Thursday, April 26, 2007

Crime is the Answer. Question: What Happens When Mental Illness Goes Untreated?

A mother throws her kids off of a pier in San Francisco. A mother in Texas drowns her children in a bath tub. At Virginia Tech, a young man massacres his fellow students. In each of these high profile cases, it was reasonably foreseeable that these crimes would occur because it was well known that these people were mentally ill.

Each day, the phone rings at my criminal defense law firm because someone has been arrested. Each day, my Assistant, Janice, prepares a report for me. This report includes information about the case, and unlike most criminal defense lawyers, includes information as to whether my prospective client needs to be examined for a hidden mental disease, defect or disorder. Guess what? We send about ninety percent of our clients for detailed diagnostic evaluations. In the past decade, two have come back normal. Two. So how do we solve the problem of crime in our community? The answer is blisteringly obvious: Mental health diagnosis and treatment.

Each day, people in this community are charged with crimes that are not high profile cases. These criminal defendants are not jumping off of a balcony flapping their arms claiming to be Jesus. Yet most have a hidden mental illness that negatively affects their behavior, mental illnesses that cause them to break the law.

The tough on crime, short on smarts crowd wants more incarceration – and it will cost you about fifty dollars per inmate, per day. This is more than a poor public policy. This is stupid. We can’t punish the Virginia Tech gunman, and even if we could, punishment is a poor substitute for the losing someone you love. I would suggest we solve the cause of most crime before someone at a local high school or college decides to enter the Biggest Shooting Massacre record books.

Here is a smart cost neutral way to start:

• Add a few questions to the pre-screening of inmates before their First Appearance when bond is addressed for the first time.
• Make “Obtain psychological/psychiatric evaluation and follow treatment as recommended” a standard bond condition in cases where it is appropriate. Diagnosis and treatment can also be made a condition of supervision in non-incarcerative sentencing cases.
• Eliminate the failure path of imposing cookie cutter talk therapy without adequate diagnosis in DUI, Domestic Violence, and drug cases. These programs skimp on the diagnostic portion and rely too much on talk therapy. Talk therapy has its place, but all the talk therapy in the world won’t heal a medical problem in someone’s brain any more than it will heal a broken arm. Diagnose accurately first, treat appropriately second.

Some people need to be locked up. Most don’t. Most people who are guilty of committing crimes need to be accurately diagnosed and appropriately treated. Diagnosis and treatment are the only way to break the cycle in our community without breaking the bank.

Unless you like setting your money on fire.

Attorney Stephen G. Cobb has been designated an expert in criminal trial law by the Florida Bar Association. He has practiced criminal law since 1990 and has four college degrees. His e-mail address is Stephen@cobblawfirm.com.