A person slammed me onto the concrete on East seventh in Skid Row — quick, onerous and with out warning.
One second, I used to be strolling. The following, I used to be on the bottom, my head hitting the pavement inches from a tree trunk. He stood over me, screaming phrases I couldn’t perceive, together with his arms swinging wildly. I coated my head and braced for blows that by no means got here.
Inside seconds, he was gone, disappearing into the chaos of downtown Los Angeles. As I gathered myself, a person supplied to deliver over a police officer who was down the road. Did I need to file a police report?
The person who tackled me didn’t want jail. He wanted psychiatric remedy. I needed I knew find out how to discover him and get him into care earlier than another person received damage.
I perceive that is probably not everybody’s response to an assault that would have despatched me to the hospital, or worse, however I’m a doctor, and I lead the Workplace of Diversion and Reentry on the Los Angeles County Division of Well being Providers. I work on the intersection of healthcare, homelessness and the felony justice system. I see what occurs when folks like the person who tackled me are arrested, briefly jailed and launched, after which arrested once more — a tragic cycle that’s typically the truth for these affected by severe psychological sickness.
I’ve additionally seen what occurs when, as an alternative of jail, they’re supplied supervised psychological well being remedy via psychological well being diversion.
Once we fail to deal with folks, we pay for jails, emergency room visits and hospital stays, shelters, regulation enforcement and court docket days at prices exceeding $115,000 per person each year. Diversion modifications that trajectory by safely treating folks affected by severe psychological sickness in the neighborhood as an alternative of in jail.
Many individuals stabilize with housing and remedy. They cease biking via jails, streets, emergency rooms, courtrooms and hospitals, and are a lot much less more likely to commit new crimes. Stopping the jail cycle via diversion and remedy makes our communities safer.
As an alternative, payments just like the lately signed AB 46, which limits psychological well being diversion, and the proposed SB 1373, which might additional curb the follow and maintain extra folks in jails, ignore proof and introduce pricey administrative delays that maintain extra folks with treatable psychological sickness in already overcrowded jails at excessive value to taxpayers.
By proscribing judges’ capability to divert folks with severe psychological sickness into remedy, SB 1373 would push extra folks via the revolving door to jails which have failed our communities for many years — as a result of they don’t seem to be supposed to deal with psychological sickness. Jails don’t deal with schizophrenia or stabilize bipolar dysfunction. They don’t rebuild belief, restart remedy in a sustainable approach or deliver somebody again from the sting of psychosis.
Untreated psychological sickness turns into extra harmful once we lock it in a cell. It’s tempting to assume incarceration improves security, however few persons are locked away without end. Expertise with psychological sickness teaches us to ask more durable, extra sensible questions: What’s going to forestall the subsequent disaster? What’s going to cut back future hurt? What’s going to assist this individual and defend the group on the identical time?
One in 4 folks enter our jails with severe and pressing psychological well being wants, comparable to untreated schizophrenia or bipolar dysfunction, delusions, hallucinations, suicidal ideas or perhaps a full disconnection from actuality. Los Angeles County has years of knowledge exhibiting what truly works. By way of diversion efforts within the Workplace of Diversion and Reentry, the county has linked greater than 15,500 people with serious mental illness to treatment over the last decade. Individuals who dedicated severe crimes stabilize with remedy and housing.
The outcomes are clear. Greater than half (56%) were never rebooked within two years of entering diversion, regardless of averaging practically 10 prior jail stays earlier than diversion. Contributors spent 380,000 fewer days in jail inside two years after coming into diversion in contrast with the 2 years earlier than. Diversion additionally reduced emergency department visits and inpatient psychiatric stays, decreasing county prices and easing stress on overwhelmed methods.
These findings present that community-based remedy, via diversion, makes communities safer and more healthy.
Whereas jail sentences are sometimes short-lived, diversion presents long-term care, court docket‑ordered accountability and mandated remedy. Contributors should seem earlier than judges, comply with scientific suggestions, take remedy, take part in substance use remedy and adjust to supervision. In the event that they fail to conform, they threat returning to jail.
Remedy requires clinicians and case managers to construct belief and a way of belonging via persistence and love with individuals who have been regularly marginalized and failed by methods. It’s the solely factor proven to interrupt the cycle that drives repeated incarceration and homelessness for folks affected by severe psychological sickness.
California has spent many years swinging the pendulum between treating psychological sickness as a public well being disaster and treating it as against the law. Every swing towards criminalization leaves extra folks sick and biking between homelessness and jail, extra households determined, extra tax {dollars} spent and extra communities unsafe.
If SB 1373 passes, extra folks with severe psychological sickness will stay in jail longer, unable to entry efficient remedy. They are going to be launched in worse situation and return to the streets, emergency rooms and jails at nice value to taxpayers and at larger threat to public security.
If lawmakers usually are not glad with the outcomes of diversion, they need to demand extra information transparency, expanded scientific capability and housing, and stronger program requirements. They need to not cut back a decide’s capability to decide on remedy.
Typically the “most secure” sentence is just not jail. It’s the one which lastly will get somebody effectively.
I nonetheless take into consideration the person who tackled me. I have no idea his title or the place he went, however I do know that if he cycles via jail with out remedy, nothing will change for him, and I worry for anybody he might encounter subsequent.
Jail is just not remedy. California ought to protect diversion, one among our simplest instruments for lowering homelessness and crime. It’s one factor that may truly change what occurs subsequent.
Clemens Hong, a doctor, is the director of the Workplace of Diversion and Reentry on the Los Angeles County Division of Well being Providers.
