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Local officials troubled that mentally ill may be getting help when it's too late

Moscow-Pullman Daily News (ID) - 5/3/2014

May 03--The number of mentally ill residents entering the criminal justice system appears to reflect national trends, and that's troubling to Whitman and Latah County officials.

A study from the Treatment Advocacy Center published in early April shows the number of people with serious mental illness in prisons and jails is 10 times the number in state psychiatric hospitals. In 44 of the 50 states and the District of Columbia, prisons or jails house more individuals with serious mental illness than the largest remaining state psychiatric hospital, leading the center to label jails and prisons as America's "new asylums."

Latah County Prosecutor Bill Thompson said the county is seeing "more and more" people enter into the criminal justice system because of their mental illness, and if the illness had been properly treated, their crimes "would have never happened," he said.

Whitman County Sheriff Brett Myers also said it is a problem that has escalated over the last decade. The frequency of crimes committed by mentally ill and the number incarcerated in Whitman County has probably doubled in that time, he said.

The study said the problem is tied to continuing closures of state psychiatric hospitals and failure of mental health officials "to provide appropriate aftercare for the released patients." What's more, as the mentally ill stay incarcerated, their illness deteriorates and they leave in worse condition than when they entered, the study says.

David Makin, Washington State University professor and research fellow with Washington State Institute for Criminal Justice, said since the 1970s, there has been a 700 percent increase in the total incarcerated population in the United States.

Since then, there has also been a nationwide drop in funding for state psychiatric hospitals.

He believes these trends stem from a fear that spread through society following the social unrest of the 1960s. He said people became more afraid of crime, drugs and disorder and wanted immediate solutions.

"Dark period" reaction

Makin said it didn't help that the 1950s and '60s were considered a "dark period" in psychiatry following reported cases of psychiatric hospitals housing patients in deplorable conditions.

So, rather than providing social services to deal with alleged criminals who may have mental issues, we "defaulted" to using the criminal justice system to deal with them while ratcheting up penalties, he said.

It's a solution that's ineffective because it doesn't address the root of the crime -- the individual's mental health. Yet, it seems to make sense on the surface.

"Even though we know it doesn't work, it's rational," he said.

What's left is a growing number of mentally ill entering the criminal justice system and a lack of state-funded hospitals.

The Treatment Advocacy Center found the only two state psychiatric hospitals in Idaho together hold 145 patients. Meanwhile the Ada County Jail in Boise and the state prison in Kuna with nearly 2,500 inmates "probably both hold more individuals with serious mental illnesses than the two hospitals combined," the study says.

Thompson expressed concern over what he said is the state's inability to provide more funding for treating mental illness.

"It's really sad that the state has not been able to provide the resources that we need as a community and the people that are suffering from mental illness need individually," he said.

He said resources available on the Palouse are effective, but there is simply not enough of them.

"I will say that the lack of community-based mental health services is at a crisis and has been for at least the past decade," he said.

"It's not the fault of the person who is mentally ill, but it is much more regularly the lack of resources in the community to provide the counseling, to provide the medical management for people who need to take certain medications to be heathy and to be stable."

One local resource

One resource that is available in Latah County is the Latah Alliance on Mental Health, an affiliate of the National Alliance on Mental Illness that educates and creates support groups for people affected by mental illnesses.

President Jane Pritchett said psychiatric personnel who are available to help the mentally ill tend to work in metropolitan areas.

"We are in an area that is very underserved by psychiatrists," she said.

In Washington, the two largest hospitals hold a combined 1,300 patients. The study quoted a psychiatrist who estimated that "between 20 and 30 percent of Washington's 16,700 (prison) inmates are mentally ill."

Like Thompson, Myers complimented the community resources available -- like Palouse River Counseling -- but the county could always use more.

Of course, it isn't just that more resources are needed. People have to actively seek out those resources to get help, he said.

"People with mental illness aren't necessarily seeking treatment or looking for the treatment they need," Myers said.

One reason is logistical. In large rural areas like Whitman County, people may have to travel long distances to get treatment and they may lack transportation or the physical ability to do so.

"It just seems like it's a big hurdle to get over," he said.

There also seems to be a stigma attached to mental health that may stop people from being open about their illness. Makin said it's almost become a taboo topic that people don't want to discuss in a supportive manner.

"We don't want to talk about mental health issues," Makin said.

Makin said he would rather see society cultivate a culture where people have greater access to help and to raise awareness about it. After all, there seems to be financial benefits to getting people treated, Makin said studies show the cost of intervention is cheaper -- pennies on the dollar, in fact -- than the cost of someone being incarcerated.

Forced to get help

For now, it seems most people don't get help until law enforcement gets involved. Myers and Pritchett said one major reason those with mental health issues get in trouble with the law is through substance abuse and drugs, often because they are self-medicating to deal with their illness.

Myers said early intervention is key to resolving these issues, but people can't be forced to get treatment.

"Unfortunately, the solution to get a lot of people in the door is to get them in the criminal justice system," he said.

There have been improvements. Beginning in 2012, Latah County began offering mental health court, a program that seeks to provide a judicial alternative to offenders whose crimes are caused by mental illness.

Moscow police officer Paul Kwiatkowski said there are currently 10 people in the court. Once a week they meet with District Court Judge John Stegner and have meetings throughout the week. These are people who are undergoing treatment, and they meet to discuss their treatment and how they're responding to it.

Thompson said they also help them earn their GED, or find employment. He said the court has been successful in that those who enter it usually stay out of trouble and are getting their treatment.

"I'm seeing some really phenomenal results," he said.

Anthony Kuipers can be reached at (208) 883-4630, or by email to akuipers@dnews.com.

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