treatment vs incarceration

How can we change the system? Is it right to send sick people to jail? Who do we turn to for help?

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Well, for me, in Charlotte, NC (Mecklenburg County) I can't say that my experience was a bad one 2 1/2 years ago when I spent 33 hours incarcerated in jail rather than be sent to a mental hospital (which I've never been over-night or inpatient in the entire 14 years of my diagnosis). But perhaps the order in which people were called in to the situation and the fact that I knew some of them made a difference. On my worst ever manic episode on Mother's Day 2008 after my wife called a close friend, and then another pastoral friend, who called a police officer who attended the church, then the officer who transported me was was the middle of the morning 1am or 2am...and my wife needed me out of the house...I guess no body thought to send me to a mental institution (even though we have one here)...but I was treated okay (except when I broke one rule in the cell and crossed a painted line on the floor which I didn't realize I wasn't supposed to go near - - - hadn't read the manual given me of what to do and not do in jail)...but minus that one occurrance, was treated with clean jump suit...but didn't have enough cells, so had to sleep on the floor (on a mat) but I wasn't planning on spending much time there and was released Monday sometime. I'm not sure the hospital would have been any better or worse for me, probably better, but I also think I would have stayed there longer...but maybe that would have been a good thing, because I certainly couldn't work when I came on different meds...but still took a month or two to get to where I could look for work. Bipolar is a journey and it takes you where it takes you...incarcerated...mental institution...or on your way or another you are riding this roller coaster.

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There are now many agencies that specialize in obtaining conditional release for adults suffering wtih mental illness. It gives them the supervision they need (with out being in jail or an institution) while allowing them to be in the community. More often than not people who suffer form mental illness commit crimes when there non compliant with their medications. Often having an agency come in and monitor medications does wonders for such people.

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I wasn't being "non compliant" with my medication when I went to jail over night.

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Where do find such an agency to moniter meds.? I tried to that myself with 30 yr old, but it didn't work out too well. Thanks for any info.

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I was not implying that you weren't compliant, however statics show that most who end up in jail is because they are not.

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You could start by checking with the court house or probation offices to see if they do referrals to such agencies that promote conditional release. Typically a probation agent refers clients to such agencies. Also a great place to start is the United Way or Health and Human Services.

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Dear Jhitchman...& all participating in this discussion,
I have Dissociative Identity Disorder, am now 61/f, living in Johnston County, NC, and in 2004 I became a "felon". [If you want some perspective on what I'm about to write you can Google: Pam Arizona & look for Raleigh News & Observer articles (11/2/04 & 9/15/05) that covered my crime - committed during an abreactive episode.]

I am, in lay terms, a multiple. Unlike some who prefer to say they "have" this or that MH disorder - for me it's best to own my multiplicity & say, I am a multiple. I live in a rural county that doesn't have a MH court (unlike Orange County just 45 minutes away). I committed my crime at one our county's largest employers' production facilities. It was bad enough that I took a (non-functional/unloaded) shotgun into their main office & convinced the two private security women to take me serious when I asked for an employee to be brought from the production floor, under threat. It was worse because this employer had to stop production for several hours & evacuate the plant of 600 employees. But worse than that was the media coverage of the "kidnapping in progress" which spread their embarrassment nationwide.

All I'm attempting to point out is that the high profile nature made it extremely difficult for the local Court to deal w/my crime as having occurred during a well documented, mental illness episode. (Pete Earley, author & father of a son w/bipolar found out what I learned first hand - that our jails & prisons are fast becoming our nation's largest warehouse system for individuals with mental illnesses. His book, "Crazy", details the length & breadth of his investigation into the situation he uncovered as a dad & a well respected investigative reporter.)

So the Court had to consider politics while they did their best for me, the Offender. I could have received 30 years active prison time for 3 counts of kidnapping & one count of a bomb threat. In an effort to do their best for all concerned, The Court paid for an independent investigator to do a 30 year MH history on me - which was in addition to the State psychiatric evaluation. It also provided my Public Defender attorney the added help of a co-council. The 2 security guards were compassionate enough to tell the Court they saw no need for me to be harshly punished sans my MH disorder. (One of these women actually stood between me & the glass windows that allowed SWAT snipers to take action if necessary, as the situation was winding down & hostage negotiators were able to accomplish getting "the host" personality back & allow me to surrender w/out further incident. Bless her.)

Still, the fact remained that the Court also had an obligation to the citizens of my county. It was also acutely aware of the controversy surrounding DID & how that could turn into a media circus...making things more embarrassing for the Employer. After 10 1/2 months in jail, a plea bargain was reached; with time served applied, I was left with 13 1/2 months prison time (and 5 years of Probation w/mandatory MH treatment twice monthly). An extraordinary outcome considering my defense was not inclusive of my actual disorder.

I am now nearing the end of the 4th year of probation w/out any further incident. I have met w/the court ordered Case Manager at our county MH Center every 2 wks during this time. And throughout each moment of these past 1127 days of Probation, I knew that if I had another episode or in any way violated the terms of my probation, I would be sent back to prison to serve out the remaining 28 years of my debt to society.

Ok, there are the facts of my particular situation. Now to impart what I want to share with those who have found themselves in a similar situation.

At NAMI's 75th conference in Sept. of 2004, in Washington, DC (where I was my county's MH delegate - just 2 months before I earned my place on the radar of the Justice System) - I attended a plenary on a model for a MH Court with over a decade of data showing successful resolutions for offenders & the general public's safety. Memphis, TN sent a delegation to the Conference to explain the Who, What, How, How Much & Why of their initiative. And they weren't the only city/state in our nation who had the stat's for how many offenders are mentally ill, how much it costs to incarcerate them, pay for their meds (or deny they need them if the budget doesn't allow) & bear the burden of trying to keep prison guards safe/sane in their jobs. The problem was widely reviewed & reported on by several organizations: Women's Prison Assoc. and Home, Inc., NY, NY published it's findings in 11/2004; the Institute on Women & Criminal Justice pub'd their report (Hard Hit: The Growth in the Imprisonment of Women, 1977-2004) in 2006; and FAMM (Families Against Mandatory Minimums) has been decrying the situation through their efforts for nearly 15 years now. And those are just a few I know of - the tip of the iceberg I'm sure.

Every state knows what's happening. Every jail is floundering under the onslaught of need versus ability to meet need. Every prison feels the effects. Every state legislature is struggling to understand how to deal with & mitigate the ever-increasing numbers...even as state-funded psychiatric facilities are being down-sized or closed - in favor of Contracted Services & for-profit beds. And every politician would tell you that the money just isn't available to allocate in order to meet the need of the target population. And many are aware of the burden on Medicare & Social Security as it applies. And the members of the fields of Psychiatry & Psychology will state their opinions of the impediments to diagnostic & treatment outcomes being effective. And the Courts of the land bear witness to the unending flow of offenders in need of alternative options. Mental Health Courts....jail diversion programs...early identifier programs in the Juvenile Justice area...substance abuse programs and a rainbow of intervention/prevention programs - all know the scope of the problem.

The challenge: Informing public perception of the cost of continuing the status quo. The debate will rage on while the funds are allocated for more prisons to be built. Where does the answer reside? At the ballet box would be my short answer. And Consumers are voters too! Every MH consumer who can add their voice to positive solutions - should speak out...tell their story...and offer an alternative solution.

Such as??? Well, I myself favor advocating for more funds for Peer Specialist Training, & then pointing out the need for increased CABHA (Critical Access Behavioral Healthcare Agency) creations - so that programs like Cascadia Behavioral Healthcare ( become the standard - so that the data from their efforts receive the attention that tax payers can wrap their brain around. Data, by the way, that indicate a reduction in costs of nearly two-thirds compared to state-run, inpatient psychiatric hospitalizations for the uninsured - by utilizing (not using) certified Peer Specialists.

WE are part of the equation...we can make a difference! There really is no viable argument FOR effective MH treatment taking place in prison/jail. There is only argument AGAINST spending that doesn't yield results. Legislators, MH providers, judges & other members of the Judicial system, consumer families, AND consumers must work together. I believe we must all find our Voice, and we all should try to speak out. I believe we must all find our Voice, and we all should try to add it to those already working on this problem.

Best to all,

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Check out:, and National Association of Drug Court Professionals. You can sign up for e-newsletters and lots of great information, goings-on, law-making ideas/changes, etc. ( Hope this helps! Jamie Rae (Casner123)

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We must educate the public that mental illness is a disease, not a crime. In my local area the authorities are starting to learn that and receive formal training. Thus, saving the jails for people who really need to be there.

We should be grateful for advocacy groups such as Mental Health America, Nami, and many, many, others who keep mentally ill people such as us from going to county prisons.

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The media is one of the biggest offenders in conveying fear and stigma about mental illness. A few days ago, a man raped a woman in the bathroom of a college building here in Columbus, OH. The man got away but police were able to catch him. Once the media started getting their information, it was noted that the rapist had been released from a "mental hospital" four days earlier. From there on, the media focused more on the rapist's mental status than on the crime he committed. I'm not suggesting that the man did not commit a heinous crime for which he should be punished to the full extent of the law, but when the media focuses mainly on his mental status rather than the crime he committed, those of us with mental illnesses often pay some price due to the perpetuation of stigma.

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