Cleveland, OH, May 14, 2021

 

Even as communities around the country discuss alternatives to policing and equitable forms of public health, we in Cuyahoga County are taking a step back from a truly care-centered, non-carceral form of addressing mental health crisis with the new, problematic Cuyahoga County Assessment and Diversion Center (CDADC). The CDADC opened on May 3 and was followed by a ribbon cutting ceremony with much fanfare the next day. In a press release, County Executive Armond Budish declared, “This is an exciting day for Cuyahoga County.”

Unfortunately, Budish’s declaration was anything but exciting for the countless number of residents living with mental illness, substance use disorders, as well as those previously incarcerated at the County Jail, who were purposely excluded from being involved in every aspect of the project’s development. Residents living with mental illness and addiction need behavioral health care, not the threat of cages.

Criminalizing Mental Illness

“Nothing About Us Without Us” has long been the rallying cry of disability rights advocates. In saying this, we are saying that individuals who have lived experience in the area of concern must have meaningful involvement in every aspect of their own care, including service delivery and training.

The Budish Administration has not lived up to these values. They have criminalized mental illness and addiction while simultaneously setting the disability rights movement back decades. People living with mental illness are more likely to be victims of crime rather than the perpetrators, and we need a care system that treats people with mental health conditions with compassionate care, not escalated violence. Requiring law enforcement involvement in mental health care does not improve public safety, it jeopardizes it.

How did we get here?

For years, local organizations and stakeholders such as the Alcohol, Drug Addiction, and Mental Health Services Board of Cuyahoga County (ADAMHS), Greater Cleveland Congregations, concerned residents, behavioral health providers, and law enforcement officers have advocated for a “crisis center” with universal access for anyone in need of services.

In 2019, Cuyahoga County hired Pulitzer/Bogard & Associates, LLC.to conduct a Mental Health Diversion Study. The County Administration convened a group of “stakeholders” identified as having a “vested interest” in the proposed project, calling the group the Cuyahoga County Diversion Committee. The committee consisted of elected officials, government bureaucrats, behavioral health providers, and nonprofits.

There were no advocacy organizations for mental health, disability rights, or homeless persons, nor any groups representing those impacted by mass incarceration included on the committee. Those with real stakes in the center’s success were excluded: residents living with mental illness and/or substance use disorders, individuals previously incarcerated at the County Jail, and the family members of these people. At no time did the County Administration, Justice Center Steering Committee, Cuyahoga County Council, or the ADAMHS Board make any attempt to solicit feedback from taxpayers or from those who will use the services. It is noteworthy that some of these same stakeholders later submitted proposals and several were awarded contracts. Their real “vested interest” was enriching their agencies through public funding.

Opioid Crisis: We have a public health care crisis that should not be solved by only offering care to those incarcerated. As Ohio continues to weather the COVID-19 pandemic, the opioid crisis continues to ravage our community. The Diversion Center opened nearly one month after Cuyahoga County medical examiner Dr. Thomas Gilson issued a public health alert in response to 69 suspected drug overdose deaths in March. If the increase in deaths continues at this pace, the County will be on track to suffer more than 700 overdose deaths this year, which would mark the first time since 2017.

We believe that there should be free, easily accessible non-carceral mental health care for all in our community. The current reality of our care system now is bleak. Drug treatment beds have always been scarce. Some programs do not offer treatment to individuals with co-occurring mental health and substance use disorders. The Diversion Center offers withdrawal management services (detox) and Medication Assisted Treatment (MAT) to those with co-occurring disorders, which are potentially life saving treatments; however, to access these forms of care, they now must be accused of committing a non-violent crime. This puts already vulnerable people in a horrible position of having to sacrifice their freedom in order to get care. No just and compassionate society should ever force people to do this.

Some of the language used on the ADAMHS Board’s Diversion Center webpage is problematic at best and outright disturbing at worst. County residents are paying to operate this Center, yet there is no clear information on what offenses potentially qualify for eligibility. Under a section entitled “Who is eligible to be admitted to the Cuyahoga County Diversion Center?”, the response says: “The person must be apprehended within Cuyahoga County.” This sends the message that people experiencing a behavioral health crisis now have to be “apprehended” to receive treatment.

How could we do be better: remember Tanisha Anderson

We need free crisis centers in every zip code that are open for voluntary patients who need mental health care. The poor practices of the Diversion Center mean it would be incapable of helping residents like Tanisha Anderson, who died following a deadly encounter with two Cleveland Police officers in November 2014. Tanisha was a law-abiding community member who had recently been released from a hospital. Her only unfortunate situation on that day of her death was having a flare up of her mental illness. Like the majority of individuals experiencing a behavioral health crisis, Tanisha was not a danger to herself or others. Therefore, she did not meet the criteria for involuntary emergency hospitalization. If there had been a crisis center open to all county residents, Tanisha’s family could have taken her for treatment, eliminating the need to involve law enforcement and jeopardize human lives.

Non-police involved and non-carceral Alternatives :

In Eugene, Wash., the nationally-recognized Crisis Assistance Helping Out On The Streets (CAHOOTS)program offers crisis response in lieu of police response. Their immediate stabilization services are provided by medics, nurses, and other crisis workers trained in mental and behavioral health. In Denver, Colo., the Support Team Assisted Response (STAR) program activates teams of mental health practitioners and paramedics to deliver emergency crisis response services without utilizing police as first responders. In St. Petersburg, Florida, a Mobile Crisis Response Team offers on-demand crisis intervention services 24/7 with the assistance of specialized licensed behavioral health therapists and psychiatrists. Each city’s program is unique to its local ecosystem, reflective of its community makeup, sensitivities, histories, and goals. Each city’s program is also reflective of local choices regarding funding and administration, as well as allocation of public resources.

The Cuyahoga County Jail Coalition calls on the County Administration, ADAMHS Board and Oriana House to not only seek funding to expand the services and capacity of the current Diversion Center but to also begin work to establish free “no wrong door” crisis centers accessible to all, not just those who have been picked up by the police. This is what community advocates originally demanded, and it is imperative that we offer care and treatment to those in our community who need it before their state of crisis has led to an interaction with our abusive and deadly justice system.