Expert: More Resources Needed To Better Identify Inmates With Serious Mental Illnesses
MARK BRODIE: A Maricopa County Grand Jury last week indicted Michael Paul Adams for first-degree murder in the death of a 17-year-old at a Peoria convenience store. Adams has said he stabbed Elijah Al-Amin after hearing rap music coming from the teen's car. His attorney has said Adams did not receive needed mental health training before being released from prison days earlier. A spokesman for the state corrections department though, says Adams had not been... designated seriously mentally ill. With me to talk about how the corrections system identifies inmates with serious mental illnesses or SMI's and more is Jose Ashford, director of the Office of Forensic Social Work at ASU. And, Jose, first off, in general do you think the state does right by people who have SMI both while they're incarcerated and then once they're released?
JOSE ASHFORD: No, at this point in time they lack sufficient resources. But at the same time they're also hampered by some of the current policy requirements., some of the statutory requirements.
BRODIE: Like what?
ASHFORD: Well, truth in sentencing, determinate sentencing. So in many ways, if a person is needing care in a community, in the form of a conditional release; we eliminated in 1993, 1994 parole. And that makes it difficult for releasing individuals effectively into the community.
BRODIE: What ideally should be happening? Let's start when somebody enters the criminal justice system, when somebody is being screened before they enter jail or prison. What is happening and what should be happening?
ASHFORD: Well, classification is the most important thing. You know, it's like in real estate; location, location, location. And prison context in correctional systems it's; classification, classification, classification. So in many ways, individuals need to be screened, to identify whether or not they have special needs. And those special needs would include mental health concerns.
BRODIE: What about that is not happening now?
ASHFORD: Well, we do have a reception center where that's taking place. And in many ways, I think it's a question of volume. If a person enters into the system and there's not sufficient information provided to the correctional officials, then in many circumstances a person can, kind of, fall through the cracks. It's interesting, that in most systems, because of the high rate of persons being incarcerated that individuals will be asked to self-identify.
BRODIE: It seems as though, this would be, to your point earlier, an issue of resources. Where, maybe, prisons and jails and other correctional facilities don't have the staff or maybe even the knowledge to really get a sense, independently, whether or not somebody does have an SMI.
ASHFORD: Yeah, I worked in the system early on when resources were available in other states. Give you an example, in Wisconsin the period would be 30 to 60 days in reception, where you would have employed social workers who would do a thorough background check to basically find out information that would help in the classification process. At this current time, there are no social workers hired by the Department of Corrections. And so, that impedes that, you know, component of the screening process.
BRODIE: Is prison really the best place to try to treat somebody with a serious mental illness, to try to help them through it or help them to get to a place where they can, sort of, function in society?
ASHFORD: No, it's general consensus that persons with serious mental illnesses, that's not the appropriate place for them. And, in many ways, you need differential responses depending upon the type of diagnosis the person has. And, once again a prison system is not as well equipped to deal with those variations.
BRODIE: What happens, when somebody has served their term and they're set to be released? I mean, does the corrections system have a way of helping those folks, sort of, make it on the outside? Is there some obligation they have to, you know, have them prepared with medication or have them hooked up with a therapist or a counselor or somebody to sort of monitor how they're doing?
ASHFORD: At this point in time, I think the director is starting to institute policies for re-entry. And that's kind of a national crisis now, because we've really emphasized a shift in policy towards determinate sentencing, truth in sentencing. And so, once a person reaches that maximum level of time served that is required by law, then there just, have to, the institution has to automatically released. But the aims and justification for this system, is no longer rehabilitation or correction. So, in many ways re-entry is being neglected at multiple levels. And this is most critical for individuals who have special needs, like serious mental illnesses.
BRODIE: So what's the answer then? I mean, it almost sounds like you're advocating for some kind of like, midway step. Somebody, maybe, has served their term and doesn't need to be incarcerated anymore but isn't quite ready to be sort of back on their own.
ASHFORD: Yeah, and I think, you know, furlough programs try to test whether or not a person is ready for... re-entry. So, a step-down program is one of the things that, quite often, is recommended. The evidence based practices for re-entry required that, let's say six months prior to release that individuals begin an individualized assessment of a person's needs. Then they establish a transition kind of level of intervention once the person is released and then the follow up period. And none of those are instituted at this point in time for individuals with serious mental illnesses in Arizona.
BRODIE: Well, what are the costs associated with that? I mean, it sounds like an extra step, I would imagine there's an extra cost there too.
ASHFORD: Yeah, we did a cost study of it and it was more expensive, obviously, than someone who's just released from jail or prison. But when you saw, we witnessed a reduction in recidivism for violent offenses in other things. And when you start looking at back costs then it's much cheaper.
BRODIE: All right, that's Jose Ashford, he is, among other things, director of the Office of Forensic Social Work in ASU's School of Social Work. Jose thank you, I appreciate it.
ASHFORD: No problem.