We must decriminalize mental illness

Originally Published in Senate District 66 DFL Newsletter, August 2021

Some people who have read my book about our family’s experience with son Jim’s schizophrenia and substance abuse lament that it doesn’t have a happier ending. I am pleased to share that since the book ended two years ago, Jim is on a better medication, is sober and doing incredibly well.

One reader criticized Fix What You Can: Schizophrenia and a Lawmaker’s Fight for Her Son because Jim “avoided the worst of it” due to my advocacy. I agree I’m a strong advocate and am fortunate to have close relationships with elected allies, including wonderful ones who represent many of us: Rep. Alice Hausman, Sen. John Marty, and Ramsey County Commissioner Mary Jo McGuire. I also have white privilege.

Even so, three years ago, Jim ended up in District Court charged with a felony, after our mental health system failed him and he was turned down for diversion to Mental Health Court. His defense attorney told us most of her clients needed mental health or drug court. What does this say about our mental health system?


A National Alliance on Mental Illness (NAMI) priority is decriminalizing mental illness. It is my priority, too.

Jim ended up with a gross misdemeanor on his record and it dogs him when he applies for a job. It’s hard to explain that when he was high, psychotic, and spurred on by a person who exploited his vulnerability, he thought burglarizing his parents’ home for drug money wasn’t a real crime.

Criminalizing mental illness is also a question of equity. According to NAMI, African Americans and Hispanic Americans use mental health service at one-half the rate of Caucasians, and Asian Americans at one-third the rate. This surely contributes to the disproportionate number of people of color who are caught in the criminal justice system.

Instead of providing needed interventions to people with serious mental illness, we let them become so sick that many commit crimes. One in two Americans with serious mental illness will be arrested at some point in their lives. According to NAMI, 26 percent of state prison inmates in the United States have a recent history of a mental health condition. The percentage is higher in jails.

The criminal justice system has become our de facto mental health system. Even if inmates receive mental health care in jail and prisons, those are anything but therapeutic places for sick and vulnerable people. The past abuses of the state hospital system are too often replicated there. The war on drugs and mandatory sentencing instead of diversion courts have contributed. About 80 percent of people with mental illness in the criminal justice system have a substance use disorder in addition to the mental illness.

Some advocates would rather work upstream on prevention and early intervention, saying it’s too late if we focus on jails, courts, and prisons. I believe we must do both. We can’t ignore the people with mental illness who are in the judiciary system, often the sickest people, who missed early intervention. Many people with schizophrenia or serious cases of bipolar disorder have anosognosia, the inability to know they are ill. They don’t seek or accept care, due to their brain dysfunction, and if they aren’t voluntary, their families are powerless to help. I wrote a book on how hard the Greiling family tried.

I thank Sen. Marty and Rep. Hausman for introducing legislation that would provide funding and improvements for treatment courts and improve mental health services in regular courts.

I’m thankful that Ramsey County is the first to begin implementing a new state law calling for more active crisis engagement with people who are spiraling down, even if they are initially unwilling, before they end up in the criminal justice system. Commissioner McGuire is enthusiastic about the effort, and, as president of NAMI Ramsey County and a member of the Ramsey County Adult Mental Health Advisory Council, I am well positioned to interact with the entire board. I’m pleased that, in addition to voluntary engagement, they are working on more truly affordable housing, also disproportionately needed by people with mental illness and substance disorders.

Not only is it morally wrong to treat people with mental illness like criminals, it is financially unwise as well. NAMI says serious mental illness cost the United States $193.2 billion in lost earnings per year. Because he couldn’t get into Mental Health Court where he would have left with a spotless record, Jim is contributing to that number.

We must do better.