By Anita Fisher
I am an African American mother of an adult male who was diagnosed with serious mental illness at the age of 21.
More than 20 years later, I have experiences to share that are frustrating and heartbreaking.
It is common for individuals living with a mental health diagnosis to self-medicate with street drugs and alcohol to relieve psychiatric symptoms (depression, voices, paranoia, etc.). An estimated 9.2 million U.S. adults experienced both mental illness and a substance use disorder in 2018. My son is one of those individuals.
My son has spent approximately 14 years cycling in and out of jail and prison. It’s not because he was committing heinous violent crimes. It’s not because he was in some gang. No, as is common for many other people with brain disorders, he used substances to self-medicate his psychiatric symptoms. This has led to an exacerbation of psychiatric symptoms, homelessness, and a range of crimes, from petty thief to more serious, non-violent crimes associated with those with substance use disorders.
Fast-Track to Prison, the Wrong Place for Care
The jails and prisons are the largest providers of mental health care. Statistics about this are always quoted in news articles and presentations about the mental health system of care. Actually, I question the “mental health care” part. The truth is the jails and prisons are where people who find themselves in a mental health crisis often end up. It is not the right place for them to receive care. Here is why they end up there. Mental health crisis calls are usually handled by police officers. Sometimes they are accompanied by clinicians and some of the officers have received training to deal with mental health (C.I.T. – Crisis Intervention Teams, or PERT – Psychiatric Emergency Response Teams.) The goal is to de-escalate and possibly transport the individual to an emergency room/center that provides mental health care. However, if that engagement becomes combative or the individual has broken any laws upon arrival to the scene, they are taken directly to JAIL, bypassing any mental health treatment center. The focus becomes punishment for the crime and “voluntary” mental health treatment in the jail/prison if the individual “wants” it.
The Uneven Playing Field
This is where the disparate treatment for Black and Brown people living with mental illness begins. As Michelle Alexander writes in “The New Jim Crow: Mass Incarceration in the Age of Colorblindness,” “we use our criminal justice system to label people of color ‘criminals’ and then engage in all the practices we supposedly left behind.… As a criminal, you have scarcely more rights, and arguably less respect, than a Black man living in Alabama at the height of Jim Crow. We have not ended racial caste in America; we have merely redesigned it.”
Why do so many more Black and Brown children like mine end up in prison? Statistics show that it is probable for Black and Brown individuals living with mental illness to end up going to jail and prison following crisis encounters, as opposed to hospitals. Also, during the court process, they are more likely to be charged with the more serious offenses and to serve longer sentences in prison instead of in local jails or getting deferments. It doesn’t have to be this way. There are mental health courts designed to offer deferment of jail time upon completion of treatment programs. But we see, time and again, racial disparities, with fewer Black and Brown individuals in these programs as a result of being charged with higher-level crimes.
The Need for Change
We need change. What can we do about this? As we carry on this nationwide conversation to address the systemic racism in America, I ask that we please address the mental health needs of our Black and Brown individuals, families and communities. We need to make more strides and more systemic changes to improve mental health care and the criminal justice system for Black and Brown individuals living with mental illness.
Anita Fisher is a NAMI San Diego member who served as the affiliate’s Director of Education for more than 10 years. She now runs Fisher Mental Health Consulting to help families navigating the intersection between mental health, law enforcement, and criminal justice.