It’s been a long time since I practiced law, but two things got my legal instincts stirring this week. They suggest strategies that might help advance the cause of mental health care.
The sheriff of Cook County, the greater Chicago, Ill. area, threatened to sue the state for turning the county jail into a “dumping ground” for people living with mental illness. Approximately 20 percent of the jail’s population receives psychiatric care. Many have committed relatively minor crimes such as shoplifting or trespass.
Then, the U.S. Supreme Court announced a 5-4 decision holding that conditions in California’s overcrowded prisons are so bad they violate the U.S. Constitution’s ban on cruel and unusual punishment. The state will need to release more than 30,000 inmates. Even so, California prisons will remain almost 140 percent over capacity.
The New York Times noted that the court’s majority opinion went so far as to include photographs of prison conditions. But in a dissenting opinion, Justice Antonin Scalia argued that most prisoners released probably will not be those with medical conditions or mental illness, but rather “physical specimens who have developed intimidating muscles pumping iron in the prison gym.”
Along with the Cook County sheriff’s threat, Scalia’s comment points to more fundamental issues.
Can states develop mental health care systems to keeps people with serious mental illness out of prisons in the first place?
Will prisoners with mental health problems who are released be able to find help in communities “on the outside?”
Will states at least improve conditions for those who remain imprisoned? In 2003, Human Rights Watch released Ill-Equipped: U.S. Prisons and Offenders with Mental Illness, a report NAMI called “the equivalent of a five alarm fire.” Prisons are probably the worst environments for treating individuals with mental illness. Conditions can push a person “over the edge” into acute psychosis.
I haven’t finished reading the court’s 50 page opinion (plus dissenting opinions), so I don’t know whether any of the Justices read or cited the Humans Rights Watch report. If they didn’t, they should have.
Legal opinions aren’t always fun to read. I once took my 10-year-old daughter to visit the law school I attended. She looked at thick volumes of case reporters on endless dusty shelves in the library. “This is the most boring place I’ve ever seen,” she said. “No way am I ever going to be a lawyer.” Part of me agrees with the sentiment. But then I remember that sometimes it’s often only legal strategies that can protect human rights against the failings of legislatures and other institutions.