U.S. GOVERNMENT PRINTING OFFICE

WASHINGTON : 

For sale by the Superintendent of Documents, U.S. Government Printing Office

Internet: bookstore.gpo.gov Phone: toll free (866) 512–1800; DC area (202) 512–1800

Fax: (202) 512–2250 Mail: Stop SSOP, Washington, DC 20402–0001

86–518 PDF 2003

S. HRG. 107–910

THE CRIMINAL JUSTICE SYSTEM AND

MENTALLY ILL OFFENDERS

HEARING

BEFORE THE

COMMITTEE ON THE JUDICIARY 

UNITED STATES SENATE

ONE HUNDRED SEVENTH CONGRESS

SECOND SESSION

JUNE 11, 2002

Serial No. J–107–84

Printed for the use of the Committee on the Judiciary

(

(II)

COMMITTEE ON THE JUDICIARY 

PATRICK J. LEAHY, Vermont, Chairman 

EDWARD M. KENNEDY, Massachusetts 

JOSEPH R. BIDEN, JR., Delaware 

HERBERT KOHL, Wisconsin 

DIANNE FEINSTEIN, California 

RUSSELL D. FEINGOLD, Wisconsin 

CHARLES E. SCHUMER, New York 

RICHARD J. DURBIN, Illinois 

MARIA CANTWELL, Washington 

JOHN EDWARDS, North Carolina 

ORRIN G. HATCH, Utah 

STROM THURMOND, South Carolina 

CHARLES E. GRASSLEY, Iowa 

ARLEN SPECTER, Pennsylvania 

JON KYL, Arizona 

MIKE DEWINE, Ohio 

JEFF SESSIONS, Alabama 

SAM BROWNBACK, Kansas 

MITCH MCCONNELL, Kentucky 

BRUCE A. COHEN, Majority Chief Counsel and Staff Director 

SHARON PROST, Minority Chief Counsel 

MAKAN DELRAHIM, Minority Staff Director 

(III)

C O N T E N T S 

STATEMENTS OF COMMITTEE MEMBERS 

DeWine, Hon. Mike, a U.S. Senator from the State of Ohio, prepared statement ...................................................................................................................... 33

Leahy, Hon. Patrick J., a U.S. Senator from the State of Vermont .................... 1

prepared statement .......................................................................................... 35

WITNESSES 

Caceci, John, Captain, Monroe County Jail, Rochester, New York ..................... 13

Margolis, Gary, Director of Police Services, University of Vermont, Burlington, Vermont .................................................................................................. 6

Mayfield, Kenneth President–Elect, National Association of Counties, and 

Commissioner, Dallas County, Dallas, Texas .................................................... 11

Strickland, Hon. Ted, a Representative in Congress from the State of Ohio ..... 3

Sudders, MaryLou, Commissioner of Mental Health, Commonwealth of Massachusetts, Boston, Massachusetts ..................................................................... 9

SUBMISSIONS FOR THE RECORD 

Bazelon, David, Judge, Center for Mental Health Law, letter ............................ 21

Caceci, John, Captain, Monroe County Jail, Rochester, New York, prepared 

statement .............................................................................................................. 23

Margolis, Gary, Director of Police Services, University of Vermont, Burlington, Vermont, prepared statement ............................................................... 37

Mayfield, Kenneth President–Elect, National Association of Counties, and 

Commissioner, Dallas County, Dallas, Texas, prepared statement ................. 50

Strickland, Hon. Ted, a Representative in Congress from the State of Ohio, 

prepared statement .............................................................................................. 59

Sudders, MaryLou, Commissioner of Mental Health, Commonwealth of Massachusetts, Boston, Massachusetts, prepared statement .................................. 72

Wilkinson, Reginald A., Director, Ohio Department of Rehabilitation and 

Correction, Columbus, Ohio, statement ............................................................. 75

(1)

THE CRIMINAL JUSTICE SYSTEM AND 

MENTALLY ILL OFFENDERS 

TUESDAY, JUNE 11, 2002

UNITED STATES SENATE, COMMITTEE ON THE JUDICIARY, Washington, D.C. 

The committee met, pursuant to notice, at 10:05 a.m., in Room 

SD–226, Dirksen Senate Office Building, Hon. Patrick J. Leahy, 

Chairman of the Committee, presiding. 

Present: Senator Leahy. 

OPENING STATEMENT OF HON. PATRICK J. LEAHY, A U.S. 

SENATOR FROM THE STATE OF VERMONT 

Chairman LEAHY. Good morning. Today, this committee is going 

to consider an important but, I am afraid, often overlooked criminal 

justice issue—the impact of mentally ill offenders on our justice 

system. The consideration of the committee will be aided by the release of a comprehensive report on that topic by the Council of 

State Governments. We are also going to hear from a number of 

criminal justice and mental health experts, who will explain why 

the issue of mentally ill offenders has presented such problems for 

State and local governments. I hope this hearing will raise awareness of the role of mental illness in causing crime and help Congress valuate what role the Federal Government can play in helping State and local governments address this issue. 

Now, we are all too familiar with the role that drug abuse plays 

in promoting crime—from drug trafficking itself, to property crimes 

committed by addicts or those seeking money to buy drugs, even 

to the tragedy of murders committed by dealers seeking to gain or 

maintain control over what have become lucrative drug markets. 

We are also well acquainted with the occasional notorious crime 

committed by mentally ill individuals—the assassination attempt, 

for example, against President Reagan. But today we will focus on 

the persistent problem of people with mental illness who repeatedly 

rotate between the criminal justice system and the outside world, 

committing a series of minor offenses that occupy the time of law 

enforcement officers and actually divert them from their more urgent responsibilities. Now, some mentally ill offenders also abuse 

drugs and/or alcohol, and that further complicates matters. 

We will hear today from witnesses who have expertise in this 

area from varying perspectives, including law enforcement, corrections, State mental health systems, and local government. 

I must admit—and I hope people won’t believe I am being parochial, but I want to give a particular welcome to Gary Margolis, 

2

who is the Chief of Police Services at the University of Vermont. 

I worked with Chief Margolis on a whole number of issues over the 

years, and not only have I but my staff has relied on his very good 

judgment. And I appreciate Representative Ted Strickland coming 

over from the other side of the Hill. He has personal experiences 

with mentally ill offenders. He served as—and tell me, Congressman, if I am right on this—a consulting psychologist at the Southern Ohio Correctional Facility before coming to Congress. I mention 

that because of how fortunate we are when people who have all 

these different backgrounds come into Congress, and both the 

House and the Senate have benefited from Congressman 

Strickland’s expertise. 

The Council of State Governments’ report was developed by nearly 100 criminal justice and mental health policymakers—Republicans and Democrats—who wanted a non-partisan report on how 

to improve the criminal justice system and how it handles people 

with mental illness. They had sheriffs, chiefs of police, prosecutors, 

judges, corrections directors, parole board chairmen, mental health 

professionals. That is pretty extensive. The Police Executive Research Forum and the Association of State Correctional Administrators worked with the Council of State Governments and the 

Bazelon Center for Mental Health Law. 

The evidence shows the severity of the problem. It found that 

more than 16 percent of those incarcerated in jails and prisons 

have a mental illness. The Office of Juvenile Justice and Delinquency Prevention reports that more than 20 percent of the youth 

in the juvenile justice system have serious mental health problems. 

The Los Angeles County jail often holds more people with mental 

illness—the Los Angeles County jail—than any State hospital or 

mental health institution in the United States. Every State witnesses examples of this. 

Last December, Robert Woodward, a mentally ill man, interrupted services at All Souls Church in West Brattleboro, threatened first to kill himself, then armed with a knife, charged three 

officers who had responded to the scene. They fired back in defense. Mr. Woodward died later that day. This is tragic all the way, 

the tragedy of the effect on the officers, the effect on Mr. Woodward, and those who were in the church. And so we have to look 

at these things. 

We should all agree that it makes sense to help State and local 

governments improve the availability of mental health services, to 

train their law enforcement personnel to recognize the signs of 

mental illness, but then to give prosecutors more tools in dealing 

with them. 

Helping people with mental illness is the right thing to do. It 

would improve the safety of all Americans, but we also have to give 

the tools to those we ask to protect all Americans. I have worked 

with Senator Hatch and others to increase funding for drug treatment. We want to reduce crime, but we should also be interested 

in this issue. I have proposed including a study on the ability of 

mentally ill offenders to reintegrate into society after their release. 

[The prepared statement of Senator Leahy appears as a submission for the record.] 

3

Chairman LEAHY. If I might, I would call on Congressman 

Strickland to come forward. 

To give you an idea, as I said, about the background of people 

who come here and absolutely improve the Congress with their 

background, Congressman Strickland represents the 6th District of 

Ohio. He has a master’s of divinity degree from Asbury Theological 

Seminary, a doctorate in counseling psychology for the University 

of Kentucky. He served as a minister, college professor, and a psychologist. Actually, all three are probably necessary just to serve 

with the rest of us up here. 

[Laughter.] 

Chairman LEAHY. At least speaking for myself. So, Congressman, 

I am delighted to have you here. Please go ahead, sir. 

STATEMENT OF HON. TED STRICKLAND, A REPRESENTATIVE 

IN CONGRESS FROM THE STATE OF OHIO 

Representative STRICKLAND. Thank you, Mr. Chairman, for your 

graciousness in having me here and giving me the opportunity to 

testify today about the solutions to the problems of the mentally ill 

in the criminal justice system. As a psychologist and as someone 

who has worked in a maximum security prison and as a Member 

of Congress who has worked through legislation to try to solve 

some of these problems, I hope that I can provide some helpful insights to you and the committee. 

The striking statistic which you have just shared with us, Mr. 

Chairman, and that we will probably hear multiple times today is 

that, according to the Bureau of Justice Statistics, over 16 percent 

of adults in our jails and prisons have a mental illness, and the Office of Juvenile Justice and Delinquency Prevention tells us that 

over 20 percent of the youth who are in juvenile justice systems 

have serious mental health problems. 

In 1963, Health, Education and Welfare Secretary Anthony 

Celebrezze said, ‘‘The facts regarding mental illness and mental retardation reveal national health problems of tragic proportions 

compounded by years of neglect.’’ He said that large State mental 

hospitals were primarily institutions for quarantining the mentally 

ill, not for treating them, and that ‘‘all levels of government, as 

well as private individuals and groups, must share the responsibilities of a 20th century approach to this outstanding national health 

problem.’’

Well, Congress responded to this ‘‘outstanding mental health 

problem’’ by passing the Community Mental Health Centers Act, 

which sought to move as many of the mentally ill as possible out 

of prolonged confinement in overcrowded State custodial institutions into voluntary treatment at community mental health centers. On October 31, 1963, President Kennedy signed the Community Mental Health Centers Act into law. Unfortunately, Congress 

failed to keep the Act’s promise by failing to fund it, and the money 

States needed to build adequate community mental health infrastructures flowed to other priorities. 

Although the reforms were well intended and had the purpose of 

protecting the mentally ill, they resulted in many of the most severely ill going without treatment and, in too many cases, becoming homeless, incarcerated, suicidal, and victimized. Ironically, 

4

these efforts are euphemistically referred to as ‘‘the deinstitutionalization movement.’’ But, in my opinion, the huge numbers of 

mentally ill individuals in jails, prisons, homeless shelters, and flop 

houses demand that we call this movement what it has become: 

transinstitutionalization. 

I believe there are two ways we must address this problem. 

First, we must require that health plans stop discriminating 

against mental health treatment. There is no scientific justification 

for treating mental health benefits differently from other benefits. 

S. 543, which has been introduced by Senator Domenici, and H.R. 

4066, which has been introduced by Representative Roukema and 

of which I am a proud cosponsor, would guarantee that health 

plans offer equal coverage of mental health and physical health. 

Second, and most important for the topic at hand today, is that 

we must give the criminal justice system that resources it needs to 

divert and treat the mentally ill. 

Senator DeWine and I worked together in the 106th Congress to 

begin to address some of these issues by creating a demonstration 

program to encourage the creation of mental health courts, which 

are courts with dedicated dockets with a dedicated judge where defendants may receive court-supervised treatment rather than jail 

terms. In most instances, the existence of the court allows a community to leverage additional mental health treatment resources 

because the base of support covers all parts of the criminal justice 

system, including law enforcement and court systems. 

However successful, the mental health court initiative is but a 

small piece in what is needed to address the problem of the mentally ill at all stages of the criminal justice system. I am glad to 

be working with Senator DeWine and with you, Chairman Leahy, 

to build on the mental health court initiative. We are working to 

craft a bill that comprehensively addresses the problem of the mentally ill in the criminal justice system by encouraging law enforcement and criminal justice systems within communities to collaborate with treatment providers to ensure that individuals with mental illness receive all the services they need to live healthy, productive lives. 

The bill under consideration will provide funds for States and localities to create diversion programs within the criminal and juvenile justice programs; provide training fund and materials so that 

police and correctional officers can recognize the symptoms of mental illness and create appropriate plans of action when a mental illness is recognized; and ensure that treatment and services, including housing, education and training, and health care are available 

when an individual with a mental illness is released from prison. 

The bill will allow States and communities the flexibility to design a treatment program that meets their individual needs, but it 

will also require collaboration on the part of the agencies providing 

these services. 

For example, a significant percentage of adults with serious mental illness in the criminal justice system were homeless upon arrest, and a lack of housing is a contributor to their difficulties in 

accessing treatment and other services or holding a job. 

The bill we will introduce will seek to address this problem by 

requiring that communities receiving grants coordinate with the 

5

Department of Housing and Urban Development and ensure that 

they have a plan of action for the housing needs of individuals with 

serious mental disorders, including those who are released from 

prison or jail. If this collaboration is successful, fewer individuals 

with serious mental disorders will commit another crime. I truly 

believe that based on my experience. 

Collaboration between education and training as well as employment agencies must also occur. The bill will address both the juvenile and adult mentally ill populations by ensuring that communities receiving grants meet the unique needs of both adults and 

youth. In addition, the bill will have an evaluation component to 

ensure that the communities that receive funds are using them for 

programs that are effective. This will also ensure that extremely 

successful programs are recognized and can be replicated in other 

communities. 

I believe this sort of collaboration is the best way to create a legislative mechanisms that will bridge the gap between the mental 

health and the criminal justice systems. It is through this gap that 

so many mentally ill defendants currently fall. Both Senator 

DeWine and I are working hard on this bill, and I am hopeful that 

it will be ready to be introduced very soon. 

In conclusion, Mr. Chairman, I want to thank this committee for 

looking closely at a problem which too many of us have turned 

away from. I believe there is a consensus among a broad spectrum 

of stakeholders and political ideologies that lead us to the practical 

steps we can take to stop the criminal justice system from being 

this country’s primary caretaker of the seriously mentally ill. I am 

so pleased and proud to be a part of this effort, and I thank you, 

Mr. Chairman, for this opportunity to speak to you this morning. 

Chairman LEAHY. Well, thank you, Congressman Strickland. And 

I directed my staff to continue working with yours and Senator 

DeWine’s on this legislation, introducing it soon. Again, just on a 

personal note, I appreciate your leadership in this. You come as 

well qualified as anybody I have served with in the Congress to 

give that kind of leadership. 

I have no questions. I also know you are supposed to be at about 

five other things in the House right now, so, of course, you are excused. But I appreciate you coming over. 

Let’s have our staffs work on the final part, and you and I can 

see what we can get passed. 

Representative STRICKLAND. Thank you very much. 

Chairman LEAHY. Thank you. 

[The prepared statement of Mr. Strickland appears as a submission for the record.] 

Chairman LEAHY. We are going to set up for the next panel, 

which will be: Chief Gary Margolis, University of Vermont, Director of Police Services; Marylou Sudders, the Commissioner of Mental Health, Commonwealth of Massachusetts; Kenneth Mayfield, 

the President–Elect of the National Association of Counties, also a 

Commissioner of Dallas County, Dallas, Texas; and Captain John 

Caceci—how close did I come? 

Mr. CACECI. ‘‘Caceci.’’

Chairman LEAHY. I am sorry. I should know that. Captain Caceci 

and I were talking about our Italian heritage earlier. My late mothVerDate Mar 21 2002 12:53 Apr 30, 2003 Jkt 085887 PO 00000 Frm 00009 Fmt 6633 Sfmt 6633 C:\HEARINGS\86518.TXT SJUD4 PsN: CMORC
6

er, whose family came here from Italy, would probably have a word 

with me if she heard me mispronounce a name like that. 

Please, why don’t you all come forward and take your places at 

the table. 

Again, I thank you for taking the time to come here. I should 

note that Chief Margolis is the chief and Director of Police Services 

at the University of Vermont. He is testifying on behalf of the Police Executive Research Forum and the Council of State Governments. He has a doctorate in educational leadership and policy 

studies. He served on the committee that produced the Council of 

State Governments Criminal Justice/Mental Health report. 

Ms. Sudders has served as Commissioner of Mental Health for 

Massachusetts since 1996. To put that in perspective, she oversees 

a mental health system that will deliver services to more than 

24,500 Massachusetts residents. She previously served as New 

Hampshire’s commissioner and is testifying on behalf of the National Association of State Mental Health Program Directors. 

I mentioned Mr. Mayfield is the Commissioner of Dallas County, 

and I enjoyed talking about mutual friends with him, but he is 

also, more importantly right now, the President–Elect of the National Association of Counties. 

The captain has worked in law enforcement for nearly 20 years 

and supervises all uniform personnel at the Monroe County, New 

York, jail where, I am sorry to say, he has had extensive experience 

with mentally ill offenders, and I must say I am glad to have you 

here because your experience is not in the abstract. I think that 

would be safe to say. 

We will begin with Chief Margolis. 

STATEMENT OF GARY MARGOLIS, DIRECTOR OF POLICE 

SERVICES, UNIVERSITY OF VERMONT, BURLINGTON, 

VERMONT 

Chief MARGOLIS. Good morning. Thank you, Senator. This is indeed an honor to be here before you today. 

My name is Gary Margolis, and I am the Chief of Police for the 

University of Vermont. As Senator Leahy knows, Vermont is struggling like other States across this Nation to improve how we respond to people with mental illness in the criminal justice system, 

and I applaud you and this committee for taking on this difficult 

issue. 

Today I am representing the Police Executive Research Forum 

and the Criminal Justice/Mental Health Consensus Project, a 2-

year initiative coordinated by the Council of State Governments. 

Together with numerous criminal justice professionals and mental 

health professionals along with victims’ advocates and consumers, 

we have developed concrete recommendations for providing appropriate responses to people with mental illnesses at risk of criminal 

justice involvement. In my testimony today, I will describe traditional responses and the problem at hand, while suggesting steps 

this committee can take to help us. 

So many police encounters involve people who essentially are displaying symptoms of untreated mental illness, and let me be clear 

at this point and from the start that any person who commits serious crime should be arrested, prosecuted, and appropriately senVerDate Mar 21 2002 12:53 Apr 30, 2003 Jkt 085887 PO 00000 Frm 00010 Fmt 6633 Sfmt 6633 C:\HEARINGS\86518.TXT SJUD4 PsN: CMORC
7

tenced, including the mentally ill. But as I will illustrate, when it 

comes to the police response to people with mental illnesses who 

commit less serious crimes, we can serve them and our communities better by a collaborative police-mental health approach. 

Many police encounters involve persons acting in a disorderly or 

disturbing manner, and the examples are plentiful. It could be the 

person urinating on a street corner or directing traffic in the middle of Main Street. In other cases, a family member called because 

their loved one with a history of mental illness needs immediate 

help and they don’t know where to turn. They may be frightened 

for their own safety, or they can no longer take the stress. 

In these scenarios, we all agree that treatment is needed. Often 

the police are the only resources available 24 hours a day, 7 days 

a week, and we simply do not possess the diagnostic expertise of 

mental health professionals. In many rural areas, we may be the 

only resource available within a 45-minutes or more drive. In communities without effective partnerships, the police have three options: first is to do nothing, and we must accept the fact that in 

some communities with severely inadequate treatment services this 

approach continues to be a reality. 

The second is to link the person with appropriate mental health 

services. But, unfortunately, as in the first, in many communities 

such services are simply inaccessible. 

The third and by far most common option is to arrest if a minor 

crime has been committed. When arrested, minor offenders with 

mental illnesses land in a criminal justice system ill-equipped to 

meet their needs, where they often deteriorate further. They then 

re-enter the community far worse and the cycle repeats. 

Only the relatively rare police call involves a person with mental 

illness exhibiting threatening behavior and brandishing a weapon. 

These tragic incidents perpetuate the myth that people with mental illnesses are more violent than the general population, and this 

is what becomes our front-page news. 

I am going to reiterate a story the Senator began with, that on 

Sunday, December 2, 2001, Robert Woodward interrupted service 

at the All Souls Church in West Brattleboro, Vermont. He held a 

three-and-a-half-inch blade to his right eye while threatening to 

kill himself if folks left the service. Mr. Woodward refused to comply with repeated requests from the police to drop his weapon, and 

when he advanced towards the officers, he was shot. He died only 

hours later. 

In a statement to a rescue squad member, Mr. Woodward said, 

‘‘Please tell the officer I assaulted that I did not want to hurt him. 

I would not have harmed him. I just wanted him to shoot me.’’ The 

Vermont Attorney General concluded that the shooting death of 

Robert Woodward, ‘‘although tragic, was legally justified.’’

There are far too many examples like this in every jurisdiction. 

Too often, we had been there before, we had known of the problem, 

but the underlying mental health issues were never fully addressed. We respond time after time to the same locations of individuals, spending considerable resources in a helpless cycle, particularly in a time when Federal authorities are relying on local police to help in our war on terrorism. And on behalf of my colleagues, I am here to state that we are frustrated. 

8

The reality is that police response is dictated by agency resources 

and community support. We must work collaboratively to develop 

solutions. The Consensus Project identified several best practices to 

serve as models. We know that effective police response to people 

with mental illness depends on extensive collaborations with the 

mental health community. Funding for the Consensus Project is an 

excellent example of this at the Federal level. The Department of 

Justice Office of Justice Programs and the Department of Health 

and Human Services Substance Abuse and Mental Health Services 

Administration each made extensive contributions. They promoted 

efforts by the State and local governments——

Chairman LEAHY. If you could hold up, somebody has a very important phone call. I don’t want them to miss it. 

In fact, if he would like to step outside and take it, he is more 

than welcome to. 

Go ahead, chief. 

Chief MARGOLIS. Thank you, sir. We know that effective police 

responses to people with mental illness depend on extensive collaboration with the mental health community. Funding for this 

Consensus Project is an excellent example of this at the Federal 

level. The Department of Justice Office of Justice Programs and 

the Department of Health and Human Services Substance Abuse 

and Mental Health Services Administration each made extensive 

contributions. They promoted efforts by the State and local governments to develop the solutions rather than imposing a one-size-fitsall Federal mandate. 

Another important step was the enactment of America’s Law Enforcement and Mental Health Project, the law that Senator DeWine 

and other committee members originally sponsored. We need your 

help and today’s hearing marks an exciting step. I respectfully request the committee consider the following: 

First, we need the Federal Government’s help in determining 

what works. 

Second, resources from the Federal Government are essential to 

seed new programs and facilitate coordination between criminal 

justice and mental health organizations. 

In closing, in these difficult times it is easy to dismiss the issue 

we raise today. I implore you to think otherwise. Our important efforts to combat terrorism cannot impede our progress on other 

fronts. There are solutions described in the Consensus Project report which we can implement with your help. The bottom line is 

we can do better. We owe it to the people with mental illness who 

need our help. We owe it to their families and loved ones, to the 

victims and to the communities who trust us, the police, to respond 

effectively to their calls for help. 

Thank you, Senator. 

[The prepared statement of Chief Margolis appears as a submission for the record.] 

Chairman LEAHY. Thank you very much. 

Commissioner? 

9

STATEMENT OF MARYLOU SUDDERS, COMMISSIONER OF MENTAL HEALTH, COMMONWEALTH OF MASSACHUSETTS, BOSTON, MASSACHUSETTS 

Ms. SUDDERS. Good morning, Mr. Chairman. Thank you for the 

invitation to testify about the interrelationship between criminal 

justice and mental health. Addressing this very serious matter requires true leadership and true partnership between mental health 

and criminal justice at all levels. 

I am here in two capacities. First, it is my great honor to serve 

as Commissioner of Mental Health for the great Commonwealth of 

Massachusetts. The mission of the department is to improve the 

quality of life for adults with serious and persistent mental illness 

and children with severe emotional disturbance. As you noted, I 

serve on any given day 24,000 individuals in Massachusetts. I am 

also here as a member of the Board of the National Association of 

State Mental Health Program Directors, which represents the $20 

billion public mental health system in the 50 States and the District of Columbia. I am authorized to speak on behalf of all State 

mental health authorities and to present a national perspective regarding the urgency this issue creates for States in both our criminal justice and mental health systems. 

I should note that NASHMHPD, in fact, has formed a task force 

devoted to this very topic. Others here this morning will focus on 

the burden on the criminal justice system. I will focus on the challenges in the public mental health system, as well as specific action 

that may be taken by Federal, State, and local governments. 

Let me begin by applauding the committee for convening this 

hearing and bringing together what some might consider the 

strangest of bedfellows. As you will hear, however, this collaboration—between those responsible for criminal justice and mental 

health systems—is essential and, in some cases, long overdue. And 

we all know the tragedies. Where the seeds of that collaboration 

have been planted, significant outcomes have been achieved. But 

these achievements have been sporadic at best. Federal leadership 

and support at this time is critically needed. 

Public mental health systems know much about how to provide 

services for people with mental illness who are at risk of criminal 

justice involvement, but we face significant challenges in translating all that we know into practice. We must overcome the conflicts and inconsistencies inherent in fragmented funding strategies 

at national, State, and local levels. 

Our efforts must involve a two-pronged approach. First, we must 

prevent criminal justice involvement of people with mental illness 

by diverting them into community treatment. And, second, we must 

meet the needs of people with mental illness who are returning to 

the community from jail or prison. And, of course, it is essential to 

ensure that a mentally ill person receives good treatment while incarcerated. This involves forging links with jails and prisons to develop effective pre-release planning, including reinstatement of 

benefits for those who are eligible and identification of suitable 

housing. 

Any systems approach must include the integration of substance 

abuse and addictions treatment with mental health interventions. 

Co-occurring illnesses must be seen as the expectation and not the 

10

exception. We know from research that when substance abuse coexists with mental illness, the risk of violence significantly increases. 

The Council of State Governments’ Criminal Justice/Mental 

Health Consensus Project provides a superb template for action. Its 

report reflects the concept that early intervention yields best outcomes. In criminal justice terms, this means fewer police encounters for people with mental illness, fewer people with mental illness 

on court dockets or in jail holding cells, less time spent behind 

bars, and a drop in recidivism rates. For mental health, this means 

greater opportunity for productive lives and meaningful community 

members and to reduce the stigma associated with mental illness. 

We recognize that people with mental illness will continue to 

come into contact with the criminal justice system. Therefore, we 

need to collaborate with law enforcement on training such as that 

embodied in the Memphis, Tennessee, Crisis Intervention Team 

model and others. In Massachusetts, the department provides court 

clinic services to all juvenile and district courts. These clinics function essentially as emergency services programs to the district 

court, performing evaluations for competency, criminal responsibilities, and for civil commitment. Persons who are a danger to self 

or others by reason of mental illness or by reason of substance 

abuse can be civilly committed from the court after an evaluation 

by a designated clinician, and a hearing, of course. Counsel in 

these commitment hearings are all specially trained in mental 

health law. 

A model for pre-release planning is our Forensic Transition 

Team. The team engages with the individual while incarcerated, 

provides service coordination, continuity, and monitoring. The key 

to success has been strong interagency collaboration with criminal 

justice, cross-training, and very flexible services. And there are 

many other models across the country that have proven to be effective. 

There are two final points I would like to offer. The CSG report 

references that mental health systems are either too overwhelmed 

or too frustrated to help some of these individuals. Mental health 

systems have been overwhelmed, in part, due to historic underfunding and erosion of base resources. We have never realized 

President Kennedy’s dream that was envisioned in the Community 

Mental Health Centers Act of 1963 that was represented earlier. 

And given that more than 40 States are experiencing significant 

budget shortfalls, this situation is only exacerbated for public mental health systems. 

Some of the solutions are reasonably obvious and not controversial. There is no need to invent some new technology. The lack of 

service response is due to funding. Then there are a set of issues 

that may appear to provide the ready solution, but the effects of 

which are largely unproven. And that is one of the reasons we need 

your help. With these new strategies, I would urge the thoughtful 

approach for innovation through pilots and rigorous evaluation 

prior to rolling out in prime time. The Substance Abuse Mental 

Health Services Administration under the leadership of Charles 

Curie is to be commended for following such a process through the 

targeted capacity expansion rants for jail diversion programs. 

11

The Criminal Justice/Mental Health Consensus Project provides 

a model for effective collaboration. We are eager to work with partners in law enforcement, the courts, and corrections to ensure better outcomes for people with mental health at risk of or with histories of criminal justice involvement. At the same time, we welcome the advocacy of our partners in the project in seeking improved services and funding and consistent policies to support 

them. 

Thank you. 

[The prepared statement of Ms. Sudders appears as a submission 

for the record.] 

Chairman LEAHY. Thank you very, very much. 

Commissioner, go ahead. 

STATEMENT OF KENNETH MAYFIELD, PRESIDENT–ELECT, NATIONAL ASSOCIATION OF COUNTIES, AND COMMISSIONER, 

DALLAS COUNTY, DALLAS, TEXAS 

Mr. MAYFIELD. Chairman Leahy, thank you for inviting me to 

testify this morning on an issue of major importance to county governments—the diversion of non-violent mentally ill offenders from 

county jails and juvenile detention facilities. 

My name is Kenneth Mayfield, and I am an elected county commissioner from Dallas County, Texas. I currently also serve as 

president-elect of the National Association of Counties. 

From 1980 until 1988, I worked as an assistant district attorney 

for Dallas County, Texas, and eventually became chief of its Juvenile Division. 

It was during this period as the county’s chief juvenile prosecutor 

that I witnessed firsthand the growing number of juveniles that 

were inappropriately housed in county detention centers by virtue 

of their mental illness. After studying the matter, it became apparent that the majority of persons with mental illness—be they juveniles or adults—are serving time for minor offenses and were usually not taking medication at the time of their arrest. It was also 

clear that many persons with a mental disability also suffered from 

a co-occurring disorder, such as substance abuse or homelessness, 

and did not have caregivers to oversee their daily care. 

Over a year ago, I organized a community-based task force in 

Dallas County to put together a comprehensive program to divert 

the mentally ill who commit minor offenses. The key focuses of the 

task force are: funding, housing, treatment eligibility criteria, communications, education/training, and law enforcement. 

Mr. Chairman, I have been gratified to receive the full support 

of every law enforcement agency in Dallas County. I have also met 

with a number of foundations and agencies interested in this program. We are presently in the process of submitting grant proposals to fund a full continuum of services. At the core of the system is a triage unit that ties together intake and assessment, 

health care, emergency, transitional, and permanent housing, 

among other services. 

The task force has already completed the production of its first 

video to provide education and training for law enforcement at 

every point of contact with the adult criminal justice system for 

persons with mental illness, mental retardation, and co-occurring 

12

substance abuse disorders. Videos to follow will target judges, prosecutors, defense attorneys, family members, paramedics, emergency 

room staff, and the community in general. 

Mr. Chairman, the mentally ill in jail and juvenile detention are 

not a problem unique to Dallas County. Of the 10 million admissions to county jails each year, it is estimated that 16 percent are 

individuals suffering from mental illness. Most of these individuals 

have committed only minor infractions, more often the manifestation of their illness than the result of criminal intent. In 1999, the 

Bureau of Justice Statistics released a study on the Mentally Ill in 

Jail. The study confirmed that too often mentally ill inmates tend 

to follow a revolving door, from homelessness to incarceration and 

then back to the streets. Too many of these individuals do not get 

adequate treatment and end up being arrested again. 

The study underscores the importance of adequate assessments. 

In Los Angeles County, for example, teams of mental health workers and community police officers divert the mentally ill from the 

scene of an incident, but not before they make a preliminary assessment. In the vast majority of cases, the diversion is to a health 

unit. 

Mr. Chairman, what the public needs to understand about this 

population is not just that they will significantly benefit from a system of comprehensive services, including housing, health and 

human services, but also that it would be less expensive and more 

effective in the long term. For minor offenders, community-based 

mental health care is far less expensive than maintaining them in 

jail. 

By keeping the mentally ill within the health and human services system, we are also better able to monitor their condition, provide treatment, and to dispense medication if needed. 

Jail has the opposite effect. It traumatizes the mentally ill and 

makes them worse. For the county health department psychiatrist, 

it often means working twice as hard to get them back to where 

they were when they entered the jail. For the sheriff, it may mean 

assigning a deputy to carefully monitor the individual in jail. 

Mr. Chairman, the confinement of the non-violent mentally ill in 

county jails also represents a major liability problem for county 

governments. In addition, it is a financial drain on county budgets 

since Federal and State funding streams usually shut down when 

a mentally ill individual enters the jail. Even the person’s own insurance policy may contain an exclusion for jail confinement. 

Multnomah County, Oregon, found that the mentally ill defendants stay in jail one-third longer than those who are not mentally 

ill. Lengthy incarcerations not only worsen their condition, they almost guarantee difficulties after their release. 

For example, in many States, even a short stay in the county jail 

is enough to disenroll a mentally ill person from such entitlements 

as Social Security, Medicaid and/or Medicare. Once an individual 

is released from jail, he or she is eligible to receive such benefits, 

but it may take weeks or months for the programs to be restored. 

The need for collaboration between criminal justice and health 

and human service agencies at the local level in dealing with the 

mentally ill cannot be overemphasized. The challenge is to create 

a seamless web of comprehensive services. 

13

King County, Washington, has successfully created integrated 

service systems for people with mental illness and other co-occurring disorders. The goal is to share clients, share information, 

share planning, and share resources across agency lines. In the 

words of one former county administrator, the experience in King 

County has demonstrated that the major challenge is creating a 

new system. ‘‘It is a matter of joint planning, pooling resources, 

and more effectively managing existing resources toward new 

goals.’’

In conclusion, Mr. Chairman, the National Association of Counties has been working with a coalition of more than 30 national organizations on a proposal for Federal assistance to foster community collaborations between criminal justice and health and human 

service agencies. The proposal provides counties with considerable 

flexibility to design creative solutions and to stimulate partnership 

programs between State and county governments. 

Thank you. 

[The prepared statement of Mr. Mayfield appears as a submission for the record.] 

Chairman LEAHY. Thank you very much, Commissioner, and you 

have raised some very interesting points, including the one about 

the insurance stopping when they are incarcerated. 

Captain? 

STATEMENT OF JOHN CACECI, CAPTAIN, MONROE COUNTY 

JAIL, ROCHESTER, NEW YORK 

Captain CACECI. I would also like to thank Representative 

Mayfield. I appreciate those words regarding corrections. 

Good morning. My name is John Caceci, and I am captain at the 

Monroe County Jail in Rochester, New York. Thank you, Chairman 

Leahy and Ranking Member Hatch, for inviting me to testify. I also 

want to thank my Senator, Chuck Schumer. I am particularly 

grateful to my sheriff, Patrick O’Flynn, for allowing me to represent our jail. 

Speaking for corrections officers across the country, I can tell you 

that identifying inmates with mental illness and treating, managing, and preparing them for release is one of the greatest, if not 

the single greatest challenges we face in overcrowded jails and 

prisons. 

I also want to acknowledge the value of the Consensus Project 

report. Although I did not participate in the effort, I know that the 

corrections community was represented extensively. The recommendations in that document are exactly on point. 

On any given day, there are about 1,400 inmates in our jail. Like 

any jail, the average length of stay for inmates in our facility is 

short. Over the course of a year, over 17,000 inmates will be 

booked into our facility. 

Like every county in the country, our jail has experienced explosive growth over the last two decades. Our facility also resembles 

most jails in that it is the county’s largest mental health facility. 

No other institution in Monroe County holds nearly as many people 

with mental illness, and that is just not right. 

We work in a jail and our job is to incarcerate offenders, not hospitalize sick people. With my testimony today, I would like to reVerDate Mar 21 2002 12:53 Apr 30, 2003 Jkt 085887 PO 00000 Frm 00017 Fmt 6633 Sfmt 6633 C:\HEARINGS\86518.TXT SJUD4 PsN: CMORC
14

view several points. First I want to give you an idea of the types 

of people who have mental illness who land in our jail. Second, I 

would like to explain the services we attempt to provide these inmates. Third, I will describe the impact the current situation has 

on the operation of our jail. And, finally, I would like to recommend 

some steps that this committee could take to help corrections administrators and line staff address this overwhelming problem. 

Between 15 and 20 percent of the inmates in our jail have a 

mental illness, which is consistent with most jails in the country. 

I want to be clear that we incarcerate many offenders who have 

committed serious, violent crimes, and some of those people have 

a mental illness. Like was said earlier, they need to be punished 

and they need to be in jail. There are no two ways about that. 

But the majority of people we see with mental illness in our jail 

aren’t murderers or sex offenders, or even criminals with a history 

of violence. They are people who have been in and out of our jail 

on countless occasions, charged with committing low-level offenses. 

We don’t blame law enforcement officers for taking these people 

to our jail. They often don’t have any other option. Take, for example, the young man whom police recently brought to us. He had a 

history of mental illness and was on several mental health medications. He had been giving his mother an extremely hard time. He 

had threatened her, and one evening he was particularly menacing. 

The mother was frightened, so she called 911. The police knew the 

emergency room would not provide prolonged care, so they brought 

him to jail. We placed him in a single cell on a 24-hour suicide 

watch. 

In regard to screening, in New York State we are unique in that 

each jail uses the same screening process. Our protocols are extremely effective. Jail suicides have dropped by 70 percent over the 

last decade in our State. At some point, we hope to establish a system in which the mental health community can inform us when 

someone with mental illness whom they have served is in our jail. 

Good release planning is paramount. I know we have talked 

about it earlier. I can’t say enough about it. We know an effective 

discharge plan includes appointments with community-based treatment providers, a short supply of medications, health coverage, and 

linkage to supportive housing. Meeting all of these objectives is difficult, but it is nearly impossible with pre-trial detainees. Staff 

often receive less than 2 hours advance notice of these inmates’ departure. 

Inmates will mental illness sometimes act out and violate rules, 

which means we have to reassign them to high-security cells, typically reserved for dangerous inmates. Other inmates with mental 

illness are vulnerable to predatory inmates. Other inmates with 

mental illness refuse medication or become manipulative. We try to 

discourage our staff from using a restraint chair, but sometimes it 

can’t be avoided. I worry that as staff try to restrain the inmate, 

someone will get injured. 

I also have in the back of my mind stories I hear from colleagues 

in other facilities across the country that things get out of control 

as the officers try to subdue an inmate, inadvertently asphyxiating 

him or her. 

15

This is one of many reasons for providing extensive training. We 

are fortunate that Sheriff O’Flynn commits extensive time and resources to our annual training. 

We would like to increase mental health coverage in our facility 

24 hours a day. We are very reluctant, however, to advocate for extensive mental health services in our jail. As it is, we receive too 

many people with mental illness. A first-rate psychiatric unit in 

our jail would simply draw more people with mental illness into 

our facility and discourage building and facilitating better mental 

health treatment options in our communities. 

For this reason, we would prefer that the community’s capacity 

to support people with mental illness improve. We would welcome 

community mental health providers into our facilities. 

If we are going to make meaningful change around this issue, we 

will need the leadership of this committee and the Federal Government. First, corrections needs to be included in any Federal effort 

or grant program designed to target offenders. 

Second, the Federal Government is in a unique position to promote collaborative efforts between corrections and the mental 

health community. 

And, third, the importance of training correctional staff on mental health issues cannot be overstated. In this regard, the National 

Institute of Corrections is an invaluable resource. 

In conclusion, local jails should not be in the business of running 

hospital emergency rooms for people with mental illness. When it 

comes to people with mental illness, we in corrections have been 

handed an incredibly complex problem which has to be addressed. 

We are returning people with mental illness to the community 

many times in no better shape than when we received them. We 

are doing everything we can to make sure these people don’t hurt 

themselves and their health doesn’t deteriorate further. This 

makes it very difficult for us to focus on protecting staff and inmates and the community. That is supposed to be our primary mission. Please help us fulfill it. 

Thank you very much. 

[The prepared statement of Captain Caceci appears as a submission for the record.] 

Chairman LEAHY. Thank you very much, Captain. 

I have a statement by Senator DeWine which will be included in 

the record at the opening of this and a statement—written testimony, rather, by Reginald Wilkinson, the Director of the Ohio Department of Rehabilitation and Corrections. That can be included 

in the record. 

Let me ask, Chief Margolis—and this is a question that actually 

several members on this committee have. What about when you get 

to a rural State, like Vermont, or rural areas of a larger State, with 

the unique problems in a rural area? 

Chief MARGOLIS. Well, certainly, Senator, the problems are in 

any jurisdiction, but in rural jurisdictions, they can be exacerbated. 

Let me answer that question, sir, with a short story. 

Sheriff Don Edson of the Washington County Sheriff’s Office relayed to me just several days ago that 2 weeks ago his deputies 

had taken into custody a person who had committed a crime. This 

person had mental illness. 

16

Now, Washington County, as you well know, sir, is 790 square 

miles with 53,000 residents. That is approximately 67 people for 

every square mile. That is fairly rural. 

The individual was brought to the court. The judge, the defense, 

the prosecution all agreed that a mental health assessment was 

needed, and the deputies had to wait for over 2 and a half hours 

with that person for someone to come and screen. Now, that is 2 

and a half hours that those deputies were taken away from the 

community to serve other calls for service. 

So this is very common, and it is frustrating, and other sheriffs 

and other police chiefs in our State of Vermont in the rural areas 

echoed this frustration. 

Chairman LEAHY. That was about Washington County. I grew up 

there, and I have known Sheriff Edson from the time he was a 

child. I know the situation you talk about. 

The Council of State Governments report has a lot of proposals 

and recommendations. If there are key areas that the Federal Government should work on, what are those? 

Chief MARGOLIS. Well, the models that were underscored and 

found, Senator, include areas like crisis intervention teams and 

comprehensive advance response where officers are specially 

trained. They work with mental health responders. In some jurisdictions, mental health professionals either respond as special 

units or as mobile crisis teams. 

We have looked at dispatch protocols, how calls are handled, and 

examined the kinds of questions that are asked by the dispatcher 

at the initial intake; on-scene assessment skills, how are officers 

trained to recognize those issues; what training topics should be included in police academies and in in-service training to help in 

these areas; information gathering and how do we evaluate the 

success of our response; and then, last, and certainly not least, is 

the collaborative areas that we can work with our colleagues in 

mental health and in corrections and in the county governments to 

begin to develop new tools to respond more effectively. 

Chairman LEAHY. There have been some places in the country 

where there have been experiments with mental health courts. Do 

you have any experience with that? 

Chief MARGOLIS. Sir, my experience with mental health courts is 

limited. My understanding is that there are a number of areas and 

a number of ways that our criminal justice professionals are seeking to address that issue. 

In speaking with members of our Vermont judiciary, what I 

learned was that we have commitment hearings that we use, but 

not very much done in the area of mental health courts per se. 

Chairman LEAHY. Captain, I am back to your testimony. I think 

we can all agree that if people commit a crime, then there are consequences for criminal conduct. I spent 8 years in law enforcement 

before I was here, and I certainly have no question about that. 

Nobody wants to see mental illness used as an excuse to avoid 

such consequences, and we have seen cases where somebody has 

tried to use that as an excuse when it is not applicable. 

So how do you do this? You have got somebody who comes in. 

How do you determine whether they should be staying in jail or 

they should be transferred to mental health services? 

17

Captain CACECI. In Monroe County, we have a wonderful collaborative effort with our mental health staff. The socio-legal clinic for 

the county handles all of our mental health situations. 

One of the things we have done is, on a daily basis, we meet with 

medical, mental health, and security commanders in the facilities, 

and we sit down on a daily basis Monday through Friday at 11 

o’clock, and we go over each case of people with serious mental illness who is in custody, all of the cases of individuals who may be 

on suicide watch, and we discuss them and we try to figure out 

who needs to maybe go to a facility that has more extensive mental 

health coverage or could we approach one of the judges with mental health, psychiatry, and those types of people to see if we can 

get those people placed in some supportive housing or other living 

situation. 

So we work in a collaborative effort to try to move certain people 

out of the facility. 

Chairman LEAHY. But you are welcoming the mental health professionals into the jail. You make this kind of determination. Is 

there a general willingness, do you think, among law enforcement 

to do that? I mean, are you unique? Or are you seeing this more 

and more around with other law enforcement? 

Captain CACECI. Senator, I recently have gone to the American 

Jail Association’s convention in Milwaukee, and I see from across 

the country colleagues such as myself that are really trying to 

move in this direction, are trying to have more collaborative efforts 

with their local mental health people, and really trying to move to 

get those kinds of people with serious mental illness out of their 

facilities, because it is a tremendous drain on their resources, staffing, and what have you to really watch these people closely. And 

they don’t want to see people deteriorate while they are in the facility. 

So I think it is across the country that we are seeing this movement. 

Chairman LEAHY. Would it be an overstatement to say you want 

to be involved in law enforcement and you want people who should 

be in a mental health situation to be dealt with by people who 

trained to do mental health matters? 

Captain CACECI. Yes, sir. 

Chairman LEAHY. Commissioner Sudders, what is your experience about how law enforcement and mental health agencies work 

together at the State level to address this? And the reason I ask, 

I am just trying to think about what kind of a model we have to 

talk about at the Federal level between the Department of Justice 

and Health and Human Services, and I am just curious. What has 

been your experience at the State level? 

Ms. SUDDERS. In Massachusetts, I am lucky and honored to have 

actually a very strong relationship with the commissioner of corrections. And so, in fact, the relationship between mental health and 

corrections at the State level is very strong. I actually have sort of 

quality control over the mental health services provided in the correctional system in Massachusetts to someone who is mentally ill 

in the prison system. They can also in the jails in Massachusetts 

transfer from jails to the public mental health system for inpatient 

18

care of there is a mentally ill offender who needs—who is really 

acutely ill, they can transfer. 

So the State level in Massachusetts, probably because both Commissioner Maloney and I believe very strongly about collaboration, 

we have a strong partnership. And so, in fact, on re-entry programs, my staff go into the prisons to start working with people 

who are mentally ill offenders to help, to engage with them so that 

when they are leaving the prison we can connect them with benefits and get them into the mental health system rather than sort 

of back on to the streets and into crime. 

But that is because of our relationship, I would say, and not because of some systems approach, if you would. And I think one of 

the things that I would point out from the CSJ report is that there 

is no one size to fit each State. Massachusetts is not a county-based 

system, for example, so you would not want to craft legislation that 

said it would all be county-based, because in Massachusetts that 

wouldn’t be terribly helpful. 

But one of the things the CSJ report talks about in collaborations, and anything that the Senate would consider I would strongly urge that would require the collaboration and true partnership 

between mental health and criminal justice, and then allow States 

and counties and providers to sort of determine what makes the 

most sense given how we have sort of figured out our systems, if 

you would, but that you would require in any legislation, in any 

funding, true collaboration between mental health and criminal 

justice that you have to demonstrate in whatever kinds of applications come forward. We all know you can sign a letter saying, yes, 

you know, we sat down and talked, but really true collaborations 

is the key. 

The other thing I would say that the jails—I think sheriffs are 

doing everything they can to respond out of necessity. I think the 

quality in jails is dependent, again, upon who the sheriff is and 

how many mentally ill people are in their jails and whether they 

want to provide treatment or really just have the mental health 

system take care of them. But for me, sir, I would say that what 

the mental health system needs to do with criminal justice is to divert people, particularly the low-incidence crimes, you know, the 

nuisance crimes, that our responsibility is to really divert them so 

that they never get into jails. And that is what we need to do, and 

I would urge you, as you ask the question of the chief, really looking at the diversion programs, mobile crisis intervention teams, assessments, working closely police with mental health experts, so 

that we divert people from ever entering into the system to begin 

within. 

Chairman LEAHY. Well, Commissioner, when you mention that, 

it makes me think, Commissioner Mayfield, if I am correct in the 

briefing material I was reading, you helped initiate a diversion program in Dallas. I was thinking on the practicality of it, because I 

happen to agree with Commissioner Sudders on this. How do you 

determine who should be diverted to mental health services and 

who, because of either themselves or the nature of what they have 

done, is going to have to be held right there in jail? 

Mr. MAYFIELD. Well, that is a very tricky assessment, Senator, 

but every police department in Dallas County—and right now they 

19

are gathering statistics for me on the number that they think they 

would divert on a weekly basis to this type of program. But every—

I met with all of the police chiefs in Dallas County, and there are 

26 cities within the county. And every one—I thought there might 

be a problem in—we are trying to open up a mental health triage 

that is open 24 hours for these individuals who are minor offenders, basically victimless crimes that they happen to be arrested and 

taken to the city’s holdover and then transferred down to the counties because of their behavior, which is usually related to their 

mental health condition. And I thought there might be a problem 

in having them transport these individuals to this location, which 

we would like to locate somewhere close to the county jail in some 

proximity because that is where they used to come in. Now, it 

didn’t matter where it is located, where the city is located In Dallas 

County, how far it is. They are willing to bring these individuals 

down to this location so that they can get the help they need rather 

than putting them in their own facilities or the county’s facilities 

where they know their condition is just going to worsen. 

We have produced a video. We are looking at all of the training 

that they get in their academies. We are making recommendations 

on perhaps some longer training, some in-depth scenarios, and we 

have done this with mentally ill and mentally retarded individuals, 

and police officers in a video to show what is the most common encounter that you would have with someone who suffers from a 

mental illness or mental retardation, and then how you respond to 

that. 

Of course, each department has to come up with criteria of—we 

hope it will be uniform, and we think it will be—of individuals that 

they would divert to this system. They have to be comfortable that 

when they bring them down there that they are going to be taken 

care of, they are going to be assessed, we are going to find out 

where they have been getting services, if they are homeless. And, 

by the way, I can’t emphasize enough permanent housing is the 

key to this revolving door, because you can divert——

Chairman LEAHY. I see a lot of heads shaking yes. 

Mr. MAYFIELD. You can divert all you want, but if they don’t—

if there is not some sort of supervised living condition for these 

people, who are often homeless, have no friends, have no family, or 

if they do have friends and family, they are not engaged with them 

to monitor them on a casual basis at the least, to see what they 

are doing, they are taking the medication that they should be taking at the time that they should be taking it, and keeping them out 

of situations where they come into contact with law enforcement. 

So that is a real key, and that is what we are really working on. 

We are working with HUD on vouchers and trying to set up not 

just triage mental health location but emergency and transitional 

housing and then permanent housing for these individuals so we 

can truly keep them out of the jails. 

Chairman LEAHY. What is the population of Dallas County? 

Mr. MAYFIELD. It is 2.2 million people. 

Chairman LEAHY. Like the Commonwealth of Massachusetts, we 

have counties, but we don’t really have a county form of government. But these models are transferable easy enough to whatever——

20

Mr. MAYFIELD. Yes. 

Chairman LEAHY. Whether you have a State system or a Commonwealth system. 

Am I correct that the National Association of Counties has put 

this issue of mentally ill offenders right up near the top? 

Mr. MAYFIELD. It is at the top. I am the incoming president, Senator. It is one of my two initiatives. The other is early childhood 

development. This is diverting the mentally ill from county jails. So 

this is the top priority that NACo has—one of the two top priorities. 

Chairman LEAHY. Kind of nice to be the boss, isn’t it? 

[Laughter.] 

Mr. MAYFIELD. Yes, sir. 

Chairman LEAHY. I was going to say, it is something like being 

a committee chairman. You can set the priorities. 

I want to thank you all for this. We had asked you—you know, 

you are going to get the transcript back of this hearing and all. If 

you get some other ideas, things that I forgot to ask or thoughts 

you have, don’t hesitate to add it. We want to learn from this, as 

Congressman Strickland was saying when he came in here. Or if 

you get some ideas and you just want to send them to me, just 

send them directly to me and I will look at it. We want a good piece 

of legislation. We don’t want to pass something just for the heck 

of passing something. 

I think it is a major problem. I thought it was a problem back 

when I was a prosecutor, but it has gotten much, much worse. You 

are talking about the homeless situation and all, and I want law 

enforcement to be able to do law enforcement. And I want the ability to help those who have mental problems that they be helped. 

Chief Margolis referred to this situation we had in Brattleboro. It 

was a terrible situation. The Attorney General’s office rules the actions appropriate on the part of the police officers. But I am sure 

for the police officers, this is nothing that gave them any great joy 

to be put in a situation like that, and they shouldn’t have to be. 

So I thank you. I commend you for what you are doing. I think 

all four of you have extraordinarily difficult jobs. And maybe people 

should realize that those who take a career in public service keep 

this country going, and I applaud all of you. 

We will stand in recess. 

Mr. MAYFIELD. Senator, let me just add, let me just say if there 

is any help that NACo as an organization can give to the success 

of this legislation, and certainly in looking at it and helping with 

comments, but I personally can give—in testifying before any committee or lobbying any of my colleagues on the Hill, rest assured 

that we will do it. 

Chairman LEAHY. Thank you. I appreciate that. Thank you all. 

[Whereupon, at 11:07 a.m., the committee was adjourned.] 

[Submission for the record follow.]

21


86518.001
22


86518.002
23


86518.003
24


86518.004
25


86518.005
26


86518.006
27


86518.007
28


86518.008
29


86518.009
30


86518.010
31


86518.011
32


86518.012
33


86518.013
34


86518.014
35


86518.015
36


86518.016
37


86518.017
38


86518.018
39


86518.019
40


86518.020
41


86518.021
42


86518.022
43


86518.023
44


86518.024
45


86518.025
46


86518.026
47


86518.027
48


86518.028
49


86518.029
50


86518.030
51


86518.031
52


86518.032
53


86518.033
54


86518.034
55


86518.035
56


86518.036
57


86518.037
58


86518.038
59


86518.039
60


86518.040
61


86518.041
62


86518.042
63


86518.043
64


86518.044
65


86518.045
66


86518.046
67


86518.047
68


86518.048
69


86518.049
70


86518.050
71


86518.051
72


86518.052
73


86518.053
74


86518.054
75


86518.055
76


86518.056
77


86518.057
78


86518.058
79


86518.059
80


86518.050
81


86518.061
82


86518.062
83

Æ


86518.063