Managing Mentally III, Nuisance Offenders: The Consequences of Restricted Civil Commitment and Decentralized Funding
High rates of mental illness among the growing, visible, urban homeless population provoke public pressure to "do something" to eliminate this "public nuisance." Conviction and jailing on misdemeanor charges provides only temporary incarceration in alneady overcrowded local jails, while, since the 1970s, restrictive commitment standards have limited the availability of civil commitment to hospitalize non-violent mentally ill people.
To encourage development of community-based mental health services and reduce the fiscal domination of state mental hospitals, some states have decentralized funding of mental health services. Under decentralization county officials make commitment decisions and distribute funds to state hospitals and community programs, on a fee-for-service basis.
Many political compromises were required to pass this decentralizing legislation in Ohio. One such compromise has the state retaining financial responsibility only for those state hospital patients committed through criminal processes. The resulting structure of financing and decision making may encourage some local officials to use criminal commitment procedures to manage nuisance offenders.