What programs do you think the PA Justice Reinvestment Initiative should fund? Let us know what you are thinking!

In response to a reader who wrote in with a question about whether the Pennsylvania Justice Reinvestment Initiative (JRI) was an efficient use of tax dollars, we took a closer look at what the JRI might mean for justice-involved individuals with mental illness or those who are at risk for justice involvement in our state. Part of broader criminal justice reforms statewide, the JRI is designed to reduce corrections costs by lowering incarceration rates, and reinvest the part of the savings into programs to decrease crime and strengthen neighborhoods. A portion of the reinvestment funds are slated for local grants to improve probation and divert low-level offenders from penetrating into the corrections system.

Some of these funds could be usefully directed toward community-based mental health care and supportive housing for people with mental illness. Persons with mental illness who are sentenced to prison tend to “max out” their sentences, in part because it is often difficult to find appropriate housing placements for these offenders in the community. Thus, persons with mental illness often return to the community without a supervised release plan for community living. Such circumstances cost tax payers money unnecessarily in at least two ways. First, holding someone in prison for the full span of their maximum sentence is wasteful when the person does not present a threat to community safety. Second, lack of mental health care and safe, suitable housing for re-entering offenders with mental illness increases the likelihood of recidivism and increased criminal justice costs.

The JRI presents an exciting opportunity to invest in evidence-based and promising programs to provide treatment and other services to prevent persons with mental illness from being swept up in the justice system. We are not aware of studies regarding the proposed justice reinvestment strategies that look at the impact of these efforts, either economically or socially, on individuals with mental disorders. What information would you need to decide whether this strategy is worth it? What programs do you think should be priorities for funding?

Imposing criminal sanctions for medication noncompliance

In a 2010 study, E. Fuller Torrey and colleagues at the Treatment Advocacy Center found that a person with serious mental illness in the US is three times more likely to be in prison than in a psychiatric hospital. The authors discuss problems with housing the mentally ill in jails and prisons instead of mental health (MH) facilities including lack of access to appropriate MH care, increased risk of suicide, likelihood of returning to prison after release and difficulty handling such persons with standard correctional protocols. In addition to calling for more treatment beds for the seriously mentally ill, the authors conclude that Assisted Outpatient Treatment (AOT), which requires selected seriously mentally ill persons living in the community to take medication under court order, should be implemented on a larger scale.

Do you think that criminal penalties for failure to take medication will help or harm justice-involved persons with serious mental illness?


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