We reached this point gradually over more than 60 years.
Beginning in the 1950s, deinstitutionalization shifted those with mental illnesses from state psychiatric hospitals to community-level nursing homes and similar facilities. Then cuts in state and federal funding in the 1980s for those facilities too often shifted those struggling with mental illness to the streets, one of several factors in the growth of homelessness and drug and alcohol addiction our communities now face. The result has been an increase in the use of incarceration at jails and prison to address problems with mental illness, addiction and homelessness.
Its impact here in Snohomish County was chronicled recently by Herald Writer Diana Hefley in a four-part series, “What Jail Can’t Cure.” Beginning with the story of Keaton Farris, a 25-year-old from Coupeville who struggled with mental health issues and died at the Island County Jail in Coupeville from dehydration and malnutrition, Hefley examined the failures in Farris’ treatment, but also outlined recent attempts by local officials to address and correct failures and deficiencies on a broader scale.
As Hefley reported, about 2 million people with mental illnesses are booked into jails across the country each year. Of those, nearly 3 in 4 also have issues with alcohol or drug addiction, reports The Stepping Up Initiative, a nationwide organization working to increase awareness and promote action to reduce the number of mentally ill in jails.
The problem with using jails and prisons to treat those with mental illnesses, say Stepping Up and others, is that it’s expensive. It’s two to three times more costly to incarcerate those with mental illnesses than those without. Nor is it effective. The mentally ill don’t receive adequate treatment in jail or prisons and are more likely to remain locked up longer. After their release they are at a higher risk of being sent back behind bars.
“Law enforcement has been a catch-all solution for too long,” Snohomish County Sheriff Ty Trenary told Hefley.
Since he took office in 2013 and following lawsuits stemming from inmate deaths at the county jail, Trenary has launched a series of reforms in his department and the county jail to discourage the use of the jail as a warehouse for those who suffer with mental illness or who struggle with homelessness. Along with instituting restrictions to limit the number of people booked for nonviolent offenses, Trenary’s reforms at the jail included screenings and the use of electronic records to track the health of inmates, increased training for staff and programs that stem from a partnership with the National Alliance on Mental Illness.
We’re also seeing action from the city of Everett’s Streets Initiative that has outlined scores of strategies, including a partnership that has sent social workers out with police to connect people with services rather than use arrests and booking as the default response. The city has strengthened its commitment to that program with $1 million to expand those patrols.
Among its recommendations, Stepping Up encourages counties across the nation to adopt a resolution to build a network of counties to share data and ideas. Snohomish County is working on much of what the resolution outlines, but the county council should consider adopting the resolution to further cement its commitment and focus its continued efforts.
There’s work to be done at the state and federal level, too.
The state of Washington remains under a federal judge’s injunction and other judicial contempt orders for failing to provide adequate mental health evaluations and treatment in a timely manner for those who are incarcerated. And Friday, federal regulators announced they planned to pull millions of dollars in funding from Western State Hospital in Lakewood because of inadequate staffing that has threatened the safety of patients and staff.
One solution offered at the federal level is the Mental Health Reform Act of 2015, which was introduced in the Senate in August. Among other provisions, the act would recommend reforms and establish a number of grant opportunities that could offer solutions for the nation’s broader need to assist those with mental illness and get them the treatment and care they need.
This problem has been building for more than 60 years. It shouldn’t require another 60 to fix it.
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