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August 13, 2007

The intersection of mental illness and mass incarceration

Among lots of good new stuff at Corrections Sentencing is this post spotlighting this new Time piece discussing the reality that much of the nation's mental health treatment takes place in prison settings.  Here is an excerpt:

Prisons ... have become the nation's "de facto" mental health care provider.  According to the Federal Bureau of Justice Statistics, there are currently 1.25 million inmates..., with debilitating disorders ranging from schizophrenia to post-traumatic stress disorder, abandoned in the U.S. prison system instead of receiving treatment in hospitals.

"If you think health care in America is bad, you should look at mental health care," says Florida state judge and criminal mental health expert Steve Leifman. More Americans receive mental health treatment in prisons and jails than hospitals or treatment centers. In fact, the country's largest psychiatric facility isn't even a hospital, it's a prison — New York City's Rikers Island, which holds an estimated 3,000 mentally ill inmates at any given time.  Fifty years ago, the U.S. had nearly 600,000 state hospital beds for people suffering from mental illness.  Today, because of federal and state funding cuts, that number has dwindled to 40,000. When the government began closing state-run hospitals in the 1980s, people suffering from mental illness had nowhere to go.  Without proper treatment and care, many ended up in the last place anyone wants to be.

August 13, 2007 at 10:09 PM | Permalink


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The prevailing attitude in our community was that mentally ill persons did not belong in jail. But they were there because there was no alternative. The sheriff would send mentally ill inmates to the psychiatric hospital and they would stabilize them and send them back to jail because they did not have room for them. The most frustrating aspect of this problem is the family and the police would cooperate and try to get the individual committed and the magistrate would not agree to commit even though he new the police would arrest the individual and put them in jail.

Because of a lot of hard work by a number of persons we now have a mental health diversion program at our jail. The idea is to move them from jail to a community treatment program and set up a support system so they will stay on their medication. The plan is to eventually have a response team similar to the one described in the Time article. What has happened is that staff that were hired to do this program have become a community resource for law enforcement and corrections.

Sheriffs from all over the state call our sheriff and ask him how he was able to start such a program. I doubt he would have one if there had not been broad support from the community.

So far what we have accomplished is to reduce the time the mentally ill are in jail and reduce the probability they will return to jail. What we really need to do is keep them from being arrested in the first place so it is a mental health issue only and the criminal justice system is not involved.

Posted by: JSN | Aug 13, 2007 11:58:27 PM

Last year, the Columbus Dispatch reported the story of a mentally ill man who was due to be released from the Franklin County Jail in Columbus. Apparently both his family and his a social worker involved with his case had expressed willingness to pick him up and asked to be notified of the time of his release. Instead, jail authorities released him at night without telling anyone. The man wandered to a construction site, went to sleep, and froze to death. Jail authorities stated that they weren't in a position to notify families when people were being released. This doesn't have to happen. It is great to see that at least one community is working reduce the involvement of the mentally ill with the criminal justice system.

Posted by: disillusioned layman | Aug 14, 2007 8:25:15 AM

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