New Report Helps Policymakers Better Respond to People with Mental Health Needs in the Criminal Justice System

NEW YORK, NY – The Vera Institute of Justice today released a new report containing recommendations on how to reduce the disproportionate contact that people with mental illness have with the criminal justice system. It proposes a “first episode incarceration” framework—modeled after promising approaches to treating people with serious mental illness by responding to their first psychotic episode—that emphasizes early intervention; a recognition of other factors besides illness that contribute to criminal behavior, such as a lack of housing; and an ultimate goal of recovery.

The report, First-Episode Incarceration: Creating a Recovery-Informed Framework for Integrated Mental Health and Criminal Justice Responses, is the latest in a series from Vera’s Justice Reform for Healthy Communities Initiative, which aims to improve the health and well-being of the individuals and communities most affected by mass incarceration. Critical to this objective is a more effective response to people with mental illness. More than half a million people with mental illness are currently held in the nation’s prisons and jails on any given day—approximately as many as were held in psychiatric institutions in the 1950s, prior to the deinstitutionalization movement.

Much of modern policy and practice to respond to this crisis is based on the assumption that people with serious mental illness engage in criminal behavior primarily because of their illness. However, a growing body of research indicates that a lack of mental health care does not in and of itself explain why too many people with mental illness are caught up in the criminal justice system. Rather, risk factors such as addiction, stress, trauma, homelessness, and unemployment can impact justice system involvement. The recommendations in this report address shortcomings in existing services and outline steps to reach people earlier and with more comprehensive support to help them not only avoid future arrest, but to ultimately live stable and productive lives. 

“The failure of the deinstitutionalization movement to provide compassionate, community-based care to people with mental illness is clear. Six decades later, policy and practice have not caught up with advancements in our understanding of mental health,” said David Cloud, senior program associate at the Vera Institute of Justice, who is leading the Justice Reform for Healthy Communities Initiative. “We must leverage the current momentum for reform to more effectively support some of the most vulnerable members of our communities. In doing so, we will not only improve their lives, but reduce our costly and ineffective reliance on jails and prisons as a treatment provider of last resort.”

The analysis and recommendations in the report are drawn from an extensive review of current research as well as original interviews with experts—including practitioners, policymakers, and academics—on responding to people with mental illness at risk of justice system involvement.

The full report can be found at