Michael Friedman & Camille Alleyne: What Does the First Step Act Do for People with Mental Illness?

Adjunct professor teams up with MSW student to assess the impact of landmark criminal justice reform on justice-involved people with symptoms of serious mental illness.

Repeated studies show that serious mental illness has become prevalent in the U.S. corrections system. Taking up this topic in a recent post on MedPageToday, Adjunct Associate Professor Michael Friedman and Camille Alleyne (MSW’19) estimate that up to 500,000 people with serious mental illness are in jails and prisons in the United States at any given time. While this is only a fraction of all people in the United States who suffer from serious mental illness, they point out that many of the mentally ill who become incarcerated do not receive appropriate mental health treatment or support services, thereby exacerbating their condition. As a result, they tend to face longer incarceration times than their counterparts without mental illness.

Friedman and Alleyne go on to examine the following features of the First Step Act, a recently signed federal law that has been widely heralded as a breakthrough in the battle for criminal justice reform:

• Help those released from correctional institutions to become job-ready and successful outside of prison
• Provide additional opportunities for sentence reduction
• Fund programming to reduce recidivism
• Give judges some flexibility in sentencing for nonviolent offenses

READ: “About the First Step Act”

Friedman and Alleyne argue that, while the Act is clearly an improvement over the status quo, it hasn’t begun to address the kinds of criminal justice issues that tend to intensify mental health difficulties. They propose additional steps they would like to see implemented in order to help improve mental health outcomes for those in the system, including:

• Improved crisis interactions between police and those suffering serious mental illness
• Bail reform and treatment alternatives to incarceration
• Faster trials to reduce time in jail for those found not guilty
• Greater use of mental health, substance abuse, and veterans’ courts
• Community-based alternatives to incarceration
• Elimination of inhumane elements of incarceration, such as solitary confinement
• Training for prison personnel regarding mental illnesses
• Enhanced mental health services in jails and prisons
• Improvements to discharge planning and release services, including Medicaid or Medicare eligibility

The authors further note that the overwhelming majority of those involved with the criminal justice system are involved at the state or local level, though the Act’s provisions apply only at the federal level. To rectify this, they propose that the federal government require states to undertake criminal justice reform as part of their block grant Medicaid eligibility, and that it also provide grants to states to develop model initiatives around the following topics:

• Police interaction
• Bail reform
• Diversion programs
• Alternatives to incarceration in high-security settings
• Mental health services, including psychiatric rehabilitation, in jails and prisons
• Alternatives to solitary confinement
• Release plans
• Eligibility for health and mental health services and for income supports immediately upon release

“Let’s hope that the First Step Act lives up to its title,” Friedman and Alleyne state, “and is just a first step in the right direction.”

READ: Will Criminal Justice Reform Help Those With Mental Illness?” MedPage Today (6.10.2019)

Related links:

• Michael Friedman: World Events as Mental Health Aggravators (4.4.19 news article)
• Professor Friedman: We Need “Assertive” Mental Health Services (2.18.2014 news article)