Anyplace But Here: The Uncomfortable Convergence Between Mental Illness and the Criminal Justice System

If someone had told me in 2008 that the single most time-consuming issue facing me as one of the newest of Americas three thousand-and-eighty-one sheriffs would be mental health, I would have laughed. I was the SWAT team leader. I was a drug education officer on patrol and a street-level narcotics interdiction officer for a larger (by Iowa standards) sheriffs office. I would do the occasional court-ordered, emergency mental health committal and the random transport from one health care facility to another mental health facility on a judges order from time to time. But that was the extent of my engagement with real, actual, and actionable knowledge of law enforcement and mental health care as a unit. Sure, you would see the news about the mentally ill, youd encounter the occasional crazy guy or gal, and youd pray that you never had to encounter someone on patrol who wanted a suicide-by-cop scenario to play out in real life. [...] Today, mental illness and how it intersects with my duties as one of Iowas ninety-nine elected sheriffs influences my obligations on a daily basis. I manage nearly three-hundred residential beds in our jail and over sixty percent of them are occupied by someone with a significant mental health diagnosis. The number of emergency mental health committals have steadily risen since I took office in 2009; and our state has slowly and steadily alleviated itself of its obligations in the mental health care arena, opting instead to delegate that responsibility down to the counties or mental health regions for which they provide minimal financial or other kinds of supports. They have shut down state run mental health hospitals, privatized mental health care insurance, decentralized the Department of Human Services, and gutted both funding and staffing for mental health care over the past twenty years to create a perfect storm of convergence whereby a nationwide crisis has become a hometown doorstep issue for my colleagues and those of us in law enforcement. [...] In America today, the fastest growing population in prison is not Blacks, Hispanics, or toothless methamphetamine addictsit is the mentally ill. We are criminalizing our brothers and our sisters, our neighbors and our friends at an alarming and increasing paceand are we not challenged to be their keepers? At a truly visceral level, this problem perplexes me to my very being. I am hurt and disappointed, no, perhaps that is too small an assertion for where I find myself standing as a sheriff. Disappointed is a father when a child forgets to pick up the Legos and you find them at 11:00pm on your way to the bathroom, stuck to the bottom pad of your left foot. I am not disappointed, I am disrespected. That is perhaps closer to the feelings of frustration, rage, anger, insult, and the hundreds of other feelings that boil just beneath the surface of my calm faade as a law enforcement administrator. You see, Ive watched legislators pass gun bills that no one really wanted in just one session, yet for twenty years in my state weve tried to reform mental health delivery systems that nearly every state citizen recognizes is necessary, to no avail. [...] If this book helps to add fuel to someones efforts, if my words provide credence to a persons argument of need for support, or bolsters strength in the observations regarding the importance of mental health reform, great! If something in my stories and narrations cause someone to pay attention and listen to the choir that is likely reading this, giving their real-life experiences more credibility, then all my efforts are well worth it. My goal is to simply champion the message that change must happen. And we can all be those champions of change.