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September 6, 2022

"Have American jails become the inferior replacement for mental hospitals?"

The question in the title of this post is the headline of this new Salon piece.  Here are a few excerpts:

London's Bedlam psychiatric hospital is infamous today for how its staff brutally abused their patients....

Things are arguably better for mentally ill people in 21st century America.  Yet a new study by George Mason University's Schar School of Policy and Government, and published in the medical journal BMC Health Services Research, suggests that any improvement may not be as great as we'd like to think.  At present, there are 10 times as many people with mental illnesses in jails and prisons than in state psychiatric hospitals.  In other words, we've substituted jails for treatment facilities. 

Niloofar Ramezani, assistant professor of statistics at George Mason University and corresponding author of the study ... believes that the study's "most important finding," is that "one should focus on building up the community's capacity to provide mental health services."  Ramezani pointed out that their study also found that "after accounting for the availability of mental health care services, the size of the violent crime problem no longer has an effect to how the jail is used."  American society is filling up its jails with mentally ill individuals in a way that, quantifiably, cannot be plausibly linked to any kind of meaningful violent crime problem....

"We've known for some time that this country's chief response to serious mental illness is incarceration, a fact that stands out because prisons are so clearly unsuited to treating mental illness," Wanda Bertram, Communications Strategist at Prison Policy Initiative, told Salon by email.  "Our organization recently found that even though 43% of people in state prisons have been diagnosed with a mental disorder, only 26% have received some form of mental health treatment, and only 6% are currently receiving treatment."...

Ramezani and the study's other co-authors ultimately argue, as Ramezani put it to Salon, that "more research needs to be done on the type of individuals with mental health issues who are incarcerated and how they are handled.  Once we know more about them, their mental health journey, and how their mental health condition is changing over time while incarcerated, we can find better solutions to provide helpful support to them if they end up in jail."

In addition to doing more research, American policymakers need to exercise the "political will" necessary to address mental health issues in a humane and effective way.

September 6, 2022 at 03:01 PM | Permalink


"Nobody's Bad, Everybody's Sick," Vol. Eight Zillion and one.

Posted by: Bill Otis | Sep 6, 2022 8:19:42 PM

Bill - Why can't you try to be more supportive of efforts to be more humane and try to help people desist from crime instead of being so cold-hearted?

Posted by: Brett Miler | Sep 6, 2022 9:26:23 PM

Brett --

Because the routine claim that everyone's sick and no one's bad is a point-blank lie. Pretending that there is no such thing as greed or wanting a quick buck is just nonsense. The defense bar itself believes no such thing, and endlessly sings that song simply because telling the truth is not something they care to do.

It is not up to society to play the humble servant to criminals in the hope that they'll change their behavior if we're nice enough. It's up to them to change their own behavior.

Posted by: Bill Otis | Sep 6, 2022 10:24:36 PM

Those of us practicing as prosecutors at the state level see a lot of defendants with mental health issues. It is hard to say what part of their criminal conduct is related to mental health.

What is clear is that, when we moved away from big warehouse that housed the mentally ill without providing much treatment, we failed to fund a replacement system that could provide mental health in the community. Given that lack of resources, we do not have many viable alternatives to incarceration for an inmate who is guilty (i.e. the mental illness does not prevent them from knowing right from wrong) but mentally ill. There are certainly cases where I would welcome such an alternative.

Posted by: tmm | Sep 6, 2022 10:35:38 PM

Bill -
If society tried to "play the humble servant" and tried to ameliorate the conditions that lead to criminal behavior (poverty, abuse/neglect, trauma) I think it would be money well spent - much better spent than on prisons. Brett Miler

Posted by: Brett Miler | Sep 7, 2022 8:33:39 AM

Brett --

You're living in a dream world. Brian lesions account for a miniscule amount of crime. The "root causes" are what they've always been: greed, a me-first attitude, unwillingness to work or defer gratification, and lack of empathy for victims.

Tell me, is it just criminals who're never responsible for what they do, or do the rest of us get the lifetime "it's-not-my-fault" pass as well?

Posted by: Bill Otis | Sep 7, 2022 5:10:04 PM

Bill - It's not that I believe that criminals are not responsible, I just believe that if we were more empathetic and compassionate towards them we might achieve more than if we pursue "tough on crime" policies that fill prisons but fail to meet the needs of the inmates who are behind bars and thus reoffend again. You seem to point to "the rest of us" in opposing soft sentences but a society who tries to meet the needs of all of it's citizens will be safer in the long term. Brett Miler

Posted by: Brett Miler | Sep 7, 2022 6:11:00 PM

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