as shared, from the Chicago Tribune Opinions, July 29...
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For more than 50 years, the Tinley Park Mental Health Center served as the treatment facility for up to 1,900 mentally ill patients annually. These days, the patients have been left to fend for themselves as the building lies vacant — a stark and eerie reminder of everything that is wrong with Illinois' mental health system.
Since the 1960s, the number of beds in Illinois' state-run psychiatric hospitals has decreased to fewer than 1,500 from 35,000, according to the National Alliance on Mental Illness. The latest closures in 2012, including the Tinley Park center, coincided with Chicago shuttering half of its 12 mental health clinics. For decades, we were told that government was not turning its back on the mentally ill. Rather, these institutions would be replaced through "reinvesting in community care" — a more humane and cost-effective means of treating those patients.
Those of us within the mental health and law enforcement communities know the truth — the "reinvestments" never come to fruition. When these institutions close, the seriously ill patients end up on their own, often on the street with no support system to keep them stable or medicated. Inevitably, they suffer psychotic states and commit petty crimes that land them within the unyielding grip of the criminal justice system — caught in a revolving door between jail and the streets.
Indeed, mental illness has been effectively criminalized in Illinois. The same society that deemed the old mental asylums as abhorrent has witnessed the evolution of jails and prisons into the new asylums. Currently, the largest mental health hospital in Illinois is not even a hospital — it's Cook County Jail, which I oversee as sheriff. My office's conservative estimate is that one-third of the 10,000 inmates in custody suffer from serious mental illnesses.
This crisis is hardly isolated to Chicago or Cook County. This ongoing nightmare is spreading throughout the nation. According to the Treatment Advocacy Center, jails and prisons serve as the largest mental health institutions in 44 states. Additionally, 10 times as many mentally ill individuals are currently incarcerated as are residing in state hospitals. According to NAMI, states collectively cut $4.35 billion in mental health spending between 2009 to 2012. Illinois ranks as the third worst offender, following a 31.7 percent reduction in its mental health budget, according to NAMI. These cuts have had tangible effects on real people.
Who are these mentally ill men and women? Contrary to popular belief, they are not dangerous criminals. Yes, we have some violent mentally ill inmates in the Cook County Jail, but they are the exceptions. The vast majority of these inmates are charged with low-level crimes of survival: prostitution, trespassing, disorderly conduct. Many are facing drug charges — for those unable to get medication to make the voices in their heads go away, heroin is often the next best solution. They are, for the most part, good people who suffer from an illness beyond their control and simply need their government to have its priorities straight.
The fact is that doing right by the mentally ill will help address our state budget problems. Incarcerating just one seriously mentally ill inmate costs two to three times the rate of the average inmate, taking into account medications and enhanced security to protect against self-harm. For a fraction of that cost, we can empower new community health centers and establish comprehensive discharge planning. It's humane and fiscally prudent.
Here's just one example. I recently met Joseph, a 54-year-old inmate who has spent most of his adult life battling schizophrenia while shuffling in and out of prisons, nearly always for petty theft. A patient at Tinley Park Mental Health Center, he established quality relationships with the staff and had a stable medication schedule. When the center abruptly closed, he felt broken. No community-based alternative was ever provided for him. Within months, he reverted to self-medication and landed in jail for stealing a $248 handbag from Bloomingdale's while in a psychotic state. "I've been falling through the cracks a long time," he told me.
Joseph recently received a one-year sentence. That $248 purse will cost Illinois taxpayers in excess of $16,000, the annual price to house a prisoner in the state facility where Joseph now resides.
Joseph and tens of thousands like him in our state deserve a fair shot at leading productive and fulfilling lives. Instead, they are falling through the cracks of broken promises. Any further talk of "reinvesting" in mental health should be accompanied by concrete plans and budgets. It's time to help the most vulnerable among us.
Tom Dart is the sheriff of Cook County, Illinois.
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