Time to Walk the Walk

by Clarence Stone

Letter to the Editor of the Daily Record. 2/9/18

One important but low visibility issue facing the 2018 Maryland General Assembly is the adequacy of treatment for the overlapping problems of mental illness and drug addiction. Today’s problems are a legacy of past policy failures.   The 1960s deinstitutionalization movement closed mental hospitals in favor of the idea of community-based treatment.

Reality took a different path, one of few community facilities but INCREASED reliance on criminal incarceration. Using jails and prisons may have looked like a quick and cheap solution. Instead, it has given us a problem that has grown bigger and more expensive with awful side effects. Today, nearly one in three persons entering incarceration suffers from a serious mental illness, and without adequate care they have a high rate of recidivism and find themselves caught in a tragic cycle.

For Maryland specifically, the deinstitutionalization past and its accompanying neglect live on. According to John Snook, Director of the Treatment Advocacy Center, Maryland continues to close psychiatric treatment beds even as needs grow.   Many of the available beds go to forensic patients, and the possibility of a comprehensive strategy of prevention recedes. Short-term thinking and non-thinking give us that worst of all combination of an inhumane response to a need and cumulating cost to Maryland taxpayers.

The 1980s war on drugs was another dismal failure, greatly increasing the incarceration rate while doing little to prevent a persisting and growing addiction problem. Incarceration has no curative capacity and is expensive to boot.   Like those with problems of mental illness, released prisoners suffering from addictions have a high rate of return to prison. “Tough on crime” is no respecter of gender. Among arrestees, women have a higher rate of addiction problems than do men.

Scarce facilities are a pervasive problem, especially with drug-related death rates in a rapid rise. Carin Miller, co-cofounder of Maryland Heroin Awareness Advocates, says addicts reach out to her organization, but clinic openings are in short supply. Six weeks is a typical wait in spite of addict need for an immediate response. Miller and others have called for emergency facilities. Verbal support comes easily, but action is sparse.   Abject neglect is unthinkable, and criminalization is, if anything, worse.   From addicts to experts there is agreement that treatment is preferable to incarceration.

Unlike many front-page issues, treatment for mental health and addiction issues is not highly partisan. These issues cross lines of party and geography. All sections of the state and all levels of society have a stake in addressing the need for more facilities. When legislators are asked about what they are willing to support, many are quick to affirm their support. However, talking the talk or nodding the head is not enough.

With incarceration remaining at a high level, the 2018 legislative session has some buzz about responding to the accumulated misdirection and neglect of the past and actually appropriating money for services and care. As always, the legislative session is short, but 2018 would be a good time to move past the talking stage and begin walking into much needed future actions.