There will probably be a lot of anger and indignation about the recently released Department of Justice report on the state of mental health in our nation's prisons. To anyone who has worked in the prison system, known a former inmate or even driven by a penitentiary though, this "new" information should come as little surprise. Depression, bipolar disorder, schizophrenia and many other mental health disorders have plagued convicts for as long as there has been prisons. Beyond that a lack of depression treatment and, indeed, much of any treatment at all, has led to a suicide rate among incarcerated individuals that is significantly higher than that of the American public.
The numbers themselves are pretty outrageous. From the LA Times:
More than half of the nation's jail and prison inmates suffer from mental health problems...
Based on a representative survey of more than 25,000 prisoners nationwide, the report found that mental health problems were associated with an inmate's violence and prior convictions. Those state prisoners with mental problems were more likely to have had at least three prior incarcerations and to have had broken prison rules.
Mentally ill inmates also were twice as likely as other convicts to have been injured in a prison fight, and substantially more likely to have been abused as a child and homeless in the year before their arrest. Three out of four were dependent on drugs and alcohol, with 37% saying that they used drugs at the time of their crime.
In 2006 PBS's premier news program Frontline won the Robert F. Kennedy Journalism Grand Prize for their piece entitled "The New Asylum" (it can be viewed in its entirety here). The program examines the plight of the mentally ill in the prison system. Since the policy shift that closed down many of the government run and funded mental institutions, prisons and jails have become the de facto facilities for holding those with any of a wide range of mental problems. On any given day, the Los Angeles County Jail, the Cook County Jail (Chicago) and Riker's Island (New York City) each hold more people with mental illness than any hospital in the United States. Often comorbid drug addiction, sometimes a symptom in and of itself, has landed individuals there, sometimes its violent crimes, sometimes it's something as small as simple assault. The trouble is that once inside, and very often lacking any form of treatment, these mentally ill convicts will enter a vicious cycle that will see as many as 80% commit more crime once they are freed.
While PBS's website has a wealth of information including an interactive US map and answers to many frequently asked questions, most of their research was based on the DOJ report that proceeded the one released this week. That report was dated 1999 and its statistics don't paint nearly as poor a picture as today's. As with many of the problems facing our healthcare system, this clear deficiency in care provides a perfect opportunity for new technologies and strategies to fill a need. Clearly, the policy of always jailing the mentally ill is not in the best interests of the offender or society in general. We need to be looking at a broad range of sentencing and treatment options once a criminal has been identified as having a mental illness. In many of these cases, especially those of low severity, treatment would make imprisonment unnecessary. Programs like the Criminal Justice/Mental Health Consensus Project have begun the hard work of bringing change to a faulty system. But there is, as this new report shows, still much necessary improvement.
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