In 1978, when I started working as a public defender in Municipal Court, I knew nothing about how mental illness affected the behavior of folks who were getting arrested. Misdemeanor cases were coming down the assembly line at the rate of 15 or 20 a day. The goal was to get the client out of jail. It seemed like nobody knew anything about mental health. Or if they did, there was no time to put the knowledge into practice. One judge told a defendant who said his case came about due to “cosmic rays,” to go home and put a lining of tin foil in his hat. This was considered clever. The good part was that this client got to go home.
At the Robina Institute conference on “Criminal Justice and Mental Illness: Creating Alternatives in Minnesota,” in January, 2016, we learned a lot about arrested people with mental illness who DON’T get to go home: they’re in jail. Sheriff Rich Stanek says a third of the people booked in jail in Minneapolis have a mental illness. With 40,000 bookings a year, that’s 13,000 people with mental illness in jail—in one county. Rural sheriffs say their numbers are even higher. I guess when I started lawyering, the percentage was the same—I must have had 5, 6, 7 clients with mental illness every day, but I didn’t know it. Most people working in court had no training in mental health, and there were few resources that could have made a difference for our clients.
Now, thank goodness, people in the justice system know. And they are doing something. That was the purpose of the Robina Institute’s January conference, and although we are still short of resources, there is a lot more information available, and people to contact on the Robina conference page. Meanwhile, to help people like me who needed to catch up, here’s a bird’s-eye view:
The regular case trajectory I knew was like this: a person with mental illness has a crisis that leads to behavior—yelling at strangers on the bus, breaking a window, stealing some small item. The police come. The person is booked into jail, stays a few days, pleads guilty for “credit time served,” and goes home. A successful outcome for all concerned, except that this process is a revolving door. Sheriff Stanek told us about a homeless veteran named “Robert,” who in the last few years has had 31 episodes that fit this old norm, all minor offenses like “disorderly conduct.” Somebody ought to do something so people like “Robert” don’t come back so often. His path through the courts is too hard on him and too hard on the community where he lives.
The model for doing something is to “intercept” the case at a point where a decision is being made, and choose an alternative to the time-honored “Plan A”:
- The 911 dispatcher sends a “crisis intervention team” to the scene, not squad cars. In 6 north central counties, that’s what happens—they send mental health workers from Northern Pines Mental Health Centers. The Director, Glenn Anderson, made a deal with all the law enforcement agencies in the 6 counties: we will show up anywhere, anytime, within half an hour. Now they go out 1100 times year, and most of the people they see get a referral to services, not a ride to jail.
- The officer who first responds de-escalates the situation by applying “Crisis Intervention Training.” Many police and sheriff’s deputies around the state have had a full 40-hour CIT course. In Duluth, law enforcement took the course WITH court staff, probation, social workers, and public defenders, people who are usually “second responders” but often end up as the first professionals to face a situation.
- The jail transfers the person to a mental health service provider. This is happening in St. Paul, where the jail and community mental health crisis center are in two buildings next to each other.
- The prosecutor offers diversion. The Minneapolis City Attorney works with a full-time probation officer who provides services to downtown misdemeanor defendants—including referrals to stable housing. This program has reduced repeat offenses by 70%. It is saving money, too, that was going to jail beds, detox, and emergency room admissions.
- The judges work with the other justice system people to create collaborative “Mental Health Courts.” Duluth, St. Paul, and Minneapolis have all got problem-solving courts devoted to mental health, directing people to resources that will help them with employment, insurance, medications, and housing, so they don’t come back 31 times like “Robert.”
- The county jail or workhouse invests in discharge planning: counties as different as Hennepin and Beltrami have got social workers who see that people with mental illness leave with health insurance, housing referrals, and dental care.
So, the justice system has been creating alternatives. Of course there are not enough resources to follow best practices across the whole state. These good models are often just examples that show what we could do, if we had the will to improve the system statewide.
It would be an improvement if we could capture the money saved in the transition from the old approaches that didn’t work, and put it into development of more humane and sensible approaches that actually reduce repeat offenses. This strategy is called “criminal justice reinvestment,” meaning, “put the money into the good outcomes.” It would be an improvement if every court recognized that it actually is a “mental health court.” It would be an improvement if the “second responders” could all get training to recognize mental illness symptoms, and then respond to crises by doing the right thing.
All these improvements are coming too late for the clients I sat with in smoky little rooms—people used to smoke, remember? Our Juvenile Detention Center used to have a cigarette machine for the kids—trying to figure out how to get them out of jail. But I’m glad we can see, now, how to change things for the better.
Visit the conference webpage to learn more and access resources, here.