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Original article URL: http://bridgemi.com/2011/12/get-the-mentally-ill-out-of-prisons-jails/

Phil's column

Phil Power is founder and chairman
of the Center for Michigan.

Get the mentally ill out of prisons, jails

Michigan taxpayers could save millions of dollars every year, not suffer any hardship and do humanity a service. How?

Simply by shifting treatment of the mentally ill from state prisons and local jails to a system of outpatient treatment and mental health courts.

This shift also would reverse a past mistake of epic proportions.

Over the past decade, the ugly truth is that the treatment of thousands of mentally dysfunctional people in Michigan has moved from state mental hospitals to prisons and jails. We may not have intended this, but that’s what happened.

In an interview last week, Wayne County Chief Probate Judge Milton Mack, who has studied these matters deeply for years, noted: “In Michigan, jail or prison has become the primary inpatient center for the mentally ill.”

How did this happen?  To save money, from 1987 to 2000, the state closed most of its mental hospitals, putting thousands of patients out on the streets in communities ill-prepared, at best, for the challenge. Without supervision, these patients, in many cases, stopped taking their medicines. As a result, many became confused and sometimes anti-social. Often, they wound up committing criminal offenses, which swelled both county jail and state prison populations.

The bid to save money by closing mental hospitals long has been exposed as short-sighted. It costs a lot to use prisons or local jails to do a job for which they are vastly unsuited: serve as treatment centers for the mentally ill.

The numbers tell the tale: There are now 43,000 prisoners in state prisons, housed at an average cost to the taxpayer of $34,000 per inmate per year, according to the Michigan Department of Corrections. Of those inmates, at least one-fifth — or at least 8,500 — are severely mentally ill, according to Judge Mack.

Mack also thinks as many as half of the rest may suffer from lesser mental disability or substance abuse.

Something has to be done — and there is a possible solution.

Lynda Zeller, the deputy director for behavioral health and developmental disabilities in the Michigan Department of Community Health, notes that the Legislature, in 2009, appropriated $1.75 million for pilot programs for nine local mental health courts. These programs require offenders ruled mentally ill to take treatment, including psychotropic medicines. These programs cost an average of less than $5,000 per patient per year.

If all the most mentally ill state prisoners were transferred to local mental health courts — admittedly an unrealistic goal — the annual savings would be just under $3 million a year. These numbers do not include inmates in local jails, half of whom are mentally ill, according to a 1999 Wayne State University study.

Together with the Michigan Mental Health Association, Judge Mack is working on a rewrite of a portion of the mental health code. The idea is to convert the old in-patient model (state hospitals) t an out-patient model (community-based treatment). The proposal would authorize involuntary treatment of those adjudged mentally ill, including being required by a judge to take proper medication.

“If we fix the mental health system in Michigan, we reduce the numbers of mentally ill in prisons and jails, we save lots of money –d we improve treatment for people who need it,” Mack said.

He isn’t the only official interested in this. In his special message on health this fall, Gov. Rick Snyder concluded, “A disproportionate share of persons with behavioral issues ultimately end up behind bars.” He called on everyone to come together to work out ways to reduce “the number of persons with mental illness, substance use disorders, and disabilities in our prisons and jails.”

MDCH’s Zeller calls this work an “absolute priority.” Last year, a Michigan Supreme Court report evaluated the results of local mental health courts. Nearly all participating counties reported positive mental health outcomes — and increased education and employment.

According to Zeller, the actual per inmate cost was even smaller than anticipated — less than $4,000. “On the evidence so far, the experiment looks very promising,” she said.

That doesn’t mean there aren’t differences in approach that need to be sorted out. Judges and law enforcement professionals, for example, tend to think community mental health folks are too concerned about their clients’ rights. Mental health professionals grumble that focusing on law-and-order risks good outcomes.

Add to that the complication of a two-year-old opinion from then-Attorney General Mike Cox, which indicated that counties have to bear the cost of treating mental illness among jail inmates, casting doubt whether state-funded programs are acceptable.

But if we can make this new approach happen, it will be a win-win-win. Taxpayers win because money is saved. Prison and law enforcement officials win because it’s effective to treat the mentally ill on an outpatient basis. And the mentally ill win, because taking their meds in an environment where treatment includes education and employment services, gives them hope for a reasonably normal life.

All of us should give this idea enthusiastic support.

Editor’s note: Former newspaper publisher and University of Michigan Regent Phil Power is a longtime observer of Michigan politics and economics. He is also the founder and president of The Center for Michigan, a nonprofit, bipartisan centrist think-and-do tank, designed to cure Michigan’s dysfunctional political culture. He is also on the board of the Center’s Business Leaders for Early Education. The opinions expressed here are Power’s own and do not represent the official views of The Center. He welcomes your comments at ppower@thecenterformichigan.net.

 

6 comments from Bridge readers.Add mine!

  1. Carol Rienstra

    How long before some of these good ideas are implemented? While people like Phil are thinking and talking my son and many others lanquish in prison. It just doesn’t make sense. We should learn more from Gerritt Heyns, the grandfather of our present director of the department of corrections. When the now-desceased Director Heyns was considered one of the leading penologists in the country, he said one-third of all people in prisons should be released immediately, one-third released with conditions for treatment, and the other third left behind bars and treated humanely. Carol Rienstra

  2. Joe

    This is something I can agree with Phil on. Did you mention that it was the same Republican Governor Engler that cut taxes and left Michigan with a billion dollar deficit that also closed those mental health facilities? Some cost cutting , eh. Staunch Republicans probably don’t believe in mental illness. It’s all about “bootstraps” but those with both a heart and a mind can crunch the numbers and do what’s right. The problem is the prison system has its own set of lobbyists and benefactors and they won’t go easily into that good night. They’re not into lowering the costs for the taxpayer. Of course, they can just lobby to pass another law infringing on personal freedoms and make up the difference.

  3. Neil

    What happens if the mentally ill are transferred from prisons and jails? Where will the former inmates live and who will pay for it? Most have no assets and none have income.

    $ 34,000 per year maintenance per person in prison is $ 2833 per month. Transferred to a group home, specializing in mental illness, at $ 50 per day is $ 1550 per month plus medicinal and miscellaneous expenses. All patients would have to be on Medicaid. Check on current rates for group homes.

  4. Neil

    An interesting question is why any particular inmate is mentally ill? What was the cause? Did all the mentally ill inherit the disease? Or, was the mental illness caused by something else? Could there be a cure? State doctors, psychiatrists, and psychologists never thought to investigate this. Curing the disease saves a lot of money.

  5. Mary Schoenherr

    We have an epidemic problem facing us, that I fear most are unaware of. Prisons are big business everywhere, including here in Michigan. The business is so big that our government, across all levels, recognizes that “fixing” many of the causes for so many to be incarcerated will lower county and state revenues. The county jails and prisons are over-loaded with alcohol and drug (both street and Dr. Prescribed) offenders, many of which are in their young adult years. Our culture encourages use of altering substances, from advertising media, money hungry Doctors who will write a pain killer prescription to anyone that knows the “back pain spiel” ….we have to have highway signs now that advertise “pain free” doctoring at every exit. Count the number of pharmacy’s on every other corner in any small town across America. We wonder what’s wrong with our youth. They have been raised to value appearance and feel good activities. They are protected by their parents through childhood and even supported in their participation in the use of alcohol and other substances. Then..when they hit adult age and have their first legal age run in with the law……off they go, into the system that will likely not get out of…..why….revenue. I was told by a policeman within the past year, that the police, lawyers and judges don’t want to see things change…..job security. Sit in your local county court room for a day and count the cases that are associated with alcohol and drugs. You will be shocked. OK….back to the issue of what happens inside jail and prison….for these young adults that have made a wrong decision ( and oh by the way, if you over 35, you likely did many of the same things that these folks are spending time in jail for) and are now carrying records that will place them in the unemplyable category, who will pay for them? Where will they live? Who will rent to or employ this population? We have a HUGE systemic problem that needs to be looked at in it’s entirety. I rant..and I apologize, as I have taken this off topic of the mentally Ill and their need for appropriate care and support. We unfortunately live in a throw away society. Mentally Ill, the weak, less than attractive….and oh the elderly, are discarded. I believe that we should take the education in Jails and prisons to the next step and provide, for those that demonsate the behavior, employment. There is so much that our prison population could do…..they could learn to cook to feed the homeless….they could learn to build to house the homeless…. They could care for the animals that are neglected…….ALL of this could be done on a profit basis…..with profits going into a foundation that is then used to support the convict for successful reciticism…….

  6. Shannon

    This artical was great to read. I am glad there is awareness to the need for our system to change. Punishment is not working. In physcology we learn that behavior modification is learned thru positive reinforcement and education. I am a POA and a personal Advocate currently working with a man on his 3rd owi offense. I am hardpressed to find the help he needs in Michigan due to cost and current laws in place. This man has been desperately asking for help for months and has not obtained anything. I have a close working relationship with him and inside the jail he tells of people leaving and returning a week later as they cannot provide the PO with a land line or they cannot find a residence. There is something very wrong with this. I had worked out of state with another facility for my clients transfer. His entire family and friends and suppoet network ly in another State. He has nothing left for him in Michigan no house car job or family. I jumped every single hoop required. I obtained 2 jobs for this man, I had him signed up for his outpatient program and all fees were paid. I spent nearly 250 hours working on this transfer. I was turned down after all of this due to him not having residency in this state. I was also told he was the worst kind of criminal and that he would never be allowed to this state to serve his sentence. I was abosolutely appauled at the responce. Especially given the fact the inmate admitted his mistake and was desperately seeking the help he needed to be accountable and ensure he would not repeat it. How is it that our society has become this? Our jobs are not being done, rights are being stripped and people are running about with thier hands in the air saying its not our job then complain about taxes. It is hypocritical and disturbing. I am currently searching in Michigan to advocate for this man to get inpatient treatment and have it count as time served. As it should! This whole process is about exactly that. Be accountable. I am very glad to see this artical and I too would like to say I am on board with this. Mental Health should be supported 100% in all inmate cases! It is no wonder our jails are crowded and the statistics of repeat offenders at a high. This should be a wake up call to our entire society! Fix the problem and you shall see results!
    Thanks for letting me rant. Where do I sign?

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