Our Opinion

JAILING MENTALLY ILL STRAINS DOLLARS, SENSE

As a Fulton County taxpayer, you can choose which publicly funded services
you believe will make your streets safer and more pleasant.

Consider these figures:

It costs $26 a day to house, feed and treat men for mental illness and
substance abuse at Jefferson Place, a public facility in northwest Atlanta
partially funded by a federal grant. The clients also receive vocational
training and help with permanent housing and jobs.

By contrast, it costs $45 a day to house an inmate at the Fulton County
Jail, which is often overcrowded. Many of the jail's inmates are in dire
need of treatment for mental illness or substance abuse, having been
arrested for minor offenses such as passing out on a park bench or
urinating on the street. If an inmate is mentally ill --- and 700 of them
are on a typical day --- his condition often worsens while he is in jail.

Would Fulton County taxpayers prefer spending their hard-earned dollars on
more effective and cheaper programs for mental health and drug treatment
programs which help rehabilitate offenders so they don't return to the
streets? Or do the taxpayers of Fulton County prefer to spend hundreds of
millions on bigger jails?

Therein lies the choice forced by dire conditions in the Fulton County
jail, which have resulted in a lawsuit and oversight by a federal judge.
Fulton County is not the only urban area facing such a choice. Last week,
the U.S. Senate Judiciary Committee held a hearing on the need for
collaboration between police and mental health professionals and
comprehensive mental health treatment in many cities.

In Fulton, U.S. District Court Judge Marvin Shoob presides over a lawsuit
filed on behalf of HIV-positive inmates at the Fulton jail, who claimed
that overcrowding at the jail had become a life-threatening circumstance.
Overcrowding has proved intractable partly because police take mentally ill
people to the jail; there is nowhere else to take them.

In his latest order, a frustrated Shoob ordered Fulton County to develop a
plan for diverting mentally ill people from the criminal justice system and
into treatment. But since there is little treatment available, he further
ordered in a footnote that the county "provide adequate funding to expand
mental health resources in the county, if necessary."

The dysfunctional system --- or non-system --- of public health services
for the mentally ill dates back 30 years, to federal court decisions
forcing huge mental hospitals to release their patients. The decisions
followed the development of new drugs, which allowed many patients to live
in the community as long as they took their medication.

But the plan fell apart when local communities failed to provide follow-up
services. As a consequence, many of the mentally ill live on the streets in
cities around the country.

"All these bucks we had been paying to warehouse people in the big
institutions was supposed to be turned to community-based services. That
funding was not forthcoming," said Dr. Steve Katkowski, director of the
Fulton County Department of Mental Health, Mental Retardation and Substance
Abuse. "Then, all of a sudden, we had this terrible homeless problem."

Experts estimate that at least two-thirds of the homeless population suffer
from mental illness, drug or alcohol addictions or a combination. While
political leaders refused to provide the funds to offer them treatment, the
public demanded that mentally ill people --- shouting obscenities,
urinating on a sidewalk or muttering strangely in front of a store --- be
gotten out of sight.

"So the homeless problem became something that had to be handled," said
Katkowski, "and we handled it, finally, by putting them in jail. Most of
these people don't need to be there."

Fulton County needs to recognize the practical benefits, including fiscal
savings, of replacing incarceration with treatment. The county needs to
provide intake centers where police can take mentally ill people for
evaluation and referral. The county also needs to provide a range of
community-based facilities, from outpatient treatment for addiction to
intensive residential treatment for the severely ill. "Let's multiply
Jefferson Place," said Katkowski.

Fulton would save money and do the right thing by spending $26 a day to
treat the mentally ill, rather than putting them out of sight at the
overcrowded jail for $45 a day.