Incarceration of Individuals with Mental Illness

A National Dilemma with Local Solutions

In the last edition of Access Press, the article Prisons: Are They the New State Hospitals highlighted the national dilemma of increased rates of incarceration for individuals with mental illness. This article will focus on the situation in Minnesota and the creative ways Minnesota is addressing this dilemma.

In Minnesota, approximately 25% of the prison population is known to have a serious mental illness, according to the Bureau of Criminal Justice statistics. However, Minnesota’s overall rate of incarceration is much lower than the national average because many individuals are diverted from the prisons to treatment and community supervision. Minnesota’s focus on restorative justice, adoption of drug courts and, as exemplified by Hennepin county, creation of mental health courts are a few of the ways that Minnesota is creatively addressing the needs of offenders and keeping people out of prison. Is this effective? Well, the crime rate for Minnesota is 21% lower than the national average, and the rate of re-offense is 23% lower than the national average.

Minnesota has made significant advances in responding to individuals with mental illness. In the past, police officers were de facto first responders in mental health crisis situations. Creation of Crisis Intervention Teams in many counties has ensured that individuals receive appropriate intervention from mental health professionals instead of solely law enforcement officers. Another key response is Minnesota’s provision of increased access to health insurance. With only 8.3% Minnesotans uninsured, Minnesota has the lowest rate of uninsured individuals in the nation. With more people insured, more people can access needed mental health treatment.

In addition to diversion programs and improved responses to individuals with mental illness, in 2001 the Minnesota legislature approved measures to require the Department of Corrections (DOC) to offer discharge planning to individuals with serious mental illness who are in prison. In 2005 the legislature passed a mandate requiring the DOC share a model discharge plan with county jails for optional implementation. When people are incarcerated their federal benefits (social security income or medical assistance) are terminated. Upon release, they do not have access to financial support or healthcare. They must re-apply for benefits in order to receive treatment, a time consuming and daunting process. Delays in treatment can be detrimental to an individual’s health and smooth transition into the community.

In the prisons, discharge planning begins 90 days before release. It includes connection to county case management, initiation of application for federal benefits, setting a post-release appointment with a psychiatrist, providing an offender a 30-day supply of medication, a prescription for another 30-day supply, as well as assisting in locating employment and housing.

Minnesota mental health advocates are also addressing the broader issues. For example, the Minnesota Mental Health Action Group is seeking ways to build a more comprehensive mental health system which includes stable housing and employment opportunities. This may help prevent even more people from having contact with the criminal justice system.

This fall, the National Alliance on Mental Illness of Minnesota (NAMI-MN) launched the Building Bridges Project. The goal of this project is to speed the restoration of federal healthcare and financial benefits to individuals with mental illness who are being discharged from correctional facilities. The Building Bridges Project convened a group of 25 stakeholders. Representatives from the state and county corrections, the state and county social services, the legislature and non-profit agencies met to discuss solutions to this issue.

The Building Bridges Project will give special consideration to the situation of individuals with mental illness in county jails. There are no statewide statistics on the prevalence of mental illness in the county jails. County jails hold people who are awaiting trial or offenders serving a short sentence for low level offenses. As some studies have indicated that the majority arrests of individuals with mental illness are for non-violent crimes, it is likely that there are many individuals with mental illness in county jails. Services may vary from county jail to county jail in Minnesota’s 87 counties and discharge planning is not mandated.

NAMI-MN, through Building Bridges, is conducting a statewide survey of county jails. This survey asks questions about the prevalence of mental illness, how the jail recognizes and responds to mental illness and current discharge practices. NAMI-MN hopes to gain a greater understanding of the current trends in jail treatment of mental illness, help support jails in providing services to clients with mental illness and offer trainings on effective ways to work with inmates that have mental illness.

While the national level issues behind this dilemma are complex, Minnesota is leading the way in finding solutions on a state level. By simply ensuring that individuals have access to treatment, housing, employment and county services upon release from prisons or jails, Minnesota may decrease the number of individuals who find themselves without treatment and end up continually in and out of jail.