March is National Criminal Justice Month and advocacy groups are drawing attention to how people with mental illness are overrepresented in jails and prisons.

According to the Prison Policy Initiative, 43% of people in state prisons and 44% of people in local jails have been diagnosed with a mental health disorder. However, placing them behind bars may not be the best solution.

John Mitchell, mental health court judge in Kootenai County, said about half of the people in his caseload have some sort of mental health diagnosis, but noted jail does little to change their behavior.

"Unless you can figure out a way to help those people address their mental health concerns, ideally at the same time they get their chemical dependency treatment, they're just going to keep coming back," Mitchell observed.

Mitchell acknowledged jail can be necessary for a person's safety or the public's safety but it has not often been the case in his 22 years heading the mental health court. He meets with people in the court typically over two years, on a weekly basis to begin with, and said he plays the role of cheerleader and coach.

John Hall, group facilitator for NAMI Idaho, has been incarcerated and said he was living with undiagnosed and untreated mental health issues. He argued diversion programs like Mitchell's are a better alternative to sentencing and added it is important to educate people before they become incarcerated.

"They have an opportunity beforehand to change the course and direction of their life through the management of their diagnosis," Hall emphasized. "Or maybe their life choices or maybe the environment that they have been in for some time."

Hall also noted peer mentor programs within Idaho's jails and prisons are showing promising results for people who are incarcerated.

Mitchell stressed it is powerful to watch the people he works with change.

"To see somebody with those things stacked against them deal with all their issues all at once and succeed, it's one of the coolest things you can do as a judge," Mitchell observed.

Wyoming ranked highest in the nation for suicide rates four consecutive years through 2021, according to the Centers for Disease Control and Prevention, and the state is funding more crisis response.

About 90% of calls to Wyoming's 988 crisis response line get an in-state answer, according to a new report. Calls used to be routed elsewhere, but the state has been working to localize responses.

Two Wyoming call centers opened in 2020 to offer 24/7 support and now average about 500 in-state calls per month, according to the Wyoming Department of Health.

Kim Deti, public information officer for the department, said the state is currently working to house the helpline's text and online chat options in-state too, and a local connection is important.

"We believe that people within Wyoming, whether they're calling, texting or chatting, they may feel more able to connect and relate to someone from their area," Deti explained.

A 2023 state law created a trust fund for the program but failed to add money to pay for it. This year, a proposed $40 million allocation was reduced to $10 million in the final state budget. Federal funds are also available through July 2025.

If you or someone you know is in crisis, help is available by calling or texting 988.

The nonprofit Inseparable published a report this month to improve crisis response systems. It encourages states to pursue policies to develop system infrastructure, accountability, workforce capacity and sustainable funding.

Angela Kimball, chief advocacy officer for the mental health advocacy organization Inseparable, said in terms of payment, response to mental health emergencies should look like the response to other emergencies.

"Police come. They don't ask whether or not there's an insurance card or a payer first. And the same is true for mental health, substance use, and suicidal crises," Kimball urged. "We want there to be a response regardless."

Kimball argued there should be funds for mental health crises beyond Medicaid.

Florida is getting attention for its efforts to create a comprehensive crisis response system for mental health needs.

A new report by the mental health advocacy group Inseparable calls for policies to expand 988 call center capacity, increase the availability of mobile response units, create more crisis stabilization centers and establish stable funding mechanisms to sustain the services.

Melanie Brown-Woofter, president of the Florida Behavioral Health Association, said the Sunshine State is doing all that and more to provide care for anyone in crisis, including adding more clinics.

"And now the certified community behavioral health clinics, we are really building an entire system that allows an individual in crisis to seek care and be linked to the right level of care at the right time," Brown-Woofter explained. "And to have those resources available that they need."

She pointed out with Florida operating mobile response teams for over 30 years, it is well ahead of other states. She notes the increased state funding to expand services and to establish central receiving facilities, which are not yet available in every state.

The facilities provide what she described as a full continuum of care, from crisis intervention to residential treatment, detox services and child care, all in one location.

Angela Kimball, chief advocacy officer for Inseparable, said it features solutions designed to ensure everyone in a mental health crisis receives the right services at the right time and provides a detailed roadmap for lawmakers.

"Our real goal here is to help create a very visual, easy to understand tool that lets them understand how they can be that champion," Kimball emphasized. "That helps ensure that no one's worst day keeps them from living their best life."

Another objective for Kimball is to spark conversations about what is achievable. For instance, the report showcased Oklahoma's RideCare program, which offers non-law enforcement transportation to urgent recovery centers. Oklahoma also distributed nearly 30,000 iPads equipped with crisis de-escalation tools to first responders and others.

Georgia provides "Peer2Peer Warm Lines" offering 24-hour support from trained specialists to people facing challenges who may not require emergency response.

June is Men's Mental Health Month and advocates in Ohio and elsewhere are working to eliminate the shame or judgment guys often face when they struggle with mental illness.

Studies show the prevalence of mental health problems is growing among children and adults but men are less likely to seek care.

Javon Howard, manager of engaging men initiatives for the Ohio Alliance to End Sexual Violence, said men need to understand it is OK to have experienced trauma and they need to find ways to better connect to their emotions.

"It's important to bring awareness to this month and bring awareness to men's mental health, because we want to encourage men to seek help," Howard explained. "We want to encourage men to feel like they are able to identify for themselves when they do need help, and to understand how to use the tools that are around them."

Studies show women have a significantly higher frequency of depression and anxiety in adulthood, while men have a higher prevalence of substance use disorders and anti-social behaviors. However, four times as many men die by suicide than women and both categories are on the increase, according to the Centers for Disease Control and Prevention.

Howard noted men often believe they will be perceived as weak if they seek mental health care. He observed the culture often tells men to "just get over it," to "man up" or "quit being a sissy." He added the fact large parts of Ohio are rural rather than urban brings a special set of problems for men seeking help.

"With Ohio being a rural state, the reality of folks having access to services can be difficult," Howard emphasized. "If you live in a community where everyone knows each other, it's harder to keep things closer to what's going on with you."

Howard added Men's Mental Health Month highlights the growing number of men across the country dealing with stress, anxiety and depression. His organization hopes to change attitudes about men seeking help to overcome their problems.