Copyright 2000 Federal News Service, Inc.
Federal News Service
September 21, 2000, Thursday
SECTION: CAPITOL HILL HEARING
LENGTH: 21789 words
HEADLINE:
HEARING OF THE CRIME SUBCOMMITTEE OF THE HOUSE JUDICIARY
COMMITTEE
SUBJECT: THE IMPACT OF THE MENTALLY ILL ON THE CRIMINAL
JUSTICE SYSTEM
CHAIRED BY: REPRESENTATIVE GEORGE GEKAS (R-PA)
WITNESSES:
SEN. MIKE DEWINE (R-OH);
BERNARD ARONS, DIRECTOR, CENTER FOR MENTAL HEALTH SERVICES, DEPARTMENT OF
HEALTH AND HUMAN SERVICES;
BERNARD MELEKIAN, PRESIDENT, LOS
ANGELES COUNTY POLICE CHIEFS ASSOCIATION;
MICHAEL F. HOGAN, OHIO
DEPARTMENT OF MENTAL HEALTH;
STEVEN SHARFSTEIN, MEDICAL DIRECTOR,
SHEPPARD PRATT HEALTH SYSTEMS;
DONALD F. ESLINGER, SHERIFF,
SEMINOLE COUNTY, STANFORD, FLORIDA;
LOCATION: 2226 RAYBURN
HOUSE OFFICE BUILDING, WASHINGTON, D.C.
BODY:
REP. GEORGE GEKAS (R-PA): The
Committee will come to order. The Committee on Crime as a subcommittee of the
full Judiciary Committee has scheduled and is now in the process of beginning
the hearing, a special hearing on the mentally ill in our criminal justice
system.
The Chairman of the subcommittee, Bill McCollum of Florida, has
for many years been involved in a series of questions and problems that have
arisen out of that very same question, including the question of insanity
defense in the death penalty arena and other prosecutions; the homeless and how
the mentally ill of that population uniquely affect that urban problem; and
continuously on the people in prison who had been or become mentally ill. So it
is not a phenomenon that Chairman McCollum has scheduled this hearing but rather
a continuum of his often expressed interest in this subject.
Without
objection I will enter into the record the opening statement that Bill McCollum
has prepared and only from it will I quote some statistics that I think can lay
that I think can lay the proper groundwork before we get to the witnesses. In
his opening statement Bill McCollum states that one of the figures is 283,000
mentally ill offenders are incarcerated in our federal, state and local prisons
and jails. It estimates that 16 percent of state inmates, 7 percent of federal
offenders, and 16 percent those held in local and county jails are mentally ill.
A similar percentage of persons on probation, approximately 547,000 also have a
history of mental illness.
I believe that that opening
paragraph on the part of Representative McCollum lays the proper foundation for
this massive and pressing problem. So the witnesses I'm sure will elucidate on
how these figures impact on their own institutions, on their own careers, on
their own ability to try to solve some of the problem.
When the time
comes we will of course subject the witnesses to some examination, a Q&A, as
is the routine in these hearings and we will hope to gain from all of it today,
a new drive toward solving some of these very distinct problems in our criminal
system.
With that I yield to the gentleman from Virginia, the ranking
member, Mr. Scott.
REP. ROBERT SCOTT (D-VA): Thank you, Mr. Chairman and
I'm pleased to join you in convening the hearing on the impact of the mentally
ill on the criminal justice system.s state mental health
hospitals have increasingly reduced their populations of mentally ill
individuals in response to a nationwide call for deinstitutionalization. The
move towards deinstitutionalization has been based upon the fact that persons
with mental illnesses are constitutionally entitled to refused
treatment or if there are institutionalized to have it provided in the least
restrictive environment.
Unfortunately, community mental
health treatment centers have not been creative at a rate necessary to
meet the needs of those individuals. In a recent report by the Department of
Justice we find that the criminal justice system has become by default the
primary caregiver of the most seriously mentally ill. More specifically, that
report stated that last July at least 16 percent of those in local jails, at
least 16 percent of those in state prisons, and 7 percent of federal inmates
reported either a mental condition or an overnight stay in a
mental hospital and were identified as mentally ill. The
highest rate of reported serious mental illness was among white
female inmates at 29 percent. The National Alliance for the Mentally Ill reports
that on any given day at least 284,00 schizophrenic and manic depressive
individuals are incarcerated while only 187,000 seriously mentally ill
individuals are in mental health facilities.
It is my
hope that this hearing will shed light on the extent to which these individuals
with mental illness are falling through the cracks and landing
in the criminal justice system where the corrections administrators are
sufficiently equipped to provide appropriate services to offenders with
mental illness and whether providing proper mental
health treatment can actually reduce crime.
Finally, I look
forward to the testimony of Senator DeWine from Ohio and Congressman Ted
Strickland from Ohio regarding specific suggestions on the role Congress should
play. And while I understand that this hearing is not on the bills that they
have introduced, that is H.R. 2594 and its companion, S. 1865, America's Law
Enforcement and Mental Health Project, and another bill, H.R.
5091, the Mental Health Early Intervention, Treatment and
Prevention Act of 2000, although this was not a hearing on those bills I hope we
will have the opportunity to touch upon what those bills might provide.
In the end our goal must be to provide a better way to address the needs
of persons with mental illness and address those needs to
prevent criminal activity. Mr. Chairman, I thank you for scheduling the hearing
and look forward to the testimony.
REP. GEKAS: We thank the gentleman.
Let the record indicate that a member of the Committee, the gentleman from Ohio,
Mr. Chabot, is present and is able and willing, I understand, to present to us
the witnesses on the first panel. Thank you, Mr. Chabot.
REP. STEVE
CHABOT (R-OH): Thank you, Mr. Chairman. I'm pleased to have two members of the
Ohio delegation here for this panel. I'd first like to welcome the Senior
Senator from my State of Ohio, Senator Mike DeWine. Senator DeWine was first
elected to the Senate in 1994, prior to serving in the other body he spent eight
years here in the House and also served as the Lieutenant Governor of Ohio. He
was also a prosecutor in the State of Ohio prior to that. He chairs the Senate
Subcommittee on Antitrust, Business Rights, and Competition of the Judiciary
Committee and the Subcommittee on Aging of the Health,
Education, Labor and Pensions Committee.
Senator DeWine has introduced
S. 1865, America's Law Enforcement and Mental Health Project,
which would provide grants to establish demonstration mental
health courts. Senator DeWine is a great advocate for those who need
help, especially children and the elderly. I'm looking forward to hearing his
testimony on this important issue and we welcome you this afternoon, Senator
DeWine.
I also have the privilege of introducing another member of the
Ohio delegation, my friend and colleague Representative Ted Strickland.
Congressman Strikland was first elected in '92, was gone for one term but came
back again in '96 and was reelected again in '98. Prior to serving in the House
he worked as a minister, a psychologist and a professor. He was a director a
Methodist children's home, an assistant professor of psychology at Shawnee State
University and a consulting psychologist at the Southern Ohio Correctional
Facility in Ohio. He holds a doctoral degree in counseling psychology from the
University of Kentucky. He is a founding co-chair of the House Correctional
Officers Caucus.
Representative Strickland introduced H.R. 2594,
America's Law Enforcement and Mental Health Project, which
would provide grants to establish 25 demonstration mental
health diversion courts. We welcome you here this afternoon, Ted, and
we look forward to your testimony as well.
REP. GEKAS: Thank you, Mr.
Chabot. We join Steve in welcoming our colleagues in the Senate and the House.
When Mike DeWine was elected to the Senate with that one bold stroke the
intelligence quotient of the Senate and House were amply increased.
But
notwithstanding that we start with the order of seniority. We'll ask Mike to
begin the testimony.
SEN. MIKE DEWINE (R-OH): Mr. Chairman, thank you
very much. Let me just tell you how nice it is to be back on a committee which I
served, a subcommittee in which I served, and a committee in which I served. And
as I recall, Mr. Chairman, you always outranked by one on the Judiciary
Committee so my leaving did not improve your lot any. (Laughter.) You just have
someone else who's right behind but I see that your progress has continued over
the years and as someone who came to the Congress together in 1982 it's good to
be with you, Mr. Chairman.
This might seem like the "all-Ohio day" with
myself and my good friend, Ted Strickland. We also have two very important
witnesses, Michael Hogan, Director of the Ohio Department of Mental
Health and Reggie Wilkinson, who's the Director of the Rehabilitation
and Correction Services in Ohio. I worked with both of them, Mr. Chairman, when
I was Lieutenant Governor. And so I'm glad that they are here and they are both
experts and they both know a lot more about this subject than I do. But I will
share a few thoughts with you, if I could.
My experience with this
problem goes back to the time when I was an assistant county prosecutor and then
the elected County Prosecutor in my home county of Greene (ph) County. I can't
tell you how often a police officer would come to me for charges and as he was
describing or she was describing this individual who was being charged would
tell me that they had a mental problem. And they would usually
say it in much more graphic terms still than that.
That's a problem that
continues today. It's a problem that is due for many reasons - the
institutionalization in the 1960s, the 1970s, other homelessness issues. We
could go on and on but it's a problem and it's much more of a problem today for
our courts and our penal systems than it's ever been in the past.
What I
have tried to do with the legislation that I have introduced in the Senate, what
Ted has tried to do with the legislation that he has introduced in the House is
to say on behalf of the federal government this is a problem and we need to try
some different things. We need to try some pilot projects. We need to try to be
of assistance to the local community, not that we want to tell the local
community how to deal with criminal justice problems but every community has
this problem. When you to Reggie Wilkinson who heads our prison system in Ohio
he will testify, he will tell you the percentage of people in our prison system
today how have a mental health problem and he will tell you
that they're trying to do a good job with these folks but they lack the
resources, candidly, to do it.
If you would talk to a county sheriff in
Greene (ph) County or Clarke (ph) County or, Mr. Chairman, in one of your
counties in Pennsylvania, they'll tell you the same thing. They deal with people
all the time who have mental health problems and they don't
have the resources to deal with them. We need to do a better job, taking what
resources we do have in the community and meshing them with our criminal justice
system. We've come a long way since I was a county prosecutor in the 70s and
there used to be a huge wall between any social services and the prison system
and the correction system and criminal justice system. We are breaking that wall
down, taking it down brick by brick but an area where we still frankly don't
have the merger that we need is in the area of mental health.
And so we need to break those barriers down to get the mental
health assistance into people in our system.
As I explain to
people, I say, well, you know, you have a lot of people who have
mental problems. Yes, we do. But if you had to pick a segment
of the population that is likely to cause you and me and our families problems
in the future because of their mental health problems it would
probably, you could probably start with looking in our prisons and in our jails.
These folks, we are already paying to house them and to feed them, and to clothe
them. It just makes sense to try to get some mental health
assistance into them and that's what our respective Bills do. I'm not here to
advocate for our Bill today but what I am here to say is this is a problem that
we as a country really have to begin to deal with it.
So I appreciate
the opportunity to be with you. This legislation that both Ted and I are
promoting is an attempt really to mesh the social services, to mesh the
mental health people, get their assistance into court, dedicate
some courts and prosecutors and judges to this very specific, very -but it needs
to be, quite frankly, a lot of expertise. I thank you for taking the time to
look at this very, very important issue.
REP. GEKAS: We thank the
Senator and we turn to his and our colleague, Representative Strickland.
REP. TED STRICKLAND (D-OH): Mr. Chairman, thank you and I would like to
begin my statement by saying how very deeply I appreciate the work of Senator
Mike DeWine. He and his staff have been absolutely wonderful in working with us
and I really appreciate Mike for that.
SEN. DEWINE: Thank you so much. I
enjoyed working with you.
REP. STRICKLAND: As a psychologist and perhaps
the only member of Congress who's ever worked in a maximum security prison I
have personally treated individuals who live out or who will live out the rest
of their lives behind bars because they have committed crimes that they most
likely would not have committed had they received adequate mental
health treatment.
I have seen the ravaging effect that a prison
environment has on the mentally ill and the destabilizing effect that the
mentally ill have on the prison environment. Inmates, families, correctional
officers, judges, prosecutors, and police are in unique agreement that our
broken system of punting the most seriously mentally ill to the criminal justice
system must be fixed.
But as we consider the effects of this system,
this broken system, I hope we remember how it became broken in the first place.
By 1963 we realized that state mental hospitals were too often
institutions for quarantining the mentally ill. So the Congress passed the
Community Mental Health Centers Act to remove the mentally ill
out of prolonged confinement in overcrowded custodial institutions into
voluntary treatment at community mental health centers. And in
October of 1963 President Kennedy signed the Mental Health
Centers Act. Unfortunately, the Congress, those of us in Congress, seemed to
have played a trick upon the most vulnerable population in America by refusing
to adequately fund community mental health centers.
And
to make matter worse we imposed restrictions on Medicaid that kept Medicaid
dollars from going into state mental hospitals. We effectively
set in motion a public health tragedy that resulted in
thousands of mentally ill patients winding up on the streets of communities that
do not have adequate services to treat them. It should not surprise us then that
jails are becoming America's new mental asylums. Our current
court systems, prisons and jails are being clogged with mentally ill individuals
who should be taking part in mental health treatment.
Law enforcement and correctional officers who are charged with
apprehending and incarcerating the most dangerous criminals in our society
cannot always do their jobs because they are forced to provide makeshift
mental health services to hundreds of thousands of mentally ill
individuals. Squad cars, jail cells and courtrooms are filled with the mentally
ill, taking up resources that should be directed towards catching real
criminals. Mental illness does not discriminate between
republicans and democrats, rich or poor, black or white, man or woman, none of
the dividing lines that so often create partisan politics. And that is why I am
especially gratified to be working on this legislation with distinguished
members from both sides of the aisle and from both sides of the Hill.
We're trying to create mechanisms that will bridge the gap between the
mental health and the criminal justice systems. I would like to
thank not only Senator DeWine but Senators Domenici, Kennedy and Wellstone as
well as Representatives Wilson, Waxman, Horn, Capps, Roukema, and Kaptur for
taking the lead on sponsoring legislation to provide criminal justice and
mental health professionals the resources they need to work
together in order to keep mentally ill defendants in treatment rather than jail.
I would like to quickly and briefly summarize the current legislation.
H.R. 2594, America's Law Enforcement and Mental Health Act
which I introduced last July seeks to help local communities close the revolving
door to recidivism among the mentally ill population by providing modest federal
grants to establish these mental health courts in order to
direct nonviolent mentally ill offenders out of jail into long term treatment.
Secondly, the Mental Health Early Intervention
Treatment and Prevention Act of 2000 which was first introduced last May in the
Senate by Senators Kennedy, Domenici, Wellstone, and I believe Senator DeWine
was heavily involved in that. It was an attempt to finally fulfill the unkept
promise that was provided through the Community Mental Health
Act of '63. It would do that by making grants to communities for mental
health treatment centers as well as the training of non-traditional
frontline mental health workers like teachers, law enforcement
and firefighters. Additionally, this Bill seeks to lessen the burden of the
mentally ill on the criminal justice system by providing grants that train
police on how to identify the mentally ill and direct them into available
treatment, to fund jail and prison programs that screen, evaluate and treat
mentally ill inmates and create these mental health courts to
direct non-violent mentally ill defendants out of this revolving door of
recidivism.
Last July members of Congress, including Congresswoman
Wilson, Congressmen Waxman, Horn, Congresswoman Capps, Congresswoman Roukema,
Congresswoman Kaptur and myself introduced H.R. 5091, a mirror companion to the
Senate Bill. As the Co-Chair of the Congressional Corrections Caucus I hope that
this Congress will seize upon these legislative opportunities with the same
courage and compassion with which law enforcement and correctional officers deal
with the mentally ill every day.
And in conclusion I want to thank this
Subcommittee for being willing to closely look at this problem from which so
many turn away. I believe that there is a welcome consensus among a broad
spectrum of stakeholders and political ideologies, that there are very practical
steps we can take to stop the criminal justice system from being this country's
primary caretaker of the seriously mentally ill. The truth is that law
enforcement and correctional officers are not and should not be psychiatrists,
psychologists, social workers, and nurses with guns.
And I thank you for
giving the good Senator and myself the opportunity to share our thought and our
feelings with you this afternoon.
REP. GEKAS: The Committee expresses
its gratitude to the witnesses. In extending the normal courtesy to them we will
not subject them to bristling cross examination (laughter) and we will excuse
you with your further gratitude and your statements will be without objection
entered into the record.
REP. STRICKLAND: Thank you, Mr. Chairman. And
could I ask unanimous consent to place into the record a statement from the
National Association of Counties in which they offer their support for this kind
of diversion effort.
REP. GEKAS: Without objection it will be so
included.
REP. STRICKLAND: Mr. Chairman, thank you very much.
REP. GEKAS: By all means. Thank you. We are ready to invite and we do
invite the next panel of witnesses to approach the witness table which is all of
one witness. Panel Number Two consists of Bernard S. Arons, the Director of the
Center for Mental Health Services, Department of
Health and Human Services.
Doctor Arons was appointed
to this position in 1993, the same year he was selected as an advisor on
mental health issues to Tipper Gore in the Office of the Vice
President. That year he also became Chair of the Mental Health
and Substance Abuse Working Group Cluster of the President's Task Force on
National Health Care Reform. He also works as a clinical
professor of psychiatry at the Georgetown University School of Medicine and
continues his private practice in psychiatry. He is a graduate of Oberlin
College and the Case Western Reserve University School of Medicine.
As
is customary again, we will ask the witness first to present his written
statement which will be accepted for the record without objection and ask him to
restrict an oral review of that testimony to five minutes more or less because
we have a great number of witnesses from whom we have to hear more testimony.
Thank you. You may proceed.
MR. BERNARD ARONS: Thank you, Mr. Chairman
and members of the Subcommittee. I would like to submit my written testimony for
the record and use my allotted time to present some oral comments and summaries.
REP. GEKAS: Without objection.
MR. ARONS: Thank you. I'm just
going to say how pleased I am at this opportunity to address this very important
issues with members of the Subcommittee and with you, Mr. Chairman. I would like
to spend a few minutes talking about this issue from a somewhat different
perspective. You've already heard very useful information from Senator DeWine
and Congressman Strickland. I'd like to talk a bit about what we can do about
this issue, five steps along the way, way before the front door of our jails and
prisons, before the front, at the front door, while inside the doors of our
jails and prisons, and then leaving, when going out those doors and reentry. And
I'll very briefly summarize my thoughts about those.
I am Director of
the Center for Mental Health Services which was established by
Congress eight years ago and given responsibility to improve our treatment, to
improve the quality of services for individuals with mental
illness throughout our country.
I think an important point that I'd like
to make is that the situation we find ourselves in is not inevitable. We know
that effective treatment is available. We know that effective treatment is
available throughout the country to provide services to individuals with
mental illness and yet those individuals with
mental illness are not receiving those effective treatments. It
is not inevitable that individuals with mental illness are in
trouble with the law, find their ways into jails or prisons, become violent or
dangerous. People with mental illness who are in treatment are
working, they're in our schools, they're volunteering, they're being good
parents, and we know that we can do something about this.
So my first
message is way before the front door of our jails and prisons that we can think
about prevention first, about providing services and treatment in the community
for individuals with mental illness. But we note that these
days that services are not available, that access to treatment is sometimes
limited, barrier of economics, of the supply of services, issues of stigma and
discrimination, and we know that individuals with mental
illness do not receive treatment. And then we stand by and watch as they respond
to the difficulties that their illness creates and often end up in difficulty
with other members of the community. The police are sometimes called. And so the
next step I think that we can intervene is in the, working in partnership
between the mental health community and police and in the
training of individuals from the police force.
We have some very
successful programs that we've been sponsoring with grants from the Center for
Mental Health Services.
One is in the State of
Pennsylvania, in Philadelphia, where we are using consumers, recipients, people
with mental illness to work in training police on how to best
intervene, how to best respond to situations in the community that involve
individuals with mental illness and we're finding that this is
a very successful program and extremely well received by the police who are
being trained.
We know that even once someone does get in difficulty
with the law that there's opportunities for diversion even before charges are
made so that we believe that there are various steps along the process where
diversion is possible before, pre-booking, before there is any charge being made
and also post-booking as well, opportunities in the court or in jails or in
prisons to divert individuals who are in need of treatment to the treatment
which is needed. We are privileged to be sponsoring as part of our
responsibility that Congress placed on us to explore and to publicize for the
country model programs. We are right now evaluating nine sites across the
country in our jail diversion program looking to evaluate the best opportunity
for pre- booking and post-booking diversion including such things as
mental health courts and we're very pleased about that.
We also have produced a summary of these issues in 1995 called "Double
Jeopardy" addressing issues of people with mental illness in
the criminal justice system using this catchy title "Double Jeopardy" from the
losses. Note that people with mental illness and who end up
with a criminal justice record often end up with a dual stigma and have a more
difficult time.
And then let me talk a bit about reentry. Once
individuals are in prison or jail will sometimes serve their terms, people with
mental illness will be sometimes even receiving treatment in
jails and prisons. And then we have developed an unfortunate situation where
when they leave there is a lack of follow up, a lack of linkage, a lack of
reentry process into the community where that treatment can be continued and
unfortunately we see a tremendous amount of recidivism, of people dropping out
of treatment. In a certain sense we have created what I like to view as a trap
door. As that person is leaving, is being brought to the door, the exits of the
jail or prison we have created a situation where right then a trap door opens
and they fall back into the system as well.
My last point is I want to
make sure that we don't create an incentive, if you will, to criminal activity.
Persons with mental illness and their families are often very
innovative, very creative. They have struggled for many years to find effective
treatment. We need to be sure that we don't create, that the only opportunity
for effective treatment is through a process of criminal activity.
And
finally partnerships are essential. We know that we've got to build a close
linkage between the mental health community and the criminal
justice community. To accomplish this that partnership is most important. Thank
you.
REP. GEKAS: We thank the gentleman. The Chair will allot itself
five minutes to pose some questions to the witness. You mentioned the problem of
reentry which goes hand in hand with the term "recidivism" and return to custody
that many of our prisoners encounter. In my recollection of our local law
enforcement procedures and in court when there is a recognized mentally ill
person let out of prison by way of probation, et cetera, the follow up is built
into it through court demands that there be a regular mental
illness check up or other conditions placed upon that probationed criminal, as
it were, the convicted person, to try to prevent that very same thing. Are those
still in use across the country, those methodologies?
MR. ARONS:
Certainly, ideally there is process, probation may be one example. There is a
process after fulfilling, that when ending one's term in jail or prison there
would be a process of setting up services and making certain that there are
certain obligations such as follow up and treatment. And I think that you'll
hear later that Ohio has made some great strides in making certain that that
happens.
Unfortunately, there are still many communities across the
country where once a person has completed their jail sentence and that they may
in fact be released we hear many examples that families will tell us that their
loved one was given a bus token, some clothes. They were due to be released on a
certain day on a certain day and at midnight on that day that their sentence is
over they are released into the community and there may not be a follow up
requirement to make sure that treatment continues. We need to really build a
system in place so that the treatment that a person was receiving if it was
effective in jail or prison continues in the community, in the mental
health center when they leave.
And I think that our
health community is where we need to work on that.
REP.
GEKAS: You stated that in the hypothetical, not hypothetical, actual episode in
Philadelphia, where a crime in progress or shortly afterwards resulted in
immediate referral to the mental health system. Are you talking
about local law enforcement there in Philadelphia?
MR. ARONS: Yes. And
that was just one example. But certainly there are other examples that we find
in other locations. And very often a call to the police about someone with a
mental illness has occurred where there may not have been a
crime actually committed or there may not have been something that the police
need to typically arrest someone for. But without other alternatives available I
think the police are often confronted with a situation where someone does need
help and yet there's no alternative to arrest and confine them.
REP.
GEKAS: The Chair reserves the balance of its time and now yields to the
gentleman from Virginia for a period of five minutes.
REP. SCOTT (D-VA):
Thank you, Mr. Chairman. Dr. Arons, do you have studies that show that
mental health treatment will actually reduce the incidence of
crime?
MR. ARONS: Yes, there have been a number of studies and also I
think some very interesting studies about diversion programs. When the police
have no alternative but either arrest or to let someone free we find that in
about eighteen percent of the time when they get called about an incident
involving someone with a mental illness about eighteen percent
of the time an arrest will occur. When there is a program for diversion where
the police have alternatives that are available bring a person for treatment
that number falls to between to and six percent so we know that there are
effective programs that are being used across the country. We need to expand
those.
REP. SCOTT: Do you have evidence that the diversion actually
works to reduce crime? When they are diverted they are they less likely to
commit crimes in the future?
MR. ARONS: We have some initial findings to
that effect but part of the purpose our nine-site study is to go ahead and
develop some very solid evidence of that. We are looking at three issues. We're
looking at the effects on the individual. Is there improvement in the condition?
Is there an improvement in their situation? Is there less recidivism? Do they
follow up in treatment? We're also looking at the effect on the criminal justice
system. We're also looking third at the effect on the community. Are we able
reduce crime on the community through these programs. Treatment may not be at
the quality that it should be.
REP. SCOTT: Well, if it is not up to the
quality that it should be is that person more likely to commit a crime in the
future or are we going to wait for the results of your study?
MR. ARONS:
I think there's -- that person is often more difficult to treat in the prison or
jail in the criminal justice system. That's often, that individual without
adequate treatment creates concern for the criminal justice provider as well.
REP. SCOTT: If a person has medical health insurance
for mental health (do they do better in ?) the system than
those that do not have insurance?
MR. ARONS: Well, the insurance
coverage for mental illness is a dismal situation in this
country at best. Even when people do have coverage the coverage for
mental illness is far less than that available for the rest of
health care and that is why states and communities throughout
the country have been attempting to pass what we call parity
legislation to try to enhance and expand the provision of mental
health services. Typically in a jail or prison whether one has
insurance or not may make less difference than when the person is released where
the availability of insurance coverage does enhance the opportunity to obtain
treatment.
REP. SCOTT: Are those with insurance more likely to get
diverted from the criminal justice system?
MR. ARON: I'm not sure we
have an exact answer to that at this point.
REP. SCOTT: Thank you, Mr.
Chairman.
REP. GEKAS: We thank the gentleman. The Chair relinquishes the
balance of its time and we excuse the witness with our gratitude. We are ready
for our panel, the next group of individuals who will testify, Panel Number
Three, which is made up of Bernard Melekian, who is the Chief of Police in
Pasadena, California and President of the Los Angeles County Police Chiefs
Association. Mr. Melekian has also served in the Santa Monica Police Department
for 23 years and awarded the Medal of Valor in 1978 and the Medal of Courage in
1980. He holds a Bachelors Degree and a Masters Degree from the California State
University, Northridge, and is also a graduate of the FBI National Academy.
He is joined at the witness table directly to his right by Michael
Hogan, Director of the Ohio Department of Mental Health, to
whom reference was made by Senator DeWine, a position that this gentleman has
held since March, 1991. Prior to that Dr. Hogan served as Commissioner of
Mental Health in Connecticut. From 1994 until 1998 he served on
the National Advisory of Mental Health Council and is President
of the Board of the National Association of State Mental Health
Program Directors Research Institute. Dr. Hogan received his Bachelors Degree
from Cornell University and his Doctorate from Syracuse University.
To
his right is the next witness, Kim Webdale, Spokesperson for Mental
Health Care and Victims Rights Issues. She became involved in these
issues after her sister, Kendra, was thrown into the path of a subway train by a
mentally ill man and killed as a result of that in January of 1999. She
currently serves as a committee member for the Council of State Governments
Mental Health Advisory Board. She received her Masters Degree
in Exercise Physiology from Adelphi University and is employed by MetLife as
Program Coordinator for its corporate wellness and fitness services.
And
lastly, Doctor Sharfstein. Steven Sharfstein is the Medical Director and CEO of
the Shephard Pratt Health System. Doctor Sharfstein is a former
clinical professor and Vice Chairman of the University of Maryland's Department
of Psychiatry and served as the Deputy Medical Director of the American
Psychiatric Association from 1983 until 1986. He received his undergraduate
degree from Dartmouth College, his M.D. from Albert Einstein College of Medicine
and his M.P.A from the John F. Kennedy School of Government at Harvard.
At the outset as in all our panels, we invite you to render your written
statement for the record which will be accepted without objection for the record
and we ask that your oral review be restricted to five minutes, more or less,
preferably less. And then to be prepared to answer some of the questions by
members of the Committee.
We'll proceed in the order in which they were
introduced so we'll start to my right with Chief Melekian.
MR. BERNARD
MELEKIAN: Thank you, Mr. Chairman and members of the Committee. I don't know
what the protocol is about that but you have my written statements and I would
ask that they be entered into the record.
I suspect that for you this is
another day of business but this is my first appearance before a professional
committee and it is the experience of a lifetime and I thank you for the
privilege of being here.
I have been a police officer for 28 years. I'm
the Chief of Police for the City of Pasadena, a city of 135,000 that host the
Rose Parade and the Rose Bowl every year. My officers would tell you that being
Chief means that I don't do any real work anymore and to some degree they might
be right. The young men and women who answer the phones and answer the public's
call for service and sail in harms way every day do the real work of law
enforcement in this country.
And five to seven hundred times a year in a
city of 135,000 people that means that they deal with issues surrounding the
mentally ill, a role to which they are both ill prepared and ill trained. I came
into this business for a variety of reasons not the least of which was to help
people and I find that with regards to this issue I am unable to do my job. I
cannot help the woman who comes into my police station in fear for her life or
the life of her children because her husband hears voices and views her as some
sort of demonic creature. I cannot help the person who is afraid of their
coworker whose desk may be wrapped in tin foil or who hears voices that no one
else can hear. I cannot help the people who are afraid of their neighbors or the
homeless person walking down the street. And I cannot help elderly parents who
are trying to take care of their middle aged mentally aged children. And I
cannot help the mentally ill themselves who struggle and often request help as
did Buford Furrow (sp) prior to the shooting at the Grenada Hills Day Care
Center.
This issue has been in my opinion improperly framed as to
whether one is for or against civil liberties. There is nothing civil about
jail. There is nothing civil about living under a bridge in Arroyo or in an
alley in any major city in this country. There is nothing civil about people's
fear and uncertainty with regard to the mentally ill. And there is nothing civil
about dying alone on the street whether in the heat of Pasadena in July or in
the cold of the District of Columbia in February.
There are many high
profile stories. I have tried to tell you one in my written remarks about my
friend, Dan, who I went to high school with, who went on to college to get a
dual degree in math and physics and was a member of the first United States
Table Tennis Team to visit China and who at the end lived alone in his parents
garage often threatening to shoot them or to burn down the garage or to burn
down the house. He terrorized his parents. He terrorized the people in his
neighborhood and he scared the heck out of the cops, including myself, who
responded to the one and two and three calls a month that came from Dan's house.
At one time I could talk to him because he knew who I was but at the end he did
not. And ultimately he died alone terrified himself and no one, certainly not me
and certainly not the system, had adequate resources to help him.
I
guess if I had more than five minutes I would have questions for the Committee
on why is the issue of mental illness before the Subcommittee
on Crime. Why have police officers in this country become the first responders
and in effect placed in the position of becoming armed social workers? Why has
the Los Angeles County Jail System housed the most mental
patients of any facility in the United States?
In some ways we have
changed mental illness into being mental
crime. I believe wholeheartedly in the good intentions of this Committee. I
believe that this issue is impacting law enforcement. It is impacting our entire
system. It is certainly placing those young men and women you sail in harms way
and who have to make deadly force decisions that they should never be faced
with. These folks need treatment. These folks need help and we need some
assistance to do that. I'm very excited to part of the Council of State
Government's effort to bring together all the people that are impacted on this
and I really thank you. I had a list of suggestions and solutions but I don't
have a long list of time and I really appreciate your listening.
REP.
GEKAS: You have additional time left on the clock, maybe 40 seconds. (Laughter.)
That's 17 seconds. (Laughter.)
MR. MELEKIAN: I think I'll relinquish my
time. Thank you, Mr. Chairman.
REP. GEKAS: Thank you. We have turned to
the next witness, Dr. Hogan.
MR. HOGAN: Thank you, Mr. Chairman, ranking
member Scott, and I appreciate the opportunity to enter my written testimony
also and to try to summarize it succinctly.
We appreciate your attention
in focusing our nation's concentration on problems in mental
health and their impact on crime and criminal justice. I believe that
the record of this hearing will establish the undeniable scope of this problem
in dollars and sense and statistics but more significantly in human tragedies
like the death of Ms. Webdale's sister. What may not be apparent and in a way is
beyond the scope of the Subcommittee's focus is that this
mental illness problem has such an impact across society. And
without detracting from the Committee's appropriate and laser focus on this
connection with crime I want to mention a couple of these dimensions.
We
know that mental illness is a factor in 30,000 suicides
nationally every year. We know that children with mental
illness have the worst grade point averages and the worst outcomes of any group
of children in school. Two-thirds of them almost never graduate from high
school. That disability from related to mental illness is the
single fastest growing category in both short-term disability programs and in
social security. And somehow our focus in addressing those
mental illness problems that you've got us attending to must be
carried out within the context of these larger issues and problems.
I do
believe a consensus is emerging that you'll hear from members of the different
panels that non-violent mentally ill offenders should be diverted to supervised
mental health treatment programs. This is what we're trying to
do in Ohio.
REP. SCOTT: Explain that again. What kind of - could you --
MR. HOGAN: Non-violent mentally ill offenders should be diverted to
treatment. We're making efforts in Ohio. As an attachment to my testimony will
indicate, we believe that diversion to supervised treatment would be more
effective. It would be more appropriate. And it would appropriately reduce the
burden on corrections. The mental health model to be outlined
by Judge Casey is, we believe, a very promising approach and we applaud the
leadership of Congressman Strickland and Senator DeWine in sponsoring
legislation to expand mental health courts.
Although
diversion is the right thing to do, in many communities across America the
question is diversion to what? The mental health safety net in
too many of our communities is stretched too thin. In the past decade
mental health spending declined compared with
health spending in general and private mental
health spending and health insurance plans declined
against public spending. From 1990 to 1997 the budget of state mental
health agencies declined six and a half percent against inflation.
Now there's no doubt in my mind that states must reprioritize
mental health and also that mental health leaders must be
galvanized to better collaboration with their law enforcement counterparts at
the state and local levels. But the problem will also not be fully solved
without correcting deep flaws in federal programs that don't work for
mental health care in states and communities. For example,
Medicaid's failure to cover psychiatric hospitalization and thus by implication,
community care; HUD's withdrawal from low income and disability housing
production. These things have contributed to the community instability of many
people with the most serious and unpredictable illnesses.
Almost 150
years ago, Mr. Chairman, the Congress enacted land grant legislation to help
states build mental hospitals but it was vetoed by President
Pierce as an area that the federal government should not get into. In 1977 the
Comptroller General issued a sharply critical report entitled "Returning the
Mentally Disabled to the Community-Government Need To Do More". With 20/20
hindsight we can now say that government has not done enough. Because of this I
thank the Subcommittee for its leadership in bringing these problems to the
nation's attention in such clear focus. It is a critical first step in
developing solutions for better mental health care and better
public safety. Thank you.
REP. GEKAS: We thank the gentleman and we turn
to Ms. Webdale.
MS. WEBDALE: Good afternoon, Mr. Chairman and
Subcommittee members. It is indeed a privilege and a pleasure to be here and to
testify before you today.
Less than two years ago I was unaware of the
problems that plagued the mental health care system and how
those problems would ultimately impact my life in the most unexpected and tragic
of ways. I recognized that the mentally ill were becoming an increasingly
prevalent sight on our streets and subways but I was oblivious to the fact that
they were infiltrating our criminal justice system and our jails at an equally
alarming rate.
As a long time New Yorker I have become as immune to
people eating out of garbage cans and displaying bizarre sorts of behavior as I
was to the homeless people inhabiting the streets. Like homelessness
mental illness was something I found disturbing, something I
pitied from afar and something I frequently ignored but it was never something I
feared. In fact when my sister Kendra moved to New York City I even gave her
some advice regarding the mentally ill population. I said just ignore them and
they won't bother you.
My words came back to haunt me on January 3,
1999. I received a phone call that evening from a reporter informing me that
Kendra was dead. A mentally ill man had thrown my 32-year-old sister from the
platform into the path of 400-ton subway train entering the station. She was
killed instantly. I cannot to describe the heartache that followed. Having to
tell my parents that their cherished daughter was dead, hearing the despair in
Kendra's four other sibling voices, and identifying Kendra's lifeless body was
just the beginning. Despite the belief to the contrary the passage of time only
served as a painful reminder of the time separating us from the life once spent
with Kendra.
After Kendra's death my family became dedicated to learning
as much as possible about violence in the mentally ill. We vowed that we would
do whatever we could to ensure that an equally devastating tragedy would not
destroy the lives of another family. We learned that Andrew Goldstein, the
mentally ill man who had killed Kendra had been in and out of
mental institutions for ten years. Despite thirteen prior
violent incidents he was repeatedly released from hospitals. A distinct pattern
emerged known as the revolving door syndrome. Goldstein would become violent, be
admitted to a hospital and then released on his own recognizance within
approximately three weeks, most often with only a few days worth of medication.
Inevitably he became violent again and the cycle would be repeated. In fact, the
more difficult and violent he became the more likely the hospital would be to
discharge him. And because he was always treated as an emotionally disturbed
person as opposed to going through the criminal justice system there was no
record at all of his criminal violent past.
This cycle would continue
until he was released two weeks prior to killing Kendra. At that time despite
his full knowledge of Goldstein's propensity towards violence his doctor
released him with the words "Hit furniture instead of a person the next time you
have violent impulses." But the next time Goldstein got the urge to strike out
Kendra would be dead, her beautiful body torn and broken on the subway tracks.
Unfortunately, our search for answers would ultimately lead us to even
more questions about society treats the mentally ill. We question how a
non-compliant mentally ill man who was a known danger to others was allowed on
the street, non-medicated and unmonitored. Why didn't Goldstein have an
intensive case manager? Why despite thirteen prior incidents wasn't Goldstein
ever held accountable for his actions? Why wasn't a hospital bed provided when
it was so obvious that in-patient treatment was needed? Why was there no
continuity of care between mental health care facilities that
treated Goldstein? How could a system that was supposedly designed to protect us
fail us so miserably? And most importantly what could be done to prevent a
future tragedy?
Ultimately we found that nothing stood in the way of
another mentally ill man striking out at yet another innocent individual. I was
on the Number Six train when almost the exact scenario played out in the 51st
Street Subway Station a few months later only this time the victim, Edgar
Rivera, would lose his leg, changing his life forever.
Other horror
stories began to emerge on a continual basis -- a lawyer who stabbed his
pregnant girlfriend to death, a case manager who was bludgeoned to death by her
mentally ill patient, and a man who stabbed his son to death was found not
guilty by reason of insanity and then murdered his wife upon his release were
only a these preventable tragedies.
We heard of mentally ill people
being released from jail who were back onto the streets with no follow up care
whatsoever, no housing, no case workers, no medication. When I discovered that
mentally ill inmates were dropped off in the middle of the night with two subway
tokens and a few days worth of medication I thought it was sick joke. After all,
what kind of a system could be that apathetic to the needs of the mentally ill
and society alike.
We discovered as you will hear today that the
problems permeated through the entire mental health care
system. From initial police contact through the criminal justice system to the
jails that contain more seriously mentally ill people than all our
mental hospitals combined. We were disheartened by the
dissension within the mental health care community itself who
disagreed on solutions to the mental health care problems
despite working on similar agendas.
But perhaps the most disturbing
question for me that will never be answered is why Kendra? Kendra was beautiful,
talented, loving, giving, and happy. Kendra loved living in New York City. She
was a huge fan of the Yankees, running in Central Park, and taking photographs
of New York City. On January 3rd, however, Kendra became a statistic, one of the
estimated 1,000 people killed by the untreated mentally ill each year. Kendra
was looking forward to visiting a friend on a rainy Sunday afternoon. She was an
everyday commuter just waiting for a train until she became the unsuspecting
victim of a sick man and an equally sick system.
Kendra was taking the
advice that now haunts me -- "Ignore the mentally ill and they won't bother
you." Now that we know the opposite is true I urge you not to ignore the
disaster the mental health care system become for ignoring the
situation will surely guarantee that more innocent lives are lost. Fortunately,
the remarkable effort on the Council on State Governments Mental
Health Advisory Board has helped identify the proverbial cracks that
have overwhelmed the mental health care system. It is time to
repair those cracks before they claim the next innocent and unsuspecting victim.
And I would just - I know I'm over my time - but I would like to take
this opportunity to thank the Chairman and all of the Subcommittee members for
their humanity, compassion and support and for their progressive approach to
finding solutions to our mental health care crisis. I am
optimistic and hopeful that change is on the horizon. Thank you.
REP.
GEKAS: We thank the witness. Let the record indicate that the lady from Texas,
Ms. Jackson-Lee, is present as a member of the Committee.
We now turn to
the final witness of this panel, Dr. Sharfstein.
MR. SHARFSTEIN: Thank
you, Mr. Chairman, Mr. Scott, Ms. Lee. It's pleasure to be here and I enter my
written comments into the record without objection and I will summarize my
testimony.
I am a psychiatrist and I am a clinician on this panel so I'm
going to focus my comments on certain clinical issues.
The first though
that I want to underscore is that today in psychiatry treatment works. We're
able to manage and stabilize some of the most disturbing psychotic symptoms of
the severely ill in a short period of time and in fact it's the effectiveness of
our medications and some of our psychosocial treatments that led to in large
part the discharge of many patients from state hospitals in the 1970s and 1980s
so that people were now living in the community. Unfortunately, as you have
heard, resources were not transferred from the closure of these units and
hospitals into community based programs and many people began to fall through
the cracks.
I want to make a comment on violence in the mentally ill.
You heard some very eloquent testimony from Ms. Webdale and that tragedy
certainly could have been prevented but it's important to know that the mentally
ill went in treatment are no more violent than anybody else. It's the folks that
have stopped treatment or dropped out of treatment, who are not in treatment who
are certainly at risk for committing crimes and for being more violent and it's
that population that we're concerned with today because these are the folks that
end up getting arrested and end up inappropriately in our jails and prisons.
What we need is access to care. What we need is an approach that assures
that when people are discharged from the hospital that they are supervised, that
they are in treatment, that they are taking their medications and coming for
appointments, that they have case managers, that they have housing - a very
critical piece of the overall puzzle because homelessness, crime and
mental illness go hand in hand. But they have other benefits.
And if they have support from various other systems of care, especially the
criminal justice system and police, that when they do come to the attention of
the police that there is a way that the criminal justice system and the
mental health system work together to provide treatment and
services to these people and not put them in jail. That's what's absolutely
critical, I think, at this point in time.
You know, there are five times
as many individuals in jails and prisons today as there are in state hospitals
and that is an incredible revolution that's taking place. I want to finish my
testimony with a quote. "A great injustice is done to the insane by confining
them in jails and houses of correction. This status then unquestionably retards
the recovery of the few who do recover their reason and their set circumstances
and may render those permanently insane who under other circumstances might have
been restored to their right mind. The consignment of the criminal and the
insane in the same building is subversive of that good order and discipline
which should be observed in every well regulated prison." The person who made
this statement to in fact the Congress of the United States was Dorothea Dix and
the year was 1843.
One of the great ironies of the 20th century is how,
when we've come up with effective treatment, when you have thrown the mentally
ill back into the 19th century and I think that we can do better. Thank you, Mr.
Chairman.
REP. GEKAS: We thank the witness. The Chair will indulge in
five minutes of questioning after repeating that the witnesses will have their
written statements entered into the record without objection.
The first
question I have is to Ms. Webdale. It seemed to me that from the account that
you rendered about the culprit who threw your sister into harm's way, that there
were thirteen previous filed violations of law or incidents of violence, which?
MS. WEBDALE: They were incidents of violence and what would happen, the
police would usually be called to the site and then Goldstein would tell them
that he was sick. He was schizophrenic. He would tell them to take him to a
hospital. And they would immediately transport him to a hospital circumventing
the whole criminal justice system. So with the exception of one incident he
didn't have a criminal record at all. In fact, six months before he pushed
Kendra he pushed another woman onto or attempted to push another woman onto the
tracks but there is no criminal record of that incident because he was treated
as an EDP or an emotionally disturbed person as opposed to being charged and
going to jail.
REP. GEKAS: But Dr. Sharfstein, isn't his individual,
this Goldstein - is that was his name was? Wasn't he a prime candidate for
institutionalization without the ability to go into the community?
MR.
SHARFSTEIN: I think that is he was unable to take his medication and be
supervised closely in the community I completely agree with you that he should
have been institutionalized somewhere for his life because of that problem.
REP. GEKAS: Haven't we all found instances when the institutionalization
started to occur that these very same things were happening, that the
individuals were out on the street not taking their medication, not being
supervised? Even though the intentions were there the reality was that the
deinstitutionalization helped them create the atmosphere for some of the
incidents like we have heard today. Does anyone care to -
MR. MELEKIAN:
Mr. Chairman, if I might, one of the real ironies when you compare the
mental health system and the criminal justice system is that
heroin addicts who are arrested and convicted for burglary and theft and the
like as a condition of probation can be compelled to take methadone as a
condition for remaining free in the community but there are no similar
provisions for the mentally with regards to medication (that can ?) demonstrably
control them.
REP. GEKAS: Mr. Hogan, you differentiated, it seems to me,
in your testimony to the non-violent prison inmate who is mentally ill. Does
that mean to imply that the violent ones still have to remain in the criminal
justice system and treated by that system as well as the mental
health system or were you implying that the non-violents should not be
in the criminal system at all.
MR. HOGAN: Good question, Mr. Chairman,
and I think that ultimately, obviously you posed a question that has to be
decided in the context of particular facts. Well, as a general matter, I would
say that if they have done something and violent and if they are dangerous and
violent they should be locked up. And then they should get care in that prison.
It is their right to get care. You heard from Director Wilkinson, my colleague
in Ohio, who has done a wonderful of improving care in Ohio state prison
systems. But I, as a non-lawyer, I would tend to make that distinction.
If they're going to put other people in harms way, they've committed a
crime, they should be found guilty and locked up.
REP. GEKAS: The Chair
reserves the balance of its time. Yields to the gentleman from Virginia for a
round of questioning. But before we do that we want the record to reflect the
attendance of the gentleman from North Carolina, Mr. Coble, a member of the
Committee. Mr. Scott.
REP. SCOTT: Thank you, I want to respond to a
question posed by Chief Melekian about why before this Crime Subcommittee rather
than another Subcommittee. I guess because we care. Maybe it should be somewhere
else and hopefully we'll consider this and elsewhere. You indicated that you ran
out of time before you could give us your suggestions. Why don't you take a
minute or so to come up with what we ought to be doing.
MR. MELEKIAN:
Thank you, Mr. Scott. From a perspective there are several things. One is that
when the mental health hospitals across the country were
dismanteled one of the solutions was a series that was supposed to happen,
particularly in California, community treatment centers. And for a brief period
of time those centers were there, were the place where the mentally ill could
get counseling and treatment and it was a resource for law enforcement officers
as an alternative for jail. By the early 1980s those had disappeared.
Clearly, another problem, particularly in California, is the authority
for emergency room doctors and other psychiatric professionals to commit people
for evaluation. Currently, the standards are so tight that if the person is not
acting violently either towards themselves or other people in the immediate
presence of the evaluator it's highly unlikely that that person will be
committed for observation.
I already discussed the issue of Buford
Furrow and others who made a generalized threat either against particular groups
of people or against specific individuals but very often absent a specific crime
there is no state or local authority to deal with those people.
I
already talked about the issue of medication and compared it with the fact that
heroin addicts can be compelled to take methadone.
There are a number of
successful programs, including ones in Ithaca, New York, Memphis Police
Department in Tennessee, and Los Angeles County Sheriff's Department that pairs
law enforcement officers with psychiatric social workers and respond to incident
involving the mentally ill. And, this has proven to greatly reduce deadly force
incidents between law enforcement and mentally ill people on the street. I think
clearly that some movement in this direction needs to occur.
On a
federal level, there are two things I would point out. One is that the increased
role that the Veterans Administration could play, particularly among those
individuals who have served in the military previously. The other is there's a
real problem in terms of funding because of the distinction that is made between
mental illness and substance abuse, when in fact very often
those issues are overlapped, particularly among the homeless. So, those are just
a few things I would suggest.
REP. SCOTT: Thank you very much. You
indicated that some people have actually made some threats. How often do threats
from mentally ill individuals actually turn into violence?
MR. MELEKIAN:
I don't have hard numbers in front of me. My guess would be somewhere around
five to 10 percent of the time. And, that's really one of the challenges for law
enforcement, is trying to figure out which of those one in 10 is real.
REP. SCOTT: Do you think some kind of, is that something that can be
improved by training or research?
MR. MELEKIAN: I think both training
and research clearly would go a long way. But, I think ultimately it may be that
if we're going to err perhaps slightly, we need to err on the side of being able
to take people, in California it's 72 hours, to place them under 72 hour
observation so that a professional can make a determination as to whether the
threat is viable or not as opposed to asking a police officer to do it.
REP. SCOTT: Thank you. My time is just about up. But, I wanted to ask
Dr. Sharfstein a question. You indicated that those who are under treatment are
no more violent than anyone else. If treatment were in fact available, would
those who are mentally ill actually access it?
DR. SHARFSTEIN: I think
that most in fact do access themselves to treatment. There is a small number,
but a significant number, that resist treatment that don't want to be in
treatment to deny that they're ill, which is actually a part of their illness,
their denial of being ill, and that's the group that we're concerned with today.
There are people that would avail themselves of treatment, but can't get
treatment because there are barriers to treatment. Then, there are people who
where there is treatment available, won't avail themselves to treatment unless
somehow a force, or where the expectation is that they will be in treatment, or
there is some consequence.
REP. SCOTT: Thank you. And Mr. Chairman, I
would like to thank Ms. Webdale for her compelling testimony. You've been
extremely helping because it puts a real life image to the problem that we're
dealing with. I want to thank you.
REP. GEKAS: We would thank the
gentleman. We turn to the lady from Texas, who's allotted five minutes for a
round of questions.
REP. SHEILA JACKSON-LEE (D-TX): Thank you very much,
Mr. Chairman, and thank you for the hearing. And, as well, let me acknowledge
the ranking member, Mr. Scott, who every time I've offered an amendment in this
committee dealing with the issue of mental health, I have
enjoyed his support and commitment to the issue.
We would hope that the
21st century kanotes (sp) progress. But, let me cite some numbers for you that
may have already been recited, but allow me to do so again. Studies show that in
state mental hospitals in 1955, there were 560,000. In 1989,
the number went down to 100,000. And in 1994, 71,000. Yet, the American Jail
Association estimates that 600 to 700,000 people suffering from serious
mental illness are being booked into jail each and every year.
Dr. Sharfstein, forgive me, are you psychiatrist? My question is, far
better than I, what was this whole issue about deinstitutionalizing individuals
and look where we are today? Would you just respond to that theory?
DR.
SHARFSTEIN: Well, the state hospitals and --
REP. JACKSON-LEE: Let me
just say, I am quite aware of the snake pit. And so, I fully appreciate some of
the tragedies that went on. But, let me understand why we couldn't improve the
conditions of treatment as opposed to embrace deinstitutionalizing and now we
have them incarcerated in jail. And, I'm sorry for interrupting you.
DR.
SHARFSTEIN: Right. Well, many of these state hospitals were snake pits and were
not places where anybody would want to be. They were an example of tremendous
neglect of the mentally ill. That was one issue.
But, I think that there
was an increasing recognition, and there were studies to show, that most people
who had their symptoms stabilized with these newer medications, and the
psychosocial treatments, and they could leave the hospital. The issue then was
could we put together community based services that met their needs?
So,
I could give you many examples where in fact that has occurred. And today, if
somebody developed a serious mental illness, there is much more
opportunity for good treatment, for active follow up, and for a decent quality
of life than there was 30, 40 years ago. There are many hundreds of thousands of
people who are not in the criminal justice system who have experienced a
mental illness, who have received treatment, and are doing well
today.
Whereas 50 years ago, they would have been hospitalized in a
state hospital and would have been there for months, if not years, in the
hospital. So, there are two sides to this. There is a group of individuals, many
of whom by the way are duly diagnosed. In other words, they have serious
mental illness and substance abuse problems who have difficulty
remaining in treatment. They are often discharged into communities that don't
have the services that they need. They are not well served by the services that
are there.
So, that's the group that we're talking about and that's the
group that gets put into jail a number of times, not just, you know, for
non-violent problems, as well as the few people who I think give the great
majority of the mentally ill a very bad name and a lot of stigma to
mental illness who are in fact violent in the context almost
always of not being in treatment.
REP. JACKSON-LEE: I glanced at your
testimony then, and I do want to thank my colleague, the congressman from Ohio,
Congressman Strickland, for this legislation dealing with diversion courts and
my work has been focused on the impact of mental illness on
children and the utilization of juvenile justice courts for children when, in
fact, I think they need 100 percent mental health services.
But, do I hear you saying that we failed ourselves when we deinstitutionalize
and did not provide sufficient number of these community mental
health services and resources?
And Ms. Webdale, might I thank
you. Obviously, your case is both enormous, and national, and tragic for your
family. Do you see a problem with the individual having had an aggressive
personality and behavior and not being found in a system that he could have been
kept off the streets to protect others and as well get treatment? Is that what
I'm hearing you saying, that you would not have been opposed of him having, it's
just that he was out?
MS. WEBDALE: He was treated many times. He was in
and out of mental institutions for 10 years.
REP.
JACKSON-LEE: When I say treated, kept in the institution and treated.
MS. WEBDALE: Right. Actually, he was in Creedmore (sp), a high security
facility, for several years. And in fact, about a year before he killed Kendra,
the short term care facility that he was in recommended to Creedmore that he be
hospitalized as an inpatient. However, they didn't have a bed available. So,
they put him on a waiting list and they actually did all the paperwork and he
was prepared to be transferred to Creedmore.
Unfortunately, his
insurance ran out. So, when he wanted to leave his short term care facility, he
basically had to just walk out the door. He voluntarily signed himself in. So,
despite the fact that he was violent, and non-compliant, he could voluntarily
sign himself out of that facility. The hospital had the option of keeping him in
by going to court. However, they decided not to do that and therefore, he was
back on the streets with absolutely no case manager, no medication, and no care
whatsoever.
REP. JACKSON-LEE: Thank you very much. I'm sorry for your
tragedy. Thank you.
REP. GEKAS: We express our gratitude to this panel
as well for the excellent testimony which they've offered and which will remain
in the record for further examination by the committee. We excuse you with our
thanks.
We invite the final panel to present themselves at the witness
table. The final panel will examine the impact of the mentally ill on the
criminal justice system. Donald S. Eslinger, the sheriff of Seminole County,
Florida, and president of the Florida Sheriff's Association. Mr. Eslinger has 22
years of service with the Seminole County Sheriff's Office. He is a consultant
and instructor for the National Sheriff's Association regarding community
policing and related topic. Mr. Eslinger received his bachelor's degree from
National Lewis University and is also a graduate of the FBI National Academy and
the National Academy of Corrections.
Michael D. Schrunk is the district
attorney for the County of Multnomah, Oregon. Is that correct, Multnomah?
MR. MICHAEL D. SCHRUNK: Yes, sir. It's Portland.
REP. GEKAS:
Yes. Mr. Schrunk has served in this capacity since 1981 and he currently chairs
the Regional Organized Crime Narcotics Task Force and is a member of the
Multnomah County's Public Safety Coordinating Council. He received extensive
experience in prosecution of criminal cases while in private practice
representing plaintiffs and defendants in civil litigation and defendant
criminal cases. Mr. Schrunk is a graduate of the University of Oregon Law
School.
With them at the witness table is Dr. Rizdon (sp) Slate, a
member of the Florida Board of Directors of the National Alliance for the
Mentally Ill and president of the Polk County Chapter of the National Alliance
for the Mentally Ill. Dr. Slate is an associate professor of criminology at
Florida Southern College and is a current task force member of the Polk County,
Florida Public Safety Coordinating Council where he is involved in monitoring a
mental health grant aimed at diverting the mentally ill from
jail. Dr. Slate received his bachelor's degree from the University of North
Carolina. His masters degree from the University of South Carolina and his
doctorate from the Claremont Graduate School.
The Honorable Jim Cayce is
now a part of this panel. He is Superior Court judge in King County, Washington.
Judge Cayce is it, or Sayce?
MR. JIM CAYCE: Cayce.
REP. GEKAS:
Cayce, spent nine years as a partner in a private practice law firm prior to his
appointment to the District Court bench in 1989. He chaired a community planning
task force to explore the feasibility of creating a Mental
Health Court in King County, which would later be implemented in
February of 1999, only the second kind of its genre in the United States. He
presided over the daily Mental Health Court calendars until his
appointment by the governor and the Superior Court in July of 2000. Judge Cayce
received his bachelor's degree from the University of Washington and his law
degree from the University of Puget Sound.
Reginald Wilkinson joins the
panel, secretary of the Ohio Department of Rehabilitation and Correction and
vice president of the Association of State Correctional Administrators. Dr.
Wilkinson has served in many capacities since joining the department in 1973,
including superintendent of the Corrections Training Academy and deputy director
of prisons. He is the past president of the American Correctional Association.
He received his bachelor's and master's degrees from the Ohio State University
and his doctor of education degree from the University of Cincinnati.
Our final witness is of special interest to the chair since he is a
Pennsylvania state senator, a post which I held prior to my coming to the
Congress of the United States, and I note that the gentleman, Senator Thompson,
has served as vice chair, or chairman of the Law and Justice Committee of that
body, a body commensurate with the Judiciary Committee, which I served when I
was in the Senate of Pennsylvania.
But, he has gained greater
distinction in his present capacity because he serves on a committee, and he's
vice chairman of a committee, that is dedicated to the subject matter at hand
for the eastern portion of the National Council on Government. So, he has dealt
into this topic for a long time now and I'm proud that as a colleague in and of
Pennsylvania and the Senate, that he graces our panel for the testimony that he
is about to give.
We will begin in the order in which the witnesses were
introduced with the same routine of offering each of the written statements to
be accepted without objection for the record and to ask each to limit the time
to about five minutes and we will proceed with the chief.
MR. DONALD S.
ESLINGER: Thank you very much, Mr. Chairman, and members of the subcommittee.
It's a real pleasure to be here. Congressman Scott, as well as the chairman,
mentioned some numbers when we first began, they mentioned that about 96,000
local inmates are suffering from some type of mental illness. I
suggest to you those numbers are staggering, but it's even more staggering to
understand that over 10 million defendants are booked into local jails
throughout the country. And this system truly creates an additional burden on
the system.
For a variety of reasons, our local jails have become the
mental health treatment centers of last resort. More often than
not housing, and in some instances treating, more mental health
consumers than the local community service providers itself. This transference
of responsibility for treatment of mentally ill to the criminal justice system
is not only ineffective and burdensome to an already overburdened justice
system, it is also costly. On average, mental health offenders
cost more to manage in jail, stay longer, and recidivate at a higher rate than
any other inmate.
The criminal justice system lacks the necessary
facilities and resources to effectively treat the mentally ill.
Further
complicating an already difficult task is the lack of coordination and
integration of the mental health services in our communities.
Some of the problems in the systems are, for example, number one, at the point
of contact in the field, most law enforcement officers are not trained to
recognize and identify mental health factors. The lack of
training combined with the lack of alternatives for disposition of an incident
involving the mentally ill person often results in unnecessary entry into the
criminal justice systems.
Number two, most jails lack the resources to
adequately and timely screen for mental health problems of the
defendants. Lack of training, insufficient access to mental
health histories, and limited or no diversion options creates difficult
management issues for jail personnel.
More often than not, inmates with
mental health problems are released from jail without proper
planning for discharge. The lack of planning is usually due to lack of formal
linkage between the criminal justice system and the community mental
health providers. As stated here today, there have been many acts of
violence relating to mental health. In Seminole County has its
own story as well.
On July 8th, 1998, Seminole County Sheriff's Office
Deputy Gene (sp) Gregory responded to a disturbance call in a rural area of
Geneva. Deputy Gregory, a 55-year-old husband, a father of three, and a seven
year veteran of our organization, was shot and killed as he approached the
residence of Alan Singletary (sp). Alan Singletary, a 44-year-old mentally
disturbed individual whose family has sought help for years. After a 13 hour
standoff, Singletary was also killed by members of our organization and two
other deputies were wounded during this incident.
This tragic incident
highlights many of the deficiencies in the mental health
delivery system's calming in many communities. Lack of coordination of services,
lack of resources, lack of information for the officer in the field, as well as
at a scene of a crisis. However, an adequately funded, integrated mental
health delivery system with the appropriate treatment, and case
management, for the mentally ill could have made a difference in this situation.
As a result, we have formed a Mental Health and
Substance Abuse Task Force. The membership in this task force includes Deputy
Gregory's widow, Linda Gregory, and Alan Singletary's sister, Alice Petree (sp).
We also established a Crisis Intervention Team, a comprehensive in jail
mental health service delivery system, post booking diversion
pilot program, which is a post booking diversion program. And by the way,
Congressman Scott, the inmates pay for this. It's not a burden of the taxpayers
of Seminole County. And, we have also started a medical security program.
While we have made great progress in addressing mentally ill
mental health issues in our community, I truly believe that
working together, and I ask this subcommittee, to look at the data collection
process. A larger scope of data collections on the mentally ill in local jails
is needed to take into account the bookings. In other words, in our facility,
the population averages about 1,000 a day. But, we book in 18 to 19,000 annually
that has an impact on our system. A national study is needed to assess the
impact of deinstitutionalization of the mentally ill.
Pre-booking
diversion pilot programs throughout the country could really have a positive
impact on the Mental Health Courts. I think one of the most
important elements, what I'm asking for here, is the coordination of community
based and in jail services is necessary to ensure seamless continuity of care
for a mental health offender and systems integration.
And, I ask the government to truly look at methods and funding to
encourage local and state governments to get more involved in system
integration. I would ask the subcommittee to give consideration on how the
federal government can in fact assess the magnitude of this problem from a
national perspective. And, I truly appreciate the opportunity to address this
subcommittee. While these endeavors may seem overwhelming, I believe that
working together at all levels of government, we can make a positive impact and
truly enhance the quality of life of all Americans as a result. Thank you.
REP. GEKAS: We thank you. Mr. Schrunk.
MR. SCHRUNK: Mr.
Chairman, and members of the committee, thank you very much for this
opportunity, and let me state in advance, commend you for taking on this
difficult task. It's been with us for a long time and I thank you for accepting
my written testimony. Let me elaborate a little bit about being a local district
attorney.
I'm Mike Schrunk. I've been elected local district attorney
since 1981. I've sat at mental health hearings. I have tried
people who were guilty but for insanity. I have processed people and like you,
being independently elected, I've fielded numerous constituent phone calls as to
what is going wrong with the system.
Portland is not unlike your
community. It's not unlike large communities and small communities across the
country. The criminal justice system in Portland, in Oregon, in the country is
treating the mentally ill by default. For one reason or another, and you've had
panelists up here explaining that to you, but the impact on the criminal justice
system is enormous. You've heard the chief and the sheriff talk about the men
and women on the street.
Let me tell you from a prosecutor's standpoint,
America's prosecutors are good. We can make decisions to charge and we can
prosecute and we can convict. And local sheriffs and corrections officials are
very good at incarcerating people. But, I ask you, is that the right thing to do
with the right population? And that's what we need to look at.
Let me
tell you, after that officer on the street, he or she has made that difficult
decision to book someone, the prosecution kicks in. We have to make a decision
to charge, which is terribly important in the community. And we sometimes
default to charge. It has to be a facts based decision.
We next face a
decision to release. Once that person is charged and brought before a magistrate
for arraignment, he or she is entitled, except in extreme cases, to release,
recognescence, bail, some form of release pending trial or ultimate disposition.
We need information. We need access to safe releases. We have to make a decision
to release. We have to make recommendations to that magistrate.
Now, you
think that's the end of it. But, we know in this system, 90 percent of the cases
plead guilty. They go by way of guilty plea disposition, negotiation, whatever
you want to call it. It happens. The men and women in the prosecutor's office
need to have alternatives. We can go and panel a jury and convict, but that's
not always right. We need to have options on what to do at trial, what options
instead of trial. What options instead of conviction, be it diversion, be it
deferred prosecution, be it a probationary sentence with mandated mental
health.
And we, representing the people, need to have
confidence in the mental health community that the mandates of
the court, or a magistrate, will be carried out. Keeping in mind that we are
trying to ensure public safety as one of our sworn duties.
Another party
that has a dickens of a time is the defense. The men and women of the defense
bar, they have a client who is difficult to deal with at best. And if mentally
challenged, can be impossible to deal with without proper treatment. We find
that this is sometimes almost impossible for a defense counsel, a deputy
prosecutor, to get together with someone with a knowing understanding of the
client, the defendant, the person now who has been charged, and to agree upon a
resolution.
One of the advantages of being elected for nearly 20 years
now is I know most people in my community. It's not uncommon that someone will
come up to me on the street and say Mike, I just finished jury duty, what were
we doing wasting our time with that loony? Now, that's a horrible sentence or
that's a horrible word to use, but they're saying it. Isn't there something
better you can do for that poor man or woman than take them to trial? And, that
is what I think prosecutors are asking.
We need to be in a collaborative
mode with the mental health community. We need to have options.
We need to make some partial decisions. We need to be able to give the
magistrate, the man or woman that is making the ultimate decision, some of those
options.
I have submitted in the written testimony stories of two
individuals, one that escalated completely out of control because of lack of
treatment until it resulted in a very serious crime. That individual should be
locked up and not let loose.
Another one who ultimately died. Sixteen
different commitments, petty quality of life things. The red light is on, so
I'll stop.
But, let me leave you with this, this population are arrested
more often. They stay longer in our local jails and they will be back unless we
do something. Thank you.
REP. GEKAS: We thank the gentleman and we turn
to Dr. Slate.
DR. RIZDON (sp) SLATE: Thank you, Mr. Chair, Ranking
Member Scott, and Ms. Jackson-Lee. It is certainly an honor to be here today and
for you all to consider this very critical issue.
I'm going to tell you
why I'm testifying today. I come at this issue from both sides of the fence, if
you will. I'm a criminologist with a Ph.D. from Claremont Graduate School. I
worked for two years as assistant to the warden at a maximum security death row
facility in South Carolina. We had a psychiatric unit there as well. And then, I
became a United States probation officer in 1986.
Shortly thereafter, I
was diagnosed as manic depressive. I had a manic episode. In the span of two
weeks, my wife left me while I was in the hospital, ultimately divorced me and I
was asked to resign my position for medical reasons as a federal probation
officer, which I did. But, you might imagine it took me a little while to brush
myself off and pick myself up, but I did.
I went back to something that
was very familiar to me, that was education. I had a master's degree at the
time, so I started teaching at a community college. I started applying to the
Ph.D. program. I was accepted and offered a full fellowship to the Claremont
Graduate School in Claremont, California. I ultimately obtained a Ph.D. and all
the while remained on lithium, the medication that holds my manic depression in
check.
I went from California to Maine. I taught in Maine for four
years, a full-time job, a criminal justice professor. And then, went from Maine
to Florida. I took a job at Florida Southern College where I currently am now.
And in taking that job, I had to look for a new doctor. I had been with doctors
in five different states over an eight year period of time, from 1986 to 1994.
My new doctor decided I was not manic depressive. He took me off my
medication. I ended up going to a football game in Columbia, South Carolina. And
at that football game, I had a psychotic episode. I was manic again. This time,
ultimately, and it's in the written testimony, I'll make a long story short, in
essence, the police encountered me.
My wife was there holding the vial
of medication saying my husband is a criminologist. He should be on this
medication. His doctor took him off this medication. He needs treatment. He
needs help. They took me directly to jail. I was placed in jail in Columbia,
South Carolina. I was assaulted by correctional officers when they moved me to a
strip cell and I was also assaulted by an inmate in Columbia.
The reason
that I tell you this story, I mean the arrest has since been expunged, the whole
nine yards, but the reason that I tell you this story is this, if this can
happen to me, with a Ph.D. in criminal justice, with my knowledge and my
background of the criminal justice system, it can happen to anybody and people
are getting hammered right and left by this system and they have nowhere to
turn.
The whole time I was in that jail in Columbia, I received no
medical treatment, no medical attention whatsoever, and you know how I got out
of jail? A United States probation officer that I used to work with back in
1986, he got wind of the fact that I was in that jail. He came down to that jail
under no authority whatsoever. He flashed his badge and he said this guy is
going with me. And guess what? The jailers were more than happy to relinquish me
because they didn't know what to do with me.
He got me into treatment.
I'm back on medication. Fortunately, I was working with a very understanding
administration at Florida Southern College and I am a criminology professor at
Florida Southern College right now. I'm fine on medication. I take my medication
religiously.
But, something has to happen in terms of this process.
There has to be better linkages between the criminal justice system and the
mental health system. And, I will tell you now, that I would
not be before you today if it were not for the love, support, and encouragement
of my wife, Claudia Slate, and my mother, Virginia Slate, and for the grace of
God because I could have died in that jail cell. And, I just think that (we need
?) to help straighten out this problem.
I've got an article in the
attachments on Mental Health Courts that I did, but something
must be done. And I'll close with this, Forrest Mann (sp) once said that in
essence, an individual should be ashamed to die until they had done something
for humanity, until they had won a victory for humanity. I know that you all
here in Congress win victories for humanity often. But, I'm asking you to win
this one for humanity because there are indeed, people are getting hammered out
there, and you all have the legitimate authority to do something in this
instance. And, I know that you can and it's the right thing to do. Thank you.
REP. GEKAS: We thank the gentleman. We turn to Dr. Cayce.
DR.
CAYCE: Thank you very much. I also appreciate the opportunity to be here and
address you today. And, as a representative of the third branch of government,
we're always interested in doing this and always appreciate the opportunity, but
we're not always unfortunately invited. So, I thank you and it's truly an honor,
especially to be here at the federal level, addressing this important topic.
When I hear Rizdon, and I've heard this a couple times, explain his
story, I wish I had the power to apologize to him on behalf of the judge that
handled his case and the judicial system that mishandled him so poorly.
Obviously, I don't have that power. What I would hope would happen if he, or
someone like him, appeared in my Mental Health Court, or now
the Mental Health Court that I started and I'm no longer at,
that they would be treated differently, that he would come out of that setting
with a new found respect for the justice system.
As someone who is
passionate about justice, I actually get tired of hearing how our system is
broken. I don't think it is. I'm proud of our justice system. I'm proud to be a
member of that and I think it works very well and it's an effective system. I do
agree that a significant failure of the justice system is when individuals with
mental illness, for whatever reason, come before the criminal
courts. The result often is a serious injustice. It's an injustice to those
defendants who appear in our courts with a mental illness and
it's an injustice to their victims.
I would like to focus some of my
time on just telling you a little bit about a day in the life of a lower court
judge. As I indicated, I am now in superior court, which is a court of general
jurisdiction handling felony and civil cases. But, misdemeanor courts handle
cases up to a year in jail as a maximum. They handle such things as DUI's,
harassment, assault, domestic violence. They also handle traffic infractions,
speeding tickets, parking tickets, small claims, sometimes civil cases up to a
certain amount of jurisdiction.
We handle what are called routinely the
rocket dockets. We have a high volume fast case fast paced business. On criminal
calendars, for instance, arraignments may be in a two-and-a-half hour period,
100 people that have to come through the court. Likewise, pretrial hearings
you've got a half day to handle between 25 and 40 individual cases. Sentencing
calendars often exceed 30 cases in a half day. And, I'm actually finding that at
the felony level, that's also the case. When you get to the trials, my last
trial took 10 days, but those pretrial hearings are handled in a fast and a
routine manner.
That doesn't work with individuals often who appear
before the courts with a mental illness. Sometimes it works,
but often it does not. In the other cases, I think we do a good job and I think
it's adequate. But, for a variety of reasons, when we encounter individuals with
significant mental illnesses, we need to slow down. We need to
take individual time, attention. We need people in the system that have specific
knowledge and training that are able to handle those individuals and their
complex problems. We need access to resources to be able to address the root
causes of the criminal behavior, if there is criminal behavior. And, we need
people who care about doing business in a different and better way.
In
addition to significant mental illness, a majority of the
people who have come through the Mental Health Courts are
facing homelessness, chemical abuse or addiction, usually no support from family
members.
I haven't had in the 275 cases I handled, I don't believe one
person had a spouse, or a significant other, very few had family members until
sometimes we'd get them involved in treatment and the family would come back.
But, we need to do business in a different and better way when it involves this
class of individuals coming into our criminal court.
The good news is
that there are better ways. There is various programs around the country that we
can turn to. And as is evident today, there is a significant interest in change
and I think we can overcome the problems by these collaborative efforts around
the country. What we need is leadership at the federal, state and local level.
We need motivation, and not from the tragic incidents which lead us to our
Mental Health Court and many other programs, lead them to get
the funding and the interest in doing business in a different way.
But,
we need motivation from grants, from folks like you, from community members who
are electing local officials. We need technical assistance, research and
evaluation, and flexibility to implement programs that work at the local levels.
And I see that my time is up, and I thank you very much for this opportunity.
REP. GEKAS: We thank you. We turn to Dr. Wilkinson.
DR. REGINALD
WILKINSON: Thank you, Mr. Chairman. Thank you, Mr. Chairman, Ranking Member
Scott, and Member Jackson-Lee, for having the opportunity to provide testimony
on behalf of the Association of State Correctional Administrators, who represent
directors of corrections for all 50 states, the Federal Bureau of Prisons, and
the United States Territories. I enter my more voluminous testimony for the
record.
To cut to the chase, in the not too distant past, many of the
inmates with mental illness currently housed in correctional
facilities would not be there at all. Many would likely have been committed to
the custody of state or local mental health facilities. As it
is, an estimated 283,000 adults, as was mentioned in Congressman McCollum's
statement, adults are in jails and prisons have a diagnosable
mental illness. That number is expected to grow. This makes
those in my position, directors of corrections, de facto mental
health directors as well as directors of correctional agencies.
There is no typical method for handling an individual with
mental illness who commits a crime. In come counties in Indiana
and Ohio, they are diverted to mental health facilities before
sentencing. In areas of Florida and Washington they are guided to special
mental health courts. In other jurisdictions, they are taken to
jail where they may not receive the kind of care that they require. Finally,
some individuals with mental illness are sent to jail and
prisons where their illnesses are neither identified or treated.
Well,
why do we want to do good mental health at all? Offenders who,
first of all, have a constitutional access to mental health
care while they're in custody of correctional agencies. Effective treatment
makes our prisons safer and easier to manage. Ultimately, good mental
health care in prison means better protection for the community and the
thousands of persons who work in our facilities.
Ninety five percent of
all prisoners will eventually leave the custody of correctional facilities.
There is no such thing as locking people up and throwing away the key. And we
want them to reenter our communities in better shape than when they left them.
Above all, we must provide quality mental health care to
offenders because it is simply the right thing to do.
Many of these
individuals have complex disorders, which include substance abuse and
mental retardation. Others have committed sex offenses and
other violent crimes, so we must deal with the phenomenon of co-occurring
disorders. Treating one disorder without addressing the other is sometimes
futile. Correctional systems must be equipped to provide a holistic menu of
programs, including alcohol and other drug abuse treatment, literacy, and much
more.
Inmates with mental illness may also exhibit
unpredictable and even violent behavior at times. They also may suffer from
fears that others are trying to harm them. Often, their illness makes it
difficult for them to follow prison rules and procedures. Sometimes their
peculiar and inappropriate behavior creates animosity and intention among other
inmates, which can lead to altercations or worse.
Some inmates with
mental illness are perceived as weak and maybe be preyed upon
or manipulated by stronger inmates. As such, they require a higher degree of
staff supervision. However, many inmates with mental illness
receive treatment and coexist as normally as possible in the prisoner
population. Others require placement within a residential prison mental
health facility or unit. Individual treatment plans are crucial for
each prisoner.
Funding for mental health services to
inmates is handled in various ways. Some are budgeted through the Departments of
Mental Health while others are dispersed through prison
system's medical budgets. Regardless of the method, paying for good
mental health treatment is an ongoing struggle for correctional
agencies. Currently, State Departments of Corrections receive technical
assistance from some federal agencies, but none from agencies to disperse money
for medical, for health care, or mental health
care.
Even the very best treatment in prison will fall apart if it is
not continued in the community upon release. This often results in the
individual once again getting into trouble and finding his or her way back to
the justice system.
Mood altering and stabilizing drugs often make the
difference between an offender coexisting normally or committing serious harm.
However, the newest and safest psychotropic drugs are extremely expensive and
most correctional systems struggle with the high cost of prescribing these
medications. There is a high probability that offenders who need
psychopharmacology and do not take them will eventually re-offend.
If
current public policy dictates that correctional systems are now catch all
agencies for many person with mental disabilities, then
correctional administrators must be given the resources to address the
complexities of providing health care to offenders who suffer
from such disabilities. It is clear that comprehensive medical care for
offenders yield positive results. Offenders are better able to cope within the
prison environment. Releasees stand a better chance of not recidivating.
Employees are safer and fewer citizens are victimized.
Mr. Chairman, I
applaud you and this committee for taking the time through this hearing to
consider the kind of testimony that I have offered, and as well as my
colleagues, and I stand available, as well as the members of our association, to
assist in any way possible. I want to say that I appreciate the leadership of
Senator Mike DeWine, and Congressman Ted Strickland, from Ohio for noting this
most important mission for correctional and mental health
agencies.
And finally, I would like to say there needs to be a better
merging of the public health, and the public safety, agencies
in this nation on all levels of government. Thank you very much.
REP.
GEKAS: We thank the gentleman. We turn to our final witness, Senator Thompson.
SEN. THOMPSON: Thank you, Mr. Chairman. I appreciate that kind
introduction. And also, I want to thank you on behalf of the members of the
General Assemblies throughout the United States, Republican and Democrat, who
are addressing this problem and trying to address this problem.
In a
former life, I was a county commission in Chester County, Pennsylvania and had
the responsibility of overseeing the mental health mental
retardation people who were implementing the federal court order to
deinstitutionalizing the mental facilities in Pennsylvania that
was issued by Judge Raymond Broader (sp) as you will recall.
I also want
to thank Mr. Scott, and Ms. Jackson-Lee, for being here to listen to us and also
Chairman McCollum for calling this hearing to begin with. I am here to kind of
bat cleanup for the panels that have been here so far. And, you heard some
extremely touching testimony from some real strong experts in the mental
health field and the field of criminal justice and in the field of
corrections.
We as legislators have to listen to these concerns, and
listen to these experts, as we develop legislation to be able to address the
problem.
At the Council of State Governments, I have chaired an effort
to bring representatives from all the key stakeholders together from across the
country. And, similar to the objective of this hearing, our goal has been to
exchange views and to try to come up with some recommendations.
And the
level of frustration that these individuals shared regarding the problem really
impressed those of us who are lawmakers. Crime victims wanted to know why the
state and local governments haven't taken action sooner. Local law enforcements,
and prosecutors, and judges believe that they were wasting a proportionately
large percentage of their time and resources on individuals who should be
treated in other fashions. Corrections administrators resented the criminal
justice and mental health had advocated their responsibility
for this population leaving the resources for prisons and jail officials to
manage this difficult and very expensive population.
And, lawmakers
across the states have learned that warehousing some categories of mentally ill
offenders in jail our prison is practically speaking a budget buster.
Corrections in Pennsylvania rank third behind only education and public
health and welfare in the current general fund budget and that
area has grown dramatically in the last few years.
While they may have
different views on the problem, and different perspectives at looking at that
problem, they all seem to agree on two issues. I think everyone who has been
here today agrees on two issues. Many individuals are swept into prison or jail
because of their mental illness and are there because there are
no resources available within the community to hold these individuals
accountable or to develop a proper treatment plan.
In addition, there
are violent offenders with mental illness who should be
incarcerated. We failed to equip the corrections administrators with the
resources to identify these inmates. As a result, many times these inmates
return to the community in far worse shape than they were when they entered the
door.
Translating the consensus that has been developed by these experts
into programs, and policy, and legislation will be tricky. One size won't fit
all. Each of our states and counties have different needs. In short, we need
teamwork and cooperation. Teamwork and cooperation among federal, state and
local governments to solve the problems. There's excellent precedent for this.
Under the leadership of Chairman McCollum, and Congressman Scott, a
juvenile crime bill has been developed which recognizes the differences between
the juvenile justice system and effectively encourages holding juvenile
offenders accountable for the delinquent behavior.
The bipartisan
leadership of this subcommittee, with Congressman Strickland, Senators DeWine,
Kennedy, Wellstone and Domenici, make us optimistic that Congress will assume a
similarly constructive and vital role in the question of mentally ill offenders.
The role of federal agencies, and the role that they have assumed, is
equally encouraging. We have had extensive assistance by the Department of
Health and Human Services, particularly the Center for
Mental Health Services, and that recites their understanding of
the problem.
And, we have had technical support by the Office of Justice
Programs and the Department of Justice, which has helped us to begin to learn of
some of the programs that have been developed by a number of jurisdictions
across the country that have been successful.
You learned today, and
heard today, of the frustrations about the impact of the mentally ill on the
criminal justice system. We have a foundation at the federal government to work
with states to begin addressing this problem and we have to all work together
before another tragedy occurs. I thank you very much for your time.
REP.
GEKAS: We thank you, Senator. The chair yields to itself five minutes for the
first round of questioning. I remember very well when I was in the Senate of
Pennsylvania, we developed, and later when I came to the Congress the same thing
occurred, a special set of options on the conviction of someone of first degree
murder in which where previously mental illness was an element
in the case, the choices were limited to not guilty by reason of insanity and
guilty period.
The alternative that we developed, which seems to have
worked, is that if the law enforcement arena finds him guilty of the crime, and
the mental health community finds him mentally ill, that we can
render a verdict of guilty, but mentally ill, and thus incarcerate him in such a
way that he would receive treatment for the mental illness.
That seems to me, although it's a death case, or a first degree murder case, is
the way that both sectors can hone in on a particular subject.
My
question is, I'm curious to know whether anyone believes that that kind of
sentencing could occur for a lesser crime and start to use both segments of the
community forces, law enforcement who imprison and the mental
health who treat can be done in other segments in the law. Yes?
DR. SLATE: What I would see as a possibility would be the idea of
perhaps withholding adjudication, particularly if we're talking about minor
types of offenders who may be mentally ill and their mental
illness caused the event to occur. Perhaps you could withhold the adjudication
and have a conditional release saying that if you will comply with your
medication, if you will go to therapy, if you will do this, that and the other,
then we will consider ultimately dropping the charges that we have against you.
But, in essence, you could hold the charges over the individual's head to get
them to comply to a certain extent.
REP GEKAS: Conditional release is
what the lady was complaining of in the death of her sister, if you recall, the
various releases of that individual who killed her sister. Wouldn't it be better
to have a conditional imprisonment until we can determine that he could be
better treated at a community related system or in a mental
hospital rather than to go the other way?
DR. SLATE: If I'm not
mistaken, I believe her situation was mostly in the treatment venue and the
situation that you were posing, as I understood it, would be that there would
have been some sort of criminal violation that has occurred so in essence you
could hold over the individual's head the criminal charges. And, if they did not
comply with whatever the conditions were, then you could in essence say okay,
we'll just put you in jail if you're not going to comply.
REP. GEKAS:
But, we do that now.
DR. SLATE: Well, not everywhere.
REP.
GEKAS: Does someone else want to venture an opinion?
MR. SCHRUNK: Mr.
Chair, Mike Schrunk. Exactly what Pennsylvania does, many states are the guilty
but insanity plea or finding by a jury will sentence. In Oregon, we call it the
psychiatric security review board for a like period of time if they were being
incarcerated. So often in many of the cases that I think we in this panel are
dealing with, and you heard reference to not the high end felony, but to the low
end perhaps felonies that the misdemeanors, and the quality of life, their
mental illness doesn't rise to the level where they would be
qualified for not guilty but for insanity or guilty but for insanity.
So, what happens, they're in a never never land. No one would disagree
that they have a mental disability or a mental
illness. Their quality of life crime, were they convicted for it, it's the ones
you hear the horror stories. In some of the written testimony, where over a five
or 10 year period, someone has been arrested 62 times and it's just, you know, a
slap on the wrist, 30 days, 30 days, 30 days and they're continually back in
chewing up resources.
And so, where you're talking about is absolutely
right, on the violent felony. And that has proved successful in a number of
states. But, the other area where Dr. Slate is talking about, many people have
experienced with a deferred prosecution, a diversion, or a straight probation.
And perhaps Judge Cayce would be a good person to respond.
REP. GEKAS:
Judge Cayce.
DR. CAYCE: I was going to comment, first at the felony
level what had happened in Washington was basically at some point the
legislature says these judges don't know what they're doing and we're going to
tell them what they have to do at sentencing and it's basically X number of
years in prison.
And they took away our discretion to impose affirmative
conditions and now they're backtracking and giving us some of that discretion so
that we can do some of these innovative things.
At the misdemeanor
level, we have always had complete discretion to impose any kind of affirmative
conditions we wanted, which enables us to do things like the Mental
Health Court. And, some of the people, many of the people, that we see
have pages and pages of rap sheets, violent and non-violent offenses. But, all
of them are going to be out of jail, no matter what, at the misdemeanor level,
within a matter of weeks or months.
So, is it better to get them into
treatment, case management services, probation services, and get them stabilized
or is it better to just lock them up, no treatment basically, unless they
voluntarily take medications, and then have them released with no services? We
found, and I think that the research shows, that it's effective to get them out
of jail up front and get them into community treatment with the court
supervision in appropriate cases.
REP. GEKAS: The time of the chair has
expired. The gentleman from Virginia is recognized for five minutes.
REP. SCOTT: Thank you, Mr. Chairman. Mr. Eslinger, you indicated that on
the question who pays for the services, the inmate pays for the mental
health services. Do you have any, does anyone have authority to make
the inmate pay for those services?
MR. ESLINGER: Well, we pay for it out
of our phone revenues. When inmates use telephone services in our facility, we
collect X amount of dollars.
REP. SCOTT: Yeah, we were talking about
those phone call rates in another hearing. (Laughter.) That's another forum.
MR. ESLINGER: Actually, I think it's only 28 percent by the way. But, we
collect those monies and put it back in the general fund and ask the commission
to specifically fund these mental health services.
REP.
SCOTT: So, when the inmate gets services, you don't have to order them to pay
anything additional?
MR. ESLINGER: No. However, we do charge booking
fee, a $10 booking fee, $2 assistance fee, as
well as co-payments for some over the counter medication, as well as some other
services that we provide. We do charge for that.
REP. SCOTT: If an
inmate is released at the end of his sentence, do you have any authority to
require follow up?
MR. ESLINGER: No, we do not. However, we have
developed this partnership with community mental health that we
do have a plan, a discharge plan, for that particular inmate. And this isn't
just for end of sentences, but this is also a pretrial inmate. Many of our
clients, many of the inmates, are pretrial inmates. So, we do have a plan in
place and the individual then, information is given to the deputy sheriff who
works what we call the community service area. So, not only does mental
health, but the neighborhood deputy checks on the well being and
ensures compliance, as well as any other supervised sanctions, like a county
probation or Department of Corrections probation officers.
REP. SCOTT:
Now, do these inmates within their sentence, do you provide, I mean, is that a
voluntary situation where they can do it if they want? Most do because they know
the need the services?
MR. ESLINGER: Most do, yes. We currently have no
sanctions in place other than supervised court ordered sanctions to ensure
compliance to this. Now, if a judge obviously, the courts get involved, then
obviously we have the ability to enforce that.
REP. SCOTT: Mr. Schrunk,
we haven't gone into as much as I guess we need to, the right of people not to
be forced into things they don't want to do. I mean, you can't make somebody get
services if they don't want services.
MR. SCHRUNK: Yes, sir. That is
correct.
REP. SCOTT: And I understand if you don't have a conviction,
you don't have any authority to order them to do anything.
MR. SCHRUNK:
That is absolutely correct.
REP. SCOTT: And if you've vindicated, and
you get the guilty plea negotiation, and somebody mentioned if you get guilty
plea negotiations for the cases coming through, and they get the routine
sentence that everybody else gets for similar types of crimes which involve a
fine or time in jail, and when they get it, they get it and that's what they
get, you don't have authority to add on to that some more unless they want to
accept it as part of the plea or you go to court and let the court try the case
and impose that kind of sentence?
MR. SCHRUNK: We do have that authority
on a negotiated plea where we have the information. That's one of the breakdowns
of the system. The mental health and the justice systems don't
always communicate properly and exchange information. There are valid reasons
for it.
REP. SCOTT: That means all you've got is a charge and you don't
know anything else. They accept a 30 day and you run it through. Then, you find
out that there's some mental health problems.
MR.
SCHRUNK: That is correct. If we --
REP. GEKAS: Would the gentleman
yield?
REP. SCOTT: I yield.
REP. GEKAS: But, doesn't in those
kind of cases after someone is found guilty in a jury trial, shall we say, that
the judge before imposing sentence puts the case in the hands of a probation
officer to report back as to whether there exists any mental
illness, or other family problems, or chronic medication problems or those kinds
of things, so that the sentence will take that into consideration?
MR.
SCHRUNK: Yes, sir.
REP. GEKAS: Is that done on a routine basis?
MR. SCHRUNK: Yes, sir. That is if the charge is serious enough.
REP. GEKAS: That's where we go --
MR. SCHRUNK: And where we're
dealing with literally of thousands and hundreds of thousands a year that cycle
through, cycle through, there simply isn't time, and perhaps another person at
this table would be the probation department for further hearings and some of
the difficulties they have. But, yes.
And Mr. Scott, you are absolutely
correct. Once a conviction is obtained, within certain parameters, a magistrate,
a sentencing judge, can impose conditions and can require mental
health treatment.
REP. SCOTT: As a condition of probation? If
you give 30 days plus a probation condition then you can level on the
conditions?
MR. SCHRUNK: You can condition and we try and leverage the
clout of the plea. And again, I defer to my colleague, my judicial colleague
here, Judge Cayce at the table, to talk about that. But, it is not always as
easy as it sounds to mandate medication. And frequently, you'll find people that
are acting out committing criminal acts with a pocket full of spills. That's
been the extent and the constant. And here's a 30 day supply and it's a sad
situation. We need a collaborative effort.
REP. SCOTT: Can I ask Judge
Cayce just to follow up?
REP. GEKAS: The gentleman is granted another
minute because of the chair's interference. (Laughter.
)
REP.
SCOTT: Thank you. And could you add to that your authority to order
mental health treatment? If the defendant doesn't have any
money, can you order the Department of whatever to provide the services?
DR. CAYCE: We can in King County District Court through the
Mental Health Court because the county has said we're going to
fund treatment for every defendant who comes through that court if they're
clinically eligible. We don't care about financial eligibility. If the state and
federal government aren't going to pay for it, then we are. So, yes, we can
because there's a pot of money available. No, if they don't have the ability to
pay for treatment, we can't order that they get it and then punish them for not
getting it when it was in fact the lack of ability to pay was the reason that
they didn't get the treatment.
The cases that you identified, the
quality of life cases, are the ones that are difficult because it's not a crime
to be mentally ill and it shouldn't be a crime. And, if the incident for which
they're before the court warrants a day in jail and the case should be closed,
then we shouldn't impose a day in jail and then all these other conditions on
top of it. We should be providing them opportunities for treatment, but we
shouldn't punish them because of the mental illness that'
presented.
And that's why it's the criminal justice response to this
problem, but it alone is not enough. Other people have to step forward and
provide assistance as well.
REP. SCOTT: Just for clarification, do you
run a Drug Court in your county?
DR. CAYCE: We have a Drug Court at the
felony level.
REP. SCOTT: And do you have a Mental
Health Court?
DR. CAYCE: Yes, at the misdemeanor level.
REP. SCOTT: At the misdemeanor level.
DR. CAYCE: It's a separate
court.
REP. SCOTT: Now, do you have a evaluation that can show that the
Mental Health Court actually reduces crime and recidivism? Has
your program been evaluated?
DR. CAYCE: It's in the process of an
evaluation. The initial evaluation is going to be out within a matter of days.
In fact, the executive summary is attached to the material that I provided. And
yes, it does show that the people who have come through the court are receiving
more treatment are receiving fewer arrests and fewer criminal convictions. There
is going to be a longer term outcomes evaluation. It's a two to three year
process and we hope as well as this the results are positive.
REP.
SCOTT: Thank you, Mr. Chairman.
REP. GEKAS: I thank the gentleman. The
lady from Texas is recognized for a period of five minutes.
REP.
JACKSON-LEE: I thank you very much. I hear a resounding and singular theme,
which is collaboration, integrated systems, larger picture and I thank you for
your honesty and straightforwardness. We happen to be in the Crime Subcommittee
of the House Judiciary Committee. But, we use a terminology here, and Senator
you may be aware of it, omnibus. It may be that we need an omnibus approach. I
know there are several legislative initiatives that seem to approach that, but
let me pose my dilemma.
Mr. Schrunk, if I could just briefly get from
you, I was waiting for you to finish the 16 different committals person's end
story who died. Could you just briefly tell me what happened with that
individual?
MR. SCHRUNK: Originally, he was arrested 41 different times,
convicted of quality of life crimes, trespassing, public indecency, urinating in
a park, you know, the things --
REP. JACKSON-LEE: Misdemeanors?
MR. SCHRUNK: Misdemeanors. Nothing that, as Judge Cayce said, you get a
day in jail, or two days in jail. At no time did we have the resource or
availability to put him in with any leverage in the mental
health system. He ultimately was arrested the last time and died in
jail an old mentally ill individual. A sad, you know, commentary on this human
being's life. There are others like that. Officers on the street will tell you
of the continually arrest recycle rate.
REP. JACKSON-LEE: So, we're
missing the continuum of care. Let me then pose this question then and my
dilemma. And, I do want to thank the National Alliance for the Mentally Ill, of
which you are a board member locally or nationally, but I do want to thank you.
And, the National Mental Health Association, along with many
other advocates that have sometimes been in the desert advocating on these
issues. But, here's my dilemma.
I practiced law in the area of
mental illness committal and would have to visit my clients in
the settings that they would be in. Some of them would be in community
health centers and they were in various states of consciousness
and reality. To Dr. Slate, I would fight the ultimate fight to have you
released. There is a question that weaves throughout this of the due process
question and the inability to, or the lack of the approach, to involuntarily
commit. And you were in a situation where you were almost a hostage.
On
the other hand, I think that Kendra's case warrants my fight for that person to
be committed against his will. As I understand it, something about insurance,
how outrageous, he walked away, nobody did anything about it and a tragedy
occurred. How do we answer that dilemma? I like the New York law that says that
if you don't follow treatment, I think Mr. District Attorney, you were talking
that, then you're involuntarily committed. We've had these circumstances where
the client says I'm not going to stay and we're in a dilemma and it's
frustrating and it's difficult and the families are threatened.
And so,
go at it gentlemen who are on this panel, to answer that and then I'd like Dr.
Wilkinson just to tell me, do you really want these people? My concern was we
deinstitutionalize. We feed it to the snake pit. We didn't do anything about
fixing the snake pit and we put them in jail. I don't know Dr. Wilkinson, but
I'd appreciate your leadership. Do you want them?
So, my first question,
maybe Dr. Slate will take me on on the due process question, and still find room
in his heart that there should be involuntary commitment for people who refuse
their treatment because I'm trying to save lives and I'm also trying to build up
lives of the individuals who needed treatment. And, I guess then it falls on us.
We need to provide the dollars for that kind of treatment. Dr. Slate, thank you.
DR. SLATE: Ms. Lee, I will definitely not take you on, that's for sure.
REP. JACKSON-LEE: Please feel free. (Laughter.)
DR. SLATE: I
will say that, as I'm sure all of the members of the subcommittee are aware,
there's a crucial balance here between individual liberties and treatment and
also the protection of society. And I guess that's why you all are sitting over
there and you have to make these hard decisions and we're sitting over here.
But, I can say this, that while there are various mechanisms in place,
and I am familiar with Kendra's Law, if you will, in New York. There are some
other means as well to address it such as the concept of myself right here. I
know I'm mentally ill. There's no question about it. I could essentially
establish a guardianship where I put in a legal document my mother, my wife, my
doctor, whoever I want to name, and essentially say these people are close to
me. If they start seeing that I am having a problem, then they can get me into
treatment even if I say I don't want to be in the treatment.
And the
reason being is when you do have the manic depression as I do, when you are
mentally ill, again that area of the brain is affected, you don't realize that
you are acting abnormal often times. I certainly didn't until later on in
retrospective.
Another thing that could be done, which is less perhaps
forceful than what some people call forced treatment, is something called
advanced directives where it's almost like a do not resuscitate clause and you
can essentially say yes, I start to act in an abnormal fashion, then I give
somebody else the right to get me into treatment. And, I don't know how you do
that. I don't know how it works. I don't know what states have it. But, you
might wear a band, or a bracelet, or something that would signify that if we
train people to look for that sort of thing. But, what that does is it at least
would give me, the mentally ill individual, some choice, some choice in the
matter.
However, I certainly am aware of going the extra mile here in
saying there may come a time when individuals should not have a choice because
they don't know, you know, what is proper under the circumstances. But, I just
want to leave it at that and I just offer those two suggestions.
REP.
JACKSON-LEE: I'd appreciate Mr. Schrunk and Dr. Wilkinson be allowed to briefly
respond, Mr. Chairman. I thank you for your indulgence.
MR. SCHRUNK: Let
me briefly tell you from a prosecutor's standpoint, I believe that if we work
together in a collaborative fashion, we can provide mental
health services without depreciating individual rights. And, I think
this is one of the areas that we got to work on. And so often, we have been
driven to opposite sides of the room and we have not been able to get together.
Judge Cayce uses the word voluntary treatment in his Mental
Health Court. You get an alternative. You can go mainstream in the
criminal justice system or you can take the Mental Health Court
route. That's one way. You've seen that successful in the Drug Court realm. So,
I think that is a dilemma and I think it is doable, preserving patient's rights.
Patient information confidentiality is another area that we need to really pull
up our socks and do hard work on.
REP. JACKSON-LEE: Dr. Wilkinson.
DR. WILKINSON: Congresswoman Jackson-Lee, not only do I not want the
inmates who are mentally ill, I don't want the 46,000 other inmates in our
system neither. (Laughter.)
REP. JACKSON-LEE: We'll call you for another
hearing. (Laughter.)
DR. WILKINSON: But, I'm not naove enough to know
that we have to have the more predatory prisoners locked up and many of them
need to be there for longer periods of time than what they are today, if not for
the rest of their lives considering some of the crimes that they have committed.
And on the other hand, and Chairman Gekas has mentioned earlier, of what
about those ones who have committed lesser crimes? Well, there are a number of
options available, including at the court level, the treatment in lieu of
conviction. And if that treatment plan has not been followed, then that person
can be convicted of that crime and punished. I believe that person who are
mentally ill who have committed crimes should be punished.
But, in some
cases, the punishment for those crimes should be held in advance until the
proper treatment has been sought because this is a public safety issue for me
running a prison to have persons who are untreated running around with the rest
of the general population.
We release in Ohio 53 percent of our entire
admissions in less than a year's period. These are the people we have to focus
on. These are the people who really need help and these are the people who are
not getting help because of truth in sentencing because in many cases they are
not obligated to be on parole. They are not obligated to be on probation. They
are not obligated to go to a halfway house. But, instead they need the help of
community mental health agencies and there is much more to this
story, but I will end it here.
REP. SCOTT: Mr. Chairman, could I indulge
your for about 30 more seconds?
REP. GEKAS: Without objection, the
gentleman may proceed.
REP. SCOTT: Are you suggesting that the --
REP. JACKSON-LEE: Thank you.
REP. SCOTT: -- abolition of parole
has resulted in an inability to deal with a lot of these problems? So, that if
there was eligibility for parole, and you had that period of transition, and you
had the fact that the person had to qualify and convince the parole board
they're ready to go that that would be a better system than this half truth
incentive thing?
DR. WILKINSON: Well, I think the whole system of
indeterminate sentencing has not worked. You can have truth in sentencing and
still have a period of post release supervision that will allow at least a
transitional period of follow up for persons who have mental
illness or mental retardation or other kinds of disabilities.
So, no, I am not advocating that we return, in many cases, to the
traditional parole system, even though it still exists, but I have a problem
with having no responsibility for follow up with persons at all once they're
released from the custody of our correctional facility.
REP. GEKAS: The
time of the gentleman has expired. Everybody's time has expired. (Laughter.) My
heart has expired. I thank the members of this panel and I thank everyone who
was involved in whatever way in this most informative hearing. We hope that it
will breed results and more of the cooperation which everyone seems to desire.
Thank you very much. This committee stand adjourned.
END
LOAD-DATE: September 26, 2000
