Recently, the leaders of the criminal justice system in La Crosse County got together to discuss the impact of untreated mental health on the local court system.  Startled by the fact that 40 percent of inmates reported some history of mental health problems upon intake, the community leaders used the forum to discuss what is currently being done and what could be done in the future. LaCrosse County is not unique in their struggle to address the combination of mental health crises and criminal behavior.  Surveys indicate more than half of all inmates in the country have a history of mental illness with more than 60 percent of county jail inmates experiencing symptoms of their diagnosis.  For comparison, the general rate in the United States of people who have experienced symptoms of mental health disorders is less than 20 percent.

The high incidence of mental health problems among those accused of crimes presents a significant problem.  Once a crime has been committed, what is the best response from our criminal justice system if the crime is linked to unresolved mental health problems?

Multiple challenges exist at every stage of the criminal justice system.  First, law enforcement needs the training to recognize a mental health crisis at the time of the investigation.  Second, even if properly identified and appropriate, diversionary programs should be made available.  It does no one any good if a treatable mental health crisis can only be safely resolved within a correctional setting because of a lack of alternatives.  Third, if criminal charges are the appropriate response, the court system needs the tools necessary to achieve the goals of sentencing.

The third requirement is the trickiest.  For most of the last century, punishments have been confined to fining, supervising, and incarcerating.  Only in the last couple of decades have the courts looked to a combination of treatment in conjunction with traditional sentencing schemes.  The purpose of treatment reflects the goals of punishment and rehabilitation—address the prior situations and prevent a reoccurrence.

The problem La Crosse County is facing is similar in a lot of counties.  They have treatment courts that are narrowly defined.  There are veterans and drug courts.  Unfortunately for the mentally ill, they may not qualify. Treatment courts can both reduce recidivism and lower the costs borne by citizens to maintain justice.  There is no reason to exclude mentally ill defendants—whose medical condition is a significant contributing factor to the crime—from benefitting from these successes.