Jail is No Place to Treat Women’s Mental Health Issues

by Karen Shain, Criminal Justice Policy Officer

The first thing I noticed when we walked into the cell block was a woman sitting on top of a metal table. She saw us and slowly crawled off the table to sit on a metal stool. That’s as far as she could go, because she was tethered to the table by a chain.

A guard told us it’s a violation to sit on the table, but they don’t sweat the small stuff in the mental health wing. We weren’t in a mental health facility; this was the Century Regional Detention Facility (CRDF), L.A. County’s main women’s jail.

This is where CRDF holds seriously mentally ill women who don’t have the resources to be admitted into private mental health hospitals. The guards explained that the women were always under physical control. They could stay in their single cells (which contained a metal bed and a toilet), be locked into a shower by themselves, could go “outside” (though a roof prevents them from seeing the sky or the sun), or they could sit chained to a table in the “day room.”

As long as a County mental health professional deems them a danger to themselves or others, these women will be held indefinitely.  The only way out is for them to get better, but how can they get better under these circumstances?

Mental illness is not a crime; it is a disease. CRDF does not treat women with this disease. It only pushes them further inward, back into their demons. What I witnessed was torture. Is that the best we can do?

I left the mental health wing of CRDF with an extremely heavy heart. But I also realized that if the Sheriff’s Department showed us this mental health wing – something they can’t be proud of – they must be looking for advocates to help them fund a new jail with improved conditions for women.

But even the goal of “improved” conditions misses the point.  Treatment, not incarceration, is the solution for most women, and effective treatment cannot happen under duress.
Nearly one out of every three women (31 percent) in county jails is there because of mental illness, which is double the percentage for men. As the nation and California dismantled mental health facilities and funding over the decades, our jails and prisons have become the largest mental institutions in the country. Believe it or not, they are also the largest geriatric facilities and homeless shelters.

Building more jails will not help these women or men, nor will it stop cycles of crime that jeopardize our neighborhoods and our personal safety because it is well-known that persons with mental illness who are put in jail have much higher rates of recidivism than those who receive mental health treatment in the community. Managing mentally ill people in our prisons and jails is also far more expensive than providing treatment in the community – treatment which is also much better than what is provided in jail.

This is not only about Los Angeles; it’s a national problem. But Los Angeles has the opportunity to do something better.

The LA Board of Supervisors is at a crossroads. They have several proposals before them to construct both a new women’s and mental health jail. The construction cost? Between $1.4-$1.6 billion, which does notinclude operating expenses, such as the almost $250 per day it costs to house and treat a woman with mental illness in jail. What if we tried something different—and better? Let’s redirect these billion plus dollars and invest instead in comprehensive and humane mental health and substance abuse treatment. As the Affordable Care Act (ACA), our national health reform law, is implemented in coming months, we have an opportunity to expand mental health and substance abuse access and treatment. Under ACA people who are financially eligible will be able to get mental health and substance abuse treatment at very little cost to California, but ONLY if they are not in jail.

California’s residents who bear the double burden of being impoverished and mentally ill should not find that their only option for mental health treatment is available if they fall into the criminal justice system. Treating them in the community would be the real way to improve their lives and those of their families and community, not putting them in a new and costly jail.

via http://womensfoundationofcalifornia.org/2013/10/18/jail-is-no-place-to-treat-womens-mental-health-issues/

Mental health prevention a wise investment

Unlike any other state in the nation, California voters asked for an investment in mental health prevention and early intervention strategies when they passed Proposition 63, the Mental Health Services Act, in 2004. So when the news media fails to present these evidence-based programs as legitimate investments, it demonstrates that this influential industry is out of touch with what Californians want, which is to give our state a chance to save lives.

Critics who dismiss efforts to eliminate the stigma associated with mental health challenges ignore the facts: Intervening at the first sign of symptoms offers the best opportunity to make a significant, positive difference in both immediate and long-term outcomes for people affected by mental health issues.

Yet studies show fewer than 30 percent of people with mental health challenges seek treatment. Fear of being labeled with a mental illness is a significant barrier that prevents people from seeking help.

Far from being just "feel good" programs as some contend, stigma reduction efforts can save lives. In fact, the U.S. surgeon general has identified reducing the stigma associated with mental illness and treatment as a key priority for the nation in addressing the public health crisis of suicide.

Of the individuals who die by suicide, 90 percent have a diagnosable mental health disorder. Too few connect with services that can change the course of their lives. On average, nine Californians die by suicide each day.

Prop. 63 enables California to make a significant difference on a statewide scale to improve awareness of the risks and behaviors associated with suicide and to equip friends and family members to connect loved ones with help. Reaching college students with mental health prevention and early intervention strategies is one part of Prop. 63's multipronged approach.

A multilayered, statewide stigma-reduction program challenges the negative stereotypes and discrimination - too often perpetuated by the news and entertainment media - which prevent people from accessing the mental health services they need.

Having nearly died of suicide as a college student, I know firsthand these proven strategies are worth California's investment.

As required by the law, the vast majority of Prop. 63 dollars are spent on delivering successful, innovative community mental health services to those with severe illness. At the same time, voters recognized prevention and early intervention strategies are so important that the law sets aside 20 percent of funding to prevent more people from reaching mental health crisis.

Any doctor will tell you that preventing heart disease is a better solution than waiting until the first heart attack. The same prescription applies here: Prop. 63's prevention and early intervention efforts meet California voters' demand to improve and save more lives.

Kevin Hines is a national mental health advocate and author of "Memoir: The Art of Living Mentally Well - Most Days - the Kevin Hines story."

Read more: http://www.sfgate.com/opinion/openforum/article/Mental-health-prevention-a-wise-investment-4028399.php#ixzz2C2YurpFd