Michigan Bill Would Establish MH Courts

Viewers across the nation were likely outraged when they watched the excruciating last moments of Timothy Souders caught on tape and broadcast by CBS's “60 Minutes” on February 11 (and rebroadcast July 29). The 21-year-old with bipolar disorder died from dehydration and hyperthermia in August 2006 after being chained down face first for 17 hours on a concrete bed in the Southern Michigan Correctional Center, where he had been sent after being caught shoplifting two paintball guns.

In a review of Souders's death, U.S. District Judge Richard Enslen attributed Souders's aberrant behavior to his untreated mental illness and ordered changes in how guards treat inmates with mental illness. Advocates claim that Souders's mental illness was mistaken as willfully defiant behavior and landed him in an isolation cell.

Souders's death raised questions nationwide over why some patients with mental illness are sent to prison. It also prompted renewed efforts at legislation in the Michigan Senate that could help prevent similar tragedies.

Two bills (SB 199 and SB 200) introduced by Sen. Liz Brater (D-Ann Arbor), would establish mental health courts modeled after Michigan's successful drug courts. Michigan's 76 drug courts give nonviolent drug offenders the chance to enroll in rehabilitation programs without being sent to jail.

Brater's bills would authorize a judge to order treatment instead of jail or prison terms for offenders with mental illness accused of minor crimes. In introducing her bills, she said that too many people are ending up in the criminal justice system inappropriately, an issue that APA has been publicizing and working on for several years. The bills would give judges the option of ordering a person into treatment and staying criminal charges up to one year while the treatment is under way. The judge would conduct a hearing on whether to divert the defendant to treatment, weighing factors such as the nature and seriousness of the alleged crime, the person's prior criminal record, and the likelihood of benefiting from mental health services.

Jail-diversion programs have proved successful throughout the country in reducing arrests and improving treatment of underlying illness. As of last year, there were about 120 diversion programs in 40 states.

Brater told Psychiatric News that the first step in intervention is to ensure that the community mental health system is working properly and has sufficient resources so that people brought into the system get adequate care. She proposed that the state shift money from the Department of Corrections' $1.8 billion budget to the Department of Community Health to pay for increased community mental health services.

Typically people with mental illness who end up in the criminal justice system have stopped taking their medications, are not getting any treatment, or are being turned away from mental health care, Brater said. But“ prisons are not prepared to treat them, and incarceration is expensive.”

The costs of incarceration, treatment, and health for prisoners with mental illness in Michigan can run as much as $50,000 a year per inmate. In contrast, community mental health care costs come to roughly $10,000 a year, and some is picked up by private insurance or Medicaid.

According to Michigan Department of Corrections figures, more than 4,000 of 51,000 state inmates are getting mental health services. More than 700 have a documented history of mental illness and confinement in a state psychiatric hospital.

Brater said that providing a supportive living system so these individuals can succeed in the community would go a long way to helping people with mental illness avoid incarceration. Police can play a key role by developing a working relationship with members of the community mental health team, she said. When trained to recognize the symptoms of mental illness, they can help calm the person down and get that individual in contact with someone from the mental health system instead of arresting him or her.

Judith Hutchins, president of the National Alliance on Mental Illness–Michigan, said the state should go further and establish police crisis intervention teams (CITs), because local police are often the first responders when a person is in psychiatric crisis. Writing in the Lansing State Journal, Hutchins noted that Akron, Chicago, Minneapolis, and other communities nationwide have CIT programs. She believes Michigan communities deserve the same.

“If nothing else, prison corrections officers also clearly need better training about how to recognize and respond to people with mental illnesses,” she said.

“I think the Brater bills face a challenging path, but we will continue to support and work for them,” Mark Reinstein, Ph.D., president and CEO of the Mental Health Association in Michigan, told Psychiatric News. He believes that a bill sponsored by the chair of the House Subcommittee on Corrections, Rep. Alma Wheeler Smith, allotting $1.9 million toward establishment of four mental health courts as a pilot project might have better chance of passing.

“The idea of treating people with mental disorders instead of punishing them makes good sense,” Michelle Riba, M.D., a past president of APA and a clinical professor in the Department of Psychiatry at the University of Michigan, told Psychiatric News.

“In general it's a good idea to be thinking about care and treatment of people with mental illness rather than just punishment, because clearly prisons are becoming major mental health hospitals throughout the country as well as in Michigan, and so we are supportive of the idea of treating people instead of criminalizing them,” she said. Riba applauded Brater for introducing the bills, calling her “a very forward-looking person.”

Brater's bills can be accessed at<www.legislature.mi.gov> by searching on the bill numbers, 199 and 200. ▪