DIVISION OF LEGISLATIVE SERVICES
VIRGINIA LEGISLATIVE ISSUE BRIEF
Number 26 December 2001

2002 SESSION: General Assembly Issues

Business - Campaigns/Elections - Constitutional Amendments - Courts -
Education - Finance/Taxation - Health - Local Government -
Mental Health - Natural Resources - Transportation - Virginians with Disabilities

Mental Health

Offenders with Mental Illness and Substance Abuse Disorders

"The United States currently has more mentally ill men and women in jails and prisons than in all state hospitals combined," according to a recent article published by the American Correctional Association. National research also indicates that fewer than 50 percent of men and women with severe mental illnesses receive mental health treatment while they are incarcerated and fewer than 25 percent of inmates with more moderate forms of mental illness receive mental health services.

In its 2000 annual report to Congress, the Coalition for Juvenile Justice estimated that 50 percent to 75 percent of young people in the criminal justice system nationwide suffer from mental illness. Thirty-six percent of the parents surveyed by the coalition said their children were in the criminal justice system because they could not get needed help outside the system.

The National Gains Center estimates that 63 percent of jail detainees have a mental illness or a substance abuse disorder; five percent have both. Among state and federal prisoners, an estimated 57 percent have a mental or substance abuse disorder and approximately 13 percent of prisoners have both a serious mental illness and a co-occurring substance abuse disorder.

Offenders with mental illness are often jailed for relatively minor offenses, such as vagrancy, trespassing, disorderly conduct, alcohol-related charges, or failing to pay for a meal. The Center on Crime, Communities and Culture says that, "when it is mental illness and not criminal intent that underlies a petty criminal act, treatment in mental health programs is demonstrably more effective at reducing recidivism than a sentence to jail."

Against this background, the 2001 Session of the General Assembly directed the Joint Commission on Behavioral Health Care, the Virginia Commission on Youth, and the Virginia State Crime Commission to study treatment options for offenders who have mental illness or substance abuse disorders (SJR 440). The scope of the study included mental health and substance abuse services needed and delivered at both the state and local levels to adult and juvenile offenders.

Among the committee's key findings were:

1. Interagency collaboration and clearly defined responsibilities for serving adult and juvenile offenders with mental illness do not exist in many communities. Moreover, there does not appear to be a consensus as to whether the responsibility for providing treatment services should lie with the criminal justice or the mental health treatment system.

2. Virginia communities lack sufficient capacity, including the availability of acute psychiatric care, to treat offenders with mental illness and substance abuse disorders while they are incarcerated and when they are released from state correctional facilities, jails, or detention homes. Lack of a comprehensive and systematic approach to finding these services has resulted in inequitable access to care across Virginia.

3. The state has not developed clinical guidelines for jails or detention homes to ensure an adequate level of mental health services for people who are incarcerated.

4. Cross training in balancing therapeutic goals with security needs and public safety is needed for law enforcement, judges, jail and detention staff, and community treatment staff.

5. No comprehensive mechanism exists to systematically collect complete and accurate data on treatment services provided to and needed by adult and juvenile offenders or to evaluate the effectiveness of the services.

The committee will organize its recommendations from its first year of work into five areas: (i) interagency collaboration; (ii) capacity; (iii) clinical guidelines; (iv) cross training; and (v) data collection, evaluation and information sharing.

Because of the current budgetary situation, most of the recommendations will be designed to lay the groundwork for future action: maintaining funds that are appropriated in the current biennium budget; gathering information about unmet needs; fostering interagency collaboration and planning; establishing minimum clinical guidelines; and providing a framework for information-sharing and evaluating the effectiveness of current programs.

Due to the size and scope of the problem, the joint committee plans to ask the General Assembly to expand its membership to include the Secretaries of Health and Human Resources and Public Safety and to continue its work for another year.

Nancy L. Roberts

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