Fixing prisons by helping the mentally ill 

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Happy New Year, comrades!

Just think, soon it will be almost a year since President Donald John Trump started to make America great again.

True, he didn't exactly "repeal and replace" the Affordable Care Act, but instead is starving it to death so health coverage will become impossible to afford. And true, the so-called "middle-class tax cut" he promised turned out to be nothing but a scheme to wildly increase the national debt by cutting the taxes big corporations have to pay.

And yes, our president is an ignorant buffoon who has made America the laughingstock of the world. True, he has driven away thousands of the best high-tech immigrants, the ones our economy needs most. But that doesn't matter so much because he did build the wall and brought all those jobs back from China and Mexico.

Why, General Motors said they are going to re-open all those closed Pontiac and Oldsmobile plants any day now!

What? Didn't happen? Well, clearly you need some more training in the world of alternative facts. But whatever you do, don't forget this:

Even when this tax cut spurs both inflation and eventually a savage recession, as some economists warn it might... And even when you lose any health coverage and you realize that consumer product protection is a thing of the past, remember this...

You'll never, ever have to worry again about Hillary Clinton's emails.

Now, back to Michigan: True, the decline and fall of our empire may be playing out on the nation's cable news screens. But while we hunker down and pray for a return to national sanity, there is something we can do here.

Michigan has a huge, bloated prison system that costs the state about $2 billion a year, far more than we spend on higher education.

That shouldn't be surprising, since our pitiful excuses for leaders have been acting as if we wanted to create convicts, not knowledge workers, by making it steadily harder to get an education.

But what would you think of a policy change that would shrink our prison population, save the state hundreds of millions of dollars a year — and give our mentally ill population better treatment?

Our legislature could make that happen this year — and one of the people whose opinion I most respect on the prison system has just given us a road map for how to do it. That would be Milton Mack, for many years the chief probate judge in Wayne County.

Mack, who had to preside over many competency hearings in the quarter-century he spent on the bench, has spent years studying Michigan's huge and insanely expensive prison system.

Long ago, he realized that a large part of the problem is that it is filled with people who are mentally ill, the casualties of a system that closed the state's large mental hospitals and never built the promised community mental health centers they said would take their place.

Some of those tossed on the street did manage to make it. No doubt there were a few in mental hospitals who didn't really need to be there. But for many of those who had been hospitalized, being on the street meant "homelessness, incarceration and impoverishment."

What it has also meant was a radical change in the prison population of Michigan. The number of inmates in state prisons has declined from around 51,000 in 2006 to around 40,000 today, due to both the aging of the prison population and the fact that we are somewhat less likely to throw someone in the slam for decades for a bag of pot.

Yet the number of mentally ill inmates has skyrocketed. Nearly one quarter of all Michigan inmates — 23 percent — are mentally ill. Prisons, as Mack noted dryly, "are not therapeutic environments," conducive to people getting better. And indeed they don't, even if they get their medication. Studies show they stay locked up longer than other prisoners, "largely because many find it difficult to follow and understand prison rules."

For much the same reason, they have far higher recidivism rates. They also cost much more. It costs Michigan taxpayers an average of $35,253 to keep someone locked up for a year.

But for the most severely mentally ill prisoners, that jumps to $95,233, money that could be used better elsewhere.

Two years ago, Mack left the bench to become Michigan's state court administrator. For the last year, he has worked on a paper called Decriminalization of Mental Illness: Fixing a Broken System, which offers an innovative policy proposal for the nation's prisons.

Here's the heart of what he is recommending:

Modify state mental health codes to allow the courts to intervene before someone gets in trouble "to help persons with mental illness secure earlier treatment in order to avoid behavior that may lead to contact with the criminal justice system."

Basically, what that means is that where merited, the courts should be able to require someone to get on medication who may not yet have committed any crime. True, that does raise questions about taking someone's freedom of choice away. Mack is acutely aware of that, and as a probate judge was very careful not to take claims that someone wasn't mentally competent at face value.

But with safeguards, he is convinced that this would shrink the prison population by as much, based on some pilot projects in other states, as 25 percent. "That would mean a savings of hundreds of millions of dollars a year," he said. Know what it costs the state to treat the mentally ill on an outpatient basis?

Michigan spends an average of $5,741 on adults who have mental illness but who are not behind bars.

Compare that to the cost of locking them up.

Preventing the mentally ill from doing anything to get themselves arrested is vitally important: "People with mental illness are 16 times more likely to be killed by the cops when they are approached or stopped by law enforcement," Mack told me.

His proposal also contains recommendations for various "intercept" policies for law enforcement to use with mentally ill prisoners already in or leaving the prison system.

But prevention is almost always a better idea than curing, and keeping mentally ill people out of prison is a very worthy goal.

Speaker of the House Tom Leonard is a conservative Republican, but told me that as a young prosecutor, he became converted to the role mental health courts and treatment can play.

He has been looking at these proposals — and may be considering legislation to make this happen soon.

More than a century ago, intelligent and progressive reformers realized that mentally ill persons don't belong in prison.

Somehow, we seem to have forgotten that. It could save money and lives if we went back to doing the right thing.

Seven dirty words: Remember George Carlin's seven dirty words? Well, the Trump administration has forbidden the nation's most important health care agency, the Centers for Disease Control and Prevention (CDC) from using seven words: "entitlement," "vulnerable," "transgender," "fetus," "diversity," and, of course, "evidence-based" and "science-based" in official documents.

Don't be surprised if next year, our bargain-basement Mussolini bans the words "democracy, First Amendment, fact-based, Constitution, Obama, impeachment," and perhaps "freedom."

People who know what this country is supposed to stand for don't go in for banning words. But there are seven terms I suggest you avoid as much as possible, especially around kids:

They are: "Trump," "Bannon," "wall," "believe me," "win," "great," and of course, "Pence." And make sure you are registered to vote.


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