Physicians for Criminal Justice Reform CORE ISSUE:  Decriminalization of mental health and addictive disorders.

1. Introduction and Background

The past decade has begun to see a shift in the system of incarcerating mentally-ill persons in Arkansas and across the nation. Based on a number of empirical studies and public-policy reviews, states have begun to question the long-standing reliance on secure confinement of offenders with mental-health issues, its effect on public safety, and on the person’s ability to join society as productive and contributing members of their community in the future.

In Arkansas a wide cross-section of those involved with administering both criminal justice and mental-health care – judges, prosecutors, police, state agency heads, mental-health advocates, families, and the patients themselves – have been able to meet and agree on a number of changes to the former system of “arrest and commit.” A primary focus of their efforts has been the design of a diversion process that places a mentally-ill offender in a treatment program rather than the criminal-justice system. This reform approach would increase the use of community-based alternatives like probation, community service, smaller therapeutic residential programs, and crisis centers.

While widespread agreement about the need for mental-health and prison reform has been achieved, less is known about the exact costs and benefits of these reforms. How will different actions by the courts or state agencies affect the state’s budget for mental-health care and for processing offenders? If cost savings are achieved, how much money may be available for more effective alternatives that help mental-health patients become reestablished in their communities?

Our research found that one year’s worth of trial and jail time for each mentally-ill person costs the state about 20 times as much as crisis treatment and counseling for the same person with mental problems. These are average comparisons, and the national data indicate that the costs of keeping prisoners with mental illness are more expensive than average prisoners; this ratio could be 25:1 or higher. Based on the current jail and prison populations, this could mean savings of millions of budget dollars from the costs of adjudication and incarceration by local and state agencies. – 4 –

It appears that Arkansas has thousands of prisoners with mental-health issues who are receiving less than appropriate care when better medical and mental-health care could be provided at a fraction of the current cost per inmate.

Before we address the financial issues of prison reform and the mentally ill, the next chapter highlights some of the issues that have been addressed by other cities, counties, and states that have been restructuring their mental-health systems to address these problems.

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