As a psychiatric social worker in a busy urban clinic, I work with patients often just discharged from long prison stays. I have seen firsthand how incarceration only exacerbates mental health problems. Many of the individuals I see suffer from what is called a co-occurring disorder. That is, they suffer from both psychiatric and addictive illness.

Commentary - in-story logoI also experience this struggle at a very personal level. I am the mother of an adult son who suffers from addictive illness and who has been incarcerated multiple times mostly for minor violations (not showing up for a probation hearing). My son suffers from a co-occurring disorder and, like many people in jail and prison, has never harmed anyone. Both his mental challenges and his addiction compromise his ability to problem-solve, plan for the future and to have a high tolerance for frustration.

Incarceration has only exacerbated his mental problems. He’s received no vocational training, no comprehensive psychiatric treatment (including medication management and psychotherapy) and no help with the huge challenges of re-entering a world with no housing, no food, no financial support and no employment. We have fought the fight so long that we’re exhausted emotionally, physically and financially. But his co-occurring disorder remains.

As a society, we have tried and failed to arrest our way out of these social and health issues. That approach is inadequate, unjust and expensive. And what do we have to show for it? About one in four individuals in state prison suffers from mental illness. Nearly four out of five who could benefit from substance abuse treatment do not receive it.


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It’s time for a better approach.

Last year, California voters overwhelmingly approved Prop. 47, which reclassified six low-level drug and petty theft offenses as misdemeanors in order to cut incarceration costs and invest those savings in mental health and drug treatment services, keeping kids in school and services for crime survivors. Prop 47 was designed to stop the punitive approach to non-violent offences and to promote safer communities by getting at the root causes of crime.

Prop. 47 creates the opportunity to shift toward a more compassionate, effective and cost-effective approach to mental illness and drug addiction. Now we need our leaders to demonstrate their commitment to carrying out that voter mandate by expanding proven crime-prevention strategies – not the same old approach of simply arresting people and doing nothing else.

San Diego is an innovative place. We can do this. We already have programs we could expand right now with state funds our county receives every year specifically for crime prevention (including mental health and drug treatment). Take, for example, San Diego’s Serial Inebriate Program, which works with repeat misdemeanor offenders struggling with alcohol and methamphetamine. There’s also the city’s Homeless Outreach Team, which connects 700 homeless people a year with services – and could do more with increased funding. The city attorney took the initiative to create a Community Court for people facing misdemeanor charges but that program isn’t currently able to link people with drug treatment.

We should also learn from others. In Seattle, for example, the Law Enforcement Assisted Diversion program directs people to social services rather than booking them into jail. The program is associated with a nearly 60 percent drop in recidivism.

Prop. 47 was a historic milestone for California, but we can’t stop until our own new vision for safety is an integral part of every neighborhood. State and local leaders need to respect the will of the voters and get behind implementation reforms rather than fight against them at the cost of community health and safety.

Caroline Ridout Stewart is a licensed clinical social worker and seasoned psychotherapist with over 25 years of experience in co-occurring disorders (persons with both psychiatric and addictive illness). She is also president of the board of A New PATH (Parents for Addiction Treatment and Healing). Stewart’s commentary has been edited for style and clarity. See anything in there we should fact check? Tell us what to check out here.

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    7 comments
    Janet Shelton
    Janet Shelton subscriber

    Maybe most of you know about the closing of mental hospitals (which also treated addictions), with the promise of community based services.  Those fund were then cut and now prisons are the new "mental/addiction" hospitals.  Except, of course, they are not and are spending huge sums to imprison people in conditions that make their problems worse.  You can find many people who agree that completely closing the hospitals was a mistake, but little has been done about it.  Maybe trends away from prison as a one size fits all solution will help this group.  Prison should not be a debtors' prison, and it is not the place for teens, who often end up there.  We need reform and hopefully can agree that it's a good idea both for social and financial reasons.

    Glenn Younger
    Glenn Younger subscribermember

    When diversions like the the Serial Inebriate Program do not work, we need to have a 3rd way.  

    For those who do not, or can not, accept alternative help we need a place.  Using the jails or prisons to store people is the high cost, and low success, solution. I don't know the answer, but as long as we have these type of offenders we need a place for them to be that keeps them safe from themselves and others.  

    For those non-violent offenders who repeat over and over, it may be time for California to do as other states have and have habitual offender statutes that allow for longer term commitments.  The funding for prisons is one of the really big pots of money the state has, time to use some of those funds to create a new alternative to the traditional prison or jail.  

    rhylton
    rhylton subscriber

    Doubtless, law-enforcement leaders are aware that proposition 47 is the law, but many of them have demonstrated that they have no intention of honouring either the letter or the spirit of the thing. One need look no further than the pronouncements and actions of some of them.


    Dumanis wishing, hoping, litigating in her attempt to keep her DNA database;


    Zimmerman with her and her department's "targeting" of released persons. She said something like "we keep arresting them and having to release them."


    Goldsmith wishing and hoping that one of more judges will see the arrest record for infractions and would then "compile" the numbers so as to find reason to impose a prison sentence.


    I call it  Law and Disorder (diss-order is better.)


    Liza Guiterrez
    Liza Guiterrez

    Dear author, law enforcement realizes prop 47 is the law; they can tell because property crimes are skyrocketing.  You know property crimes, the crime of choice for people like your son.  Instead of enabling him, why don't you get him to his probation appointments so he won't be in violation...causing another arrest warrant and the system to bog down even further.


    The title of the article is very misleading and only its only purpose is its shock value. Shame on you.

    Janet Shelton
    Janet Shelton subscriber

    @Liza Guiterrez  Just because some article suggests that doesn't mean it is true.  Crime is down.  Stats in CA, vetted by law enforcement, say that.  Our former sheriff (Landsdowne) says that.  But if you have some stats on that (primary sources, please), post them.

    Desde la Logan
    Desde la Logan subscriber

    Dear Commenter. The people of California realize that prop 47 is law. And we're tired of law enforcement and the DA not abiding by it. Instead of enabling law enforcement to oppose the law they are required to enforce why don't you support democratic rule? The people voted and so far the courts have upheld prop 47.

    Shame on you for being against democracy.

    DavidM
    DavidM subscriber

    @Liza Guiterrez "Skyrocketing?"  I don't think that means what you think it means.  According to the Public Policy Institute, California property crimes fell in 2013 and 2014, after a small uptick in 2012.


    http://www.ppic.org/main/publication_show.asp?i=1036


    Even if we were to assume that property crimes are higher today then last year, a rise from an historic low is not "skyrocketing."  Moreover, property crimes are still among those that lead to jail time; just not the felony label.