As a boy, I attended a small Catholic school and remember well many lessons, not only on the 3Rs, but also on higher moral ideals: feeding the hungry, clothing the naked, sheltering the homeless, and setting captives free.
To a nine-year-old in 1970, those ideals were abstractions, to say the least. My classmates and I had no experience of hunger or homelessness beyond the faces we saw in posters for the overseas missions. And, there were certainly no sightings of naked or captive people on the maple-lined sidewalks of our small Ohio town-we'd have heard about that for sure.
Like all children, my classmates and I have grown up to see and understand the world much differently than we once did. For example, I've come to realize that people hunger for many things beyond food, that no clothing can conceal a loss of dignity or self-respect, and that it takes a lot more than shelter to make a person feel at home.
In recent months, I've had a chance to understand a great deal more about what another of those boyhood ideals-setting captives free-really means. While it certainly means moving people from mental illness or addiction into recovery, it also means preventing incarceration for some offenders, releasing others into treatment, and preparing and supporting others for a successful re-entry into the community.
Putting in place regulations that support jail-diversion, parole-to-treatment, and effective re-entry initiatives can be complicated from a legislative standpoint, since they often require changes in state or local laws. But such initiatives are quite easy to understand at the local level. Just ask this question: What happens when law enforcement intersects with individuals suffering from mental health and substance use disorders?
In many communities, the answer is simple: many of these individuals bounce between poverty, homelessness, and incarceration. And, while homeless and incarcerated people are out of the sight of many Americans, the costs of their care are not. A homeless individual can cost up to $30,000 per year in uncompensated hospital ER, crisis, and medical care as well as repeated arrests, bookings, trials, and incarcerations.
Estimates say that up to one-third of those incarcerated in federal and state prisons and county jails-nearly 800,000 people-are non-violent, mentally ill or substance-abusing offenders who would be far better served at far lower costs in some form of court-ordered or community-based treatment programs. The November/December issue of Behavioral Healthcare examines this issue in detail.
Alison Knopf's feature presents the elements of effective jail diversion programs: collaboration with law enforcement, crisis intervention training for police, formation of crisis response teams, creation of alternative crisis care resources, and development of mental health and drug courts.
The cover story offers a case study about how leaders in Bexar County, Texas, developed these elements through community-wide collaborations into an effective jail diversion program and a highly integrated and cost-effective system for community crisis care. Their results were so compelling that Texas legislators asked all the state's counties to adopt this approach.
This month's Tools for Transformation column details a truly “outside the box” effort to develop 100 state prison inmates into certified peer support specialists. While these peers now serve other prisoners, many look forward to work as community-based peer specialists upon release.
The motivation that drives those who create, lead, and serve justice initiatives like these is impossible to explain in “ordinary” terms like money, power, or success. I would struggle further to explain, except for the fact that I believe that many of you know exactly what I'm referring to. Even latecomers, those who get involved in an initiative because it seemed like the “right” thing to do-fiscally, politically, or logically-come to realize that it may also be the most powerful, transforming, and human thing they'll ever do, too.
Dennis G. Grantham, Editor-in-Chief Behavioral Healthcare 2011 November-December;31(8):6