The criminal justice system bears an alarming share of the load of mental health care in the United States, often placing people with mental illness and substance use disorders in systems that have neither the resources nor the expertise to provide them the care they need. An estimated two million people with serious mental illness are booked in our jails each year. The Bureau of Justice Statistics reports that only a third of inmates with mental illness receive treatment, and for those that do, too often they receive less than the optimal care.

The American Psychiatric Association (APA) is one of the main partners in a coalition that is advocating for systemic changes to how the criminal justice system addresses behavioral health. APA, along with the National Association of Social Workers (NASW), the American Psychological Association, and others, has released a comprehensive list of policy recommendations on this important area for the 116th Congress and the Trump Administration.

Our goal is to affect meaningful change for the thousands of people with mental illness in our country who are languishing in prisons and jails without access to proper treatment for mental illness and substance use disorders. Many of the recommendations in the consensus document are informed by the thorough, evidence-based work of the report from the Interdepartmental Serious Mental Illness Coordinating Committee (ISMICC), on which many APA members served.

We strongly support existing efforts to address the issues at the heart of the intersection of mental health and the criminal justice system. Jail diversion, drug courts, Crisis Intervention Teams (CITs) and offender reentry programs have done vital work, but they are not available in enough places across the country to address the national need for those services, and the programs that do exist require additional support, training and funding.

The next steps in our fight to reduce recidivism and improve the lives of people with mental illness and substance use disorders in America will require close coordination between state, local and federal authorities. Jails should not be the first line of treatment.

We need to use telemedicine more to connect those in crisis with a trained mental health professional and treat patients incarcerated in rural communities. Expanded adoption of collaborative care models can really improve the outcomes for those with co-occurring disorders. Congress should continue to fund Certified Community Behavioral Health Clinics, which were some of the first community-based programs to have first responders use electronic tablets to deliver telemedicine in real time.

We also need the help of Congress to ensure that funds are provided for community-based crisis services, so the resources are in place to treat those with serious mental illnesses instead of sending them to jail in the first place.

You can read the full list of recommendations here. Know that these are the next steps in what will be a long process of moving the care for thousands of Americans with mental health and substance use disorders out of a correctional setting, and into a medical one, where treatment, recovery and prevention are emphasized above all.

Saul Levin, M.D., M.P.A.

APA CEO and Medical Director