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Is jail the best we can offer?


Forum explores what happens when mentally ill people intersect with law enforcement
GREENPORT–“What happens when a mentally ill person is arrested? Will authorities take his history into consideration? Will they get their medications? Are they suicidal?” Those were some of the questions posed by Jeanne E. Mettler last week at a symposium called Navigating/Advocating Within the Local Criminal Justice System held at Columbia Greene Community College and sponsored by the local chapter of the National Alliance for the Mentally Ill (NAMI).

The event was designed to help professionals in law enforcement, legal services, social work, healthcare, and psychiatric fields along with friends and family of those affected by the disability, to become better acquainted with what to expect when a person with mental illness gets arrested, faces a court action or is incarcerated.

A former criminal defense attorney, Ms. Mettler said that during her 34 years in the field she has represented a number of individuals with mental illness accused of crimes. In her introduction to a symposium she walked her audience through a typical scenario from arrest and arraignment through custody, incarceration and release.

Problems that occur when a person with mental illness comes into contact with the criminal justice system and addressing those problems is becoming a big issue in a system not set up to handle the special needs of this population. Columbia County Sheriff David Harrison Jr. said 17% of inmates in local correctional facilities are affected by mental illness.

A young person with a psychiatric disability who gets caught up in the system can end up with a police record that will diminish employment opportunities for the rest of his or her life. Patients who forget or who don’t take their medication might end up in jail, a place where they could be more vulnerable than others to mistreatment and even suicide. If a person can’t cooperate in his or her own defense, it can extend confinement time and seriously affect how a case is resolved. And suicide, especially during the first two days of incarceration, is a risk for this group, reports a NAMI pamphlet entitled “How You Can Help,” distributed at the symposium. The publication also states that upon confinement, a person’s belongings including any medications are taken away. The correction facility takes care of medications but there can be a time lag before the medications are administered.

Last year National Public Radio estimated that there might be 350,000 incarcerated mentally ill individuals nationwide. The NAMI website reports that in the general population, one in four Americans suffers from a mental or substance-use disorder each year. The organization says that these conditions are more common than diabetes, heart disease or cancer and our society is not able to help everyone who needs treatment.

Locally Columbia Memorial Hospital has only 18 mental health beds. But those beds are not “forensic” and cannot be used to treat dangerous patients, which limits their use in treating individuals in the criminal justice system.

Among those who spoke at the symposium in addition to Sheriff Harrison and Ms. Mettler were: Brian Stewart, a clinical psychiatrist from Columbia Memorial Hospital; Arlene Levinson, a county public defender; District Attorney Paul Czajka; Hudson City Court Judge John Connor, Jr.; Amy Van Alstyne, head nurse at the Columbia County Jail Medical Unit; and Daniel Michaud, Columbia County mental health services coordinator. Each of them discussed how mental illness impacts their particular roll in the criminal justice and mental health systems.

Mental illness is a hidden disability, said one attendee. Unlike a broken limb, the condition is not readily apparent even to police, though Sheriff Harrison said deputies receive training in how to recognize its symptoms.

Mr. Michaud said police are encouraged to bring people exhibiting erratic behavior directly to the hospital. Police have a checklist of 16 questions to consider in their initial evaluation during the arrest process. Evaluations by psychiatrists can be requested later in the process by the court or by a defense attorney.

Of 93 emotionally disturbed persons cases last year, said Sheriff Harrison, 62 were hospitalized because they were perceived to be a risk to themselves and others.

Speakers said that the people who make up this vulnerable sector of the local population are more likely to suffer from substance abuse, including alcoholism, poverty, crime and learning disabilities, and are more severely affected by the weak economy and the resulting budget cuts.
“Outcomes in courts vary widely depending on how the disease manifests,” said DA Czajka. He said his office is open to appeals from individuals suffering from mental illness and their advocates to reconsider past arrests.

“Mental illness can decrease criminal culpability; it might mean the person is incapable of forming criminal intent; it could be an important factor that could affect the manner in which they are prosecuted and could result in a lesser offense or outright acquittal,” said Mr. Czajka.

The district attorney praised the county Drug Court program run by Judge Jonathan Nichols, and Vet Track, a program for veterans with addictions. During the evening it was also reported that a detox protocol used at the county jail has become a model for other jails.

The two 50-minute therapy sessions available to inmates is not enough, said a psychiatric nurse in the audience, who also warned that some psychotropic medications might influence a person to plead guilty.

“Sometimes it’s better to take a short sentence and do treatment later,” advised Public Defender Levinson, who said that jail-related treatment programs may have too many strict rules for inmates with mental illness to complete successfully and might result in a longer incarceration.

NAMI provided a list of mental health resources available in Columbia County: Mental Health Center Crisis Hotline, 518 828-9446; Columbia County Mental Health Center, 518 828-9446; Mental Health Association of Columbia and Greene Counties, 518 828-4619; and Twin County Alcohol and Substance Abuse Recovery Services 518 828-9300. For the state chapter of NAMI in Albany, call 518 462-2000, its hotline is 800 950-3228 and the website is

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