Without family or a means to earn money for rent, many turned to life on the streets. They were then arrested on minor charges by the police, under social pressure to %u201Cdo something%u201D about the homeless population. Approaching one third of homeless people have a psychological disorder.
Implications for the Mentally Ill Inmate
A common disorder to develop in prison is depression, a byproduct of institutionalization. In the context of a total institution, inmates are systematically broken down and manipulated by the staff. Their lives are completely supervised, homogenized, and organized. In the process, inmates tend to learn behaviors counter productive to their survival in the outside world. Some of these behaviors may include, %u201Caggressiveness and intimidation of others or, conversely, extreme passivity, manipulative behavior and reluctance to discuss problems with authority figures. These behaviors create barriers to engagement in mental health services and treatment.%u201D (Barr)
A result of the effect of prison life on inmates is the alarmingly high rate of suicides. Suicide is the leading cause of death in inmates, accounting for over half the deaths occurring while inmates are in custody. Almost all who attempt suicide have a major psychiatric disorder. More than half of the victims were experiencing hallucinations at the time of the attempt. These deaths are tragic because mental disorders are highly treatable with 60-80% success rates.
Implications for Society
The overflow of the mentally ill has overloaded the prison system. The American Correctional Association recommends that jails should operate at 90% of capacity. All jails were at 85% capacity in 1985, and were up to 111% capacity in 1987. The overcrowded conditions disrupt the efficiency and function of the prison system. Room for booking and close observation areas upon admission is at a scarce. Even if a mentally ill inmate is correctly recognized as in need of further observation or treatment, on-sight mental health professionals are scarce; there may not be anyone on duty at odd hours. Admittance screening is rushed and many mentally ill inmates who should receive treatment instead slip through the cracks of the system. The original social goal of society to provide these individuals with more humane mental health care is lost.
Half of the mentally ill inmates report three or more prior incarcerations. The long-term costs quickly add up. While the direct cost of mental health services was $69 billion in 1990, the estimated hidden costs of loss of productivity and long term health care costs were an additional $78.6 billion.
Why You Should Get Involved
Our society has attached a glaring stigma to mental illness, which makes it difficult for individuals to ask for or receive help. The perception that mentally ill people are violent is a common one. In reality, studies have shown that they commit violent acts no more often than a random sample of their peers, if they do not abuse alcohol or drugs. The small percentage of mentally ill people who do represent a significant risk to themselves or others should not be ignored though. These people do belong in a correctional facility. However, many are arrested on minor charges and for non-violent crimes. In fact, 29% of jails in one survey reported holding mentally ill persons against whom no charges were ever pressed. **They are jailed because more appropriate community based programs do not have the funding or space to deal with them.**
Mental illness is stigmatized across every culture, every gender, and every geographic region of America. These individuals are feared and avoided as perpetrators of violence, an undeserved reputation. People need to realize that psychological disorders are a disease. They can be diagnosed and treated as such with high rates of success. Living with mental illness is a terrifying experience. It can be a confusing and disorienting time of their lives. On their own, those with mental illness often end up jobless and on the street. They need our help to set them on the path to mental health. We cannot morally afford to toss them into the prison system, to hide them in a dark corner of the American conscious.
Out of sight, out of mind.
A large number of prison inmates today suffer from psychotic disorders that are severe enough to warrant mental health care. Numerous court cases have established that mentally ill inmates have the constitutional right to these services. However, more often than not, inmates are denied these needed services. Most prison administrators report that they do not have the resources or ability to respond to the needs of mentally ill offenders. They describe their programs as %u201Cgrossly understaffed%u201D and %u201Cin urgent need%u201D of help from mental health organizations to develop appropriate programs. In effect, today%u2019s prisons and jails are shouldering the responsibility for the mentally ill which used to reside with community based hospitals and institutions.
What May Be Done
The federal district courts have formulated six components of a minimally adequate mental health treatment program
A large number of prison inmates today suffer from psychotic disorders that are severe enough to warrant mental health care. However, less than a third of these individuals receive the care that they have a constitutional right to. I find it abhorrent that, instead of seeking to rehabilitate these inmates, prison conditions drive them further into their illness, even to the point of suicide.Federal Bureau of Prisons Central OfficeRehabilitating and treating the incarcerated mentally ill benefits everyone. The inmates can become productive members of society once again. The overcrowded prison system saves money and space by not having to deal with repeat offenders. Short-term costs are offset by the long-term savings in health care.
Please work to ensure that the mentally ill receive the help they need. The Correctional Mental Health Associates recommend that prisons employ at least the following staff to provide adequate care:
1.5 FTE psychiatrists
1 MSW social worker supervisor
3 BA level social workers
2 registered psychiatric nurses
5 licensed practical nurses
Also, please increase the supervision and access to crisis centers to decrease instances of suicide upon admission.Thank you for your efforts to reform the mental health loop holes of prisons.
Sincerely,
Your Name Here
Contacts to send the letter to:
National Criminal Justice Reference Service, P.O. Box 6000, Rockville, MD 20849-6000
U.S. Department of Justice, 950 Pennsylvania Avenue, NW, Washington, DC 20530-0001

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