Mental Health Reform

Floor Speech

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Mr. CORNYN. Mr. President, on another note, I wish to spend a few minutes talking about a very important hearing that we will be having tomorrow in the Senate Judiciary Committee, something that I feel very passionately about, and that is finding a way forward on mental health reform. As shocking as it is, our jails and our streets have become places where people suffering from mental illness basically are left without treatment and without recourse.

Tomorrow I will have the honor of chairing that hearing where we will discuss the intersection of our mental health system such as it is and our criminal justice system, and hopefully we will be able to find a way forward to push toward real reform. The goal of the hearing is to better understand how to bring help and support for those who struggle with mental illness.

This is an area where we can and we must do better. Too often, after the fact, we find out that families faced with the choice of allowing their loved ones' mental health to continue deteriorating, letting their illness spiral out of control until they become a danger to themselves or others--there are very few choices available to families whose loved ones are becoming more and more ill. True, they could go to court and seek a court order, seeking a temporary commitment to a mental institution, but that frequently exacerbates frayed relations among family members, and it stigmatizes the individual who is suffering from mental illness issues.

We need to give those families more and better choices on how to deal with their loved ones, hopefully to keep them from becoming a danger to themselves and to the community. Thanks to the marvels of modern medicine, for many people suffering from mental illness, if they will just follow doctors' orders and take the medication that has been prescribed for them--frequently under some doctor's supervision--many of them can get much better and become more productive in society.

One of our witnesses tomorrow will be Pete Earley who wrote a book called ``Crazy.'' He is not talking about a person. He is talking about our so-called system of mental health treatment. Pete Earley wrote this book because, as an accomplished journalist and writer, he knew of no other way than to write about the issue to help his very own son who had encounter after encounter with the criminal justice system because he had untreated mental illness.

Sadly, the failure to adequately address mental health in the United States has led to a drastic increase in the number of mentally ill individuals being locked up in prisons and jails, still without adequate treatment. I don't think anyone would support the idea of turning our prisons and our jails into warehouses for the mentally ill, but that is what has happened by default.

We need to provide better choices to law enforcement officials, to families, and to the individuals who suffer from mental illness. So often many of them will self-medicate with drugs and alcohol, compounding their problems, creating more and more of this turnstile effect within the criminal justice system where no one ever gets better and the illness never gets treated.

As criminologists and mental health experts will tell you, locking up people with mental illness without treatment will make them only more dangerous and increase the risk of crisis, but unfortunately this is an all-too-common practice across our country.

This is a shocking number to me when I read it, but one estimate suggests there are as many as 400,000 current inmates in our prisons across America who suffer from some form of mental illness. That is because, at least in part, the United States has witnessed a rapid decline in psychiatric and mental health hospitals over the past decades. The idea was that you couldn't institutionalize people so you had to let them out. Unfortunately, just letting them out without finding a way forward to help them deal with their mental illness resulted in many of them becoming homeless, living on our streets or in our jails and our prisons when they commit petty crimes such as trespassing and the like.

Since 1960, more than 90 percent of State psychiatric beds have been eliminated--90 percent. But prison is a poor and often very harmful replacement for a treatment facility. Our goal in the hearing tomorrow is to work toward another solution, one that would give families greater flexibility, including actual treatment options for the people they love.

A bill I introduced, the Mental Health and Safe Communities Act, offers one proven approach to treating mental illness. It borrows from a successful model of reform, put into place in my hometown in Bexar County, TX, more than a decade ago.

Let me say a word about borrowing from these successful local and State models as opposed to imposing a one-size-fits-all approach at the national level, not knowing whether it would actually work in this big and diverse country we live in. I believe that taking successful examples of best practices at the local and State level--those are the best subject matter for us to look at in terms of scaling these up on a national level where appropriate.

The Bexar County sheriff, Susan Pamerleau, a champion of mental health reform in San Antonio, will testify tomorrow about the San Antonio story. Bexar County's mental health program focuses on treatment of the mentally ill instead of just putting them behind bars and leaving them untreated. The results have been very impressive.

These reforms have reduced the size of our overcrowded jails, which has been a perennial problem. It has saved tax dollars, and it has improved the lives of people who otherwise would be put behind bars and left to their own devices.

I look forward to hearing from Sheriff Pamerleau tomorrow. I bet other members of the Senate Judiciary Committee and anyone else who cares to listen will learn a lot about how we can bring these reforms to the rest of the country.

Another part of this is to help equip law enforcement, teachers, judges, and people who work in the courts with the knowledge and skill set they need to spot mental illness early on. Wouldn't it be more helpful if teachers, parents, and counselors were empowered to help identify people who need help early on in school? Doesn't it make sense to train our law enforcement officials how to deal with a person suffering from a mental health crisis? Do you slap the cuffs on them? Do you get engaged in a violent confrontation? Or do you try to deescalate the incident in a way that is safer for the law enforcement official as well as the person being confronted?

There are better ways for us to respond effectively at the early signs and help to train the people who are in the best position to identify people who need help early on. This legislation includes specialized training for those on the frontlines, such as law enforcement and judicial officials, so they are ready to respond and can react swiftly and safely should a mental health crisis erupt.

The truth is that this is a difficult issue and one that raises hard questions. But I am grateful to Chairman Grassley of the Senate Judiciary Committee for not shying away from this topic but embracing it and having witnesses such as those we will have tomorrow who I think will open the eyes of many people to something they perhaps don't encounter in their daily lives because they don't go to our jails or our prisons or they don't have a loved one who suffers from mental illness. I think this will open a lot of eyes, and it will help us continue the conversation so we can find some common ground and work toward real solutions.

Reform is long overdue. All you need to do is visit our jails, as I have done in Harris County, Bexar County, and Dallas County, to see that too often our jails are occupied by people who--yes, they may have committed petty crimes, nonviolent crimes, but they really need some help. If we give them the help, they can turn their lives around and become more productive.

It will save taxpayers money, and I think it will be a much more humane and efficient system of dealing with people suffering with a mental health crisis. I am hopeful we can advance substantive legislation to help those struggling with mental illness and their families and, as a result, make our communities safer.

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