Local programs fit philosophy to treat, not jail, mentally ill

By Danis Russell
Published in The Flint (MI) Journal

My first exposure to the world of mental health treatment was in 1973. I was a volunteer “counselor” at the Mahoning County Jail in Youngstown, Ohio.

I was called a counselor even though I had scarcely a year of psychology classes, having spent my early college years thinking I was going to be a veterinarian. I don’t remember a lot about my first experiences there, other than it was scary, and I was assigned to do things I didn’t think I should be doing.

I led groups and talked with the prisoners about their problems. (I can’t really call it counseling.) I remember being told that I was allowed to do all of this because I was big, I showed up when they asked me to, and they did not have anybody else to work with the “mentals” (their term) because they had a very small budget for that kind of thing.

Thirty-five years later, lack of adequate funding for treatment of individuals with mental illness in jails is a disgrace and becoming a national epidemic. As The Flint Journal so aptly pointed out, putting the mentally ill in prison beds is a practice that must stop. Whether one agrees with the economic or the humanistic argument, there is a strong consensus that the current practice does not work.

The treatment community and the advocacy groups have been warning for years about how the jails and prisons have become the new state hospitals, but nobody has paid much attention. Whether because of tight budgets, a sudden awareness that treatment can work, or because of the alarming increase in tragedies like Virginia Tech and the Omaha mall shooting, society is starting to pay attention. Finally.

The board of directors of Genesee County Community Mental Health strongly believes that individuals with mental illness do not belong in the legal system without proper treatment, and that the legal system is not equipped to deal with their special challenges. Board members also know that once an individual enters the system, it can become a revolving door.

With this philosophy in mind, over the past several years the CMH board has directed and approved the following initiatives:

A Mental Health Court, with Probate Judge Jennie Barkey, which has been described in detail in The Journal.

CMH staff at the county jail to review admissions for mental health history.

A multi-systemic therapy program. MST is an intensive evidence-based program for moderate- to high-risk juvenile offenders involved with the Family Court. To date, this program has treated 36 youth in the community, where before they would have been sent to an out-of-state residential program for up to a year at considerable cost to the county. We are now able to treat most of the individuals and families in the community for a fraction of the cost.

Child psychiatric services and a full-time therapist at the Regional Detention Center in Flint Township.

Steps to develop a “maltreated infant and toddler court” with Probate Judge Robert E. Weiss.

None of the preceding are mandated CMH programs. Medicaid, the major payer of CMH services and largest component of the CMH budget (75 percent), cannot be used for anybody in a jail or prison, so most of these initiatives are financed by our dwindling general fund.

Yet these programs are starting to make a dent, albeit not enough of one, and they won’t cure the jail overcrowding problem.

But they are a good start. Our hope is that by collaborating with all of our partners - the courts, law enforcement and the support of the general public, we will be able to instigate policy and funding changes to really attack the problem. With everyone on the same page, we might have a chance.

Danis Russell is chief executive officer of Genesee County Community Mental Health.

Copyright 2008 Flint Journal