Weapons of Mass Destruction (WMD)

As we consider the effects of this broken system, we should remember how it became broken in the first place. In 1963, it was believed that state mental hospitals were too often institutions for quarantining the mentally ill. In response to this perceived mental health problem, we in Congress passed the Community Mental Health Centers Act to move the mentally ill out of prolonged confinement in overcrowded state custodial institutions into voluntary treatment at community mental health centers. On Oct. 31, 1963, President Kennedy signed the Community Mental Health Centers Act into law.

Unfortunately, we in Congress failed to keep this Act's promise by failing to fund it. Thus, we set in motion a public health tragedy that resulted in thousands of mentally ill patients being dumped out of state hospitals into communities that did not have the adequate services to receive them. Efforts that were meant to protect people with mental illness resulted in many of the most severely ill going without needed treatment and, in too many cases, becoming homeless, incarcerated, suicidal, and victimized. Ironically, those efforts are euphemistically referred to as "the deinstitutionalization movement." In my opinion, the huge numbers of mentally ill individuals in jails, prisons, homeless shelters, and flop houses demand we call this movement what it has become: transinstitutionalization.

I am working on legislation to create mechanisms that will bridge the gap between the mental health and criminal justice systems- the gap through which so many mentally ill defendants currently fall- to provide criminal justice and mental health professionals the resources they need to work together to keep mentally ill defendants in treatment rather than jail.

H.R. 2594 seeks to help local communities to close the revolving door of recidivism among the mentally ill population by providing federal grants of up to $400,000 to 25 local jurisdictions to establish mental health courts in order to direct nonviolent mentally ill offenders out of jail, into long term treatment. Mental health courts are uniquely effective at reducing the recidivism of seriously mentally ill offenders because they use the power of the criminal justice court to ensure that the defendants receive long term mental health treatment. Misdemeanor defendants who are determined to be seriously mentally ill are offered treatment in lieu of jail, subject to their continued compliance.

Background of the Problem

As we consider the effects of this broken system, we should remember how it became broken in the first place. In 1963, Health, Education and Welfare Secretary Anthony Celebrezze said, "The facts regarding mental illness and mental retardation reveal national health problems of tragic proportions compounded by years of neglect." He said that large state mental hospitals were primarily institutions for quarantining the mentally ill, not for treating them and that "all levels of government, as well as private individuals and groups, must share the responsibilities of a 20th century approach to this outstanding national health problem."

We in Congress responded to this "outstanding national mental health problem" by passing the Community Mental Health Centers Act which sought to move as many of the mentally ill as possible out of prolonged confinement in overcrowded state custodial institutions into voluntary treatment at community mental health centers. On Oct. 31, 1963, President Kennedy signed the Community Mental Health Centers Act into law.

Unfortunately, we in Congress failed to keep this Act's promise by failing to fund it. We refused to provide the money needed to help states build adequate community mental health infrastructures. To make matters worse, we imposed restrictions on Medicaid that kept Medicaid dollars from going into state mental hospitals. Thus, we set in motion a public health tragedy that resulted in thousands of mentally ill patients being dumped out of state hospitals into communities that did not have the adequate services to receive them.

Do not misunderstand me. I know that reform efforts were well intended. However, those same reform efforts that were meant to protect people with mental illness resulted in many of the most severely ill going without needed treatment and, in too many cases, becoming homeless, incarcerated, suicidal, and victimized. Ironically, those efforts are euphemistically referred to as "the deinstitutionalization movement." In my opinion, the huge numbers of mentally ill individuals in jails, prisons, homeless shelters, and flop houses demand we call this movement what it has become: transinstitutionalization.

Impact of the Mentally Ill on the Criminal Justice System

Law enforcement and corrections officers will tell you that they are at ground zero of our country's mental health crisis, 24/7. Here are just a few of the grizzly statistics:

. 25% to 40% of mentally ill individuals become involved in the criminal justice system;

. In July 1999, the Department of Justice issued a Special Report announcing that at least 16% of state jails and prisons, or 260,000 people, are individuals with severe mental illness. That is more than four times the number of people currently in state mental hospitals;

. The American Jail Association estimates that 600,000 to 700,000 bookings each year involve individuals with mental illness;

. On any given day, at least 284,000 schizophrenic and manic depressive individuals are incarcerated, and 547, 800 are on probation;

. By default, L.A. County Jail is now the largest mental institution in the United States, holding an estimated 3,300 mentally ill inmates on any given night.

These statistics represent countless backwards steps that have been made in the name of progress. They remind me of what the governor of Virginia said when he expressed dismay that he was "forced to authorize the confinement of persons with mental illnesses in the Williamsburg jail, against both his conscience and the law," because of lack of appropriate services. That was in 1773.

More than two hundred years later, we have unfortunately come to accept incarceration and homelessness as part of life for the most vulnerable population among us. Unfortunately, our

expectation of what life has to offer the most seriously mentally ill is tragically low. I believe that our low expectations result at least in part from the backdrop of hopelessness that is created by the 200,000 individuals with schizophrenia or manic-depressive illness who are now living out their symptoms on the streets. In many cities, including our nation's capitol, seriously mentally ill people are now an accepted part of the urban landscape, sleeping on sidewalks, shuffling through the streets, talking to people only they can see. Unlike the rest of us, law enforcement officers don't have the luxury of looking away.

Ironically, in the midst of this tragedy comes unprecedented reasons for hope for the mentally ill. The U.S. Congress declared the 1990s The Decade of the Brain. During the last decade, an explosion of information about mental illness has occurred. New technologies opened windows onto the human mind, revealing for the first time how the molecules of our brains coordinate thought, feeling and emotion. MRIs showed us what schizophrenia looks like. Brain imaging showed us how behavioral therapy actually changes the brain's physical make-up. Research helped us not only gain a better understanding of what mental illness looks like but how we can better treat it.

Just last year, Surgeon General Satcher released the first-ever Surgeon General Report on Mental Health. Though the Report deals extensively with the neuroscience of mental health, it emphatically stands for the proposition that neuroscience alone cannot treat the human mind. The Surgeon General makes clear that neuroscience and behavioral science are necessary partners in understanding and treating mental illness.

This seminal report alerted the nation and the world about the prevalence of mental illness, how it effects children differently than adults, how delivery systems currently work, and how they might change to work better in the future. But perhaps most importantly of all, the Surgeon General's Report refutes any effort to moralize mental health, officially ending the distinction we have too long made between mental and physical health.

Mental illness does not discriminate between Democrats or Republicans, rich or poor, black or white, man or woman- none of the dividing lines that so often create partisan politics. That is why I am especially gratified to be working on legislation with distinguished members from both sides of the aisle, and both sides of the hill, to create mechanisms that will bridge the gap between the mental health and criminal justice systems- the gap through which so many mentally ill defendants currently fall. I would like to take this opportunity to personally thank Senators DeWine, Domenici, Kennedy, and Wellstone, as well as Congresspeople Wilson, Waxman, Horn, Capps, Roukema and Kaptur for taking the lead on sponsoring legislation to provide criminal justice and mental health professionals the resources they need to work together to keep mentally ill defendants in treatment rather than jail.

I would like to briefly summarize the current legislation that seeks to lessen the burden of the mentally ill on the criminal justice system:

1. H.R. 2594, America's Law Enforcement and Mental Health Act, which I introduced last July, seeks to help local communities to close the revolving door of recidivism among the mentally ill population by providing federal grants of up to $400,000 to 25 local jurisdictions to establish mental health courts in order to direct nonviolent mentally ill offenders out of jail, into long term treatment. Mental health courts are uniquely effective at reducing the recidivism of seriously mentally ill offenders because they use the power of the criminal justice court to ensure that the defendants receive long term mental health treatment. Misdemeanor defendants who are determined to be seriously mentally ill are offered treatment in lieu of jail, subject to their continued compliance.

2. S. 1865, a companion to H.R. 2594, was introduced last November by Senators DeWine and Domenici. Substantively the same as H.R. 2594, S.1865 calls for the creation of 125 pilot mental health courts.

3. S. 2639, the Mental Health Early Intervention, Treatment and Prevention Act of 2000, was introduced last May by Senators Kennedy, Domenici and Wellstone to help finally fulfill the unkept promise of the Community Mental Health Act of 1963 by providing, among other things, grants to communities for mental health treatment centers, as well as the training of non-traditional front line mental health workers, like teachers, law enforcement and fire fighters. Additionally, S. 2639 seeks to lessen the burden of the mentally ill on the criminal justice system by providing grants that (1) train police on how to identify the mentally ill and direct them into available treatment; (2) fund jail and prison programs that screen, evaluate and treat mentally ill inmates; and (3) create mental health courts to direct non-violent mentally ill defendants out of the revolving door of recidivism into long term, wrap-around treatment.

4. H.R. 5091, a mirror companion to S. 2639, was introduced last July by myself and Congresspeople Wilson, Waxman, Horn, Capps, Roukema and Kaptur.

As Co-Chair of the Congressional Corrections Caucus, I hope that this Congress will seize upon these legislative opportunities with the same courage and compassion with which law enforcement and corrections officers deal with the mentally ill every day.

Conclusion

I want to thank this sub-committee for being willing to look closely at a problem from which too many of us turn away. I believe that there is a surprising consensus among a broad spectrum of stakeholders and political ideologies that there are very practical steps we can take to stop the criminal justice system from being this country's primary caretaker of the seriously mentally ill . The truth is that by helping the seriously mentally ill we help ourselves.