Controversial cases spotlight mental health-criminal justice gap

Published: Jun. 14, 2019 at 4:48 PM EDT
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The controversy over three high-profile cases dropped last week by Chittenden County's top prosecutor has highlighted crucial gaps the state faces when it comes to carrying out criminal justice and the treatment of mentally ill offenders.

The murder and attempted murder suspects were deemed insane at the time of the crimes, so their cases were handed off to the Vermont Department of Mental Health for treatment. But the department raised its own alarm, saying they could not promise public safety.

"We provide that mental health treatment in the least restrictive settings possible," said Vermont Mental Health Commissioner Sarah Squirrell. She says that is their mission -- treating patients' mental illnesses and not holding them in the hospital if they don't need to be there. "We are not in the business of assuring public safety."

Squirrell says there's an important distinction missed by many in recent discussions about the role her department has in deciding whether a patient in their care needs hospitalization. One of the criteria for that is that a patient is a danger to themselves or others.

"We are assessing risk -- dangerous to self or others -- as it relates to the individual's mental illness. And essentially someone could still be dangerous to themselves or others for reasons that are not their mental illness," Squirrell said.

For instance, they can't predict -- or treat -- tendencies towards criminal behavior. That, she says, is better handled by corrections programming.

Reporter Cat Viglienzoni: How do we bridge that gap?

Sarah Squirrell: I think that's a great question. And right now as a state we have a real opportunity to reflect on and come together about a true forensic system of care in Vermont.

Squirrell says Vermont is unusual in that it does not have some sort of partnership between corrections and mental health in complex cases like the ones in Chittenden County.

Reporter Cat Viglienzoni: For the public who might go, 'Why don't we already have this?'

Sarah Squirrell: It's a great question.

Whatever the answer, the back-and-forth between the state's attorney's office, the governor's office, and mental health officials, have made it clear that on some level all of them agree on one thing -- that need for more collaboration to make sure that Vermonters are safe.

"We should always step back and say, 'What can we do differently.' And I think that's the opportunity that we have right now," Squirrell said.

So what would a forensic system of care look like here? The commissioner says it could include competency restoration programs, corrections and mental health working together to determine when someone is released back into the community, and oversight boards. Those are all things she hopes mental health providers, lawmakers and public safety officials will start talking about soon as they consider changes.