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Mental health, substance abuse issues common among arrestees

Updated: 
August 4, 2015 - 1:30am

HONOLULU — Half of the people arrested in Honolulu have mental illness or substance abuse issues, despite police efforts to get such people treatment rather than put them behind bars.

The percentage of psychologically troubled arrestees has doubled since 2010, according to information compiled by nurses who work in the downtown cellblock and reported by the Honolulu Star-Advertiser.

“We’ve made good progress at diverting people from the criminal justice system,” said Honolulu Police Department psychologist Michael Christopher. “But we still arrest two people for every one we divert.”

The spike in the number of mentally ill people behind bars coincides with cuts to mental health care services and a growing Honolulu homeless population.

Four out of 10 detainees at the downtown jail have no permanent home.

“Folks who have severe mental illness live in a consistently vulnerable state,” said Steven Balcom, crisis services coordinator with the Health Department’s Adult Mental Health Division. “Their income is very low, and once they fall into homelessness, it’s extraordinarily difficult to get them out, just from a resources perspective.”

The problem isn’t limited to Honolulu: Across the U.S., there are 10 times more people with serious mental illnesses in jails and prisons than in state psychiatric institutions, according to the national nonprofit Treatment Advocacy Center.

“To an extent, in America we have kind of defaulted to manage our mentally ill population by putting them in jail,” said Jerry Coffee, clinical director for the Institute for Human Services, which helps homeless people. “You’re incarcerating somebody not because they had intent to break the law, but because they are incapacitated and broke.”

He said many mentally ill people are arrested because of symptoms of their illness.

More than 40 percent of the mentally ill people arrested were on warrants, most of them for failing to appear in court for previous incidents, said Christopher, the police psychologist.

Showing up at the right time, date and place can be a major hurdle for people struggling with such illness.

Most other arrests are for behavior directly attributable to a mental illness, according to Christopher.

It’s uncommon for violence to be triggered by mental illness, according to chief of psychiatry at the Department of Health’s Adult Mental Health Division Dr. James Westphal.

“According to the best research estimates, only approximately 4 percent of violence toward others in American society is attributable to mental illness,” he said. “We’re talking about very small but unfortunately very publicized events.”

Westphal said the best way to minimize the risk of violence among mentally ill people is “early detection and treatment, and intervention to assist with taking medication in the community.”

The jail diversion program is increasing training of police recruits to help redirect mentally ill people to treatment facilities. Starting with the next class, recruits will receive 24 hours of training in mental health crisis intervention rather than the current three hours.

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