A nationwide criminal defense practice focusing on representing people with mental disabilities.
Federal Prison Reform Bill Calls for Increased Treatment for the Mentally Ill
On May 22, 2018, the House of Representatives passed the First Step Act , a bill aimed at reforming the federal prison system. The bill focuses on rehabilitating the incarcerated by investing $50 million over a five-year period by providing vocational training, educational resources, and mental health treatment for inmates. The bill allows inmates to earn good time credits towards release by participating in programs and expands the number of days inmates can spend in a halfway house at the end of their sentences. The bill still awaits consideration by the Senate.

No Sentencing Reform
Prison reform advocates were disappointed that the bill didn’t include comprehensive sentencing reform and claim that it should reduce mandatory minimum sentences and allow judges more discretion during the sentencing phase of federal cases. Many believe that without cutting how many and how long people go to prison, there really is no reform. The Senate’s Sentencing Reform and Correction Act is also making its way through Congress. Without the support of the President and in the face of an Attorney General who believes that “ being soft on sentencing means more violent crime ,” however, it faces little chance of getting passed. Opponents of the First Step Act fear that if the bill passes, Congress will call it a success and turn its attention away from the reforms in sentencing that still need to be made. 

Mental Health Treatment
The focus increased funding for mental health treatment in prison, however, is promising. Studies show that prisoners with mental illness have a high rate of recidivism and that continued mental health care can help. Though the First Step Act makes modest improvements, it is a positive move for prison reform. Congress hasn’t passed prison reform legislation in a long time. However, the inmates in the federal prison system constitute a small portion of the overall U.S. prison population.

As Henry Dlugacz noted in Representing People with Mental Disabilities A Practical Guide for Criminal Defense Lawyers , edited by Elizabeth Kelley :

On any given day, the United States incarcerates approximately 2.3 million people in 3,163 local jails, 1,719 state prisons and various juvenile detention facilities, federal prisons, and Indian county jails. 
Estimates of the prevalence of serious mental illness among this mass of humanity vary according to the methodology and definitions employed. However, it is estimated that between 8 percent and 19 percent of all prisoners in the United States have a serious mental illness resulting in a significant functional impairment, with an additional 15 percent to 20 percent requiring some type of psychiatric intervention during the course of their incarceration. In the jail population, a conservative estimate is that 14.5 percent of men and 31 percent of women come into jail with current symptoms of serious mental illness. 

Reform in State Prisons
The increasing number of mentally ill prisoners placed in the custody of state jails and prisons means there needs to be reform in the state systems as well. In many states, due to the shortage of hospital beds , the prison system becomes the largest repository for the mentally ill. Some states have promised increased mental health treatment with mixed results. For instance, the Illinois Department of Corrections is currently facing an injunction after it failed to comply with a settlement agreement that called for improvements in mental health care response. Some states, such as Florida and South Carolina , are cutting mental health funding due to budget constraints. It is clear that reform must come from the states as well as the federal government in order to provide a comprehensive solution. This solution should include more mental health resources outside of prison and an increased use of diversion programs to prevent mentally ill offenders from ever stepping foot in jail or being ensnared in the criminal justice system to begin with.
Elizabeth Kelley
Criminal Defense Attorney
Elizabeth Kelley is a criminal defense lawyer with a nationwide practice specializing in representing people with mental disabilities. She is the co-chair of The Arc's National Center for Criminal Justice and Disability, has served three terms on the board of the National Association of Criminal Defense Lawyers, and serves on the Editorial Board of the American Bar Association's Criminal Justice Section Magazine.  Learn more .
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Treatment, Not Jail, Not Prison
This video vividly describes the challenges faced by people with mental disabilities in the Cook County, Illinois jail. It also shows the humanity and courage displayed by some public officials like Cook County Sheriff Tom Dart.  
Representing People with Mental Disabilities
Representing People with Mental Disabilities: A Criminal Defense Lawyer's Best Practices Manual , edited by Elizabeth Kelley is available for purchase from The American Bar Association. It contains chapters devoted to a variety of issues confronted by people with mental disabilities in the criminal justice system such as Competency, Sanity, Malingering, Neuroscience, Jail and Prison Conditions, Working with Experts,and Risk Assessment. Chapters are written by academics, mental health experts, and criminal defense lawyers. In the Introduction, Elizabeth writes that "This is the resource I wish I had had many years ago."