FEBRUARY 17, 2020


Ensuring Los Angeles County鈥檚 Approach to Reducing Homelessness and Promoting Behavioral Health is Trauma-Informed and Evidence-Based

Individuals with behavioral health challenges (e.g., mental health and/or co-occurring substance abuse disorders) have frequent contacts with the criminal justice system. Overwhelmingly, this population tends to commit lower-level offenses that impact our communities鈥 quality of life but are non-violent and do not warrant harsh or lengthy sentences. Incarcerating this population is not only inhumane, it does nothing to 鈥渇ix鈥 deeper public health problems such as substance abuse or mental health disorders which are frequent drivers of contact with the criminal justice system. You can鈥檛 cure cancer with a hammer, just like you can鈥檛 treat mental illness with punishment.

The band-aid approach of incarcerating this population continues to be ineffective, extremely expensive, and it disproportionately impacts communities of color. Beyond the conditions on our streets, the clearest sign of the failure of this approach is the LA County Jail, which has the dubious distinction of doubling as the nation鈥檚 largest mental health institution. Individuals suffering with addiction or mental health disorders also make up a large portion of our homeless population, and due to the biggest domestic policy failure of our lifetimes-the war on drugs-the criminal justice system鈥檚 approach for the past forty years has been to apply punishment instead of treatment and housing. The approach has severely backfired, and it has exacerbated Los Angeles鈥 homelessness crisis.

As is evident on street corners across the county, individuals suffering with addiction or mental health disorders are disproportionately represented in our homeless population. The longtime head of the Los Angeles Homeless Services Authority, Peter Lynn, recently told the New York Times,鈥 There is probably no more single significant factor than incarceration in terms of elevating somebody鈥檚 prospects of homelessness.鈥 A single criminal conviction closes literally hundreds of doors and is a major barrier to securing stable employment and housing.聽 And the inability to find employment or housing are primary factors that drive recidivism.聽

Criminal convictions also foreclose other benefits such as voting (in some places) and school loans. What鈥檚 more, incarceration traumatizes people, further making them more likely to reoffend.

In recent years, a housing crisis, an opioid epidemic born from big pharma, and a surge in the use of methamphetamine have made the problem worse. LA County鈥檚 homeless population has risen sharply, seeing an increase of 20,000 in the past eight years, and deaths among this population have doubled since 2013. That鈥檚 not only heartbreaking and deplorable, it鈥檚 an outrage. This is ground zero for the homelessness, addiction, and mental health crisis that is gripping the nation. And while lawmakers scramble to piece together policies that might withstand the test of legal scrutiny, they have yet to identify a coherent plan that will protect the civil liberties and humanity of our unhoused residents while improving the public health and safety of our communities.

Today, one in three inmates in the county jail have serious mental illnesses, or about 5,100 of the 17,000 individuals in the average daily inmate population. More than 60% of them would be eligible for diversion if there were more facilities capable of providing supportive care, according to a recently released study. As Kristen Ochoa, the medical director of LA county鈥檚 Office of Diversion and Reentry, recently told the Los Angeles Times, if there were sufficient services to divert individuals in this manner it, “would save the county hundreds of dollars a day in incarceration costs for each inmate and, for many, end a cycle of being arrested and released, then becoming homeless and getting arrested again.”

Proposition 47, which L.A. voters overwhelmingly approved, is essential to ending this vicious cycle as it provides funding necessary to support these mental health services while removing the scarlet letter of a felony conviction, records that keep this population in a paper prison and unable to find employment or housing. L.A. and California said “yes” to moving in the right direction, however, this was the first step of many that are necessary to unwind decades of bad policy that led us to where we are today.

George Gasc贸n has fought for housing rights, worked to divert individuals at the earliest contact with law enforcement to community-based health and social services as an alternative to jail and prosecution, and he has promoted initiatives that enhance behavioral health services, equity, and justice. He took these steps because he knows incarcerating our unhoused neighbors or those with mental illness or co-occurring disorders is counterproductive and makes it more difficult for them to successfully reenter our communities. He has aggressively championed trauma-informed and evidence-based practices for treating this population in order to prepare them for their eventual release.

Housing is not within the purview of the District Attorney, but a key component of any successful strategy will be to dramatically increase housing options for this population. This is because it is exceptionally difficult to stabilize individuals with behavioral health disorders when they are living on the streets. For example, an essential aspect of the housing continuum is meaningful reentry services and housing for people getting out of prison. They are at dramatically increased risk of homelessness, and if not in a home or transitional housing, they frequently return to our streets. Some of the funding to support this additional housing stock may be realized by shrinking the footprint of the criminal justice system, specifically the number of jail and prison commitments.

While housing may not be under the purview of the District Attorney, there are many things the DA can do to address our behavioral health crisis and its nexus to homelessness. George Gasc贸n鈥檚 vision for bringing these services together, along with trauma-informed policies and programs to enhance public safety and promote a seamless system of care for individuals with mental illness and ultimately interrupt the cycle of homelessness, addiction, and criminal activity is below:

Enact policies to prevent homelessness and keep people in their homes.

The best way to prevent homelessness is to keep people in their current homes. One of the most effective ways to do that is by intervening before families are forced to leave their homes. A comprehensive eviction defense program will support tenants at every moment of their tenancy, from move in all the way through to eviction proceedings, including mediation or court, if necessary. George Gasc贸n will work to reduce eviction filings in order to help stabilize communities through cost-saving early interventions and through leveraging existing systems for support. Gasc贸n will also ensure line-level prosecutors and their supervisors work directly with legal advocacy groups, tenants, and others to avoid, where possible, ever reaching the courtroom.

This will not only reduce the trauma of displacement but will reduce inflow into homelessness.

Divert individuals from the earliest contact with law enforcement by dramatically expanding Law Enforcement Assisted Diversion (LEAD).

More than half of all people incarcerated in prisons and jails have a mental illness: 56 percent of state prisoners, 45 percent of federal prisoners, and 64 percent of jail inmates. Of those who have a mental illness, about three-quarters also have a co-occurring substance use disorder. Jails and prisons are fundamentally places of punishment and control, not treatment and rehabilitation. By virtue of their very nature鈥攆rom their architectural design to the manner in which they are routinely operated鈥攋ails and prisons tend to exacerbate mental illness and further traumatize individuals. Adding treatment services to traditional jail facilities will never adequately address this inherent problem.

Many studies have shown that prisoners with mental illness are especially vulnerable to a wide range of potential harms in correctional facilities. This vulnerability is reflected in the fact that they are not only more likely to engage in suicidal and self-harming behavior, but they are also more likely to incur disciplinary infractions, more likely to be victimized by other prisoners, and more likely to be the targets of use of force by correctional staff. They often find themselves mired in a cycle of disciplinary infractions, imposed sanctions that include isolation or solitary confinement, and further deterioration of their mental health, leading to the increased likelihood of future infractions. This downward spiral exacerbates mental illness, hampers rehabilitation, and increases recidivism.

Regardless of whether individuals receive adequate care while incarcerated, all jail inmates are eventually released and returned to their communities. Individuals suffering from mental illnesses are regularly released without adequate reentry plans, programs, or connections to community programs to continue mental health treatment. In some cases, individuals are released without adequate medication or prescriptions. Failure to adequately prepare for community reentry and continuation of mental health services can exacerbate psychiatric conditions and increase the likelihood of addiction, homelessness, and recidivism.

George Gasc贸n would dramatically expand LA County鈥檚 Law Enforcement Assisted Diversion (LEAD) program. Research has shown these programs are more effective than traditional interventions. LEAD is an innovative pre-booking diversion program that refers repeat, low-level drug offenders at high risk of recidivism at the earliest contact with law enforcement to community-based health and social services as an alternative to jail and prosecution.聽 Immediate connection with intensive case managers who provide crisis response, immediate psychosocial assessment, and long-term, wrap-around services such as substance use disorder treatment and housing is proven to be more effective.聽

By working with law enforcement to intercept individuals and channel them directly into community-based interventions at the point of arrest or pre-arrest, LEAD has been shown to effectively disrupt the cycle of individuals with behavioral health issues through our criminal justice system and uses a low barrier, harm reduction based model of care to help participants work toward achieving stability in the community.聽聽

LEAD is a major component of Gasc贸n鈥檚 proposed system of behavioral health justice centers. See below for more details.

Establish a system of Behavioral Health Justice Centers as an alternative to traditional criminal justice interventions.

Comprehensive efforts to improve public safety must confront the role of mental illness and addiction. Law enforcement has few options to offer individuals in a mental health crisis. When a person commits a minor crime and also suffers from mental illness, officers do not have many reasonable options for diverting people out of the criminal justice system.聽

George Gasc贸n will advocate for the creation of Behavioral Health Justice Centers (BHJC) across the county, a concept developed initially for San Francisco by a team of experts that is equally applicable to Los Angeles. The concept leans on best-practices gleaned from Memphis, San Antonio, and Miami. A BHJC enables a seamless continuum of care, helping to make treatment and rehabilitation of individuals with mental illness in our justice system more effective, more efficient, and more just. BHJC鈥檚 would be locations law enforcement can divert individuals who have committed low-level crimes (via the LEAD program) who are suffering from behavioral health disorders. BHCJ鈥檚 serve as a hub for LEAD and have case managers on-site, and provide short-term housing (2-3 days) as well as longer-term housing (2-3 weeks) in order to treat and stabilize individuals in crisis prior to transfer to community based treatment options. Individuals who would otherwise be in custody for more serious offenses who have mental health disorders would also be treated in a secure setting rather than in the county jail.聽聽

By investing in a Behavioral Health Justice Center, Los Angeles would take a bold step toward creating a justice system that promotes the well-being and safety of all of our community members.

Expand the Los Angeles County Homeless Court Program and more fully integrate the District Attorney鈥檚 Office in a leadership role in the program.

The Los Angeles County Homeless Court Program is at present administered by the Los Angeles City Attorney鈥檚 Office. Its staff, along with teams from the Public Defender鈥檚 Office, attends homeless connect days in the community and provides assistance to individuals experiencing homelessness or who are at risk of becoming homeless. The Homeless Court helps participants resolve eligible traffic and pedestrian infraction citations by engaging in services instead of paying fines and fees they cannot afford. Through the program, the LA County Superior Court can dismiss open infractions, suspend fines and fees, and recall any associated warrants. Even though the program is staffed by the City Attorney, it is funded by the county. Leadership from the DA has been non-existent, and that needs to change.

George Gasc贸n believes the DA should play a leadership role in the program. As District Attorney, Gasc贸n would establish a Homelessness and Behavioral Health Unit in the office and staff it with specially trained attorneys and clinicians to lead the Homeless Court Program and support the great work already being done by dedicated city attorneys and public defenders.

Gasc贸n would also expand the Homeless Court鈥檚 criminal record clearing program. Recently, officials from the city and county of Los Angeles partnered to void over two million low-level citations that were more than five years old. While commendable, it did not go far enough.聽 Which is why Gasc贸n would implement a CONNECT program (see below).

Establish a Homelessness Advisory Board.

George Gasc贸n knows that in order to be effective, any efforts undertaken by the DA, or by any elected or appointed officials and policymakers, must include the voice of people who are homeless, or have recently been homeless. The lack of a regular, consistent and prominent platform for the voices of people who are or have been homeless leads to misinformed policymaking, faulty program development, and poor budgeting decisions. To broaden our perspective on important policy issues, and to increase the voices of constituencies into decision-making that impacts them, George Gasc贸n will create a Homelessness Advisory Board comprising people who are, or have been homeless that have had contacts with the criminal justice system in Los Angeles County.

Any such board must also represent different segments of the diverse homeless population in Los Angeles County, including people with different levels of acuity, length of time homeless, experience with economic hardship, substance abuse, domestic violence, or mental or physical disability, and other factors and reflect the significant over-representation of African Americans in the homeless population.

Develop policies and implement programs, such as the CONNECTion To Services Program (the CONNECT Program), that support diversion to services and prioritize alternatives to enforcement, citation, or arrest for low-level quality of life crimes or life-sustaining activities.

Approximately 3 out of 4 people experiencing homelessness in Los Angeles County are unsheltered. That means on any given night, around 40,000 people sleep outdoors, in a tent or makeshift shelter, or in their vehicles. In addition to a lack of privacy or access to hygiene services, people experiencing homelessness are also much more likely to be cited by law enforcement for quality of life crimes, such as loitering, trespassing, or urinating in public. These behaviors are often used as pretexts for arresting or citing people experiencing homelessness. It isn鈥檛 just these low-level quality of life crimes that are being disproportionately enforced against people experiencing homelessness, however. Increasing and more frequent interactions with the police have also led to more arrests for disrupting or preventing city operations, resisting arrest, and assault on an officer. Simultaneously, public health and safety must continue to be preserved for both our housed and unhoused neighbors.聽

We know these arrests further entrench the cycle between homelessness and jail; being arrested can further traumatize people and make it more difficult for them to obtain employment or long-term housing. We also know people experiencing homelessness cannot afford to pay their citations or fines, and left unpaid, the record of the citations can create additional barriers to employment and housing, not to mention increasing fines.聽

Gasc贸n would implement the CONNECT Program to ensure infractions and charges are dismissed for people experiencing homelessness if they agree to receive help from a caseworker or social service provider. For these individuals, the CONNECT Program allows them to meet their obligation under the citations by getting the help they need from a trusted social service provider in our community.聽

George Gasc贸n is committed to reducing or eliminating barriers to employment and housing by dismissing citations or charges for low-level, non-violent crimes and ensuring a connection to services in lieu of fines or jail.

Adequately train attorneys on the American Bar Association Criminal Justice and Mental Health Standards.

The ABA Criminal Justice and Mental Health Standards were revised in 2016 and have raised the standard of practice for attorneys in criminal courtrooms. According to the ABA, judges, prosecutors, and defense lawyers should have a better understanding of mental health, they should be knowledgeable about resources in the community, and they must explore alternatives to incarceration for people with behavioral health disorders. If implemented properly, the new standards will encourage defense attorneys to consider recidivism and the long term liberty interest of their clients. Prosecutors will need to consider long term public safety goals that are achieved through treatment rather than incarceration. The changes will have an impact on plea negotiations, diversion opportunities, mitigation and sentencing. Overall, attorneys and judges should be afforded better education opportunities when it comes to behavioral health so they can meet the ABA鈥檚 new standards of practice.聽

As Los Angeles County District Attorney, George Gasc贸n will raise the bar for training and expectations of lawyers in a way that will impact the approach to these defendants in Los Angeles and set the standard for attorneys across California.