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April 9, 2014

Reviewing how US prisons now serve as huge warehouses for the mentally ill

This MSNBC article, headlined "Prisons are the ‘new asylums’ of the US: Report," effectively summarizes a new study documenting that that US prisons now "house ten times more people with mental illnesses than its hospitals." Here is more:

The report, released Tuesday by the Treatment Advocacy Center, found that state prisons and county jails house approximately 356,268 people with mental illnesses, while state mental hospitals hold only 35,000. The disparity is also a nationwide problem – only six states have psychiatric hospitals with more people in them than a prisons or jail.

Prisons, according to the report, have become the nation’s “new asylums.” The number of beds available at hospitals for mental health patients has been dropping for decades. And as the population of incarcerated people has exploded, so has the number of people with serious problems....

The report provided a breakdown of the number of mentally ill prisoners in each state’s correctional facilities, the laws governing treatment, and examples of how inmates are treated. Among others, they include a Mississippi prison designed for mentally ill inmates, overrun by rats, where some prisoners capture the rats, put them on makeshift leashes, and sell them as pets to other inmates. There was also a case in which a schizophrenic man spent 13 of 15 of his years in prison in solitary confinement....

“Inmates who linger untreated in jails and prisons become increasingly more vulnerable to their symptoms and the resulting victimization or violence,” the report read. Dr. E. Fuller Torrey, founder of the Treatment Advocacy Center and lead author of the study, said in a statement, “The lack of treatment for seriously ill inmates is inhumane and should not be allowed in a civilized society.”...

The report’s authors admit that reducing the number of mentally ill inmates in jails would have to come along with a massive recommitment to high-quality mental health care in hospitals – a tall order in this age of austerity. In the interim, they advocate for more outpatient treatment and jail diversion programs, as well as more planning, both when inmates enter the system and leave it.

The full report released by the Treatment Advocacy Center is titled "The Treatment of Persons with Mental Illness in Prisons and Jails: A State Survey," and it can be accessed in full at this link.

April 9, 2014 at 01:59 PM | Permalink


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Mad Prisoners are the ‘new victims’ of US Society
"warehouses for the mentally ill"?
"vulnerable to their symptoms and the resulting victimization..."?

-- Perhaps better stated as /criminals, who have a mental illness designation of some sort/.
The "mental illness" may have nothing to do with the crime; the judge or jury
found said mentality insufficient to excuse the crime(s).

Posted by: Adamakis | Apr 9, 2014 4:33:39 PM

Adamakis, I don't think I can describe your comment as anything but deliberately ignorant. As you must know, just because a defendant cannot make out the legal defense of insanity (typically a very high bar requiring that the defendant did not understand the nature of the criminal act) does not mean that his mental illness was not a significant contributing factor to his crime. Moreover, for defendants who waive their jury trial right and plead guilty, no judge or jury will ever decide whether their mental illness should excuse their wrongdoing.

Posted by: Curious | Apr 9, 2014 4:48:28 PM

Not sure about the "new" -- the numbers just are a bit more noticeable perhaps given drop-off (going by the article) in other areas. The typical mental ill person, to guard against stereotyping, is more likely victim than aggressor. But, taking the overall subset of those who break the law, there was always a subset that was mentally ill, for a variety of reasons. Prisons always contained among everyone else this sort of individual, who were "warehoused" there. This is true also given the very hard "not guilty by reason of insanity" (or similar sentence) even if the person has some mental illness all the same.

Posted by: Joe | Apr 9, 2014 5:59:01 PM

The comments from the article linked from my name are highly relevant
..... State psychiatric hospitals began closing en masse 50 years ago amid deinstitutionalization, a shift to community-based treatment. But a persistent lack of funding for mental health services has left many without needed support. As a result, people with serious mental illness often wind up homeless or cycle in and out of jail.
The Great Recession worsened the problem. States cut more than $4 billion from mental-health budgets from 2009 to 2012, eliminating thousands of in-patient psychiatric beds, according to a 2012 report by the National Association of State Mental Health Program Directors.
Now officers spend a disproportionate amount of time on mental health calls, said Michael Biasotti, who has studied the impact of deinstitutionalization.
"If I could make one recommendation, it would be to prevent individuals from deteriorating to the point where law enforcement becomes involved. Return care and treatment of the most seriously ill back to the mental health system," Biasotti, the police chief in New Windsor, N.Y., told a U.S. House panel last month."

Posted by: peter | Apr 10, 2014 3:14:07 AM

1. “ “ does not mean that his mental illness was not a significant contributing factor to his crime ” ”
 .......... Did not Gacy, Bundy, Hasan etc. have “mental illness” according to your definition?
So yours is a characterisation of generic “defendants”, which conveniently rescues a category
of criminals from fair adjudication and punishment, the most egregious encompassed.

2. “ “ Moreover, for defendants who waive their jury trial right and plead guilty …” ”
.......... So, once again, the “illness” is responsible for the disposition of the guilt phase, as though the “illness” mandated a particular plea. Too funny.

3. “ “ no judge or jury will ever decide whether their mental illness should excuse their wrongdoing.” ”
.......... No, but you apparently will, because you know better, and punishment is retribution.

Posted by: Adamakis | Apr 10, 2014 8:59:44 AM

Adamakis, I didn't say that a defendant with a mental illness shouldn't be prosecuted or punished. I simply noted that your skepticism toward the article, based on the availability of the insanity defense, is completely off-base. The problem of mental illness in our society, and in our prison system, is an important and troubling one. We must punish criminals but at the same time we can and should attempt to improve the delivery of mental-health services to those in need so that we can prevent crimes before they even occur. Better to treat a mentally-ill person before he commits a crime, than to wait until he does and punish him after. Better as well to treat prisoners with mental-health issues so that they are less likely to reoffend upon release. Your attempt to write this off is, I think, a pretty sad example of play-acted toughness for the sake of toughness.

Posted by: Curious | Apr 10, 2014 11:13:16 AM

|| “The disparity is also a nationwide problem – only six states have psychiatric hospitals with more people in them than a prisons or jail.”||
1)----- Ooh, disparity! And once psychiatric facilities outpace prisons or jail, what a wonderful world that would be.

Actually, if an innocent person were forced to prison or jail, that would be an immoral and unconstitutional atrocity.
A generic comparison of numbers and a subsequent gripe, however, is infantile thinking, akin to complaining that
Laotian immigrants have a higher per capita income than Mexican immigrants. Oh the disparity!

|| “they advocate for more outpatient treatment and jail diversion programs”; “before he commits a crime” -- Curious ||
2)----- More diversion for “mentally ill” convicts? Why do they earn this diversion from equal treatment and justice?
If one fancies prevention, then discourage and decry marijuana and other addictive dangers,
which are so prominently associated with crime.

|| “Studies on the cost of incarcerating mentally ill people, the study said, ..” ||
1)----- I advocate for dole recipients to be drug tested, and for benefits not be used to reward fathering or mothering children without both parents.

My scepticism is due to the vacuous and monolithic content.
One chooses to mindlessly lap it up.
Better yet, one could shed his bias and critically evaluate it.

Posted by: Adamakis | Apr 10, 2014 1:54:54 PM

Dunning-Kruger Effect much?

Posted by: ungrateful.biped | Apr 10, 2014 2:01:25 PM

The whole issue of mental illness and crime is a morass from which there is no escape. We call it "mental illness" but the primary markers of many of the "disorders" in the DSM are not mental at all but social. Psychology has allowed mental illness, social deviance, and crime to become conflated under the well-intentioned guise of helping the patient. The result is that there is not even any agreement between psychology and the law--what is the difference between mental illness and crime, anyway? Should anyone care?

Posted by: Daniel | Apr 10, 2014 3:19:51 PM

I have to admit this is one thing Europe used to get right. They first decide if you committed the crime. THEN they decide if your normal and go to a regular prison or have a mental problem and go to a prison for the criminally insane.

Posted by: rodsmith | Apr 11, 2014 2:58:46 PM

Antisocial Personality Disorder is a highly validated diagnosis, and for 150 years. It has a physical sign, less response to the Cold Pressor Test. It is a defect, and what is missing will never be replaced. It is associated with criminality, and massive costs, like a natural disaster. It should not be counted as a mental illness in prison. It is associated with charm, and superior manipulative skills.

Nor should addiction be counted as a mental illness for this discussion.

Limiting the term to psychosis (voices, delusions, forma thought disorder), and mood disorder, about a third of jail beds are filled with straight psych patients. Many committed nuisance crimes, with low bails, that no one is paying. That is because they cannot be on the loose outside. Jail costs are a tenth those of a hospital.

So this seeming failure is actually an area of success. Most jails have good psychiatric coverage, adequate treatment rates, and the mental patients are doing quite well within the structure of their walls.

Posted by: Supremacy Claus | Apr 12, 2014 6:32:08 AM

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