A critical issue is the intersection of behavioral health and the criminal justice system.

We have a high percentage of people behind bars who are suffering from mental illness, drug addiction, or both, and without adequate treatment for their behavioral health issues these offenders will not recover and will probably reoffend again. This is both a public health and a public safety issue, a moral and an economic challenge that we must confront and resolve.

Here are some national and local statistics to give some idea of the size of the problem:

• Nationally: 1 in 100 U.S. citizens are behind bars: in jail or in prison (over 2.3 million in total). The U.S. incarcerates more people per capita than 26 of the largest European nations combined. 
• In New Mexico the rate is only slightly better as we have about 1 in 150 citizens behind bars (over 13,000 are behind bars in New Mexico—we have more in our county jails than in our state prisons). A recent LFC report focuses on those incarcerated in the state prisons and identifies a key issue:[1]
  • Ninety-five percent of incarcerated offenders will be released back into the community. 
  • About 50 percent of offenders will return to prison within five years, with the average offender making three trips to a NM Correctional facility, with others many more.
    • The citizens of New Mexico will, therefore, pay costs of arresting, prosecuting, housing, rehabilitating and supervising offenders many times over. A 2012 LFC program evaluation estimated that if current trends hold, offenders released in FY11 will cost taxpayers an estimated $360 million in corrections costs alone over the next 15 years.
      • Reducing recidivism, even by just 10 percent, can save millions. 
  • As the LFC report goes on to state, rigorous research has demonstrated that some programs and strategies reduce recidivism and improve public safety.
• Which brings the discussion back to the behavioral health issues behind bars, as untreated drug addiction and mental illness are the hidden drivers of much of the re-offense rate identified in the LFC report, as well as additional costs borne by the New Mexico taxpayer:
  • Looking to national data again
    • 80% of offenders  abuse drugs or alcohol, and
    • Nearly 50% of jail and prison inmates are clinically addicted.
    • Approximately 95% return to drug abuse after release from prison, and
    • 60 to 80% of drug abusers commit a new crime after release from prison.
  • Clearly, drug abuse fuels much of the re-offense rate referenced earlier. A related piece of information that also points to additional cost drivers involves the offender population with mental health issues:
    • On any given day, between 300,000 and 400,000 people with mental illnesses are incarcerated in jails and prisons across the United States, and more than 500,000 people with mental illnesses are under correctional control in the community.[2]
      • The rate of serious mental illness is two to six times higher among incarcerated populations than it is in the general population (14.5% of men and 31% of women in jail settings).
        • In a U.S. Justice Department survey, 16 percent of state inmates were estimated to have a mental illness.
        • In U.S. Justice Department and SAMHSA surveys, 9 percent of individuals on probation and 7 percent of individuals on parole were estimated to have a serious mental illness.[3]
    • Related to the earlier point on drug involved recidivism, over 70% of people in jails with serious mental illness also have a co-occurring substance-use disorder.
      • But despite these high rates, between 83% to 89% of people with mental illness in jails and prisons do not receive care. 
      • People with serious psychiatric needs are more likely to be violently victimized and more likely to be housed in segregation while in prison and stay for longer periods.  
      • This latter finding is echoed in NM data as the NMSC during a study of the effect of mental health diagnoses on length of stay in detention facilities in Bernalillo and Dona Ana County found that receiving mental health services could add on average an additional 36 days to a defendant’s length of stay, while arrestees with a diagnosis of a psychotic diagnosis could add as much as 121 days to the length of stay.
      • Such additional days add significant additional dollars to the costs borne by New Mexico taxpayers, even before such offenders have been released and are in a position to reoffend again.
• As the LFC report mentioned earlier states, “rigorous research has demonstrated that some programs and strategies reduce recidivism and improve public safety.” Adult Drug Courts and Mental Health Courts are two such programs, showing cost-benefits of $3 to $4 for every dollar invested. These programs were developed as an alternative to this costly revolving door of incarceration. They treat the offender’s addiction or mental illness, the disease that drives the repeat criminal behavior; do so for an extended period of 9 to 12 to 14 months, while holding the offender accountable through frequent drug tests (or monitored medication for those with a medically treatable mental health issue), probation visits and judicial hearings; and require prosocial behavior, such as renewed education, community service, and steady employment. 
• These programs turn tax drains into tax payers. More studies have been done of drug courts than of all other criminal justice programs combined.  They conclude that drug courts work, that they reduce substance abuse and re-offense and are more cost-effective than jail (by 3 to 1) or prison (by 5 to 1). 

[1] NM Legislative Finance Committee, “LFC Results First: Evidence-Based Programs to Reduce Recidivism and Improve Public Safety in Adult Corrections,” July 2013
[2] National Leadership Forum on Behavioral Health/Criminal Justice Services, “A Call to Action. Ending an American Tragedy:
Addressing the Needs of Justice-Involved People with Mental Illnesses and Co-Occurring Disorders,” September 2009
[3] Fred Osher, MD; David A. D’Amora, MS; Martha Plotkin, JD; Nicole Jarrett, PhD; Alexa Eggleston, JD, “Adults with Behavioral Health Needs Under Correctional Supervision:  A Shared Framework for Reducing Recidivism and Promoting Recovery,” Council of State Governments Justice Center, 2012

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