Treat­ment, not jail time

A Mont­gomery County pro­posal could get the men­tally ill the help they need.

The Washington Post Sunday - - SUNDAY OPINION -

THE IN­CAR­CER­A­TION of men­tally ill in­mates is a na­tional epi­demic, with lo­cal jails in Los An­ge­les, Chicago and else­where now count­ing among the coun­try’s largest de facto men­tal in­sti­tu­tions. One re­sult has been pres­sure and pro­pos­als to di­vert some peo­ple charged with non­vi­o­lent and mi­nor crimes to treat­ment rather than a cell.

That’s a crit­i­cal re­form, but in or­der for it to work, courts and judges have to take a lead­ing role, which is start­ing to hap­pen in Mont­gomery County.

The county, a lib­eral bas­tion, is a lag­gard whenit comes to de­vis­ing in­no­va­tive al­ter­na­tives to ware­hous­ing the men­tally ill be­hind bars. That’s start­ing to change thanks to key of­fi­cials, in­clud­ing the county’s top pros­e­cu­tor, John McCarthy. They aim to es­tab­lish a men­tal health court that, like the county’s drug court, would chan­nel some non­vi­o­lent of­fend­ers into com­mu­nity-based pro­grams.

To that end, a task force, chaired by for­mer county coun­cil mem­ber Phil An­drews and com­posed of lo­cal de­fense lawyers, pros­e­cu­tors, jail of­fi­cials, men­tal health pro­fes­sion­als and oth­ers, is be­ing formed by county cir­cuit Ad­min­is­tra­tive Judge John W. De­be­lius III. The goal is to shape a work­able pro­posal for set­ting up the court in the com­ing months. Then it will re­quire buy-in from judges, par­tic­u­larly at the dis­trict court level, which han­dles the great­est vol­ume of ar­restees — plus some money.

The im­pe­tus is clear. Even as the num­ber of peo­ple charged with crimes and booked into jail has dropped over the past three years in Mont­gomery, the num­ber re­quir­ing im­me­di­ate men­tal health ser­vices has soared by about 60 per­cent, to more than 1,600 an­nu­ally.

That mir­rors the trend na­tion­ally, where jail and prison chiefs say that large pro­por­tions of their in­mates, and some­times ma­jori­ties, are men­tally ill— partly a re­sult of the clos­ing of many big state men­tal hos­pi­tals start­ing in the 1970s. Left on the streets and to their own de­vices, with lit­tle in the way of mon­i­tor­ing or treat­ment op­tions, men­tally ill peo­ple of­ten end up in trou­ble.

Those charged with crimes such as tres­pass­ing, van­dal­ism and public uri­na­tion needn’t be con­fined in jails, where men­tally ill peo­ple are more likely to be sex­u­ally vic­tim­ized than other in­mates. They’re bet­ter off— and the public is bet­ter off, ow­ing to the like­li­hood of re­duced re­cidi­vism — if they en­ter court-su­per­vised treat­ment; jail is not a ther­a­peu­tic en­vi­ron­ment.

Ideally, Mont­gomery would fol­low other lo­cal­i­ties whose men­tal health courts are struc­tured to in­clude in­put not only from pros­e­cu­tors and public de­fend­ers but also from county case work­ers, pri­vate providers of men­tal health ser­vices and po­lice. Caseloads should be man­age­able enough that the small num­ber of judges — per­haps just one or two to start in the cir­cuit court — would be­come fa­mil­iar with in­di­vid­ual de­fen­dants and able to en­sure com­pli­ance with court or­ders re­gard­ing their treat­ment and su­per­vi­sion.

Mont­gomery’s dis­trict court, which han­dles the lion’s share of de­fen­dants, is so far wary of par­tic­i­pa­tion, cit­ing the strain on caseloads that might arise from as­sign­ing judges to full-time men­tal health court duty. The court’s re­luc­tance, along with the need for re­sources from the county — for hous­ing, case work­ers and treat­ment — are chal­lenges that Mr. An­drews’s task force will be charged with ad­dress­ing.

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