Prisons as the New Mental Hospitals
April 14, 2004 - 5:53pm
Today, more seriously mentally ill people are in prison than in mental health facilities. The majority of them will not receive adequate treatment for their illnesses, putting them further at risk.
The reasons for the high number of mentally ill in prisons are many, but chief among them is the lack of community-based support for mentally ill people. Human Rights Watch reports that 50 years ago, mental health care was delivered mainly through institutionalizing those with mental illnesses, often against their wills. This resulted in over half a million people being committed to the care of state-supported mental hospitals.
In the 1960’s, states began downsizing or closing public mental health hospitals. A combination of newly invented anti-psychotic medications and a strong movement against involuntary commitment and the often oppressive treatment of the mentally ill in mental hospitals had the positive result of freeing hundreds of thousands of mentally ill people. Those who led the movement to free mentally ill people envisioned and worked for the development of a network of community-based mental health centers that would provide the support that mentally ill people needed.
As the political climate grew more conservative in subsequent decades, mental health centers, like so many other essential services, did not receive the funding they needed to meet the demand for services. Because of lack of funding, mental health services are falling short, and prisons are picking up where the old, oppressive state mental health hospitals left off.
The imprisonment of mentally ill people today is not much different than involuntary commitment of mentally ill people to mental hospitals prior to the 1960’s. Mentally ill people often spend many years, if not their whole lives in prisons, just as they used to spend their lives in mental institutions, suffering inadequate and often inhumane treatment. The most significant difference between mental hospitals and prisons may be cost. While state hospitals cost approximately $90-$100,000 a year per patient, prisons confine mentally ill people for around $35,000 a year. And, while budgets for community based mental health services have shrunk, the budgets for state prisons have exploded.
As with the rest of the prison population, a disproportionate number of mentally ill in prisons are poor. Mentally ill people with the financial resources to pay for the support they need are often able to avoid run-ins with the law, but when treatment is too costly, mentally ill people often end up without the medication, support and protection they need. Many become homeless, and once people with serious mental illnesses become homeless, run-ins with police become almost inevitable.
Article by Scot Nakagawa
According to a 2003 Human Rights Watch report, approximately two to four hundred thousand people with mental illnesses reside in U.S. prisons and jails. While about 5% of the U.S. population in general suffers from mental illness, a 2000 report from the American Psychiatric Association reported as many as one in 5 U.S. prisoners were seriously mentally ill, and up to 5% were actively psychotic at any given moment.
According to the Human Rights Watch report, Congressman Ted Strickland informed the House Subcommittee on Crime in September 2000 that between 25 and 35% of all mentally ill Americans would come under the thumb of the criminal justice system at some point in their lives. This is supported by the American Psychiatric Association’s research that indicates that over 700,000 mentally ill Americans are processed through prison or jail annually.Today, more seriously mentally ill people are in prison than in mental health facilities. The majority of them will not receive adequate treatment for their illnesses, putting them further at risk.
The reasons for the high number of mentally ill in prisons are many, but chief among them is the lack of community-based support for mentally ill people. Human Rights Watch reports that 50 years ago, mental health care was delivered mainly through institutionalizing those with mental illnesses, often against their wills. This resulted in over half a million people being committed to the care of state-supported mental hospitals.
In the 1960’s, states began downsizing or closing public mental health hospitals. A combination of newly invented anti-psychotic medications and a strong movement against involuntary commitment and the often oppressive treatment of the mentally ill in mental hospitals had the positive result of freeing hundreds of thousands of mentally ill people. Those who led the movement to free mentally ill people envisioned and worked for the development of a network of community-based mental health centers that would provide the support that mentally ill people needed.
As the political climate grew more conservative in subsequent decades, mental health centers, like so many other essential services, did not receive the funding they needed to meet the demand for services. Because of lack of funding, mental health services are falling short, and prisons are picking up where the old, oppressive state mental health hospitals left off.
The imprisonment of mentally ill people today is not much different than involuntary commitment of mentally ill people to mental hospitals prior to the 1960’s. Mentally ill people often spend many years, if not their whole lives in prisons, just as they used to spend their lives in mental institutions, suffering inadequate and often inhumane treatment. The most significant difference between mental hospitals and prisons may be cost. While state hospitals cost approximately $90-$100,000 a year per patient, prisons confine mentally ill people for around $35,000 a year. And, while budgets for community based mental health services have shrunk, the budgets for state prisons have exploded.
As with the rest of the prison population, a disproportionate number of mentally ill in prisons are poor. Mentally ill people with the financial resources to pay for the support they need are often able to avoid run-ins with the law, but when treatment is too costly, mentally ill people often end up without the medication, support and protection they need. Many become homeless, and once people with serious mental illnesses become homeless, run-ins with police become almost inevitable.
The growing number of mentally ill people in prisons is just another sign that prisons are becoming cure-alls for society’s social problems. More and more often, for those with a drug or alcohol addiction or mental illness, for people suffering poverty or lack of adequate job training and education or those who society has identified as threats to the social order, prison is the solution. And, the more we turn to prisons, the more expensive they become, sucking resources from basic services, and making it more likely that people will go to prison. It’s a vicious cycle that needs to be interrupted.
The solution, of course, is not to simply push seriously mentally ill people out from prison. For many, prison is the first opportunity to be diagnosed and treated. We need to invest in creating a social safety net for the mentally ill by demanding adequate funding for community-based mental health services. We need mental health courts, which are the equivalent of drug courts that divert some who are arrested for drug-related crimes to treatment rather than incarceration, to assist the most at-risk mentally ill people rather than incarcerate them. But, in order for this to happen, our societal priorities must shift from using prisons as a cure-all for our problems.
