The National Alliance for Mental Illness (NAMI) Utah and the Utah Support Advocates for Recovery Awareness (USARA) are longtime advocates for individuals and families who struggle with mental illness and/or substance use disorders. We’ve seen the triumphs and tragedies for Utahns across the spectrum. These brain disorders don’t confine themselves to any single age group, demographic or economic status. But all too often they contribute to actions that may land the person in the county jail or state prison.
Because of our role, we have an important perspective on the state of Utah’s current review of how it deals with its inmates, probations and parolees in partnership with the nonprofit Pew Foundation’s Justice Reinvestment Initiative. We start by recognizing that mental illness and addiction are brain disorders — physical conditions similar to other chronic disorders such as diabetes or cardiovascular disease, all of which require comprehensive and continuous health care.
We absolutely recognize that people who break the law and cause harm to others should face the legal consequences of their actions. However, persons who have committed offenses due to behavior influenced by brain disorders require treatment, not punishment. NAMI Utah and USARA believe that a prison or jail is never an optimal therapeutic setting and that the state of Utah has an obligation to develop and implement appropriate programs for individuals whose untreated brain disorders may lead to more bad behaviors or crimes.
In Utah, 63 percent of new court commitments to prison are for nonviolent crimes — most related to addiction or mental health issues. Nationally, 75 percent of inmates in both state prisons and county jails have an addiction disorder; 64 percent of jail inmates have a mental health issue. Jails and prisons have become the default placement for nonviolent individuals with brain disorders. Community-based treatment for these individuals would be a vastly better option for them, as well as for taxpayers, since the costly option of prison cells could then be reserved for violent and high-level offenders. Utah has both the tools and the capacity to better determine who can be safely treated in the community and who needs to be removed from society through incarceration. We need to align our policies and our laws with what evidence-based research tells us and to find a different approach to get to the root of the problem.
As evidenced by the waiting lists for treatment services for the uninsured in Utah, a big constraint in reforming our criminal justice system is lack of resources for both early intervention and for treatment of brain disorders. We need to invest more in both. For example, an estimated 80 percent of the inmates in the Salt Lake County jail have no health insurance or access to health care. Those few who have insurance may not have coverage for treatment of brain disorders.
It’s time to rethink and reform health care coverage as it relates to people with brain disorders. We applaud Gov. Herbert, Speaker Lockhart, President Niederhauser, Chief Justice Durrant and Attorney General Reyes in their bold call to action in terms of reforming our criminal justice system. We ask that they also conduct a robust study of alternatives to incarceration, which include early access to intervention, treatment services, ongoing recovery management, and most importantly a straightforward mechanism to provide insurance coverage for individuals and families so that they are able to gain access to the help and services they need to address their health issues.
Mary Jo McMillen is executive director of Utah Support Advocates for Recovery Awareness (USUARA). Jamie Justice is Utah executive director for National Alliance for Mental Illness.
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