Quote Of The Month 9/30/25
“Our criminal justice system is filled with people who need mental health and substance use care to prevent them from re-entering the system...”
--Debra A. Pinals, M.D.
"A woman we'll call Teresa sits alone in a county jail cell, longing for her children. She has been in and out of jail for 10 of her 32 years, for charges related to drug dealing and drug use. Removed from her biological parents as a young girl after experiencing terrible abuses, she spent her early years in foster care and juvenile hall. She’s had abusive boyfriends, and her children are in the custody of her mother. She is diagnosed with post-traumatic stress disorder and major depressive disorder, along with addictions to opioids and methamphetamine.”
This is the kind of person Pinals knows well. She has blazed a trail in understanding the mental health issues that lead to incarceration and recidivism. She is an M.D. and director of the Program in Psychiatry, Law, and Ethics at the University of Michigan Medical School, and says today, out of the 6.5 million people under correctional supervision, roughly 1,040,000 have some form of significant mental illness. Meanwhile, jails have become de facto mental health institutions, suicide rates among incarcerated people are increasing, and the co-occurrences of substance use disorder and mental disorders among correctional populations are on the rise.
In Indiana and across the country, we are in the process of a sea change in the ways we deal with these issues. We finally have realized that childhood trauma and violence are at the root of a great majority of those who suffer from mental instability and substance use issues. To that end, in recent years the Indiana Department of Correction has made some changes along with the courts, like diversion programs, mental health and drug courts, and other interventions to try to stem the rising tide. But, says Pinals, "with the growing numbers of people affected, these innovations must get up and running faster and become more effective."
Governor Braun has requested a plan, by June of 2026, from the Indiana Department of Correction to reduce recidivism. Considering that request, there is one statistic the governor might want to have: It is the percentage of reentrants who have substance use issues and those with serious mental health issues. Those percentages will undoubtedly overlap greatly, but if I were a betting man, I'd bet that the number will be pretty close to the recidivism rates we've been seeing for years.
If I’m right—and I think I am—we’ll need a better playbook. 1. We will have to provide more mental health services (and mental hospitals, rather than housing sick people in prisons) and, 2. We need to better stem the flow of drugs into Indiana and expand counseling and support for people with addiction use issues.
If not, the merry-go-round will never stop.
Jim
