- The Washington Times - Tuesday, December 5, 2006


Larry Lamb has lived a half-century of failures: three stints in New Jersey state prison, four psych-ward confinements, drug and alcohol abuse dating back to adolescence, and more time in county lockups than he can count.

A year ago, he began racking up successes.

Lamb, 50, hasn’t had a drug-tainted urine sample since he enrolled in an intensive program for mentally ill inmates as he was being released from jail. He’s taking antidepressants, keeping appointments with his therapist, working when he can find a job and paying off court-imposed fines from his prior life of crime and homelessness.

“I knew I needed help,” Lamb said. “I never let anybody get close to me.”

Advocates for the mentally ill say Lamb’s situation is common among the nation’s inmates, 55 percent of whom suffer from a mental health problem, according to a study released in September by the Justice Department’s Office of Justice Programs.

Yet, the availability and intensity of mental health services for people in the nation’s criminal justice system varies greatly, said Karen Bower, a lawyer with the Bazelon Center for Mental Health Law, a Washington-based group advocating for the rights of the mentally ill.

A similar disparity in post-incarceration services exists nationally, with some people receiving comprehensive discharge planning before they leave prison or jail, others being offered limited mental health or social services, and some getting none.

“You are much more likely now than you were 10 years ago to get some sort of assistance at discharge,” said Tammy Seltzer, director of state policy with the National Council for Community Behavioral Healthcare, a nonprofit association representing community mental health providers and addiction counselors. “Nationally, we’re still very far from where we need to be. There are some wonderful programs, but there are not enough programs to serve everybody who is in this situation.”

Services are severely lacking for those with dual diagnoses, like mental illness and drug dependence, said Miss Bower. In one class-action lawsuit filed by Bazelon in New York, mentally ill parolees are suing for access to chemical-addiction programs. Another suit brought by a mentally ill inmate in New Jersey forced the state to revamp its prison psychiatric programs to replace the practice of segregating inmates whose psychiatric disorders made them disruptive.

Without adequate support or access to medication and counseling, those discharged or paroled with serious mental illness — defined as schizophrenia, bipolar disorder or major depression — often wind up cycling back through the criminal justice system, Miss Bower said.

Lamb is among a small group of ex-inmates in New Jersey participating in pilot programs for such parolees. The programs offer comprehensive services — housing and job assistance, medication management, counseling and education — aimed at reducing recidivism among this high-risk, high-maintenance population.

Until this year, New Jersey had no services for the mentally ill after they left state prison, and only nine of the 21 counties have any post-incarceration services for those leaving county jails.

“The dilemma was, ‘Where do I put a person like this?’ ” said Kevin McHugh, director of community programs and grant management for the New Jersey Parole Board. “We don’t want to keep them in jail, and the likelihood for them to fail on the outside was high.”

In New Jersey, a mental health task force created by former Gov. Richard J. Codey last year brought the oft-forgotten mentally ill inmate population into focus and highlighted the need for new partnerships between state agencies such as mental health and parole, said John Monahan, a task force member and president of Greater Trenton Behavioral HealthCare, a mental health services provider.

Two pilot programs have started since the task force issued its report. PROMISE, or Program for Returning Offenders with Mental Illness Safely and Effectively, provides up to six months of post-incarceration services to paroled inmates who have a history of criminal behavior related to untreated mental illness.

The program began in the spring and now has 16 parolees and can accommodate a maximum of 30. So far, five persons have completed the program, and two committed parole violations and returned to prison.

Mr. Monahan’s company runs a second pilot project called Coming Home, which relies on state, county and grant funding to provide outreach services to state and county inmates. Counselors begin working with inmates three months before discharge to develop a plan for living on the outside and continue to work with parolees until they are self-sufficient.

A three-year, $300,000 grant from the Robert Wood Johnson Foundation funds the portion of the project dealing with state prisoners. The money will pay for services for 60 state prisoners and underwrites efforts to amend state policy so such services can become widespread and permanent.

“We have to see to it that people who have serious mental illness get the help that they need so they don’t wind up incarcerated and they get help before problems happen for them,” Mr. Monahan said.

Lamb, who is among the ex-Mercer County Jail inmates in Greater Trenton Behavioral HealthCare’s Corrections Project, credits his counselor, Anthony Towns, for his success. But Mr. Towns says Lamb is modest.

“I haven’t done anything more for Larry than I’ve done for any other client,” Mr. Towns said. “In any therapeutic relationship, the client and the counselor should have some type of bond. Larry came to me with motivation to succeed. It just so happens that Larry connected with me.”

Lamb just moved into his first apartment, is re-establishing a relationship with his teenage son and says he’s hoping, one day, to find someone to share his new life.

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