When you have a physical illness, injury, or disorder, most of the time treatment is simple. You go to a hospital or doctor and they use medicine or pharmaceuticals to treat your symptoms. Yet, what if your disorder affects your brain, your mood, thinking, and behavior. For these illnesses and disorders the treatment path is complicated and most of the time non-existent. In the past, the US has tried to battle mental illness through psychiatric institutions, but the lack of knowledge on how to treat the ill led the institutions to experimental and inhumane treatments so they were shut down. Today, the path for the mentally ill heads directly to prisons where they are criminalized simply for having an untreated mental illness.
My interest for this issue spurs from learning about the injustices the mentally ill face, especially homelessness and imprisenment, from my church. I was shocked when I learned that more than 40% of prison inmates have a mental illness, whereas less 15% of the American population does (Raphael). Thus I was inspiried to do this project to share with more people this astronomical injustice that I feel everyone should know about. Additionally, I noticed this inefficient and uneffective system was costly on both the economy and people’s emotional well-being. I was intrigued to research mental health treatments because they are new, innovative, and excited. On the other hand, I am currently really interested in the law and delving into the legislature for this project furthered my knowledge of how the criminal justice system works.
A Quick History of Deinstitutionalization
Deinstitutionalization is “a term for a range of procedural, statutory, and ideological changes that attempt[ed] to transfer the care of the chronically mentally ill from institutional to community settings” (Steadman), in the 1970’s.
The late 1800s and early 1900s Mentally ill held (mostly involuntarily) in mental hospitals that treated mental illnesses unethically and improperly. Treatments included:
- Electroconvulsive therapy
- Narcotherapy (severe drugs and acupuncture)
- Leucotomy (brain surgery)
- Many other barbaric options
An inmate being treated in a mental hospital in the 1910s
Antipsychotics (drug therapy) and other self-treatment
options introduced possibility of at-home treatments
(but they were optimal for people will more acute mental illnesses)
Population of mental hospitals reaches a peak at
559,000 patients, or 0.3% of the American
population (Mental Health America).
1954-1962 (Civil Rights era)
The end of inhumane treatment of the mentally
ill was included in the demands for equal rights
of the disabled. (Mental Health America)
The Community Mental Health Act passed,
moving treatment for mental illness from hospitals
and institutions to community centers.
President Kennedy assassinated and most of the
funding intended for the community mental health centers
went toward fighting the Vietnam war (Mental Health America).
As mental hospitals closed, “the country experienced a nearly
fivefold increase in incarceration rates” (Raphael and Stoll).
The 1970s – present day
Funding for community centers is continuously cut,
fewer people receive treatment, a growing population
of mentally ill persons in prisons.
Source: Mental Health America
Present Day Issue
Due to the failure of deinstitutionalization in the 1970s, the mental health care system in America lacks structure, depth, and financial support and therefore has very little effect on the lives of those suffering mental illness today. Additionally, today’s healthcare infrastructure lacks the supplies and funding desperately needed to treat the mentally ill. For reference, currently, there are about 35,000 available beds nationally in mental health centers and hospitals whereas the optimal number is closer to 200,000 (Carey). This lack of available services leaves hundreds of thousands of people with severe mental illnesses without any support. Thus, as of 2018,
their are 10 times as many people with mental health issues locked up in jails and prisons than there are receiving treatment in state hospitals (Fernandez). Additionally, while the national incarceration rates have been steadily decreasing for about 50 years, the crime rate of citizens with acute and severe mental illness has been on a steady incline during the same time. With the massive increase in patients with mental illness over the last couple of decades needing treatment in prisons, the prison staff and equtpment are overworked and overused so quick and often methods of treatment are favored. This makes many of the ‘treatments’ inside prison violent and often barbaric and although they may stop symptoms for a short time, these treatments have considerably large consequences. Outside of prisons, community centers and other treatment methods are continuously closed, leaving more and more people without access to centers. From the beginning, there was an insufficient amount of community mental health centers, and as time progressed, especially after recent economic recessions, additional centers were closed. For example, from 2009 to 2012, Illinois cut funding toward mental health services by 32% which led to the closure of slightly under 50% of facilities (Fernandez). These closures are absurd especially considering the community centers are supposed to be open and accessible to everyone. It is evident that treatment options for mental illnesses have come a long way since the initial treatments used in institutions, yet most of the doctors who are treating these patients, mostly within prisons, resort back to the old barbaric treatments. Additionally, A clear inverse correlation between mental health treatment service availability and the mentally ill prison population is present. Although it is very clear, the government does not acknowledge this correlation and chooses to continuously cut funding to community centers which are directly fueling the jails. It is obvious that prisons today have become overworked places that inhumanely treat patients for mental illnesses. Whereas, most outside services, like hospitals and community centers, have developed evidence-backed, humane treatments that work but lack the proper funding to truly implement them. Therefore, if more services were available outside of prisons, more mentally ill patients could be treated and live as functioning members of society. This information begs the question, should preemptive money be invested to treat patients outside of prisons in hospitals or community centers or should we wait and let them inevitably end up being tortured in prisons?
Doable Solutions for Everyone!
Although this issue seems unsolvable, there are many little things everyone can do that could vastly improve the lives of those with mental illnesses and keep them from being incarcerated. Firstly, if you are over 18 you should vote in favor of candidates with mental health on the top of their agendas (if your not sure, most democrats support mental health care reform). For example at the national level, Joe Biden’s additions to Obamacare provide free mental health and substance abuse services to all Americans. Another option to challenge this issue is to buy from businesses that hire and support inmates after prison especially those with mental health problems. If inmates are released from prison and provided with a stable environment (income and housing), they are considerably less likely to be reincarcerated due to things symptomatic of their mental illness. A quick google search should reveal if there are any business like this near you. Also, support low income housing projects as these are an afordable place for people with mental ilness to find stable housing. Additionally, if a mental health center is proposed for your neighborhood, support its opening and convince your neighbors to do the same. Mental health centers do not increase violence or decrease property value although almost everyone believes they do. Finally, people with mental illness need to be treated like people by everyone. So if you have a neighbor, a family member, a aquaitence, who has a mental illness, try your hardest to support them with dignity and respect so they can discover who they are and what they would like to accomplish with their life.
In order to completly stop the high incarceration rate of the mentally ill, there needs to be a complete systemic restructuring. First, community mental health centers need to be expanded, and those that were closed need to be re-opened. Next, the 3.6 billion dollar budget currently entrusted to the Substance Abuse and Mental Health Services Administration needs to be reinvested into new programs and treatments that are humane and backed by evidence, especially within the prisons (Carey). Finally, and most importantly, the criminal justice system needs to work with mental health treatment systems to redirect persons with serious mental illnesses to treatment hospitals outside of prisons rather than prison itself. Furthermore, if these first steps are executed properly, the federal government will see how prioritizing treatment over incarceration is inexpensive compared to the current system. It costs $150 dollars a day to imprison someone without mental illness, and almost $450 dollars to imprison someone with severe mental illness. Whereas it only costs $27 dollars a day to treat seriously mentally ill persons outside of prisons (Fernandez). Therefore, if a mentally ill inmates crime is not violent or dangerous, it is more cost-effective and ethical to treat them in facilities outside of prisons. Next, if funding for community centers is increased, the proactive treatment of mental illness will cause the crime rate of the mentally ill to exponentially decline. If all mental illnesses in a community are treated, it will eliminate crimes that are purely symptomatic of mental illnesses. Next, if the population of the mentally ill in prisons declines, the staff will finally have the adequate training and equipment to properly treat the remaining inmates. Therefore, by passing legislation to increase community centers, re-direct funds, properly train staff, and prioritize treatment over punishment, the governments at state and national levels will improve the care of every citizen with a mental illness while decreasing incarceration rates and total cost. Additionally, our society needs to change the stereotypes surrounding the mentally ill.
Thank you so much for reading through my webpage and I hope you learned something new! Please leave any comments, ideas, or questions below, I would love to see peoples thoughts!
Additionally I would love to know:
- Were you aware of this injustice prior to reading this webpage?
- Are you going to do something to help fight against this injustice?
- Did you find anything surprising?