BAIL SETTING / JAIL DETENTION OF PEOPLE WITH SMI.
Opposes bail setting that can hold someone captive from medical treatment and/or management for serious mental illness (and cash bail in general). The practice of bail setting that supersedes the need for critical medical treatment has resulted in lawsuits being filed across the country on behalf of people waiting for unconstitutionally long periods of time to receive “competency restoration” (which should not be conflated with treatment – which is medical care intended to promote wellness and well-being…competency restoration is for the explicit purpose of preparing someone who is neurologically detached from reality for prosecution).
MENTAL HEALTH COURTS
While DJP continues to support the proliferation of mental health courts as a just way to keep people with mental health issues out of jails, there is a concern that mental health courts are modeled in such way that anosognosia/symptomatic behaviors and may be punished with jail time. Psychosis generally and Schizophrenia particularly are not “mental health issues”, they are neurocognitive / neuropsychiatric disorders. The administration of these courts fail to reckon with the behavioral symptoms of neurocognitive disease logically and morally. The criminal justice system needs a way of adjudicating matters that involve crimes committed by people with severe mental illness, however, part of that process needs to be an examination of failures that occurred in the case management in the community, failure or latency in diagnosis, and other factors. The language of “recidivism” which is illogical in the case of chronic or serious mental illness needs to be eliminated and replaced with terminology that is reconciled to medical science. Jail diversion programs often require guilty please – which is unjust.
CARE AND MANAGEMENT OF PSYCHOSIS-SPECTRUM DISORDERS
As stated on the Advocate’s Workshop page, diagnosis and management of psychosis spectrum disorders, particularly Schizophrenia, needs to be removed from the mental health system and integrated fully into a sub-specialty of neurology. That subspecialty might credential allied specially trained paraprofessionals in order to support supervising clinicians and to address regional shortages in credentialed clinicians in the sub-specialty.
Supports long-term to permanent dignified institutional housing (such as LTSRs) for people with serious mental illness who are too ill for supportive housing in the community (i.e. “supportive” vs “supported” – there is a distinction. Supported housing can involved 24/7 onsite staff, while supportive may have no onsite staff). Families are not equipped to care for a subgroup of the SMI population any more than jails and prisons.
DISPOSITION OF NGRI DEFENDANTS
DJP advocates for medically-centered, not punitive, high-security hospitals or other institutions that are suitably configured, structured, and staffed for housing people who have committed violent crimes for long term care, stabilization and containment until such time that the individual can be stepped down to locked units or secured LTRS. DJP takes issue with advocates and civil liberties organizations who have pressed legislatures to apply the Olmstead Ruling of the U.S. Supreme Court to an unreasonable degree. The result of this advocacy is a critical paucity of appropriate institutional settings to place those who have committed violent acts due to their illness. Judges are refusing to accept NGRI and GBMI pleas and are sentencing philosophically innocent people to prison stating fears that the defendant will be turned out the hospital into the community. The willful exploitation of the Olmstead “mandate” by the states leads to a paucity of dignified institutional residency. Judges are punishing people for fear of the application of a supreme court ruling.
FORENSIC DESIGNATION FOR CLINICIANS & MEDICAL FACILITIES CRIMINALIZE SMI.
Favors the designation of criminologist for any person engaging in psychological assessment of individuals engaged with the criminal justice system – who passively or assertively participates in buttressing the prosecutorial apparatus. Proposes that the medical profession should cease conferring the credential of “forensic psychiatrist” to medical professions specializing in the treatment of people afflicted with severe mental illness. A psychiatrist is a medical doctor who specializes in the diagnosis and treatment of mental illness. DJP believes that a doctor is a doctor and a hospital is a hospital. Attaching the forensic designation is manifest of the pernicious dissociation of violence from the neuropsychiatric disease. (The dissociation of SMI from violence is discussed in E. Fuller Torrey’s book The Insanity Offense)
DEFINITION OF INSANITY BY THE STATES
Opposes the Supreme Court’s decision to permit each state to construct its own definition of insanity. Moreover, proposes a carve-out, specialized defense that does not obscure the grave condition of severe mental illness behind a generic legal definition of “insanity”.
Opposes lawsuits against state departments of human services for the scarcity of forensic hospital beds for inmates awaiting transfer for “competency restoration”. Counties should be held responsible for holding human beings in need of medical treatment for serious brain disorders in jail – particularly anosognosic people who will likely refuse medication while jailed. DJP does not condone the use of a legal terminology (incompetence) that seeks to abstract the truth that lack of competence is caused by a grave medical condition. These lawsuits charge state departments of human service/mental health with providing more ‘forensic’ beds. The last thing that is needed is more forensic beds that serve as a conduit to immoral due process and unjust conviction. The number of forensic beds have increased as civil beds become increasingly extinct. DJP supports lawsuits against those directly responsible for detaining the sick in jails for these unconstitutionally long periods of time.
Strongly opposes M’Naghten’s Rule as being disengaged from and entirely in dissonance with the neuroscience of psychotic disorders or other severe disorders of consciousness. There needs to be an explicit special defense for SMI that is in accord with clinical insanity.
FELONY DIVERSION PROGRAMS
Supports the proliferation of felony mental health courts and preferably other models (such as sequential intercept) that do not operate upon the presumption of sanity prescribed by the criminal justice system. Opposes mental health courts that incorporate the administrative policies and procedures characteristic of traditional criminal courts – and which require guilty pleas for eligibility.
Opposes the characterization of re-entry by individuals with severe mental illness into the criminal justice system as “recidivism” as this terminology is in dissonance with the neuroscience of psychotic disorders.
Asserts that the interests of the sovereign states in promoting public safety are better served morally and constructively by proactive humane policies rather than back-end, unjust prosecution and punishment of the symptomatic consequences of severe mental illness that is untreated, mismanaged, refractory to treatment, or in relapse.