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EDITORIAL: Jails still sub for treatment

The Citizens' Voice - 11/25/2022

Nov. 25—Prisons long have been a principal substitute for mental health treatment in Pennsylvania and most other states. Now a new state Supreme Court ruling illustrates the breadth of the problem.

Although the state's Mental Health Procedures Act of 1976 precludes an "incompetent" person from participating in any legal proceeding he cannot understand, that is not always how it works in practice. The law requires courts to determine if the person can achieve competency with treatment, but the demand for such services far exceeds the supply.

One result is that people deemed incompetent to stand trial languish in prison awaiting treatment. Another is that they sometimes are charged for crimes in the prison, exposing them to more legal proceedings for which they are incompetent to participate.

Recently the state Supreme Court ruled that judges are free to halt trials or other legal proceedings and dismiss charges when a defendant clearly is incapable of participating in his own defense. Before that, proceeding in such cases largely was left to the prosecutor who brought the charge.

The ruling is just a step toward greater justice within the legal system for people with mental health disorders that preclude them from participating effectively in the process.

It does not resolve how to proceed when a judge stops a case in which the defendant is incapable of participating, and doesn't resolve the severe shortage in mental health services underlying the problem.

It also does not address how to deal with people already in prison who are incapable of participating in their defense. The court did not suggest a number of such inmates, but it probably is large.

An analysis by the Harrisburg news organization PennLive found that at least a third of people in Pennsylvania prisons suffer from mental illness. Another news organization, SpotlightPA, recently reported that in county jails statewide, the number of inmates with mental illnesses could be as high as 50%.

Not all mental health disorders render defendants incapable of participating in their defense.

But the state Legislature should expand the limited programs available to help restore competency, and ensure that it is available to people already in state prison.


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