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More than 60% of persons incarcerated in jails and prisons may be mentally ill with substance abuse disorders, according to Dr. Bert Pepper, psychiatrist and noted expert on the criminalizing of mental illness, who spoke at a recent forum on this growing problem.

"We need a public health approach to mental disorders and substance abuse if we want to help people," Pepper stated. "Treatment works, but we're not doing it." Only 20,000 prison therapeutic community residence slots are available nationally for an incarcerated population of one million. Vast sums of money have been used to build new prisons cells over the last 25 years which could have been used for community mental health and other social services.

Pepper's remarks were delivered at a forum titled "From Hospitals to Handcuffs" which was held on May 17th in Albany to promote awareness among legislators and other policymakers of the issue of the criminalizing of mental illness. Also featured were Sol Wachtler, consumer advocate and former Chief Judge of New York State, Dr. Nahama Broner, mental health researcher from New York University, and Catherine Abate, former state senator and former New York City corrections commissioner.

"The major limitations of drug courts is that the majority of drug addicts are mentally ill-and drug courts don't deal with that," Pepper also noted. "So now we need dual diagnosis courts or MICA courts as a replacement." He criticized a lack of historical awareness among policymakers of what has been going on to people living with mental illness and substance abuse in the last several decades.

Bringing new public attention to this issue, Judge Wachtler spoke of his personal experience as a person living with mental illness in federal prison. "I tell you that if you're not mentally ill when you go in, you certainly will be shortly thereafter," he said. "The first thing they do is put you in solitary confinement to observe you. I saw a psychiatrist once while I was there."

Wachtler was sharply critical of mental health treatment in the federal prison system, noting the general lack of services, the use of older medications to sedate inmates, and the practices of moving prisoners living with mental illness from one prison to another without effective treatment until they are finally released into the community.

As a result of his own experience, Judge Wachtler is now seeking to educate judges across the state on the realities of mental illness through a program to be offered by the state Office of Court Administration. He echoed the call for alternative treatment courts to deal with the related problems of substance abuse and mental illness. "We realize the enormous populations in our prisons who are mentally ill. And we know, and I know from very personal experience, that these people do not receive treatment."

The forum was co-sponsored by the Mental Health Association in NYS (MHANYS), NAMI NYS, Civil Service Employees Association (CSEA) and the New York State Catholic Conference.