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APA Ensures Congress Recognizes `Human Face' of National Tragedy

James H. Scully Jr., M.D., is medical director and CEO of APA.

Each day the Gold Room in the Rayburn House Office Building hosts events designed to educate and inform members of Congress and their staffs. September 27 was no different, but the room was especially full that Wednesday.

For several years now APA and NAMI—the National Alliance on Mental Illness—have joined to sponsor a congressional luncheon to preview Mental Illness Awareness Week (MIAW), which, as you know, is an annual observance to raise awareness of mental disorders and their treatments.

This year's symposium in the historic Gold Room brought needed attention to a dire situation: that our nation's jails and prisons have become the primary mental health care facilities in the United States today (Psychiatric News, October 20).

Psychiatrists and patient advocates know that this is a function these institutions are neither designed nor equipped to handle. Furthermore, we know firsthand that people with mental illness are one of the most vulnerable and treatable populations in our society, yet they are being housed in punitive institutions.

Clearly, a great deal of education is needed to solve the problem of inappropriate incarcerations. APA's Department of Government Relations, led by Nicholas Meyers, is on the job. In addition, APA's Committee on Jails and Prisons, chaired by Henry Weinstein, M.D., provided valuable leadership for MIAW activities, as well as fact sheets and statistics to help illuminate this vital issue. Our Office of Communications and Public Affairs lent key support through news releases, "talking points" on the topic, and other materials.

This year's MIAW theme, "The Criminalization of the Mentally Ill," was covered from different angles. The standingroom-only crowd heard from three noted speakers: Richard Nakamura, Ph.D., deputy director of the National Institute of Mental Health; Wilson Compton, M.D., M.P.E., director of the Division of Epidemiology, Services, and Prevention Research at the National Institute on Drug Abuse; and Tom Hamilton, Ph.D., former president of NAMI-Texas and NAMI's liaison to APA's Committee on Jails and Prisons.

I was also pleased to see a good friend of APA's in attendance: Rep. Grace Napolitano (D-Calif.), who founded and co-chairs the Congressional Mental Health Caucus, which now boasts more than 70 members from both parties.

By the end of the two-hour event, the Capitol Hill audience was clearly impressed that the crisis of incarcerating people with mental illness amounts to a true national tragedy and must be reversed.

They heard data from the new report by the U.S. Department of Justice titled "Mental Health Problems of Prison and Jail Inmates," which stated that more than half of all inmates had a mental health problem. Many of these people suffer from very treatable disorders like major depression, bipolar disorder and substance abuse.

Moreover, attendees at the MIAW lunch came to understand the vicious cycle in which some people with mental illness, if left untreated, develop symptoms and behaviors that can lead to their arrest and incarceration. Most importantly, the members of Congress and their staffers took away the message that appropriate treatment for people with mental illness— and funding for it—is urgently needed.

APA presented a message bound to resonate with members of Congress: the current practice of incarcerating mentally ill people hurts the correctional system, tax-payers, and people who could be helped by being diverted to appropriate care and treatment. Indeed, there are medical, social, and fiscal issues that all need to be addressed to change the unacceptable status quo. It is imperative that members of Congress support increased funding for community-based mental health services and jail-diversion programs.

While this congressional event is an opportunity to preview MIAW, it is an occasion for the mental health community from coast to coast to observe MIAW. led by NAMI, the overarching theme of the week-long focus, this year from October 1 to 7, was "Building Community, Taking Action."

This year we took action by using our MIAW symposium to put a human face on those with mental illnesses who have become ensnared in the criminal-justice system. One day in the very near future, we hope that the criminal-justice system will be a just system. A key way to accomplish this is to divert people with mental illness to a setting in which they can receive appropriate treatment—treatment that we know can work.

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