Disabled Comprise Large Percentage of Prisoners, Study Shows

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By Jessica DaSilva

July 18 — The prison population includes high percentages of people with disabilities who are “swept up into the criminal justice system” because of a lack of available community resources, according to a panel of social justice and criminal justice reform leaders who spoke at the White House on Monday.

The panel coincided with the release of a study from the Center for American Progress, a left-leaning think tank, finding that a reduction in state mental hospitals and other institutional facilities over a 60-year period were not accompanied by provision of alternative remedies to help those former residents.

As a result, it is prisons and jails that provide more mental health care and disability resources than other community agencies, the report stated.

Individuals with disabilities and mental illnesses found themselves jailed for low-level infractions like sleeping on sidewalks because there were no other options available, the study says.

The study cites to numbers from the Bureau of Justice Statistics showing that people serving time in state and federal prisons are three times more likely than the general public to report having a disability. Jail populations are more than four times more likely, the study said.

One in five inmates reported having a mental illness, according to the study.

Treatment a Cheaper Alternative

CAP argues in the study that treatment programs are cheaper than jailing the mentally ill. It mentions a 2014 study that surveyed Los Angeles County and found jailing an individual with mental illness exceeded $48,000 a year, but treatment amounted to less than $20,500.

The study details reform measures for various aspects of the criminal justice system that would better address the needs of people with disabilities, according to the study.

Police, for example, often engage in “mercy booking” where they arrest people displaying signs of mental illness because jail offers food, shelter and needed health care, the study says. Well-meaning officers will sometimes take people with disabilities to emergency rooms, not realizing they can't receive proper mental health care there.

The problem becomes compounded in minority communities, which see higher rates of disability and more interaction with police officers, according to the study.

The best way to combat ineffective policing of the disability community is with information and training, the report asserts.

Taking a more proactive approach in communities is another way to enact meaningful reform, the study states. Creating “community crisis centers” that have short-term beds, substance abuse treatment, case managers and other social services are another way CAP recommends to ensure that people with disabilities get the right attention they need.

Burden Shifted

Peter J. Koutoujian—sheriff of Middlesex County, Mass., who spoke on the panel—told Bloomberg BNA that without community resources like housing, substance abuse treatment, mental health care and health insurance, the burden for care has shifted to the criminal justice system.

“We're criminalizing mental illness,” Koutoujian said in a phone interview.

Not only are people with mental illness jailed for lower offenses, but incarceration typically exacerbates mental illness, he explained.

However, Koutoujian said it's not as easy as providing treatment programs. Prisons can provide classes and training for employment, education and parenting, but all prisons can do for mental illness is evaluate and stabilize inmates, he explained.

“The long-term solution is done outside prison,” he said.

Koutoujian said he's been vocal about the need to address mental health concerns since he first became sheriff five years ago. He said he's implemented a number of reform efforts, such as enacting a Massachusetts law that allowed for the suspension of Medicaid coverage for incarcerated individuals rather than termination.

Now inmates can have their coverage reinstated upon release.

While Koutoujian said 2 to 3 percent of the general population is without insurance, about 26 percent of inmates entering incarceration are typically uninsured.

If inmates are not registered for Medicaid when they start their sentences, they're evaluated for Medicaid qualification, Koutoujian said. Those who qualify are registered and have their coverage suspended so they will have insurance when they're reintroduced to the community, he said.

Koutoujian said the result is a 33 percent reduction in recidivism for those prisoners who have health insurance when they leave prison or jail.

The need for more comprehensive types of reform is necessary to adequately react to the reality of high disability rates in imprisoned populations, he added.

“We don't choose who we incarcerate,” Koutoujian said.

To contact the reporter on this story: Jessica DaSilva at jdasilva@bna.com

To contact the editor responsible for this story: C. Reilly Larson at rlarson@bna.com

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