Introduction
The current society often locks up thousands of people with various mental health conditions in solitary confinement. These conditions comprise of delusional disorders, severe depression, schizophrenia, and other mental conditions. Whereas some people engaged in violent crimes and present threats to themselves, prison staff, and other inmates, most are imprisoned for minor offenses since there is no place they can receive treatment. The recent years have witnessed a growing number of mentally ill inmates with states closing their psychiatric hospitals to support outpatient community health centers, which are usually overcrowded and underfunded. In an effort to minimize the flooding of mentally ill inmates, around 300 courts that specialize in mental health have diverted them to treatments that courts monitor as opposed to jails. However, most participants re-offend while various experts argue psychiatric treatment alone would not deter criminal behavior. Meanwhile, courts in over half-dozen states have argued that solitary confinement of people with mental illness is unconstitutional. However, some experts claim solitary is crucial to isolate dangerous inmates (CQPress, 2015). The paper discusses the issues surrounding prisoners with mental illness and ideal courses of action.
Background
The corrections system has witnessed the increasing prevalence of serious mental illnesses to the extent that prisons and jails are now referred to as “the new asylums. Today, more individuals with severe mental illnesses are in jail or prison in 44 states compared to those housed in the biggest psychiatric state hospitals. However, states have lost over $4 billion in treatment finances during the past few years, forcing them to shrink or close mental health hospitals and clinics (Davoren et al., 2015). The issue has led to more mentally ill inmates ending up in prisons and jails while the trends continue to worsen due to the inability of corrections officials in coping with them. Studies reveal that the Los Angeles County Jail, New York’s Riker’s Island Jail and Chicago’s Cook County Jail each hold more inmates with mental illnesses than any existing psychiatric hospital within the United States. Overall, estimates reveal that around 15 percent of inmates in state prisons and 20 percent of inmates in jails have a mental illness (Hopkin, Evans-Lacko, Forrester, Shaw, & Thornicroft, 2018). The figures reveal the worrying trends of the cases mentally ill individuals landing in prison.
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The growing number of mentally ill inmates, together with ways of treating their conditions while holding them responsible for their offenses and maintaining prison safety, is receiving growing attention from psychiatric experts and criminal justice. Mental health advocates claim that budget cuts in mental health services at community levels have led courts and the police to lock up many troubled people in prisons and jails, which lack adequate equipment to treat them. Also, numerous inmates are placed in solitary confinement inappropriately, exacerbating or causing mental problems. However, certain experts claim just a minority of offenses that mentally ill people commit result from their illness, citing other forces, including affiliating with criminals and using drugs. Thus, they contend that treatment alone would not hinder mentally ill criminals from returning to prison or jail (CQPress, 2015). Meanwhile, the unions in support of prison guards defend the utilization of solitary confinement as crucial to prevent inmates from posing dangers to themselves and others.
Issues
Various issues surround the prisoners with mental illnesses, which worsens their conditions even more. For instance, studies claim that mentally ill inmates remain in prison or jail longer compared to other prisoners. In Orange County Jail, Florida, inmates stay in jail for an average of 26 days, whereas for mentally ill patients, it is around 51 days. When it comes to New York’s Riker’s Island, inmates stay in prison for an average of 42 days, whereas mentally ill patients remain in jail for about 215 days (Fazel, Hayes, Bartellas, Clerici, & Trestman, 2016). The major reason for incarcerating the mentally ill prisoners longer compared to other prisoners revolves around the fact that they face challenges in following and understanding prison rules. For example, a certain study revealed that jail inmates were about twice as likely to be charged with violating rules within the facility. An additional study undertaken in prisons from Washington State suggested that mentally ill patients accounted for approximately 42 percent of violations despite comprising of just 19 percent of the population in prisons (Haney, 2017). Also, pretrial inmates having severe mental illnesses face extended incarcerations compared to prisoners in many states if they need restoration or evaluation of fitness to stand trial. According to a 2015 study by state hospital officials, around 78 percent of the 40 responding states waitlisted pretrial prisoners for hospital serves. The waits range for 30 days in various states, while others can have waits that range between six months and one year (Fazel, Hayes, Bartellas, Clerici, & Trestman, 2016). Experts argue that inmates with mental illnesses in certain states spend considerable amounts of time waiting for competency restoration to ensure they can be tried compared to the time they would spend in prison for an offense they are charged.
An additional issue facing mentally ill inmates revolves around the behavioral management problems they create, which contribute to their isolation. Due to the impaired thinking of the mentally ill prisoners, most of them with severe conditions present problems with behavioral management. This serves as a major force behind their over-representation in a subset of inmates in solitary confinement. In Wisconsin, for instance, an audit carried out in three state prisons found that from 55 percent to 76 percent of prisoners in isolation were mentally ill (Davoren et al., 2015). Also, other issues surrounding mentally ill patients is that their chances of committing suicide are considered high. Studies reveal that suicide is among the major death causes in correctional facilities. Many individuals claim that between 15 percent and 20 percent of prisoners with severe mental health illnesses commit about half of the inmate suicides (Haney, 2017). Washington State revealed the pervasiveness of mental illness among prisoners who tried suicide was around 77 percent compared to 15 percent among prisoners in the general jail population (CQPress, 2015). Most claim that the increased rates of suicides among mentally ill inmates emanated from the decision of coercing such individuals behind bars.
Actions
Due to the worsening issues surrounding the increased cases of mentally ill patients, it would be crucial to adopt certain actions to minimize the severity of the effects. Firstly, it would be crucial to emphasize on ensuring that good service are readily available for individuals with psychotic illnesses. Good care support and planning allow individuals with mental illnesses and their families and supports persons to plan for times when symptoms become worse and receive the right support and care early before the involvement of the police (Hopkin, Evans-Lacko, Forrester, Shaw, & Thornicroft, 2018). Responsive, sensitive, and well-resourced services, elimination of stigma, and social inclusion policies among the strategies that would improve the outcomes for individuals with mental illness, minimize symptoms, and ensure the society becomes safer. A second strategy should be to ensure mental health individuals do not participate in the criminal justice system by offering strong services, income support, good housing, and addressing poverty. It would also be vital to address the prevalence of drug use within society. Thirdly, when individuals with mental health conditions enter the criminal justice system, society has the responsibility of offering the needed care and support (Davoren et al., 2015). The police who usually handle incidences of mental health issues require support and training from the mental health sector to assist individuals during a crisis.
In case the crime is minor and affiliated with mental health issues, diverting the people to mental health services would be the ideal option. If persons are presently unwell, courts should ensure to undertake a forensic psychiatric assessment early to ensure the person is evaluated on whether fit to follow a court process. If the mentally ill individuals enter the correctional system, three responsibilities exist (Davoren et al., 2015). Firstly, individuals should be screened for mental health problems and distress, since many people are reluctant to come forward for assistance or do not understand help is available. Secondly, they should receive mental healthcare ideal for their care while supporting them during the incarceration process. Thirdly, there would be a need for supporting the mentally ill inmates during their release process and their re-integration into the society (Hopkin, Evans-Lacko, Forrester, Shaw, & Thornicroft, 2018). The process would require tackling issues, such as financial support, housing, connection with community mental health services (medical and support), and social and family support. Probation, bail, and parole services should match those needs.
Conclusion
In conclusion, the current society often locks up thousands of people with various mental health conditions in solitary confinement. The loss of treatment finances during the past few years by states has forced forcing them to shrink or close mental health hospitals and clinics. The issue has led to more mentally ill inmates ending up in prisons and jails while the trends continue to worsen due to the inability of corrections officials in coping with them. The growing number of mentally ill inmates, together with ways of treating their conditions while holding them responsible for their offenses and maintaining prison safety, is receiving growing attention from psychiatric experts and criminal justice. Also, mentally ill inmates face certain issues, such as remaining in prison or jail longer compared to other prisoners, the behavioral management problems they create, and increased chances of committing suicide. Thus, the provision of good services, including income support, good housing, addressing poverty, and diverting the people to mental health services would be the right approach toward dealing with the challenge of mentally ill inmates in the society.
References
CQPress. (2015). Prisoners and mental illness. CQ Researcher, 25 (11), 241-264.
Davoren, M., Fitzpatrick, M., Caddow, F., Caddow, M., O’Neill, C., O’Neill, H., & Kennedy, H. G. (2015). Older men and older women remand prisoners: mental illness, physical illness, offending patterns and needs. International Psychogeriatrics, 25 (7), 747-755.
Fazel, S., Hayes, A. J., Bartellas, K., Clerici, M., & Trestman, R. (2016). Mental health of prisoners: Prevalence, adverse outcomes, and interventions. The Lancet Psychiatry, 3 (9), 871-881.
Haney, C. (2017). “Madness” and penal confinement: Some observations on mental illness and prison pain. Punishment & Society, 19 (3), 310-326.
Hopkin, G., Evans-Lacko, S., Forrester, A., Shaw, J., & Thornicroft, G. (2018). Interventions at the transition from prison to the community for prisoners with mental illness: A systematic review. Administration and Policy in Mental Health and Mental Health Services Research, 45 (4), 623-634.
