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The social safety net of last resort

Phyllis Harrison-Ross | , M.D. | 6/22/2011, 3:25 p.m.

One big reason is the mass psychiatric hospital deinstitutionalization that began in the 1960s. It was an action that did not include developing adequate community resources to serve an ill population and allow them independent living, especially those who do things that are against the law.

Instead, we have trans-institutionalized them, shifting many from psychiatric hospitals to prisons. In addition, prisons and jails are holding many ill people who were not under appropriate treatment at the time they were arrested.

Here's what must be done:

* Public health officials, physicians, psychiatrists and addiction and other treatment providers need to discuss their differences with judges, prosecutors, public defenders, correctional officials and probation and parole officers. They need to realign their relationships and build a new consensus on protocols that support a medical recovery-public health approach.

* Elected officials and legislators who are on committees that have justice system oversight, along with those on public health and substance abuse committees, must monitor this relationship-building and require medical professionals and their criminal justice partners to reach a consensus.

* Elected officials must be informed of the progress of these efforts.

* Health care professionals must learn how to collaborate with inmates' employment, housing, education and vocational training as well as spiritual and family relations.

* Adequate resources must be allocated to health care professionals to enable them to take this comprehensive and holistic approach to service provision.

Dr. Phyllis Harrison-Ross is commissioner of the New York State Commission of Correction. She has more than 35 years as a mental health professional, and is emeritus professor of psychiatry and behavioral health services at the New York Medical College.