More prosecutors, police and local leaders need to choose compassionate treatment over punishment. A new national toolkit offers a road map for how we find our way there.
By Sarah George, Miriam Krinsky and Brendan Cox
When Porter Burks began experiencing a mental health crisis on Oct. 2, his family called 911 hoping to receive help for the 20-year-old who had been diagnosed with schizophrenia. Instead, five Detroit police officers arrived at the home, where they fired 38 rounds at Burks, killing him and leaving his family forever shattered.
The horror that haunts this family is sadly not uncommon in America. Far too often people calling for emergency aid when experiencing or witnessing a mental health crisis are met with armed police who arrest, injure or kill those who simply need help.
People living with mental illness and their loved ones deserve more. We need law enforcement, prosecutors, health experts and community leaders to come together to chart a new way forward in responding to mental health crises. And a recently released national toolkit offers a road map for how we find our way there.
4 in 10 incarcerated people have a history of mental illness
About 20% of adults in the United States are reported to be experiencing mental illness, a quarter of whom live with a severe mental illness.
Despite research indicating that the vast majority of these individuals pose no threat to their communities, they are grossly overrepresented at every stage of the criminal legal system – about 40% of people incarcerated have a history of mental illness.
This disparity is perhaps most notable in fatal encounters with law enforcement. Police are too often the autopilot response to a mental health crisis, and they frequently escalate the situation. People with untreated serious mental illness are 16 times more likely to be killed when approached by law enforcement and estimated to be involved in at least one in four of such fatal encounters.
This year, police have killed nearly 100 people during mental health or welfare checks.
Rising number of suicides in prisons and jails
The outcomes can also be devastating when people with mental illness are arrested and put behind bars, not only separating them from support systems but also placing them in destabilizing environments. More than 60% of individuals with a history of mental illness do not receive treatment while in prison.
These factors compound the challenges individuals face when they reenter their communities.
We also see hundreds of people every year tragically end their own lives while incarcerated. According to federal data, from 2001 to 2019, the number of suicides increased 85% in state prisons, 61% in federal prisons and 13% in local jails.
Existing systems to prevent self-harm are woefully insufficient. In October, a 28-year-old man at Rikers committed suicide while in a mental health observation unit. In Houston, a man hung himself in his cell last month, and earlier this year a man killed himself by ramming his head repeatedly against his cell walls after a prior suicide attempt.
Incidents such as these have led courts in Arizona and Louisiana to conclude that inadequate care and horrific conditions violate constitutional rights.
COVID-19 isolation and loss
These issues could not be more timely. The prevalence of mental health conditions has worsened through the isolation and loss of the past three years. Our leaders need to invest in new strategies grounded in public health – not punishment – that will provide treatment and support rather than compound trauma.
A critical step in addressing the needs of people with mental illness is to remove law enforcement from the front lines of crisis response. Interventions like mental health crisis hotlines (like the new national 988 number) and mobile crisis teams allow individuals to receive immediate support from trained, trauma-informed personnel.
Comprehensive nonpolice responder models, such as CAHOOTS in Eugene, Oregon, and Denver’s STAR program are equipped to respond in lieu of police to a variety of crisis situations, significantly reducing violent law enforcement encounters.
In 2019, CAHOOTS responded to about 24,000 calls and required police backup in only 311 cases, a mere 1.3% of calls. These approaches not only benefit individuals but also free up law enforcement capacity so that officers can focus on serious crime.
Police and prosecutors must also collaborate to find ways to keep people with mental illness out of the criminal legal system altogether. We should divert cases and connect individuals to treatment rather than resort to arrest.
When an individual is arrested, prosecutors should screen for mental illness and identify whether an individual would be best served by deflection from the system, or diversion and alternative to incarceration programs.
And if people experiencing mental illness are incarcerated, they must be provided with competent care while inside and be connected to community services upon reentry.
The good news is that we know what strategies work – and we’re seeing more and more communities nationwide choose these proactive approaches that emphasize compassionate treatment over punishment, resulting in improved outcomes for both the individual and their community. But we need more prosecutors, law enforcement and local leaders to recognize that responding to mental illness with violence and incarceration only compounds harm.
When someone is in crisis and needs help, we have a choice: We can continue to try to incarcerate our way out of our country’s mental health challenges or we can respond with humanity and care, saving lives and creating healthier, safer communities.
Originally published in the USA Today.
Sarah George is state’s attorney for Chittenden County, Vermont. Miriam Aroni Krinsky is executive director of Fair and Just Prosecution, a former federal prosecutor and author of “Change from Within: Reimagining the 21st-Century Prosecutor.” Brendan Cox is a retired police chief of Albany, New York.