I went to meeting of our local Criminal Justice Commission last week. The commission created a task force called the Criminal Justice, Mental Health and Substance Abuse Planning Council. After months of research the council held a “summit” to prioritize their goals. The consultant admitted – out loud – that he had to be educated about dual diagnosis before he started his research. There were charts, cost estimates and a free breakfast.  They came up with a fancy bureaucratic-babble name that I have already forgotten. 

I wanted to scream. I know these people mean well but they are designing programs that probably won’t work. Why? Because they do not know what they do not know. Most alcoholics and addicts charged with a crime have another mental illness. Most mentally ill people charged with a crime are also addicts or alcoholics. The number one reason for relapse among recovering alcoholics and addicts in the criminal justice system is untreated depression, biplolar or other mental illnesses. The number reason that the mentally ill in the criminal justice system cannot be stabilized is because they are abusing drugs and/or alcohol.

The medicine for depression and bipolar and other mental illnesses are antidepressants, mood stabilizers, anti-psychotics and other medications (preferably NOT benzodiazepines.) The medicine for alcoholism and addiction is a 12-step program – the most successful abstinence program ever.  Who in the criminal justice system knows what a 12-step program is? Who knows how a 12-step program works? Who knows the 12-steps? If judges, prosecutors, attorneys and probation officers could answer these questions they would know what questions to ask to determine if someone is really clean and sober and working a program.

Learning about 12-step programs is simple, easy and costs almost nothing. Get “the” book and read the first 168 pages. Then make sure the addict or alcoholic in court gets “the” book, reads the first 168 pages and works a program. As for medication, it is stupid and cruel to release a mentally ill inmate with a prescription for a week’s worth of medication, as they do here.

Jails, unlike prisons, are for defendants who cannot post bail or are serving short sentences. Many dual-diagnosed defendants have not been in jail long enough to know whether their newly prescribed medications will work. It can take many week, even months, to find out if a particular drug will work. What good is giving a prescription for a week’s worth of medications that may or may not work? 

How do we make sure that these dual-diagnosed criminals continue to take their meds and show up for check-ups after their release? Simple. Pay them – with money or reduced sentences. Every time they show up – on time – for an appointment they get $50 or their probation reduced by a day or week. This will tick off Rush  Limbaugh but it is much cheaper and we will all be safer if mentally ill criminals  take their medications and stay clean and sober. 

We can pay them to stay healthy or we can pay for them to fill our jails and prisons.

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    Last reviewed: 6 Apr 2009