October 28, 2008 -- Spokesman-Review (WA)

Editorial: Early Treatment Of Mentally Ill Can Reduce Inmates

Our View: A Healthier Solution

Original: www.spokesmanreview.com/opinion/story.asp?ID=266177

Part of the reason Spokane County is facing such challenges with its jail budget is that we continue to treat cells as a repository for the mentally ill.

The jail budgeted $2.3 million for medical care and medications, but the true amount overshot that by $438,000.

The county should have fewer inmates in the first place, but society has never settled on a comprehensive solution after deinstitutionalizing the mentally ill some 30 years ago.

Some severely sick people wander the streets, adding to the homeless population. Some land in emergency rooms or get arrested.

Once arrested, the odds of their ever digging out of the hole are long.

For one thing, they lose Medicaid coverage and must wait two months for reinstatement once they emerge from incarceration. And so, the recidivism rate is high.

The U.S. Department of Justice reports that 46 percent of state inmates and 64 percent of local inmates have a diagnosable mental illness.

That puts a tremendous strain on law enforcement officers who may not have the necessary training to deal with them.

An analysis by the Seattle Post-Intelligencer found that the state spends $1.8 billion a year on severely mentally ill people, with only 30 percent of that amount going for treatment.

The rest of the money is spent in places like jails, courtrooms, police precincts and emergency rooms.

Spokane County officials say they need a new $245 million jail complex. The county was one of eight in the state to reluctantly impose a one-tenth of 1 percent sales tax for mental health programs.

A continuation of this kind of stopgap spending is extremely wasteful and does little good for those with mental disorders.

So, that's the problem. What's the solution?

The key has to be front-end treatment. With the 0.01 percent tax hike, the county was able to intervene before situations reached the crisis stage. That, in turn, headed off expensive hospitalizations.

But it's not nearly enough. More money is needed to connect people with the services they need.

The state needs to reverse its spending strategy so that most of the money goes directly to treatment, not to criminal justice. Paying those upfront costs is a better deal for taxpayers and a healthier solution for the mentally ill.