The Mentally Ill and Incarceration: A Broken System
Working in a jail or prison is like working in a large mental health hospital, without all the necessary trained staff needed to actually run effectively.
As a matter of fact, the biggest mental health providers in our nation right now are our jails. The three biggest mental-health providers in the nation today are: the Cook County Jail in Chicago, the Los Angeles County Jail and Rikers Island jail in New York.
These are no places for people who are severely and chronically mentally ill.
Decades ago when there were plenty of beds in state hospitals, the most severely ill were often locked away in asylums and forgotten in order to “keep society safe”. Often times they were locked away and offered no real help and suffered horrible conditions and treatment.
Today jails and prisons have become the new asylums.
The mentally ill often get into trouble due to their illness. Often the crimes are as harmless as sleeping on a park bench, trespassing or having an open container of alcohol. Rarely are they violent offenses.
A 2010 study by the Treatment Advocacy Center and the National Sheriffs’ Association estimated that 40 percent of the seriously mentally ill have been in jail or prison at least once in their lives.
In the county jail I work in I would say about 75% have some sort of mental illness while about 10% have a severe mental illness that should be treated at a psychiatric facility and not in jail.
Most jails and prisons, like us are understaffed. We currently have four full mental health professionals including myself and a psychiatrist. Ideally, we’d have at least three or four more but there’s not enough funding.
Many corrections officers are under trained when it comes to dealing with the mentally ill and the overall outlook of mentally ill inmates on both medical and security staff in jails and prisons is not usually conducive to effective treatment. Especially for the severely and chronically mentally ill who are often in and out of jail.
Like the young lady I met earlier this week. She’s a 38 year old woman who came up in the foster care system. She had came from an abusive and neglectful family and it’s unclear if the abuse and neglect caused her mental illness or if she was abused and neglected because of it. Either way, starting at a young age she suffered almost every kind of horrible abuse you can imagine.
As an adult she has been arrested over 20 times for everything from possession of cocaine, parole violations and battery.
In 2001 she was arrested for aggravated battery after she attacked and kicked a state hospital guard who ended up suffering a heart attack and dying.
In 2003 she was arrested after two men reported they had unprotected sex with her without knowing she was HIV positive. She later told authorities she knew she had HIV since 1999 and didn’t tell any of the at least 200 men she claims to have had unprotected sex with. She plead guilty and served 23 months.
She continues to cycle between being on the streets, going to jail, the state hospital and prison.
Often times no one wants to take her (the state nor DCF) because she is so mentally ill and has grown more and more violent.
When she came into our jail there was a big push to get her out and back to some place that could manage her better.She’s trapped in a system that in some ways may have helped create her and doesn’t want anything to do with her.
In many ways she has been abandoned since she was a child and as an adult who is now nearing the end stages of AIDS, she is still alone and abandoned.
Continuing to incarcerate the mentally ill over and over again doesn’t work. It doesn’t help anyone. We lock them up where they may or may not get treatment and then send them back out on the street where they may or may not get treatment.
What’s the solution?
We need more state and federal funding for mental health, reform treatment laws to address intervention, assisted outpatient treatment for released mentally ill inmates, expansion of mental health courts that offer treatment instead of incarceration and ideally a health care system that provides systematic health care for those suffering from a mental illness.
If we can find a way and the money to build a wall between between the United States and Mexico, surely we can do this!