FacebookTwitterGoogle+RedditEmail

Prisons as Mental Institutions

by JOANNE MARINER

U.S. prisons and jails, packed with over two million inmates, hold many people that society would be wise to keep elsewhere. With state budgets bankrupted by the high costs of mass incarceration, the need to reconsider the draconian sentences meted out to nonviolent drug offenders has never been more obvious.

There is, moreover, another sizeable group of prisoners for which wholesale imprisonment is even less appropriate: the mentally ill. Prisoners with mental illness frequently endure violence, exploitation and extortion at the hands of other inmates, and neglect and mistreatment by prison staff. Not only is the experience of imprisonment counter-therapeutic for such prisoners, many mental health experts believe that it dramatically increases their chances of psychiatric breakdown.

Despite good reasons to limit the incarceration of the mentally ill, their numbers behind bars continue to grow. Over the past few decades, the country’s prisons and jails have become the default mental health system. Somewhere between two and four hundred thousand mentally ill people are incarcerated, several times more than the number of people living in mental institutions.

The results, from a therapeutic, humanitarian, and human rights perspective, are appalling. “We are literally drowning in patients,” explains one California prison psychiatrist, “running around trying to put our fingers in the bursting dikes, while hundreds of men continue to deteriorate psychiatrically before our eyes.”

“Criminalizing” the Mentally Ill

The American Psychiatric Association, in a study published in 2000, concluded that as many as one in five prisoners was seriously mentally ill, with up to 5 percent being actively psychotic at any given moment. It also estimated that over 700,000 mentally ill people were processed through prison or jail each year. The mental disorders affecting these prisoners include such serious illnesses as schizophrenia, bipolar disorder, and major depression.

There are no national data on historical rates of mental illness among prisoners, but state information suggests that the proportion of mentally ill prisoners has grown significantly. Human Rights Watch, in a report published last week, traces this increase to the inadequacy of the country’s mental heath services.

With the “deinstitutionalization” effort that began in the 1960s, hundreds of thousands of mentally ill men and women were released from state institutions. These people escaped grim conditions and sometimes brutal treatment. They largely did not, however, obtain proper care after their release. Rather than receiving continuing mental health treatment, mentally ill people were released to communities that had made little or no accommodation for their care.

While states cut funding for mental hospitals, they did not make commensurate increases in the budgets for community-based mental health services. Chronically underfunded, the country’s mental health system does not reach anywhere near the number of people who need it.

Left untreated and unstable, mentally ill people enter the criminal justice system when they break the law. And given the punitive criminal justice policies of the past few decades, they often face long stays behind bars.

Neglect and Abuse

In a series of disturbing passages, the recent Human Rights Watch report described the abuses endured by the mentally ill while incarcerated.

To begin with, few prisons or jails have sufficient numbers of trained staff to accommodate prisoners’ mental health needs. As a result, many mentally ill prisoners go untreated, or receive treatment that is extremely limited in both quantity and quality.

From other prisoners, who label them “dings” or “bugs,” the mentally ill are vulnerable to assault, sexual abuse, exploitation, and extortion. From security staff, who frequently dismiss their symptoms as faking or manipulation, they may face physical abuse and mental harassment. Human Rights Watch cited numerous cases of correctional officers who taunted mentally ill prisoners, deliberately provoked them, physically mistreated them, used force against them maliciously, or turned a blind eye to abuses against them by others.

Viewing mentally ill prisoners as difficult and disruptive, correctional staff also frequently place them in barren high-security solitary confinement units. Held in small, sometimes windowless cells, these inmates are deprived of nearly all human interaction and have extremely limited mental stimulus.

In such harsh conditions, some mentally ill prisoners deteriorate so severely that they must be removed to hospitals for acute psychiatric care. But after their condition stabilizes, they are frequently returned to the same segregation units until the next psychiatric episode occurs.

The Need for Reform

The immeasurable human suffering caused by the mass incarceration of the mentally ill is not only inhumane, it is unnecessary. While some dangerous offenders must be confined to protect society, there are many low-level, nonviolent offenders with mental illness who could be safely diverted into community-based mental health treatment programs. By reducing the overall number of mentally ill prisoners, such programs would also free up prison resources that could be used to remedy the generally low quality of prison mental health care.

Federal legislation is currently pending in Congress to institute such reforms. The bill, called the Mentally Ill Offender Treatment and Crime Reduction Act, would provide federal grants to divert mentally ill offenders into treatment programs rather than prison or jail. It would also allocate funding to improve the quality of prison and jail mental health services, and to establish discharge programs for mentally ill prisoners who are released.

It is national shame that our prisons and jails serve as mental institutions. It reflects a lack of planning, a failure of public commitment, and a single-minded focus on punishment. The pending legislation, which is long overdue, represents a saner and more compassionate approach.

JOANNE MARINER is a human rights lawyer. This article is based on Human Rights Watch’s just-released report, “Ill-Equipped: U.S. Prisons and Offenders with Mental Illness,” which was written by Sasha Abramsky and Jamie Fellner. She can be reached at: mariner@counterpunch.org

 

JOANNE MARINER is a human rights lawyer living in New York and Paris.

More articles by:
Weekend Edition
July 29, 2016
Friday - Sunday
Michael Hudson
Obama Said Hillary will Continue His Legacy and Indeed She Will!
Jeffrey St. Clair
She Stoops to Conquer: Notes From the Democratic Convention
Rob Urie
Long Live the Queen of Chaos
Ismael Hossein-Zadeh
Evolution of Capitalism, Escalation of Imperialism
Margot Kidder
My Fellow Americans: We Are Fools
Ralph Nader
Hillary’s Convention Con
Lewis Evans
Executing Children Won’t Save the Tiger or the Rhino
Vijay Prashad
The Iraq War: a Story of Deceit
Chris Odinet
It Wasn’t Just the Baton Rouge Police Who Killed Alton Sterling
Brian Cloughley
Could Trump be Good for Peace?
Patrick Timmons
Racism, Freedom of Expression and the Prohibition of Guns at Universities in Texas
Gary Leupp
The Coming Crisis in U.S.-Turkey Relations
Pepe Escobar
Is War Inevitable in the South China Sea?
Norman Pollack
Clinton Incorruptible: An Ideological Contrivance
Robert Fantina
The Time for Third Parties is Now!
Andre Vltchek
Like Trump, Hitler Also Liked His “Small People”
Serge Halimi
Provoking Russia
David Rovics
The Republicans and Democrats Have Now Switched Places
Andrew Stewart
Countering The Nader Baiter Mythology
Rev. William Alberts
“Law and Order:” Code words for White Lives Matter Most
Ron Jacobs
Something Besides Politics for Summer’s End
David Swanson
It’s Not the Economy, Stupid
Erwan Castel
A Faith that Lifts Barricades: The Ukraine Government Bows and the Ultra-Nationalists are Furious
Steve Horn
Did Industry Ties Lead Democratic Party Platform Committee to Nix Fracking Ban?
Robert Fisk
How to Understand the Beheading of a French Priest
Colin Todhunter
Sugar-Coated Lies: How The Food Lobby Destroys Health In The EU
Franklin Lamb
“Don’t Cry For Us Syria … The Truth is We Shall Never Leave You!”
Caoimhghin Ó Croidheáin
The Artistic Representation of War and Peace, Politics and the Global Crisis
Frederick B. Hudson
Well Fed, Bill?
Harvey Wasserman
NY Times Pushes Nukes While Claiming Renewables Fail to Fight Climate Change
Elliot Sperber
Pseudo-Democracy, Reparations, and Actual Democracy
Uri Avnery
The Orange Man: Trump and the Middle East
Marjorie Cohn
The Content of Trump’s Character
Missy Comley Beattie
Pick Your Poison
Kathleen Wallace
Feel the About Turn
Joseph Grosso
Serving The Grid: Urban Planning in New York
John Repp
Real Cooperation with Nations Is the Best Survival Tactic
Binoy Kampmark
The Scourge of Youth Detention: The Northern Territory, Torture, and Australia’s Detention Disease
Kim Nicolini
Rain the Color Blue with a Little Red In It
Cesar Chelala
Gang Violence Rages Across Central America
Phillip Kim et al.
Open Letter to Bernie Sanders from Former Campaign Staffers
Tom H. Hastings
Africa/America
Robert Koehler
Slavery, War and Presidential Politics
Charles R. Larson
Review: B. George’s “The Death of Rex Ndongo”
July 28, 2016
Paul Street
Politician Speak at the DNC
FacebookTwitterGoogle+RedditEmail