Transcript Mental Health, Criminal Justice, & Trauma

Mental Health, Criminal
Justice, & Trauma:
The Need for New Approaches
Consistent with the CRPD
Criminal Justice/Mental Health
Parallels
Criminal Justice/Penal
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Prison/Jail
Prisoner
Political Model
Imprisonment
Crime
Denial of Guilt
Punishment
Isolation
Confession of Guilt
Obedience
Parole/Probation
Mental Health
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Mental Hospital/Psychiatric Center
Mental Patient
Medical Model
Involuntary Commitment
Symptoms
Lack of Insight
Treatment/Therapy (Forced/Coerced)
Seclusion & Restraint
Admission of Mental Illness (insight)
Cooperation/Compliance
AOT order/Case Manager/Tx Team
Statement by Manfred Nowak
Special Rapporteur on torture and other cruel,
inhuman or degrading treatment of punishment.
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“First, they are often segregated from society in institutions,
including prisons, social care centers, orphanages, and mental
health facilities. They are de-facto deprived of their liberty,
sometimes for long periods of time, either against their will or
without their free and informed consent. Inside these institutions,
persons with disabilities are frequently subjected to neglect, severe
forms of restraints and seclusion, aw well as physical, mental and
sexual violence.”
“Similarly, in the private sphere, persons with disabilities are
especially vulnerable to violence and abuse, including sexual abuse,
inside the home, at the hands of family members, caregivers, health
professionals and members of the community. “
---- Manfred Nowak
October 23, 2008
The mental health and criminal justice systems
are both traumatizing and repressive.
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Criminal Justice/Penal System
Abolition/Reform can not be accomplished
through the mental health/psychiatric
system.
Systems are reciprocal ( movie)
Systems are reactive, fear based &
Coercion/Force
CRPD - Articles
Article 12 – Legal Capacity (capacity to have rights
and capacity to act)
Article 13 – Access to justice for PWD
(accommodations support networks)
Article 14 – Liberty & Security of the person on a
equal basis with others (Probation/AOT/IOC)
Article 15 – Prohibits torture & cruel, inhuman or
degrading treatment or punishment
(forced/coercive interventions – Intimidation)
CRPD Articles
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Article 16 – requires prevention of exploitation,
violence and abuse. (free & informed consent –
conditions (psychiatric drugs/probation/parole) –
due to diagnosis.
Article 17 – PWD right to respect for
physical/mental integrity
Article 19 – Right to live in community with
choices equal to others (Probation/Parole
conditions medications/MH courts/Residential)
CRPD - Articles
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Article 25 – equality in health care and
services, including free and informed
consent. (Forced/Coerced medications in
all aspects of Penal/MH system –
development & access to holistic
alternatives in these systems) (MH
screening results in discrimination/labeling
obsolete to informed trauma care)
Criminal Justice System/Psychiatric
Diversion - Institutions – Re-Entry
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Institutions (Jail/Prison)
Jails
Prisons
Diversion
Crisis
Specialized Courts
Re-entry
Probation (AOT/IOC)
Parole
People w/disabilities who are
detained/imprisoned are subjected:
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Force/Coercion
Violence (Restraints/tying to bed/chairs &
chemical restraints)
Isolation/Seclusion (based on PWD)
Sexual Assault (Dominance/Subordination)
Discriminatory Disciplinary Policies
(Reasonable Accommodations – Prison/Jail
Programs exclusion)
Diversion
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Police Response to “crisis” (ER/Involuntary
Commitment)
Social Issues Criminalized – (family/neighbor
disputes, homelessness, substance abuse &
assumed “odd behaviors” Voices/Visions)
Court Based Diversion (Mental Health Courts –
Segregating People by “illness” with the judicial
system, mandating tx & punishing failure, serves
to perpetuate the criminalization of PWD) Serve
Jail Time and/or adhere to treatment/service
plan)
Re-Entry
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Shift from CJ to MH – there is a significant
shift in due process procedures.
Probation/Parole Stipulations – mandated
tx, psychiatric drugs, coercion/force,
threat of non-compliance
Penalized – Social Problems,
unemployment, poverty, substance abuse,
trauma
Recommendations
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Language – Social issues being
criminalized – trauma – people see/feel
their issues
Reasonable Accommodations – Access:
Legal services, peer support/advocacy,
family support. (Assisting w/lawyers) –
education, medical treatments, holistic
therapies, exercise & accommodation for
programs
Recommendations
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Criminal Justice system needs to remain a
system based on law & not a treatment referral
system.
Legislative Changes Must Occur – Policy
Abolition & Development (parole/probation/MH
laws IOC/AOT/Institutions)
Countries: Human Rights Treaty Obligations.
(US obligations – CAT, ICCPR, CERD) US does
not hesitate to criticize other countries for their
HR violations – it has been derelict in complying
with our own HR commitments.
What Does "Trauma Informed" Mean?
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trauma model an alternative to medical model
recognize 90%+ people with mental health
diagnosis are trauma survivors
all psychiatric symptoms can potentially be
explained by trauma perspective
what happened to you, not what is wrong with
you.
values subjective experience of people rather
than focuses on expertise about pathology
(changing?)
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way to address how system traumatizes + retraumatizes
people. rates of violent/traumatizing events much higher
in institutions
looks at power relationships and misuse of power in
institutions
emerged out of consumer/patient movement, women's
movement, domestic violence activism, reform police &
hospitals
political resistance to recognizing trauma: Freud, sexism,
medical expertise, status quo, oppressions <-> trauma
"trauma informed" is an evolving concept. create
ongoing dialog and education in your community and
organization
RESOURCES
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www.CHRUSP.org
www.WNUSP.net (CRPD Manual)
www.mentalhealthpeers.com
www.willhall.net