NYAPRS Note: A NYT article from this weekend highlights what many of us know to be a desperate situation: the proportion and numbers of persons with behavioral health struggles in jails and prisons is astronomical. The difficulty with reporting on the issue can be a problem of binaries; it’s impossible for most people outside of our community to envision a probable solution that does not include increased hospital beds and institutional care. Below, NYAPRS board co-president and Community Access CEO Steve Coe presents a concise, systemic community-based alternative to incarceration. This type of education for reporters, government leaders, and community members diminishes the use of the disparaging duality that often accompanies news and policy regarding mental health treatment.
Dear Mr. Kristof,
Thank you for writing about this subject and the other difficult social issues you have embraced.
It’s truly a national disgrace that we incarcerate thousands of our fellow citizens for no other reason than they need help. Fortunately, this is a challenge we can address by implementing proven, effective models that cost much less than jails, prisons, or other forms of incarceration, such as the “asylums” of yore.
As the director of a community-based mental health program for almost 35 years, I can reliably report that 1) medications alone are never the answer, 2) people respond to care that is compassionate and sensitive to the complex issues each person presents, 3) training former patients to deliver this care will revolutionize “treatment“ as we know it, 4) short-term, community-based, alternatives to hospitals reduces trauma and results in longer-term engagement with treating professionals, 5) training police to respond to “emotionally disturbed persons” (called Crisis Intervention Teams) and creating special crisis centers can divert these individuals from the criminal justice center in the first place, 6) for people already arrested, special mental health courts are effective in steering people into treatment and support programs, and 7) forced treatment of any type never works.
All of the solutions mentioned above are working around the country, unfortunately, not usually all in the same place. New York State is in the middle of a Medicaid reform process that we hope will result in a system-wide transformation that will incorporate all these, and many more, innovative programs to help bestow full citizenship on a group that has been poorly served for decades.
A final thought, per Sheriff Dart’s quote above: America incarcerates a larger percentage of its citizens than any other country in the world, so it’s not a surprise that we lock up a lot of people with mental illness. Asylums used to be our de facto solution for many social ills; now we use prisons. Going backwards 150 years is not the answer when we have many truly humane and effective options in front of us.