Mental Health, Criminal Justice,

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Mental Health, Criminal Justice, Trauma

• The Need for New Approaches Consistent with the
  CRPD

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Criminal Justice/Mental Health Parallels

• Criminal Justice/Penal
• Prison/Jail
• Prisoner
• Political Model
• Imprisonment
• Crime
• Denial of Guilt
• Punishment
• Isolation
• Confession of Guilt
• Obedience
• Parole/Probation

• Mental Health
• Mental Hospital/Psychiatric Center
• Mental Patient
• Medical Model
• Involuntary Commitment
• Symptoms
• Lack of Insight
• Treatment/Therapy (Forced/Coerced)
• Seclusion Restraint
• Admission of Mental Illness (insight)
• Cooperation/Compliance
• AOT order/Case Manager/Tx Team

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Statement by Manfred NowakSpecial Rapporteur on
torture and other cruel, inhuman or degrading
treatment of punishment.

• First, they are often segregated from society in
  institutions, including prisons, social care
  centers, orphanages, and mental health
  facilities. They are de-facto deprived of their
  liberty, sometimes for long periods of time,
  either against their will or without their free
  and informed consent. Inside these institutions,
  persons with disabilities are frequently
  subjected to neglect, severe forms of restraints
  and seclusion, aw well as physical, mental and
  sexual violence.
• Similarly, in the private sphere, persons with
  disabilities are especially vulnerable to
  violence and abuse, including sexual abuse,
  inside the home, at the hands of family members,
  caregivers, health professionals and members of
  the community.
• 
  ---- Manfred Nowak
• 
  October 23, 2008

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The mental health and criminal justice systems
are both traumatizing and repressive.

• Criminal Justice/Penal System
• Abolition/Reform can not be accomplished through
  the mental health/psychiatric system.
• Systems are reciprocal ( movie)
• Systems are reactive, fear based Coercion/Force

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CRPD - Articles

• Article 12 Legal Capacity (capacity to have
  rights and capacity to act)
• Article 13 Access to justice for PWD
  (accommodations support networks)
• Article 14 Liberty Security of the person on
  a equal basis with others (Probation/AOT/IOC)
• Article 15 Prohibits torture cruel, inhuman
  or degrading treatment or punishment
  (forced/coercive interventions Intimidation)

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CRPD Articles

• Article 16 requires prevention of exploitation,
  violence and abuse. (free informed consent
  conditions (psychiatric drugs/probation/parole)
  due to diagnosis.
• Article 17 PWD right to respect for
  physical/mental integrity
• Article 19 Right to live in community with
  choices equal to others (Probation/Parole
  conditions medications/MH courts/Residential)

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CRPD - Articles

• Article 25 equality in health care and
  services, including free and informed consent.
  (Forced/Coerced medications in all aspects of
  Penal/MH system development access to
  holistic alternatives in these systems) (MH
  screening results in discrimination/labeling
  obsolete to informed trauma care)

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Criminal Justice System/PsychiatricDiversion -
Institutions Re-Entry

• Institutions (Jail/Prison)
• Jails
• Prisons
• Diversion
• Crisis
• Specialized Courts
• Re-entry
• Probation (AOT/IOC)
• Parole

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People w/disabilities who are detained/imprisoned
are subjected

• Force/Coercion
• Violence (Restraints/tying to bed/chairs
  chemical restraints)
• Isolation/Seclusion (based on PWD)
• Sexual Assault (Dominance/Subordination)
• Discriminatory Disciplinary Policies (Reasonable
  Accommodations Prison/Jail Programs exclusion)

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Diversion

• Police Response to crisis (ER/Involuntary
  Commitment)
• Social Issues Criminalized (family/neighbor
  disputes, homelessness, substance abuse assumed
  odd behaviors Voices/Visions)
• Court Based Diversion (Mental Health Courts
  Segregating People by illness with the judicial
  system, mandating tx punishing failure, serves
  to perpetuate the criminalization of PWD) Serve
  Jail Time and/or adhere to treatment/service
  plan)

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Re-Entry

• Shift from CJ to MH there is a significant
  shift in due process procedures.
• Probation/Parole Stipulations mandated tx,
  psychiatric drugs, coercion/force, threat of
  non-compliance
• Penalized Social Problems, unemployment,
  poverty, substance abuse, trauma

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Recommendations

• Language Social issues being criminalized
  trauma people see/feel their issues
• Reasonable Accommodations Access Legal
  services, peer support/advocacy, family support.
  (Assisting w/lawyers) education, medical
  treatments, holistic therapies, exercise
  accommodation for programs

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Recommendations

• Criminal Justice system needs to remain a system
  based on law not a treatment referral system.
• Legislative Changes Must Occur Policy Abolition
  Development (parole/probation/MH laws
  IOC/AOT/Institutions)
• Countries Human Rights Treaty Obligations. (US
  obligations CAT, ICCPR, CERD) US does not
  hesitate to criticize other countries for their
  HR violations it has been derelict in complying
  with our own HR commitments.

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What Does "Trauma Informed" Mean?

• trauma model an alternative to medical model
• recognize 90 people with mental health
  diagnosis are trauma survivors
• all psychiatric symptoms can potentially be
  explained by trauma perspective
• what happened to you, not what is wrong with
  you.
• values subjective experience of people rather
  than focuses on expertise about pathology
  (changing?)

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• way to address how system traumatizes
  retraumatizes people. rates of violent/traumatizin
  g events much higher in institutions
• looks at power relationships and misuse of power
  in institutions
• emerged out of consumer/patient movement,
  women's movement, domestic violence activism,
  reform police hospitals
• political resistance to recognizing trauma
  Freud, sexism, medical expertise, status quo,
  oppressions lt-gt trauma
• "trauma informed" is an evolving concept. create
  ongoing dialog and education in your community
  and organization

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RESOURCES

• www.CHRUSP.org
• www.WNUSP.net (CRPD Manual)
• www.mentalhealthpeers.com
• www.willhall.net