and into housing, treatment and recovery, and incorporates
initiatives to access appropriate federal benefits. The value of this
approach is evident, both in the reduced economic and social costs of
arrest and prosecution and in the positive outcomes for the individuals,
their families and the community.
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