Webinar presenter Dr. Dan Phillips answered a number of your questions after his presentation, Mental Illness in the Criminal Justice System. Here are just a few of his responses.
Audience Question: Can you talk a little bit more about this relatively new diagnosis called Complex PTSD? Can you talk a little bit more about that?
Dr. Dan Phillips: Let me stress once again that I’m not a psychiatrist. I’ve just recently probably heard about this term in the last 2 months. I don’t want to give out wrong information on this. I believe it may have something to do with not just PTSD but a more severe form that continues for longer but I really don’t feel comfortable. I think it’d be best if Cal looked that one up. I don’t feel comfortable talking about that. I don’t want to give anybody here misinformation.
Audience Question: What, in your opinion, can be done to specifically reduce the number of mentally ill individuals in the criminal justice system?
Dr. Dan Phillips: I think that although I didn’t talk about today, there are mental health courts out there that can coordinate the treatment and what happens to people with mental illnesses. Too often, what happens is that it’s kind of catch-and-release. A police officer arrests somebody, they go to jail, they go to jail for a while, they get out. Those happen back and forth. Just like there are drug courts for the last twenty, twenty-five years I think it started in Broward County, Florida, I’m not sure, but they had mental health courts where the judge can have everybody at the table; probation and parole, jail people, law enforcement, counselors. It can kind of oversee what happens. I think any way that you can try to keep the person in treatment to encourage them to be in treatment instead of staying in jail is a positive thing. Let me stress this too. When you work in police work, in corrections, or in mental health, I tell my students all the time that every job has potential risks to it but when you work in law enforcement corrections and mental health, the kind of things that you do have life-and-death consequences. And many times what I found is that people who work in these systems don’t always feel comfortable reaching across the aisle and deal with other people in these situations. The first thing is the places where I’ve seen mental health treatment and diversion programs worked best have usually been when the person charged is the police department the person charged, the jail, the people on mental health all sit down and have lunch together and have a serious connection to make things happen. They can happen voluntarily or you can wait like they did in Memphis till there’s an incident and all of a sudden you have to do something.
Audience Question: You by chance have any statistics on mental illness and incarcerated juveniles?
Dr. Dan Phillips: That’s a good question. I even thought about including things with juveniles here. What you need to know is that juveniles have a great deal of need for mental help. I don’t have the statistics here with me. I recently wrote a piece for publication on juveniles who are incarcerated and what you need to know is that they probably have even more mental health needs. But I’ll also say this, anytime you kind of can reach somebody at a younger age and deal with that is so much better. If you can get that mental health problem dealt with when you’re 15 as opposed to 50, everybody benefits. So just off the top of my head, I don’t have the stats that can tell you that you’d probably find more mental health problems amongst juveniles but an intervention that early might be much more successful.
Audience Question: Do you have any statistics around suicide rates of correction staff?
Dr. Dan Phillips: I don’t have the numbers of correction staff. I used to show a video to my class that looked at suicide rates of law enforcement officers. Now the numbers can be a bit tricky because police officers probably do have a higher suicide rate than the rest of the US population. But part of that is because police officers are male and males have a higher rate. One thing what I did in service training for police officers, I came in ready to talk about people and the criminal justice system and I had a number of officers come up and talk about their personal issues that one police officer who shared a story where he shot somebody. He was devastated. So I think it’s very important we make sure that mental health resources, maybe chaplain or counselors are available for people who work in the system. I think unfortunately that the people who protect us oftentimes don’t get protected themselves. I have a student who is a firefighter who just completed a bachelors’ degree, is going to school to get a masters at counseling because he was at ground zero of the World Trade Center murders and he saw things that he says nobody who has been in that kind of environment could understand. So, he specifically wants to set up a counseling center for first responders. It doesn’t do us any good to talk about suicide prevention for people who are inmates or detainees if we’re not talking about suicide amongst people who work with them. Many of my students think that worst corrections- if you’re law enforcement officer you have a lot of control and I oftentimes say, “No you don’t always have a lot of control.” You just have a front-row seat to all the bad things that go on in life and you have to see these things and punch out and try to go home and live a normal life. I think we all liked to go home and share with our loved ones the things that we go through. Sometimes I go home and tell somebody about the student that irritated me today but when you witnessed the things that you witnessed in law enforcement and corrections, it’s not always a great thing. It’s not okay to go home and share that with people so we definitely take that mental health and potential suicide of corrections and law enforcement.
Audience Question: You touched on something just a few seconds ago about telemedicine. Can you explain a little bit more about how telemedicine works for those in jail settings and those with mental health issues?
Dr. Dan Phillips: The idea originally had to do with people who lived in very rural areas. I don’t know how many of you live in a rural area. I used to live in an area where to buy a pair of shoes is probably a 30-mile trip, to do anything other than eat at fast food was more than a 30-mile trip. What end up happening in these situations is after a while even the thought of transporting somebody even if it’s absolutely necessary just becomes overwhelming and it was a double whammy because not only you are in a rural area where it is hard to travel somewhere probably living in a rural area, you don’t have any resources or fewer resources. So, the idea originally around telemedicine was to put somebody in a facility like a jail in front of a screen where somebody sitting in another location could observe this person and then give them triage then give them information that the jail staff or the police about whether they needed to be transported or not. Increasingly, what I’ve seen telemedicine used for, is that sometimes you have a doctor that maybe four miles away but that doctor tells you that there’s no way he or she is coming into that facility. If you’ve never been in a correctional facility they can be intimidating places and a lot of times you’ll find medical people not wanting to go there. Sometimes telemedicine works even at a distance of four miles but the idea is that a doctor may not be able to get him a full treatment but they can triage them and see if they can go ahead and bring them into the hospital or towards your time to bring them to the hospital.
Audience Question: We’re having more people wrestling with mental illness or is it that we’re more aware of these issues or maybe there’s more research being done and that we’re just being more sophisticated with our diagnoses? Or is it a little bit of all of the above? What are your thoughts in this seemingly growing situation with more people having mental illness?
Dr. Dan Phillips: There are several things you could look at there. One, you could look at the DSM-I in 1952 till the DSM-V in this 2013, the bulk is several times bigger. We have added more things in what we call mental-illness but let me make one thing clear; the mental illnesses that we’re talking about are a series of persisted mental illnesses. I believe that we may be seeing more of these kinds of illnesses. At the same time, I think that we’re being in recognizing more. I lived in a rural community where if you have a serious methamphetamine problem, people thought that was bad but if you want to get mental health treatment that was concerned also. So the same people walking around treating themselves with substance abuse, self-medicating. They were being discouraged from seeking treatment so I think what’s caught on recently is here where I live in Kentucky, the churches have a lot of control over the community, increasingly with the opioid explosion epidemic. I hear more churches now willing to publicly talk about substance abuse, mental health problems, suicide, family abuse. So, I think there’s more of openness to the whole thing. But not one thing I do want to stress with you is many times when I taught classes, I’ve had students say, “We never had like a suicide in my family.” This may sound odd to you but I’ve encouraged kids to go home and ask your parents, has there ever been a suicide in our family? I’m amazed with how many times that some parents will find and tell their kids you know your uncle so and so, the one I told you died of a heart attack, he didn’t. It was a self-inflicted gunshot wound. Suicide, historically, if they ruled it was a suicide, people back hundreds of years, the family could not inherit the money if you ruled it a suicide, the insurance will not pay off. If you ruled in a suicide the family would be looked at. Suicide may be one word that one thing I’ve talked about regularly that people do not want to talk about so I believe that were becoming more open and aware about this and it’s possible we may have seen more kinds of these problems. Again, I just want to give you guys support in knowing that things you detect in people today may save a life or transform a family. I’m sorry you are in a situation where you have to deal with it but your power and energy to solve this problem is greater respect and I talked about this in my criminal justice classes all the time.
Click Here to Watch a Recording of Mental Illness in the Criminal Justice System.