Thursday, September 21, 2000

Give help, not prison, group urges

$2.3M for mental health, substance abuse

By Tim Bonfield
The Cincinnati Enquirer

        On the heels of studies praising the success of drug courts, Tristate communities might soon see a similar concept for criminals with psychological problems — mental health courts.

        A group said Wednesday it plans to pump $2.3 million over the next four years into improving mental health and substance abuse treatment in Tristate prisons and jails.

    The Health Foundation of Greater Cincinnati released a 112-page report Wednesday, “Mental Illness and Substance Abuse in the Criminal Justice System.” Among its findings:


    Many states do not keep consistent records on how many prisoners suffer serious mental disorders such as schizophrenia and manic-depression.
    In Ohio prisons, an estimated 23 percent of male inmates and 39 percent of female inmates are mentally ill. As of December 1999, about 15 percent of the prison population had been placed in a psychiatric case management program.
    In Kentucky, 14 percent of prisoners are taking psychotropic medications, but an estimate of the total number of mentally ill prisoners was not available.
    In four Southeastern Indiana counties, the percentage of prisoners with mental illness ranged from 13 percent to 36 percent. Treatment data were not available.


    Nationwide, an estimated 70 percent to 85 percent of state prisoners need substance-abuse treatment, but 12 percent actually receive it.
    In Ohio, 75 percent of inmates abused illegal drugs in the six months before incarceration. One-third of inmates in 1996 were in prison because of drug crimes, such as trafficking and illegal use. Treatment is provided primarily through halfway houses once prisoners are about to be released, or through diversion programs before going to prison.
    In Kentucky, 62 percent of inmates reported using illegal drugs the month before entering prison. However, 7 percent of inmates are enrolled in drug-treatment programs and 5 percent have participated in drug-awareness programs.
    In Indiana, 23 percent of prisoners were incarcerated for drug offenses. About 11 percent of prisoners were in drug-treatment programs in 1997.

        The idea of giving counseling instead of jail for nonviolent, mentally ill offenders was one of several pilot projects expected to flow from a 112-page study of the criminal justice system by the Health Foundation of Greater Cincinnati.

        “In Ohio, we have more mentally ill people incarcerated in prisons than we have getting treatment in hospitals,” said Patricia O'Connor, vice president of programs for the Health Foundation.

        “It can be easier to get into trouble with the law than it is to get treatment, especially if you are poor. We believe there are more effective, more humane ways to handle these cases.”

        The study reports taxpayers, families of crime victims and convicts, and society in general pay a high price for packing jails and prisons with drug addicts and mentally disturbed people without providing the treatment they need.

        Among ideas to be considered with the Health Foundation's $2.3 million infusion:

        • Mental health courts to keep people out of prison.

        • Providing more substance abuse and mental health services before convicts leave prison.

        • Special programs for female prisoners who suffered sexual abuse.

        While many service providers have long criticized heavy spending on prisons over treatment, even some prosecutors see a need for fresh ideas.

        “I see the effects of drugs and alcohol every day,” said Sally Blankenship, prosecutor for Dearborn and Ohio counties in Indiana. “Despite strong efforts by law enforcement, this continues to be a plague on our society.”

        The debate over punishment and rehabilitation has raged for years. Only rarely has an organization with real money stepped in on the side of treatment.

        The Health Foundation of Greater Cincinnati, once a tiny private charity, was reborn in 1997 when it received the proceeds of the $250 million sale of the ChoiceCare HMO to Humana Inc. The Health Foundation now ranks as one of the Tristate's most powerful charities, using its endowment to provide more than $11 million a year in grants.

        Better treatment for convicts falls under two of the foundation's four priority areas: services for serious mental illness and substance abuse treatment.

        “It's a growing problem that's already been a significant problem,” said Mac McArthur, execu tive director of the Transitions Inc. substance abuse program in Northern Kentucky. “But it's a problem that not many people want to talk about.”

        Much like the rest of the country, prison populations in Ohio, Kentucky and Indiana grew more than 250 percent from 1977 to 1996 to exceed 82,000 people behind bars.

        While treatment programs aren't cheap, prisons cost more. The average cost of building a jail cell is about $100,000 and the cost of housing a prisoner runs from $15,000 to $30,000 a year, Mr. McArthur said.

        “So it costs more than a typical American house to build the cell and more than an Ivy League education to keep them there,” he said.

        Treatment costs vary, but a year of medications and counseling for schizophrenia would cost less than $8,000, the study reported.


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