As perhaps the only member of Congress who has worked in a maximum security prison, I have seen the unintended effects of "deinstitutionalization" directed at America’s mentally ill. I have seen individuals who are living out the rest of their lives behind bars because they have committed crimes that probably would not have been committed had they received mental health treatment. I have seen the effect of prison on the mentally ill and the effect of the mentally ill on the prison. Individuals decompensate. Institutions destabilize. It is an obvious fact that prisons are neither designed nor intended to be therapeutic environments.

I believe that our society has unintentionally shifted the burden of caring for many seriously mentally ill individuals from the mental health system to the criminal justice system. Inmates, families, guards, judges, prosecutors, and police are in unique agreement on this one issue: Our broken system must be fixed. That is why I have introduced a bill that will help coordinate the criminal justice and mental health systems’ response to this most difficult-to-treat population. H.R. 2594, America’s Law Enforcement and Mental Health Project, would establish 25 federally funded mental health courts to divert nonviolent misdemeanants away from jail and into wraparound treatment.

My bill is modeled after mental health courts that have sprung up in communities that decided they can no longer afford to ignore the critical needs of mentally ill offenders. Broward County, Fla.; King County, Wash.; and Anchorage, Alaska, are communities where an intradisciplinary task force of stakeholders has created a specialized court of therapeutic jurisprudence to address the complex issues that mentally ill defendants present to courts. In a mental health court, a dedicated judge and court liaison collaborate with community mental health providers to implement a therapeutic plan that includes talk therapy, medication, housing, and job training. It is a voluntary program that promises dismissal of charges for successful treatment compliance. The goal is to prevent mentally ill individuals from becoming criminalized by ensuring that they receive the mental health services they deserve.

Skeptics say that mental health courts are a fine concept in theory, but are flawed in reality because there are insufficient services to which mentally ill offenders can be diverted. If we wait to act until the services exist, nothing will ever change. We have already waited too long.

A former governor of Virginia expressed dismay that he was "forced to authorize the confinement of persons with mental illnesses in the Williamsburg jail, against both his conscience and the law," because of lack of appropriate services. That was in 1773. In July 1999 the Bureau of Justice Statistics estimated that 16 percent of America’s jail and prison populations are seriously mentally ill. (While 16 percent may seem high, that figure is probably low because the Department of Justice relied upon self-reporting for its methodology.) The American Jail Association now estimates that there are between 600,000 and 700,000 bookings of mentally ill offenders each year. And we know that the largest provider of mental health services in this country is the L.A. County Jail. How long must we wait?

No one can describe this crisis better than those who are trying to cope with it. At a recent Department of Justice forum on the mentally ill in the criminal justice system, one law enforcement person after another stood up and described what it is like for them at "ground zero." John Rutherford, director of corrections at the Jacksonville Sheriff’s Office in Jacksonville, Fla., said:

"In late July 1995, as a new jail administrator within our agency, I was shocked to discover. . .that I was also now the director of the largest residential mental health facility in Duval County, with over 212 inmates on psychotropic drugs. . . .I want to talk to you about the cases that are trespass after warning, indecent exposure, disorderly intox, breach of the peace—those minor misdemeanors that bring these severely mentally ill offenders to jail.

"I want to tell you particularly about one incident that occurred that brought this into focus for me, and I will just call him Inmate Gilbert. I met Inmate Gilbert at the back door of the jail as he was being tripped out to the hospital. He was literally bloody and bruised from head to toe. I tried to inquire what had occurred, and it was clear from speaking with him that he was totally psychotic. I asked the officers, and they reported that he had begun banging his head against the wall in a holding cell, and they had to go in and forcefully subdue him. And Inmate Gilbert was a very large man; handcuffs would barely go around his wrists.

"Two officers were injured in the melee. Inmate Gilbert was severely injured in the melee. I looked to find out what it was that had brought him to our facility in that condition. It was indecent exposure. He was wearing only a shirt, standing in a downtown building in the middle of the afternoon, screaming at the building, and people walking by and people that weren’t walking by. That was his condition.

"We brought him into our facility at jail intake, processed him like we would any other inmate. . . .During the several hours that he spent in that holding cell, he continued to decompensate off his medication and after several hours hit rock bottom and began to bang his head against the wall—and I have already told you the rest of the story."

Like the police and prosecutors, public defenders are struggling to cope with the frustrations of processing mentally ill petty offenders through a beleaguered criminal justice system. Dave Norman, an attorney for Washington D.C.’s Public Defender Service, Mental Health Division, spoke at a mental health court forum on Capitol Hill, which was cosponsored by the Congressional Women’s Caucus and the Congressional Correctional Officers’ Caucus (of which I am a cochair). Mr. Norman told us:

"[Mentally ill offenders] are not fit subjects for our retribution or punishment. The notion that the prospect of incarceration will deter them from committing crimes just doesn’t apply here. Their crimes are typically either a direct result of their illness or constitute what the National Commission for the Mentally Ill in the criminal justice system has characterized as ‘survival behavior.’ Their crimes are as much a result of our failure to coordinate the efforts of our mental health and criminal justice systems in a way that will best address their unique circumstances and bring an end to this cycle."

Mental health courts are a public policy triage—a critical first step in stopping the shameful practice of warehousing our most vulnerable citizens in places that should be reserved for those who owe a debt to society. I am proud to be the original sponsor of the first piece of federal legislation to help communities implement their own mental health courts. And I am delighted that Senators Mike DeWine (R-Ohio) and Pete Domenici (R-N.M.) have recently introduced a companion bill in the Senate, S.1865.

The plight of the mentally ill in the justice system is an issue that affects us all and requires cooperation at every level to correct. We have unfortunately come full circle in the way that we treat the homeless and mentally ill. Before the turn of the century, we arrested them and threw them into jail. Then humanitarian reform redirected them into state hospitals. Now we are entering the next millennium, and jails are once again America’s asylums. It is a shameful situation that cries out for reform.