RUTHFULLY YOURS

http://www.nationalreview.com/node/429106/print

Not again! This past Saturday, a Chicago police officer responding to a 911 call shot and killed Quintonio LeGrier, an allegedly mentally ill man who had been threatening his father with a baseball bat and, bat in hand, was approaching the officer. The officer’s bullets also killed Bette Jones, an innocent bystander. There were 1,126 fatal shootings by police this past year. Half were shootings of persons with mental illness. In Chicago, as elsewhere, families and friends of the deceased called for better police training, echoing a call frequently made by mental-health advocates. But by limiting the proposed reforms to calls for police training, the families and public are letting these mental-health advocates off the hook for their own culpability.

The mental-health system has essentially severed the tie between gaining public mental-health funds and using them to serve the most seriously ill. Police chief (ret.) Michael Biasotti, former president of the New York State Association of Chiefs of Police, explained the phenomenon to Congress in 2014:

We have two mental-health systems today, serving two mutually exclusive populations: Community programs serve those who seek and accept treatment. Those who refuse, or are too sick to seek treatment voluntarily, become a law-enforcement responsibility. . . . [M]ental-health officials seem unwilling to recognize or take responsibility for this second, more symptomatic group.

The numbers prove he is right. In the United States there are fewer than 100,000 seriously mentally ill people in psychiatric hospitals being cared for by the mental-health system. But there are 365,000 seriously mentally ill people incarcerated, along with 770,000 on probation or parole and 165,000 homeless. Clearly the police are serving more of the seriously ill than the mental-health system is, and they are the real experts.

This too often puts the policemen’s own lives in peril. At least half the attacks on officers are by persons with mental illness. And while mental-health advocates correctly claim that most people with mental illness are not more violent than others, we cannot ignore the fact that those with serious mental illnesses who are allowed to go untreated are, in fact, more violent than others. A 2013 investigation by Mother Jones found that 63 percent of mass shooters between 1982 and 2012 had mental illnesses.

So instead of having the mental-health system train the police on how to handle the mentally ill, the police should train the mental-health system on how to stop shunning the most seriously ill.

Police want to overturn policies espoused by the mental-health industry that include closing psychiatric hospitals, making civil commitment more difficult, and focusing public mental-health resources on sideshows like bullying and stigma, rather than serious mental illness. Those policies are killing far more of the mentally ill than police bullets, causing the over-incarceration crisis, and costing taxpayers billions. They may have been responsible for Mr. LeGrier’s death.

We need more psychiatric hospital beds. At a press conference, the grieving mother of Mr. LeGrier asked, “Why couldn’t he be in the hospital if something had to happen?” The answer is that Illinois has less than a quarter of the psychiatric beds it needs. As a result of this shortage, the Cook County jail has become the largest psychiatric facility in the country. Sheriff Tom Dart runs the jail and has become a hero to families of the seriously mentally ill because he has frequently taken on the mental-health industry by arguing for what they oppose: more hospitals for the seriously ill. Long before the shooting, he told 60 Minutes:

There is no one who can argue the jails are not the new insane asylums. That’s what they are. The irony is so deep that you have a society that finds it wrong to have people . . . in state mental institutions, but those very same people were OK if we warehouse them in jails. You’ve got to be kidding me!

More psychiatric beds, not just police training, has to be on the agenda. Another solution supported by law enforcement and families of the seriously ill is to make greater use of Assisted Outpatient Treatment (AOT). Assisted Outpatient Treatment is court-mandated monitored treatment for a small group of the most seriously mentally ill who have already accumulated multiple incidents of arrest or violence. The six-month court order requires them to stay in treatment while they continue to live free in the community. It has reduced incarceration, arrest, and hospitalization by figures in the 70 percent range. Importantly, it saves taxpayers 50 percent of the public cost of care by replacing expensive hospitalization and incarceration with less-expensive community treatment. Greater use of AOT is strongly supported by the National Sheriffs Association, the International Association of Chiefs of Police, the U.S. Department of Justice, and parents of the most seriously mentally ill.

In response to the suggestions of parents of the seriously ill and those in law enforcement, Representatives Tim Murphy (R., Pa.) and Eddie Bernice Johnson (D., Texas) introduced the Helping Families in Mental Health Crisis Act (H.R.2646), which takes steps to increase the number of hospital beds and promote wider use of AOT. It also puts first responders on key federal mental-health committees, so they can fight proposals from the mental-health industry that will cause more people to become a police responsibility. And since, like it or not, police are the new mental-health system, the bill provides funds for police training. Most important, it starts to rein in the out-of-control mental-health industry by tying the granting of some previously unfettered federal mental-health dollars to an obligation to serve the most seriously ill. All those components might have kept Mr. LeGrier alive and well.

Why do families call police to help mentally ill family members? Because calling the mental-health system, in spite of the billions spent on it, is too often useless. That is what has to change.

— D. J. Jaffe is executive director of Mental Illness Policy.Org, a think-tank on serious mental illness, and is looking for a publisher for his book on mental-illness policy.