Mental Health, Criminal Justice: Can We Do Better?

On Thursday, April 20, community members from the Twin Cities and beyond came together to hear from experts on a critical topic: addressing mental health and the criminal justice system. The 12th Annual Community Forum, sponsored by St. Paul Sunrise Rotary, Minneapolis City of Lakes Rotary and the Woodbury Rotary Club, featured a panel discussion on the topic, which is top of mind for many Minnesotans as we seek to create a healthier – and more just – state.

The panelists represented the range of professionals involved in the intersection of criminal justice and mental health. Tom Crann of Minnesota Public Radio moderated the discussion between Tom Roy, Commissioner of the Minnesota Department of Corrections, Dr. Eduardo Colón, Chief of Adult Psychiatry at Hennepin County Medical Center (HCMC), and Sue Abderholden, Executive Director of the National Alliance on Mental Illness-Minnesota (NAMI-MN).

A video produced by students at Gordon Parks High School kicked off the discussion. The short film, titled “End the Cycle,” highlighted the challenges students face as they navigate mental health issues. Two members of Russell Herder’s creative team – Julian Lissiman and Brian Herder – assisted the students with creating the powerful video, as part of RH’s efforts to give back to the communities we serve.

The video shined a spotlight on how long people struggle to navigate the painful and confusing world of mental illness. The students found:

“Mental health problems can look like a lot of other things” – especially alcohol, substance abuse, or general misbehaviors.

“It’s hard to get help even when you ask” – there is a great need for more education and resources to address mental health of kids and teens. Even if they get to courage to ask for assistance, trusted adults may not be able to help.

“Having mental health issues is not against the law but it can get you in a lot of trouble” – in many cases behavior related to mental health issues can lead to young people getting in trouble at school or with the law.

Finally, Gordon Parks students issued a strong call to action, asking all of us to: “See the signs, get the help, end the cycle.”

These themes were echoed by the professional panelists, who see the persistent links between mental health and Minnesota’s criminal justice system.

Corrections Commissioner Tom Roy highlighted the steps Minnesota is taking to be more positive and proactive in addressing mental health issues. He stated that more than 90 percent of people in custody are associated with chemical dependence or abuse, and many crimes are committed while people are in an altered state.

NAMI-Minnesota Executive Director Sue Abderholden stated that many mental illnesses become present during adolescence, with half of mental illness present by age 14 and three-quarters by age 24. Many of these young people (70 percent) have more than one diagnosis, and as the “End the Cycle” video demonstrated, it is incredibly difficult to get help. Abderholden said that as a result of broken public policies, the U.S. never built a comprehensive mental health system and there is often a criminal response – rather than a health care response – to mental illness.

HCMC Chief of Adult Psychiatry Dr. Eduardo Colón, shared these sentiments, and sees the intersection of mental illness and criminal justice every day. Today, the U.S. does not regularly use long-term institutionalization for people with mental illness, he reminded us, but we have failed to provide the comprehensive services that people with mental health issues need to lead full, healthy lives. Dr. Colón stressed the need for mental health screenings when people enter the criminal justice system. He also said we must do more to provide humane care that reduces recidivism and treats the person’s underlying health issues.

Other key observations and suggestions from the panelists included:

We need to do more upstream, especially when it comes to youthful intervention. But that requires significant financial resources. As Commissioner Roy said: “We need resources upstream but we have to paddle hard and we need an expensive canoe.”

Not all criminal offenders and criminal offenses are because of mental illness. And vice versa, not all people with mental illness commit criminal acts.

It costs less to treat mental illness than it does to imprison someone. Commissioner Roy estimates there is a $6 payback for every dollar invested in prevention and health, and the true societal savings are in reducing future crime and victimization.

There is already ample evidence about what works: access to treatment, stable housing and employment opportunities. Abderholden said the last thing we need is another study of this problem, and added we should stop suspending young students in kindergarten through third grade.

The main issue is about money and stigma and who will spend the money it takes to shoulder mental illness. Dr. Colón said: if we don’t invest in health and social services, then we will pay for mental health problems through the correctional system.

There was widespread agreement about the need to break down stigma and shatter negative images of mental illness. Abderholden said the best way to break the stigma of mental illness is to share personal experiences and change our language to get rid of harmful stereotypes.

The panelists also discussed the importance of helping people coming out of the criminal justice system by providing the resources they need to stabilize and heal – including stable housing, employment or simply uninterrupted access to medications. Dr. Colón added: “there is nothing more tragic than a patient saying they were better off in jail.”

Much more can be done to improve proactive responses to mental health issues. Increasing Crisis Intervention Training (CIT) is one area where Minnesota is leading the U.S., Roy added, but more training is needed to help de-escalate situations. Bringing more accountability to practices like solitary confinement, enforcing mental health parity laws, bolstering Minnesota’s mental health and schools program, and providing mobile mental health crisis teams are several of the steps that NAMI-MN’s Sue Abderholden emphasized. Dr. Colón re-stated his call for mental health professionals to screen every person who enters a jail or prison, and for increased resources throughout the system.

The distinguished panelists found a lot of common ground throughout the discussion and question/answer period. Throughout it all, the answer to the key question, “can Minnesota do better, when it comes to addressing mental health and the criminal justice system?” was a resounding Yes.

There are clear steps Minnesota can proactively take to address and treat mental health issues to avoid paying the societal and financial costs later. Our communities, schools, police forces and health professionals are just a few of the places where we need to undertake this mission. As the Gordon Parks students so powerfully reminded us: “No one can get through this world alone.”

MPR’s coverage of the event, including the full audio recording, can be found here.

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