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Mental illness can trap homeless in justice system

August 15, 2018 | By Faith Miller

People living with mental illness can often find themselves swept along in a vicious cycle — from homelessness, to substance use, and finally incarceration.

In June, the Colorado Division of Criminal Justice released “A Study of Homelessness in Seven Colorado Jails,” which surveyed homeless and non-homeless inmates in Arapahoe, Denver, El Paso, Larimer, Mesa and Pueblo counties.

A question driving the study was whether homeless people were “moving to Colorado for legal marijuana and then committing crimes,” according to the Division of Criminal Justice. But the numbers seem to show otherwise: Most homeless inmates had come to Colorado before rec weed was legalized in 2012, and only about a third of the homeless inmates who came after 2012 listed marijuana as a reason for coming to the state.

However, the El Paso County Sheriff’s Department seemed to consider those statistics as supportive of the marijuana-and-crime argument. The report was “consistent with what we see in our jail population with the legalization of marijuana and mental health being contributing factors to the homelessness among those in our facility,” department spokesperson Natalie Sosa said in an emailed statement.

Either way, the data certainly showed a connection between mental health and homelessness (defined as living on the street, outdoors, in an abandoned building, in a shelter, for free with family or friends, or in a motel in the past 30 days).

Almost two-thirds of homeless inmates reported a mental illness, compared to 46 percent of their non-homeless counterparts.

The statistics on substance abuse trended similarly. Almost half of homeless inmates surveyed for the study reported a substance use disorder, as did about a third of non-homeless inmates.

The numbers reflect a flawed system, says Tom Luehrs, executive director of the St. Francis Center, a nonprofit serving the homeless population in Denver. Luehrs pointed to the January closure of Arapahoe House, formerly the state’s largest treatment provider for drug and alcohol abuse. The nonprofit had been operating in the red for years, with increasingly insufficient funding from state and federal governments.

“Because of the lack of mental health services,” Luehrs says, “people … who would and should be in housing getting supports — their housing is prison and their supports are prison guards.”

Notably, study respondents who reported homelessness were more likely to be in jail for using or selling drugs than committing assault or robbery. That tendency was quite apparent in El Paso County, where homeless inmates were more than seven times more likely than non-homeless people to have been charged with drug-related crimes. Homeless inmates across all jails were half as likely to have committed a violent crime.

It goes to show that self-medicating to deal with “troubling mental health situations,” Luehrs says, is ultimately what lands many homeless people in jail.

Some respondents said they had to put other needs, such as housing, food and employment, before solving addiction problems. That supports the philosophy of “housing first,” which focuses on putting individuals in homes before making them get sober or get a job — both of which can be difficult without having a safe place to rest, eat and shower.

But many inmates surveyed in the study, even those who hadn’t been homeless before coming to jail, didn’t know whether they’d have a place to live after they were released.

Nearly half of people who were housed before going to jail expected to be homeless, or didn’t know whether they would be homeless, after leaving. Of those who were homeless before jail, only 18.7 percent thought they would be housed.

That points to a common situation for inmates leaving jail.

“Somebody is doing OK, and they’re basically making it, but they have no safety net,” Luehrs says, “and then they go into jail or into prison, they come out and obviously they’ve lost their job. So unless there’s some family or friend connection they will often end up at our center [looking for housing].”

Inmates lose Medicaid benefits while in jail as well, further endangering their chances of having a stable life after they are released.

That’s where Medicaid sign-up systems come into play. House Bill 1295, passed in 2002, requires state prisons to help inmates reentering society sign up for medical assistance, if they had been receiving assistance before going to prison.

Otherwise, says former state representative Andrew Romanoff, who co-sponsored the bill, “essentially we were releasing or paroling people with severe mental illness without treatment … and lo and behold 80 percent of them re-offended within 12 months, in part because they didn’t get the treatment they needed.”

In August 2015, the El Paso County Sheriff’s Department followed suit, setting up a similar program in partnership with the Department of Human Services. DHS provides the county with employees to help inmates apply for Medicaid, food assistance, job placement and other benefits.

Mental health advocates agree that the connection between homelessness and jail can’t be broken without better health care, affordable housing and jail diversion programs.

Otherwise, says Romanoff, who is now president and CEO of the nonprofit Mental Health Colorado, people with mental illness are liable to stumble onto a dangerous, well-traveled path: from job loss, to homelessness, to addiction; then committing a crime to support a drug habit, and finally incarceration.

“Now you’ve gone from somebody who might have been at some point leading a fairly stable and productive life to somebody who’s in the criminal justice system.”

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