Highlights
Data from Pew is combined with previous research indicating the complexity of mental health, substance abuse, and co-occurring disorders in the justice system and policing.
Police officers routinely come into contact with people under the influence of drugs or alcohol or individuals with mental health backgrounds or both. Out of 54 million yearly police-citizen contacts, what could go wrong?
Author
Pew Overview (reordered paragraphs)
Policymakers are increasingly focused on justice system interactions with and outcomes for people with either mental illness or substance use disorders. What has received less attention, however, is the extent to which people with co-occurring mental health and substance use disorders (hereafter called co-occurring disorders) become involved with the justice system.
To better understand this issue at the point of arrest, which is the “front door” of the criminal legal system, The Pew Charitable Trusts analyzed data from 2017 to 2019 from the National Survey on Drug Use and Health (NSDUH). NSDUH is an annual, nationally representative, self-reported survey and the only national data source for trends in the incidence and treatment of behavioral health (which includes mental illness and substance use disorders). The survey also asks respondents whether they were arrested in the past year and, if so, how often.
Pew’s analysis found that adults reporting co-occurring serious or moderate mental illness (hereafter “mental illness”) and substance use disorders in the past year were far more likely to be arrested compared with both those with mental illness alone and those who didn’t experience any mental illness or substance use disorder.
Adults with co-occurring disorders made up 2% of the U.S. population but 15% (1 in 7) of all people arrested from 2017 to 2019. Almost half of these individuals had a substance-related arrest, such as drug possession, as the most serious charge.
More than 1 in 9 adults with co-occurring disorders were arrested annually, 12 times more often than adults with neither a substance use disorder nor a mental illness, and six times more likely than those with a mental illness alone.
Women with co-occurring disorders were arrested 19 times more often than women with neither a substance use disorder nor a mental illness and accounted for more than 1 in 5 of all women arrested.
Black adults with co-occurring disorders were arrested 1.5 times more often than their White counterparts.
People with co-occurring disorders were also unlikely to receive treatment for more than one disorder, even though research demonstrates that simultaneous, coordinated treatment for multiple diagnoses produces better outcomes compared with separate treatment for only mental illness or substance use disorder.
- Only 1 in 10 adults with co-occurring disorders (10%) received treatment for both of their conditions.
- About 2 in 5 adults with co-occurring disorders (42%) did not receive either substance use or mental health treatment of any kind in the prior year.
- Black and Hispanic adults with co-occurring disorders were less likely to receive mental health or substance use treatment (47% and 43%, respectively) than White adults (64%).
About 60% of people with a mental illness who were arrested had a co-occurring substance use disorder. NSDUH doesn’t explicitly ask respondents whether these arrests resulted in time spent in jail, so recent national level data on how many of these arrests led to incarceration is not available.
About 650,000 adults with co-occurring disorders were arrested annually in the years 2017-19. This was more than 1 in 9 of all adults with co-occurring disorders.
In contrast, about 1 in 50 adults with mental illness but no co-occurring substance use disorder and about 1 in 100 adults with no behavioral health issues—that is, neither a substance use disorder nor a mental illness—reported a past-year arrest.
People with co-occurring disorders were roughly six times more likely to be arrested annually as those with a mental illness alone, and 12 times more likely to be arrested than those with neither a mental illness nor substance use disorder.
Source
Previous Reports
Previous research reports suggest that mental health and substance abuse issues for those coming into contact with the justice system may be more prevalent than Pew suggests. Pew addresses co-occurring disorders which are different from the data below:
CNN
Source
Under The Influence At Arrest
Editor’s note: This is discontinued research from the National Institute of Justice, US Department of Justice available through the Web Archives.
I use this data, last released in 2000, because of the large, methodologically correct numbers involved. Those of us who write about crime and justice routinely use older USDOJ data because, quite simply, it remains the best available research.
Report Summation:
Anywhere from 56 percent (Charlotte) to 82 percent (Chicago) of arrestees tested positive for the presence of some substance at the time of an arrest.
The ADAM Program collected data from more than 30,000 adult male arrestees in 34 sites and from more than 10,000 adult female arrestees in 32 sites. Additionally, data were collected from more than 2,500 juvenile male detainees in nine sites and more than 400 juvenile female detainees in six sites.
The level of recent drug use among 1999 ADAM arrestees was substantial. Every site reported that at least 50 percent of adult male arrestees tested positive for at least one drug.
In 27 of the 34 sites, more than 60 percent of the adult male arrestees tested positive for the presence of at least one of the NIDA-5 drugs, ranging from 50 percent in San Antonio to 77 percent in Atlanta.
For female adult arrestees, the median rate for use of any drug was 67 percent.
Among adult males, marijuana was the drug most often detected in 24 of the 34 reporting sites, and cocaine was the drug most likely to be detected in the other 10 sites. Among adult female arrestees, cocaine was the drug most often detected in 25 of 32 sites.
In the remaining sites, marijuana was the most frequently detected drug (four sites) followed by methamphetamine (three sites). Multiple drug use was evident among arrestees in some of the ADAM sites.
Source-Web Archives
National Institute Of Justice (list of available ADAM documents)
The report cited is at the National Institute of Justice.
Mental Health
There is immense controversy regarding police interactions and the use of force at the time of an arrest. The simplest of exchanges can explode. People need to understand the dynamics. According to national polling, two percent of police stops involve the use or threat of force.
Per Bureau of Justice Statistics research, more than half of all prison and jail inmates had mental health problems. These estimates represented 56% of state prisoners, 45% of federal prisoners, and 64% of jail inmates, Mental Health And Crime.
Add substance abuse and histories of violence and data stating that most correctional offenders come from troubled backgrounds (i.e., child abuse and neglect, brain injuries, exposure to violence) and we begin to understand the dangers and difficulties of police officers making stops and arrests and the complexity of the crime problem.
Source
Conclusions
“I know there’s a saying that ‘Hurt people, hurt people,’” Winfield said. “But where I come from, hurt people kill people, CBS News Covering Baltimore. Cops deal with a lot of “hurt people” daily.
Police officers routinely come into contact with people under the influence of drugs or alcohol or individuals with mental health backgrounds or both. Out of 54 million yearly police-citizen contacts, what could go wrong?
Yes, arrests and serious accidents make up a small portion of those contacts but there is a point where arrests or citations become problems partially or solely due to offenders and their limited cognitive abilities (i.e., they were drunk or abused as a child-a co-occurring disorder).
Anyone who has been a cop can tell endless stories about confrontations that get out of hand because of drunk drivers or stoned arrestees. What should be a simple interaction becomes confrontational or violent because the suspect simply won’t comply with verbal requests or warnings.
The insights from Pew are valuable and research-based. But based on previous data not addressing co-occurring disorders, it doesn’t represent the totality of the problem.
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