Tuesday, April 15, 2008

Mentally ill inmates cost $400M year
Granholm hopes to establish 5 mental health courts to reduce jail, prison crowding and costs.

Gary Heinlein / Detroit News Lansing Bureau

Corrections officials say more than 12,500 of Michigan's 50,000-plus prison inmates -- 1 in 4 -- have a history of mental illness.

Advocates call that shameful. Policymakers trying to get the $2 billion state corrections budget under control call it expensive.

It costs an average of $31,325 a year to house a state prisoner, so mentally ill inmates represent a $400 million annual expense.

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That's why Gov. Jennifer Granholm wants $3.4 million in the coming fiscal year to establish five mental health courts -- pilot projects designed to keep more mentally ill residents from flooding jails and prisons.

Mental health courts would parallel drug courts the state set up several years ago to keep some substance abusers out of the penal system.

"Clearly, not taking in prisoners with mental illness, or with significant medical conditions, is one strategy to be able to reduce the prison population costs," Granholm told The Detroit News. "And, frankly, (it's) a much more humane strategy for dealing with mentally ill inmates who have not committed especially violent crimes."

Officials like Macomb County District Judge Dawnn Gruenburg wholeheartedly agree.

Gruenburg, who heads a new coalition advocating a better approach to care for the mentally ill, said current policies often create a "revolving door": jail sentences, inadequate care, a deepening disorder, additional arrests and, eventually, prison.

State Sen. Liz Brater, D-Ann Arbor, introduced legislation last year that would let judges decide when to divert individuals charged with crimes into programs for the mentally ill or mentally disabled. It could serve as companion legislation to Granholm's proposal.

Programs would be keyed to individual needs. Most could be administered by community mental health agencies; some would involve monitoring to assure that patients are taking prescribed medications and following productive daily routines. Others might require special housing.

Brater said Democratic and Republican lawmakers have expressed support for the concept, but she's still cautious about its chances.

"There's a gap between recognizing something is needed and agreeing how to do it," she said.

Local officials with overflowing jails aren't waiting for state policymakers to act. Some already are looking for alternative, non-jail ways to deal with mentally ill defendants.

Oakland County Sheriff Mike Bouchard's 2-year-old effort has kept 400 low-level offenders out of jail cells, or released them early into treatment and self-help settings. It is three-pronged: diversion of mentally ill offenders prior to booking for crimes; diversion after they have been booked -- and, in some cases, already are behind bars; teaching police how best to interact with the mentally ill.

The post-booking portion, alone, spared the county 6,609 jail-bed days and saved at least $630,000 through February 2007, said county corrections coordinator Ann Russell.

"I've been in this business for 30 years and this has been one of the areas where it's been hard to break through," she said. "There never were enough resources, never enough money."

Under a 6-month-old Genesee County program, Probate Judge Jennie Barkey holds criminal charges in abeyance for mentally ill lawbreakers, as long as they follow her orders.

A case manager from the Genesee Community Mental Health Agency rises early each day and checks the names of new county jail inmates against the agency's records of people with psychiatric disorders. He also reviews arrestees who may be mentally ill but aren't on file.

Candidates for the new program are arraigned by Barkey. Charges against the 40 defendants in the special program have ranged from urination in a public place to assault and battery. They are offered the choice between immediate prosecution and her court-ordered regimen.

"They have to take responsibility. There will be no sentence for a year," Barkey said. "They sign an agreement, then they're mine. We take anyone the victim will agree (to allow in the program) and Community Mental Health and the prosecutor will agree to take. Police love it and, often, the victims do, too."

The orders she issues usually are simple. "William" has to take his medication as directed, provide Barkey with a list of his daily activities and get his taxes completed. "Edward" must provide the judge with a list of 10 places he has applied for jobs and make sure he takes his prescriptions.

Dan Russell, CEO of Genesee's Community Mental Health Agency, said the program saves money and people.

But he expects that as it grows, there will be a need for a greater range of mental health care options -- including special living arrangements for some -- that will require more money. He and other proponents hope it can come from some of the saved jail and prison costs.

Russell added, "Those who are mentally ill need something other than jail."