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Q&A
‘Jail diversionist’ Maurice Richardson

BY KRISTEN LOMBARDI

Advocates have long complained that the collapsing system of mental-health services in Massachusetts isn’t taking care of the state’s mentally ill population, many of whom are landing in the state’s prisons for committing minor infractions. Those critics may be right. Every year, as many as 685,000 people with mental illness are sent to jails in the United States. And that’s far more people than it should be, says former District Court judge Maurice Richardson, who is now retired from the bench and teaching psychiatry at UMass Medical School. Richardson spent 27 years watching the mentally ill cycle through the criminal-justice system — only to get stuck. Today, he’s launched a "jail-diversion" initiative that he hopes will change all that. The program aims to steer mentally ill people who are arrested for non-serious crimes away from prisons and into treatment. The Phoenix spoke with Richardson about what it takes to set up diversionary treatment in this state.

Q: How is the criminal-justice system failing when it comes to the mentally ill?

A: A lot of people come into the system with mental-health problems. Many act out in a bizarre way that constitutes a violation of the law. Someone who is delusional could climb on a table at McDonald’s and claim to be a Russian czar. Or he could think he’s got a right to go to the supermarket and help himself to food. People can be loud and unruly when mentally ill. They can have a high co-dependency on alcohol or drugs. When you have someone with mental illness and a minor drug offense like marijuana possession, police aren’t sure what to do. They feel an obligation to arrest someone who commits a crime. But once you do, you start into the criminal-justice world. Mentally ill people become the court’s problem, and not all of them should be.

Q: So is this why you’re advocating for jail diversion?

A: Yes. Did you know that the institution that has the greatest number of mentally ill people in the United States today is the Los Angeles County Jail? Sixteen percent of people presently in jail are considered mentally ill, including in Massachusetts. That tells me there are more mentally ill people in jail than anybody figured. And many of these people — those charged with innocuous offenses — don’t need to go through the criminal-justice system. They can be diverted before booking by the police or in court by the judge so they can get treatment, not a criminal trial.

Q: Are there any diversion programs here?

A: Not really. A few judges have used this technique. I used to divert the mentally ill in my courtroom at Dedham District Court. When we would get somebody who was mentally ill, we worked out how to help this person. We talked to the prosecutor and defense attorney and worked out a pre-trial probation. If you have a defendant who has mental illness and agrees to go to treatment, you assign him to do that for six months. If he’s met the conditions — gone to doctor's appointments, gone to AA meetings — then the case will be dismissed. If not, then you have the trial.

Q: What would you like to see happen here?

A: I’d like to see us develop an array of effective diversion programs in police departments and courts, especially the district and juvenile courts. At UMass Medical School, we developed the Massachusetts Mental Health Diversion Resource Program. We’re advocating for these programs and giving communities assistance. Right now, we’ve started a program in Worcester. We happened to start there because of UMass, but we expect that 65 percent of our effort will be in Boston. I’m speaking to judges and police officers in Boston about their interest in supporting such a program next week.

Q: Given the $30 million in cuts that the Department of Mental Health is facing, is it likely you’d see funding?

A: We’re very concerned about those cuts. They include a block of money on which the Department of Mental Health counts for funding homeless programs for the mentally ill. Another block of money goes to its county-jail program. The DMH has a strong presence in the county jails. Case workers help with prisoners’ mental-health issues, particularly preparing them for DMH assistance when they get out. That effort’s been dealt massive cuts. The one thing we cannot do is go to DMH for funding. Even in a good year, it’s flat-funded. If the legislature won’t give DMH new money, we’ve got to go to the federal government and private sources. That’s what we’re doing.

Q: Are the state’s prisons becoming de facto mental hospitals?

A: That 16 percent says a lot to me. That’s a high number. The state prisons aren’t a de facto hospital yet. But they could become one if we don’t do something.

Issue Date: December 6 - 13, 2001

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