Psychiatr News August 17, 2007
Volume 42, Number 16, page 5
© 2007 American Psychiatric Association
Michigan Bill Would Establish MH Courts
David Milne
A television show documenting the case of a young prison inmate's being
punished for behavior stemming from his mental illness prompts legislation to
reduce the chances that such events can occur again.
Viewers across the nation were likely outraged when they watched the
excruciating last moments of Timothy Souders caught on tape and broadcast by
CBS's "60 Minutes" on February 11 (and rebroadcast July 29). The
21-year-old with bipolar disorder died from dehydration and hyperthermia in
August 2006 after being chained down face first for 17 hours on a concrete bed
in the Southern Michigan Correctional Center, where he had been sent after
being caught shoplifting two paintball guns.
In a review of Souders's death, U.S. District Judge Richard Enslen
attributed Souders's aberrant behavior to his untreated mental illness and
ordered changes in how guards treat inmates with mental illness. Advocates
claim that Souders's mental illness was mistaken as willfully defiant behavior
and landed him in an isolation cell.
Souders's death raised questions nationwide over why some patients with
mental illness are sent to prison. It also prompted renewed efforts at
legislation in the Michigan Senate that could help prevent similar
tragedies.
Two bills (SB 199 and SB 200) introduced by Sen. Liz Brater (D-Ann Arbor),
would establish mental health courts modeled after Michigan's successful drug
courts. Michigan's 76 drug courts give nonviolent drug offenders the chance to
enroll in rehabilitation programs without being sent to jail.
Brater's bills would authorize a judge to order treatment instead of jail
or prison terms for offenders with mental illness accused of minor crimes. In
introducing her bills, she said that too many people are ending up in the
criminal justice system inappropriately, an issue that APA has been
publicizing and working on for several years. The bills would give judges the
option of ordering a person into treatment and staying criminal charges up to
one year while the treatment is under way. The judge would conduct a hearing
on whether to divert the defendant to treatment, weighing factors such as the
nature and seriousness of the alleged crime, the person's prior criminal
record, and the likelihood of benefiting from mental health services.
Jail-diversion programs have proved successful throughout the country in
reducing arrests and improving treatment of underlying illness. As of last
year, there were about 120 diversion programs in 40 states.
Brater told Psychiatric News that the first step in intervention
is to ensure that the community mental health system is working properly and
has sufficient resources so that people brought into the system get adequate
care. She proposed that the state shift money from the Department of
Corrections' $1.8 billion budget to the Department of Community Health to pay
for increased community mental health services.
Typically people with mental illness who end up in the criminal justice
system have stopped taking their medications, are not getting any treatment,
or are being turned away from mental health care, Brater said. But
"prisons are not prepared to treat them, and incarceration is
expensive."
The costs of incarceration, treatment, and health for prisoners with mental
illness in Michigan can run as much as $50,000 a year per inmate. In contrast,
community mental health care costs come to roughly $10,000 a year, and some is
picked up by private insurance or Medicaid.
According to Michigan Department of Corrections figures, more than 4,000 of
51,000 state inmates are getting mental health services. More than 700 have a
documented history of mental illness and confinement in a state psychiatric
hospital.
Brater said that providing a supportive living system so these individuals
can succeed in the community would go a long way to helping people with mental
illness avoid incarceration. Police can play a key role by developing a
working relationship with members of the community mental health team, she
said. When trained to recognize the symptoms of mental illness, they can help
calm the person down and get that individual in contact with someone from the
mental health system instead of arresting him or her.
Judith Hutchins, president of the National Alliance on Mental
Illness–Michigan, said the state should go further and establish police
crisis intervention teams (CITs), because local police are often the first
responders when a person is in psychiatric crisis. Writing in the Lansing
State Journal, Hutchins noted that Akron, Chicago, Minneapolis, and other
communities nationwide have CIT programs. She believes Michigan communities
deserve the same.
"If nothing else, prison corrections officers also clearly need
better training about how to recognize and respond to people with mental
illnesses," she said.
"I think the Brater bills face a challenging path, but we will
continue to support and work for them," Mark Reinstein, Ph.D., president
and CEO of the Mental Health Association in Michigan, told Psychiatric
News. He believes that a bill sponsored by the chair of the House
Subcommittee on Corrections, Rep. Alma Wheeler Smith, allotting $1.9 million
toward establishment of four mental health courts as a pilot project might
have better chance of passing.
"The idea of treating people with mental disorders instead of
punishing them makes good sense," Michelle Riba, M.D., a past president
of APA and a clinical professor in the Department of Psychiatry at the
University of Michigan, told Psychiatric News.
"In general it's a good idea to be thinking about care and treatment
of people with mental illness rather than just punishment, because clearly
prisons are becoming major mental health hospitals throughout the country as
well as in Michigan, and so we are supportive of the idea of treating people
instead of criminalizing them," she said. Riba applauded Brater for
introducing the bills, calling her "a very forward-looking
person."
Brater's bills can be accessed at
<www.legislature.mi.gov>
by searching on the bill numbers, 199 and 200. 
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