Mental Health and the Criminal Justice System
By William King Self, Jr., CELA 
There are large numbers of underserved individuals with mental illness in communities across the U.S.–largely due the federal government’s failure to fund community programs in the wake of deinstitutionalization. A disproportionate number of these individuals become embroiled with the criminal justice system. It’s been reported that the number of prison inmates being treated for mental illness tops the total being served by hospitals and treatment centers.
Too often, first responders are unaware that they are witnessing a mental health crisis. They may misinterpret someone’s behavioral tics or failure to respond to questions, and quickly escalating tensions can lead to violence. It was just such a tragedy that led the City of Memphis in 1988 to partner with NAMI  (National Alliance on Mental Illness) and two local universities to teach specialized police units (Crisis Intervention Teams), to defuse explosive situations and to connect individuals with mental health services rather than arrest them. With the passage of the Americans with Disabilities Act in 1990 came increased focus on law enforcement’s obligations to the disability community. Subsequently, police departments throughout the country (more than 40 states) have developed Crisis Intervention Team (CIT) programs based upon what has become known as the Memphis Model .
Roughly 25 percent of the Memphis police force−both emergency dispatchers and patrol officers−has been trained as CIT officers. The CIT officers receive 40 hours of training from mental health providers and advocates. A key element of the Memphis CIT program is that it consists of volunteers who are already trained officers, not new recruits. The volunteers are taught to recognize signs of autism, schizophrenia, OCD, drug-related psychosis, and other mental illness and to employ a variety of de-escalation techniques in order to increase the safety of all parties. They are counseled, for instance, to seek assistance from caretakers and family members, to speak softly and to repeat and rephrase requests for information.
CIT officers are patrol officers stationed in every precinct of the city, and 911 calls that may involve individuals with mental illness, including the elderly with dementia, are routed to them for response. If appropriate, they convey individuals to a central “triage” treatment unit at the emergency room of the Regional Medical Center.
The results have been dramatic—fewer arrests, less use of force and a decrease in violent emergency room incidents. With fewer prisoners requiring care for mental illness and lower injury rates among officers, the program more than pays for itself.
A related initiative, also developed in Memphis, is the Jericho  Project, a jail diversion program developed by the Shelby County Public Defender’s office. Jericho seeks to provide integrated treatment and community supports to individuals with severe, untreated mental illness. The program has been embraced by prosecutors and judges alike, who regularly refer individuals to Jericho as part of conditional release or probation strategies. The Jericho project, like the Memphis Model, has impressive successes to its credit. Over 50 percent of its participants have broken free of the re-arrest cycle.
These models are encouraging, but they’re only a beginning. Far too few police officers are aware of the needs of people with mental illness. The potential for heartbreaking and traumatic misunderstandings is huge. Individuals with mental illness need understanding, not jail sentences.