Shockingly about 450 million people around the world suffers from mental illness. Many of these illnesses and disorders are mostly common in the prison and populations. The high number of mentally ill inmates in prison are related to numerous factors: the common stereotype and stigma associated with people suffering with a mental illness is that they are a danger to the public, the failure to provide proper treatment, care and rehabilitation, ignorance regarding mental health, and the lack of mental health services and treatment in prisons.
Also, the lack of community-based treatment options and facilities may be the causing factor of the recent rise in the number of inmates with mental illness. In a mental health crisis people are more likely to encounter the police than receive psychiatric help. Then when that individual becomes incarcerated his or her resources become even more scarce. The issues with the policies for mental health is that there aren’t enough outlets or it’s accessibility to treatment to the incarcerated.
In the 1900 biennial report, Warden C. P. Hoyt petitioned to have five prisoners who have been ruled insane transferred to a mental asylum for the insane but were unable to be transferred because the facility was over crowded. Also, the asylum had no facilities or experience for handling patients with such diagnosis. Back then people weren’t informed on mental health. They believed people with a mental illness would escape from mental facilitates and thought jail was a better alternative for treatment. “Nor could Territorial properly care for these prisoners.
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J. W. Collins, then prison physician, wrote, “This class of prisoners are now, and have always been, confined in cells and cannot be properly cared for. Hoyt then pleaded for more funding from the governor to build a new cell house for the criminally insane, as well as a new hospital and tuberculosis clinic.
Mentally ill inmates were a danger to themselves and others and needed to be isolated in order to protect “the lives of the officers and prisoners.” (Colorado College 2018) The Colorado legislature gave the prison half of the funds necessary to begin construction on the building. In 1906, Warden John Cleghorn insisted that the prison receive the rest of the money to complete the facility for the mentally ill, once again they failed to receive the money.
The prison continued to propose and inquire about the construction of their new cell house. The cell house was designed to isolate the mentally ill inmates from the other inmates in hopes to treat them. Unfortunately, the jail never received the funds for it and questions were left unanswered in regards on what to do with the inmates who were mentally ill. The needs of the mentally ill fell behind other issues that were deemed more important in the prison. Projects that made the prison money and work programs were more important while the mentally ill were completely forgotten.
In many countries, people with a mental illness are being wrongfully locked up in prisons simply due to the lack of mental health services available. People with mental illnesses that have committed minor offences are often sent to prison rather than treated for their disorder. These illnesses then continue to go unnoticed, undiagnosed and untreated. The prison environment can have a negative effect on the mentally ill. For example, the overcrowding, isolation, violence and lack of privacy all those factors can cause more potential damage to someone who is mentally ill. The mass incarceration of the mentally ill are due to the closing of mental facilities. Mental hospitals have been over crowed for years not having enough beds to provide treatment to a huge number of individuals that require services.
The closing of those facilities has left a gap in the system of rehabilitation of the mentally ill. Now that the bed numbers are low in the hospitals mentally ill inmates remain in jail. The USA considers jail as a long-term treatment for the mentally ill. Reason being it’s less expensive to have them remain incarcerated then to provide full services and treatment for the inmates. States are starting to receive lawsuits for not transferring inmates with serious mental illnesses from prisons to hospitals. The lower bed numbers present an opportunity to decrease the number of incarcerated inmates with serious mental illness.
Which brings me to one of my proposals to address the social welfare problem. My proposal would be to divert people with mental disorders towards the mental health facilities. Prison in not a place for someone who is severely suffering from a mental illness also, there’s little to no treatment options for those who are mentally ill and incarcerated. That’s precisely why I believe the mentally ill need to be in state hospitals instead of state prisons. Prisons aren’t equipped with the proper information or training to handle individuals with such illnesses. Nor do they possess the proper treatment plans and medications for the inmates.
My other proposal to address this issue would be to provide prisoners with access to mental health treatment and care. The most common mental illness found in inmates have been, psychotic illness, depression, personality disorder and psychosis. The many causes for suicide in prison are mental health disorders and substances abuse. Access to treatment for prisoners with mental illness, should also include substance abuse as a part of the services available to all prisoners. Treating mental health needs will improve the health and quality of life of the prisoners. They are more mentally ill individuals incarcerated than are walking free. Not even half of the mentally ill inmates receive treatment. Being incarcerated and not being treated can cause more damage to the individual who is already mentally ill.
The political ramifications to my proposals of diverting people with mental disorders towards the mental health facilities would be the cost. The cost of transferring of inmates to state mental hospitals are expensive, also the cost of treatment in jail are more expensive than state facilities. According to the National Alliance on Mental Illness “the cost of incarcerating a person with mental illness is three times the cost of incarcerating a person without one. Housing an inmate with mental illness in jail costs $31,000 annually, while community mental health services cost about $10,000.” (NAMI 2018)
It’s ultimately cheaper to treat a person with a mental illness then to send them to jail. The other issues with diverting inmates to state hospitals would be the additional armed security for state hospitals. Additional security would be required to ensure the safety of the workers and other patients in the hospital. The state would have to hire and pay more armed officers and get them trained and informed on how to handle inmates with mental illnesses.
The issues with providing inmates with access to mental health treatment and care is the cost of care and prescription drugs, mental screening and the hiring and retraining employee’s to be able handle inmates who are mentally ill. Community treatment programs cost an about $60 a day for each inmate, while incarcerating a mentally ill individual can cost up to $137 per day. Also, the cost of prescription drugs has increased significantly in the last decade. “A report published by New Hampshire on inmate health care cited pharmaceutical costs as one of the major factors for its corrections health care costs increase between 1998 and 2002. The report found that the state’s cost for pharmaceutical products more than doubled in five years and the average cost for pharmaceuticals per inmate increased by 48 percent.” (Medical News Today 2018).
Inconsistency is one of the biggest reasons for screening and failure to give treatment. Many inmates that are mentally ill have gone undiagnosed and treated. Consistency is vital to treatment for anyone who suffers from a mental illness. By not receiving treatment it can cause the inmates to act out of their normal behaviors or worsen their mental state. Suicide is one of the leading causes of deaths in state and federal prison. The responsibility of suicide prevention is on the health staff, and there’s barely staff equipped or trained to delivery those services.
Training on mental health issues should be provided to all people involved in prisons including prison administrators, guards and health workers. Training should expand the staff’s understanding of mental disorders, raise awareness on the rights of the mentally ill, and change the stigmatizing attitudes. An important part of training for all prison staff should be the recognition and prevention of suicides. Being able to identify someone who is mentally ill and knowing how to approach that individual and deescalate the situation.
According to Psychiatry Advisor researcher Joseph Galanek spent nine months in an Oregon maximum-security prison to learn first-hand how the prison manages inmates with mental illness. He discovered, “through 430 hours of prison observations and interviews, is that inmates were treated humanely, and security was better managed when cell block officers were trained to identify symptoms of mental illness and how to respond to them. In the 150-year-old prison, he discovered officers used their authority with flexibility and discretion within the rigid prison structure to deal with mentally ill inmates. (Medical News Today 2018) That case study proves the theory that with appropriate policies and staff training the mental health needs of prisoners with severe mental illness can be addressed in the correct manner.
Addressing the mental health needs of prisoners can help be a main factor in decreasing the likelihood of re-offending and reduce the number of people who return to prisons. By diverting people with mental disorders away from jails and into treatment facilities will ultimately reduce the high costs of housing a mentally ill prisoner. Jails are currently overcrowded by diverting the mentally ill it’ll reduce the number of inmates and allow room for individuals who truly need to be there.
The proper treatment for mental illnesses should be a part of the public health goals within prisons. There are many effective treatments for mental disorders, but the resources are often limited for an inmate. Addressing the mental health issues in prisons not only benefits the individual; but also, the prison population. By educating and understanding the problems faced by those with mental disorders, the stigma and discrimination can be reduced. Ultimately, providing treatment to prisoners with mental disorders increases the chances that upon release of prison they will be able to adjust to community life.
References
- Mind – How Common are Mental Health Problems?
- National Center for Biotechnology Information – Mental Illness in Prison: Inmate Rehabilitation & Reintegration
- National Center for Biotechnology Information – The Treatment of Prisoners with Mental Illness
- National Center for Biotechnology Information – The Prevalence of Mental Illness in Prison
- National Center for Biotechnology Information – Mental Health in Prisons: Inmate Characteristics and Service Use
