Behavioral Health
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How the criminalization of mental illness and substance use disorders impacts African-Americans in Ohio

February 3, 2020
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It is well established that minorities, especially African-Americans, are overrepresented in the nation’s criminal justice system, and have been since the prison population began to skyrocket four decades ago, and Ohio’s penal system looks no different.

 Black people in Ohio are nearly three times more likely to be in jail compared to the state’s general population.

The U.S. Census Bureau estimates African-Americans make up 13 percent of Ohio’s population,[1] however the Ohio Department of Rehabilitation & Correction’s 2019 Annual Report disclosed that of the 45,040 men incarcerated in an Ohio prison in 2019, 47 percent or 20,988 were Black men. Of the 3,948 women incarcerated in an Ohio prison in 2019, 25 percent or 970 were Black women.[[2]](https://drc.ohio.gov/Portals/0/Annual report final ODRC.pdf) While African-Americans make up 13 percent of Ohio’s total population, they disproportionally make up 44.8 percent of its prison population. This does not account for the number of Black Ohioans in county jails, on community control, probation or parole. According to incarceration trends, Black people in Ohio are nearly three times more likely to be in jail compared to the state’s general population.    

It is also widely known that individuals with mental illness are overrepresented in the criminal justice system. Ohio’s prisons have become the largest mental health provider in the state. As of 2015, more than 1 in every 5 Ohio inmates has a diagnosed mental illness and there are 10 times as many mentally-ill inmates as there are patients in Ohio’s six psychiatric hospitals.[3]

 As of 2015, more than 1 in every 5 Ohio inmates has a diagnosed mental illness and there are 10 times as many mentally-ill inmates as there are patients in Ohio’s six psychiatric hospitals.

What’s troubling is while African-Americans are more likely to be involved in the criminal justice system, they are less likely to be identified as having a mental health problem and therefore less likely to receive treatment, even while incarcerated.[4] Barriers to care include lack of insurance, lack of awareness regarding available treatment, concerns about stigma, misdiagnosis and distrust of the health care system because of past experiences. For those who do receive treatment, they are often given poorer quality of care and lack access to culturally-competent providers.[5]  

Incarceration itself also impacts important factors of mental and physical health. Formerly incarcerated people are 10 times more likely to be homeless and lack of housing can significantly worsen mental health problems.[6]

 For those who do receive treatment, they are often given poorer quality of care and lack access to culturally-competent providers.

Various communities across the country, including Bexar and Harris counties in Texas and Oakland county in Michigan are working to decriminalize mental illness by enacting pre-arrest diversion programs. These programs are designed to serve as an alternative to jail or the emergency room for people who come into contact with the criminal justice system due to low-level, non-violent offenses such as trespassing or panhandling because the person is homeless or mentally ill. The goal of these programs is to arrange for individuals to connect with community services and case managers to assist with housing, consistent medical care and transportation to avoid recidivism in these vulnerable populations.  

Successful programs rely on three key factors:

  • Law enforcement and behavioral health collaboration. This can take many forms but often includes training officers in mental illness and crisis intervention and/or partnering with behavioral health providers in the community to offer direct support when called.
  • Community policing. When law enforcement officers engage with their community directly, they are able to identify people with behavioral health problems and substance use disorders early and assist with access to treatment before they are ever called.
  • A central drop-off site available 24-hours a day. This serves as a point of entry into the diversion program with a strict norefusal policy and a clear discharge policy.While Ohio currently does not have a pre-arrest diversion program that includes a facility or drop-off site, there are communities with programs in place such as the Drug Abuse Response Team (DART) housed in the Lucas County Sheriff’s Office. Officers on the DART team respond to opioid overdoses and offer assistance to individuals by helping them enroll in substance use treatment, including detox and avoid making arrests.  

Bringing true pre-arrest diversion programs to Ohio would dramatically impact many communities, especially the Black community. These programs could provide true diversion as individuals would never be booked into jail. Pre-arrest diversion centers can help bridge the gap in disparities between Black people and the general population in regard to mental health care services.  

[1] https://www.census.gov/quickfacts/fact/table/OH/SEX255218  

[2] https://drc.ohio.gov/Portals/0/Annual%20report%20final%20ODRC.pdf  

[3] https://www.dispatch.com/article/20150419/NEWS/304199871  

[4] Primm A, et al. “African Americans,” chapter in Disparities in Psychiatric Care. Ruiz and Primm editors. Washington, DC: Lippincott, Williams & Wilkins. 2010.  

[5] https://www.nami.org/find-support/diverse-communities/african-americans  

[6] https://www.prisonpolicy.org/reports/housing.html

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