Seeking Justice: ‘Are We Punishing People for Being Sick?’

This is part of an ongoing series from the National District Attorneys Association highlighting local criminal justice issues. Previous articles can be found here.

LOS ANGELES — The Los Angeles County jail has more than 17,000 inmates at any one time. More than 4,000 of the inmates have a serious mental illness.

This makes the Los Angeles County jail the nation’s largest mental institution.

As the District Attorney, it is my duty to seek justice—that means determining what is the right thing to do and then doing it.

I can still recall the first time I began questioning the interaction between the criminal justice system and those with mental illness.

It was 2011 and Miriam was just 28 years old when she moved to Los Angeles to attend graduate school. While in school, she began to have trouble sleeping and felt that demons were attacking her.

One day, Miriam ran into the hallway of her apartment building and began banging on a neighbor’s door while holding a knife and uttering threats of killing herself. A security guard tried to intervene, but she assaulted him, which led to the police being called. She was placed on a 72-hour hold. During her hospital visit, she was not only heavily sedated, but was diagnosed with having a mental illness.

After a few days, the medication wore off and she once again felt that someone was out to harm her.

This led to a second incident where she jumped into a car whose owner had left it unoccupied and running. Miriam had driven a few feet before the driver confronted her. As he struggled with Miriam for the keys, he overheard her utter the phrase: “Please give me a piece of my mind.” Not able to overpower the owner, she ran away leaving her purse in the man’s car.

Two days later, she was arrested and charged with a felony—carjacking.

I remember the day Miriam’s mom called on me asking for help. She said that her daughter was not a criminal, but suffering from mental illness and if the District Attorney’s office dropped the charges, she would personally see that her daughter was medicated. As a mother, I identified with her pain. As a prosecutor, I weighed the crime against Miriam’s actions.

That was several years ago. Recently, I wanted to find out what happened to Miriam. I learned that she was under the care of a psychiatrist and has not committed any new offenses.

In cases like Miriam’s, prosecutors face difficult decisions. We could dismiss the case and let people like Miriam go free knowing that someday they could stop taking their medications and hurt someone. Or we could charge them with a crime and use probation to make them take their medication.

In Miriam’s case, we insisted she plead guilty to a felony and be placed on probation. In addition, the judge ordered her to seek medical care, as we tried to get assurances that she would remain in treatment.

Although we were “successful” in prosecuting Miriam’s case, there is an impact to her life in terms of career opportunities. When applying for jobs, she’s saddled with the dilemma of disclosing this episode where she was accused of being a thief or identifying herself as someone with mental illness. Either answer will make it difficult for her to get a job.

Yet Miriam is one of the fortunate ones. She takes medication—at least for now. Her felony conviction was later reduced to a misdemeanor.

Many people in the criminal justice system are not so fortunate. They are chronically in crisis due to mental illness, homelessness and, in some cases, substance abuse.

Miriam’s story is important to this discussion: She puts a face on this terrible disease. Her story also gives us a place to begin discussing alternatives to incarceration for people with mental illness. In many circumstances, those who have a mental illness are stigmatized and blamed for their condition. There are instances where they actually do more time in custody than someone without a mental illness. This is wrong.

A person whose disease or disorder affects his or her mind should not be punished for his or her condition. We must do better.

Finally, there is widespread interest in helping those with mental illness. In 2013, I helped form the Criminal Justice Mental Health Task Force (now known as the Mental Health Advisory Board). It is a collection of knowledgeable stakeholders. Our mission is to evaluate the needs of those with a mental illness at risk of entering the criminal justice system in Los Angeles County. We believe we can intercept people at various stages of the criminal justice process—beginning with their first interaction with law enforcement. You can read about our findings on the LADA website in a report called “A Blue Print for Change.”

In 2015, the Los Angeles County Board of Supervisors dedicated $120 million to address the treatment and housing needs of people with a mental illness by creating the Office and Diversion and Re-Entry Program (ODP).

Los Angeles County hopes to divert people living with a mental illness out of the criminal justice system and into effective treatment programs. There is one important stipulation to this plan:  If the person hurts another person then jail may be the most appropriate place to receive treatment. However, we have concluded we can be far more effective if we commit to fully support the aggressive expansion of diversion programs and fully fund all available housing options.

The use of the jail as a massive mental health ward is inefficient, ineffective and, in many cases, inhumane. Then there is a moral question: Are we punishing people for being sick? We must do more to stop the practice of criminalizing people for having a mental illness. Public safety should have priority—but justice must always come first.