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Wednesday, November 20, 2019  Spokane, Washington  Est. May 19, 1883
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Opinion >  Guest Opinion

Bob Lutz: Behavioral issues only made worse

By Bob Lutz

A previous guest opinion (“Well-being of our children is paramount,” Jennifer Hansen, Ashley Beck and Sheila Masteller, Aug. 29) brought to light an unfortunate truth: Family violence and trauma is far too common, with its repercussions on adults and children having both immediate and long-lasting impacts. Adverse childhood experiences, aka ACEs, are life-altering events that may lead to physical, emotional and mental challenges.

Parental incarceration and/or regular contact with law enforcement and the justice system is an ACE that disrupts the home environment and may lead children into situations of neglect, risky behavior and inadequate access to health care. Research has shown these young people, numbering more than 5 million nationwide, are more likely to struggle with anxiety, depression and thoughts of suicide, to misuse illicit substances and to experience homelessness. Importantly, they often find themselves part of an intergenerational cycle, as they are three times more likely to be involved in the juvenile justice system than their peers. Children of color are further disproportionately affected, due to racial and ethnic disparities caused by institutional and societal prejudices.

The United States has the highest rate of incarceration in the world, with an estimated 6.6 million adults in the correctional system. Although ranking in the top 10 of having the lowest rates in the U.S., Washington imprisons four times more people than Canada and three times more than Mexico. And locally, Spokane holds the dubious statewide distinction of having the highest filing of felony charges, both drug-related and overall.

Recent data demonstrate African Americans are jailed at a rate seven times, Native Americans four times and Latinx two times greater than whites. The average annual income of the individual before incarceration is $19,000, and less than half have a high school diploma/GED. Almost half of jailed individuals were charged with misdemeanors, with a length of stay of approximately seven days; those whose cases were eventually dismissed spent more than a month in jail on average, with the cost of almost $135 per day per person. Incarceration contributes to destabilization, with lost jobs and housing causing further continuing cycles of recidivism, and individual and family dysfunction.

Our decadeslong “war on drugs” has often criminalized people who suffer from substance use disorder (SUD). This has resulted in mass incarceration, perpetuating already existing disparities negatively impacting people of color. They have been marginalized, referred to as “junkies,” stripped of their humanity and stigmatized. This often co-occurs with mental health conditions. Not surprisingly, there is a high prevalence of ACEs among individuals with SUDs – experiencing physical and emotional abuse or having an incarcerated parent or personal experience with the justice system are risk factors for SUD. In addition, interaction with the legal system is a policy-driven risk factor for homelessness – incarceration increases the rate of homelessness. As stated by the U.S. Interagency on Homelessness, “Criminalization (of homelessness) creates a costly revolving door that circulates individuals experiencing homelessness from the street to the criminal justice system and back.”

Substance Use Disorder is a chronic disease of the brain and not a moral failure. It causes changes in function and chemistry that impact decision-making, personality and behavior. The developing brains of young people are especially sensitive. ACEs further increase the likelihood of developing SUD.

Our local justice system houses more than 900 individuals. Almost 60% of them have received treatment for a behavioral or mental health diagnosis prior to their incarceration. Meeting their needs is complicated by the incarceration process itself. Criminalizing their condition only worsens the prognosis for both the individual and our community, as the justice system is designed to punish, not to heal. The impacts extend beyond the accused and the victim – they affect and shape all of us, now and for the future.

Fortunately, there are steps we can take to counteract this poor prognosis, by investing in people and our community. Research has shown placing nonprofit services in high-crime neighborhoods significantly reduced criminal activity. Our local Community Court, which connects individuals with treatment and services, significantly reduces the likelihood of re-arrest. And the Community Diversion Unit pairs mental health professionals from Frontier Behavioral Health with police to respond to individuals in the community experiencing homelessness or mental health crisis.

While not speaking to the legal requirements of our justice system or the politicization of SUD and visible homelessness, we can speak to what is advisable from a public health perspective – criminalizing and quarantining our citizens struggling with behavioral health conditions is not a solution. It merely conceals the wound while allowing the bleeding to continue.

Carmen Pacheco-Jones is the African American/Black Health Initiative coordinator for the Spokane Regional Health District. Bob Lutz is the Spokane County health officer.

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