Corrections

Six Questions County Leaders Need to Ask
by Risë Haneberg, Dr. Tony Fabelo, Dr. Fred Osher, and Michael Thompson

Not long ago the observation that the Los Angeles County Jail serves more people with mental illnesses than any single mental health facility in the United States elicited gasps among elected officials. Today, most county leaders are quick to point out that the large number of people with mental illnesses in their jails is nothing short of a public health crisis, and doing something about it is a top priority.

Over the past decade, police, judges, corrections administrators, public defenders, prosecutors, community-based service providers, and advocates have mobilized to better respond to people with mental illnesses. Most large urban counties, and many smaller counties, have created specialized police response programs, established programs to divert people with mental illnesses charged with low-level crimes from the justice system, launched specialized courts to meet the unique needs of defendants with mental illnesses, and embedded mental health professionals in the jail to improve the likelihood that people with mental illnesses are connected to community-based services.

Over the last 40 years, local jails have increasingly become de facto psychiatric treatment facilities for the millions of people with mental illnesses and substance use disorders who become involved with the local criminal justice system. Counties and states are at the breaking point, many without the resources or capacity to address this population’s mental health needs while ensuring an appropriate criminal justice response and protecting public safety. The national Stepping Up movement offers state and local governments a roadmap for navigating the complicated process of addressing this urgent issue.