Incarceration and treatment: Mental Health in jail
Each year, the overlap between mental health recipients and incarcerated persons increases. Although the problem has been identified, a lack of progress has contributed to the issue. While more is being done now to help decrease the imbalance than has ever been previously done, statistics show we still have to work to complete. Since the closure of asylums, the criminal justice department has, in many ways, become the major provider of mental health services. Families are finding it harder and harder to help their loved ones with mental illness once they enter the criminal justice system. The numbers of serious mental illness within the criminal justice system varies by each report but consistently supports suggestions for change.
Incarceration and Mental Health Rates
In research, the exact numbers of occurrence of mental illness in prisoners are hard to determine and rates often vary by each study. The studies all show the numbers can decrease with work. Most studies limit their research to mental illness ailments that are considered serious. According to Jann Ingmire, News Officer of Social Sciences at the University of Chicago, “Researchers are defining serious mental illnesses to include things such as schizophrenia, bipolar, spectrum disorders and major depressive disorders.” Of the 9.6 million adults (4% of the U.S. adult population) living with serious mental illness, they account for 15% of state prisoners and 24% of jail inmates (Edwards). Cox, Morschauser, Banks and Stone found in their study that although the general population of correctional facilities is by far in the majority with the young male population but women with mental illness are twice as likely to be incarcerated as their mentally ill male counterparts. The same authors also determined in their findings that the risk of incarceration increased with age (Cox, et al.). While our already over-whelmed system is even more overwhelmed by the current influx of inmates needing treatment, many mentally ill inmates are falling through the cracks.
Mental health treatment for inmates is frighteningly inconsistent. In a 2003 report from HRW, it is said that seriously mentally ill inmates are often ignored and their behavior considered to be “malingering”. As referenced by Christine Sarteschi, a recent study of 618 inmates from Michigan “determined that of 65% of those 618 inmates who were identified as having severe psychiatric symptoms had not received mental health treatment in the past year” (p.6). Some prisoners have up to a 12 month wait for mental health treatment (Sarteschi, p. 6). Many prisoners, who have not been treated for their serious mental illness, are punished for their behavior by being placed in severe and extreme confinement (HRW). The lack of training in correctional facilities officers makes it hard for the officers to distinguish between bad behavior and mental illness exacerbation (Sarteschi, p. 7). Any way you add the numbers, the heavy burden of mental illness is overwhelming an already plagued criminal justice system.
The Strain on Society
When the asylums were closed in the 1960s, society took on the strain. Many of the mentally ill now had nowhere to go and no support systems. “Hundreds of thousands of people with serious mental illness today end up homeless, cycling through emergency rooms, short-term hospital stays, jails and prisons” (Edwards). It is society’s taxes that fiscally cover the costs of these stays. It has been found that it “costs roughly twice as much to incarcerate an inmate with a mental illness than one without and can run states up to $100,000 per inmate per year” (Edwards). This does not include the transportation and staffing it takes to get the mentally ill to treatment. In Oklahoma, it is law that local law enforcement transfers those in crisis with mental illness to a facility for emergency treatment (Johnson, Ch. 2). A lack of beds in treatment facilities means that these officers are often driving hundreds of miles for transport of their mentally ill passengers. As referenced by Johnson, in 2013, the police agencies in Oklahoma racked up almost one million miles transporting mentally ill patients (Ch. 2). While the state reimburses for the mileage that these officers travel (Johnson, Ch. 2), it is left up to the tax-paying society to cover the extra costs of overtime and staff training needed to keep everyone safe. More than 17,000 police agencies are in the U.S. and barely more than 2,700 of these agencies have a Crisis Intervention Team (CIT) programs (Johnson, Ch. 4). This is just another statistic that shows how much room for improvement the United States has when it comes to the mentally ill.
Suggestions for Change
As mentioned before, the greatest population in the prison and jail systems is the young male (20-39) population (Cox, et al.). This fact has at least one study stating that the majority of mental health services and correctional facilities need to revamp the system with a major part of the focus on the mental health needs of the young male population (Cox, et al.). That same study concluded that if the Medicaid program was expanded so that inmates were not dropped from the program at the start of incarceration, not only would it allow an increase of coordination between correctional facilities and mental health programs, but would also allow for the Medicaid program to help the correctional facilities with the extra costs associated with mentally ill inmates (Cox, et al.). When an issue becomes as big as the U.S. issue with mentally ill inmates, it affects all of society indirectly, if not directly. From our taxes to the long response time of the police inundated with calls from the mentally ill, it affects us all.
Works Cited
Abramsky, Sasha, and Jamie Fellner. Ill-equipped: U.S. Prisons and Offenders with Mental Illness. New York: Human Rights Watch, 2003. Human Rights Watch. Human Rights Watch, Sept. 2003. Web. 25 Feb. 2015. <http://www.hrw.org/reports/2003/usa1003/usa1003.pdf>.
Cox, Judith F., Morschauser, Pamela C., Banks, Steven, & Stone, James L. "A Five-Year Population Study Of Persons Involved In The Mental Health And Local Correctional Systems: Implications For Service Planning." Journal Of Behavioral Health Services & Research 28.2 (2001): 177. Psychology and Behavioral Sciences Collection. Web. 25 Feb. 2015.
Edwards, Haley Sweetland. “Dangerous Cases.” Time 184.21/22 (2014): 54-59. Academic Search Premier. Web. 23 Feb. 2015.
Ingmire, Jann. "New Approaches Needed for People with Serious Mental Illnesses in Criminal Justice System." New Approaches Needed for People with Serious Mental Illnesses in Criminal Justice System. University of Chicago, 13 Oct. 2014. Web. 25 Feb. 2015.
Johnson, Kevin. "Mental Illness Cases Swamp Criminal Justice System." USA Today. Gannett, 21 July 2014. Web. 25 Feb. 2015.
Man behind bars. Digital image. Fast Company. Mansueto Ventures, LLC, n.d. Web. 25 Feb. 2015. <http://g.fastcompany.net/multisite_files/fastcompany/imagecache/1280/poster/2014/01/3024452-poster-p-1- google-invite-lands-man-in-jail.jpg>.
Sarteschi, Christine M. "Mentally Ill Offenders Involved With the U.S. Criminal Justice System." Mentally Ill Offenders Involved With the U.S. Criminal Justice System. Sage Open, 16 July 2013. Web. 25 Feb. 2015.
Incarceration and Mental Health Rates
In research, the exact numbers of occurrence of mental illness in prisoners are hard to determine and rates often vary by each study. The studies all show the numbers can decrease with work. Most studies limit their research to mental illness ailments that are considered serious. According to Jann Ingmire, News Officer of Social Sciences at the University of Chicago, “Researchers are defining serious mental illnesses to include things such as schizophrenia, bipolar, spectrum disorders and major depressive disorders.” Of the 9.6 million adults (4% of the U.S. adult population) living with serious mental illness, they account for 15% of state prisoners and 24% of jail inmates (Edwards). Cox, Morschauser, Banks and Stone found in their study that although the general population of correctional facilities is by far in the majority with the young male population but women with mental illness are twice as likely to be incarcerated as their mentally ill male counterparts. The same authors also determined in their findings that the risk of incarceration increased with age (Cox, et al.). While our already over-whelmed system is even more overwhelmed by the current influx of inmates needing treatment, many mentally ill inmates are falling through the cracks.
Mental health treatment for inmates is frighteningly inconsistent. In a 2003 report from HRW, it is said that seriously mentally ill inmates are often ignored and their behavior considered to be “malingering”. As referenced by Christine Sarteschi, a recent study of 618 inmates from Michigan “determined that of 65% of those 618 inmates who were identified as having severe psychiatric symptoms had not received mental health treatment in the past year” (p.6). Some prisoners have up to a 12 month wait for mental health treatment (Sarteschi, p. 6). Many prisoners, who have not been treated for their serious mental illness, are punished for their behavior by being placed in severe and extreme confinement (HRW). The lack of training in correctional facilities officers makes it hard for the officers to distinguish between bad behavior and mental illness exacerbation (Sarteschi, p. 7). Any way you add the numbers, the heavy burden of mental illness is overwhelming an already plagued criminal justice system.
The Strain on Society
When the asylums were closed in the 1960s, society took on the strain. Many of the mentally ill now had nowhere to go and no support systems. “Hundreds of thousands of people with serious mental illness today end up homeless, cycling through emergency rooms, short-term hospital stays, jails and prisons” (Edwards). It is society’s taxes that fiscally cover the costs of these stays. It has been found that it “costs roughly twice as much to incarcerate an inmate with a mental illness than one without and can run states up to $100,000 per inmate per year” (Edwards). This does not include the transportation and staffing it takes to get the mentally ill to treatment. In Oklahoma, it is law that local law enforcement transfers those in crisis with mental illness to a facility for emergency treatment (Johnson, Ch. 2). A lack of beds in treatment facilities means that these officers are often driving hundreds of miles for transport of their mentally ill passengers. As referenced by Johnson, in 2013, the police agencies in Oklahoma racked up almost one million miles transporting mentally ill patients (Ch. 2). While the state reimburses for the mileage that these officers travel (Johnson, Ch. 2), it is left up to the tax-paying society to cover the extra costs of overtime and staff training needed to keep everyone safe. More than 17,000 police agencies are in the U.S. and barely more than 2,700 of these agencies have a Crisis Intervention Team (CIT) programs (Johnson, Ch. 4). This is just another statistic that shows how much room for improvement the United States has when it comes to the mentally ill.
Suggestions for Change
As mentioned before, the greatest population in the prison and jail systems is the young male (20-39) population (Cox, et al.). This fact has at least one study stating that the majority of mental health services and correctional facilities need to revamp the system with a major part of the focus on the mental health needs of the young male population (Cox, et al.). That same study concluded that if the Medicaid program was expanded so that inmates were not dropped from the program at the start of incarceration, not only would it allow an increase of coordination between correctional facilities and mental health programs, but would also allow for the Medicaid program to help the correctional facilities with the extra costs associated with mentally ill inmates (Cox, et al.). When an issue becomes as big as the U.S. issue with mentally ill inmates, it affects all of society indirectly, if not directly. From our taxes to the long response time of the police inundated with calls from the mentally ill, it affects us all.
Works Cited
Abramsky, Sasha, and Jamie Fellner. Ill-equipped: U.S. Prisons and Offenders with Mental Illness. New York: Human Rights Watch, 2003. Human Rights Watch. Human Rights Watch, Sept. 2003. Web. 25 Feb. 2015. <http://www.hrw.org/reports/2003/usa1003/usa1003.pdf>.
Cox, Judith F., Morschauser, Pamela C., Banks, Steven, & Stone, James L. "A Five-Year Population Study Of Persons Involved In The Mental Health And Local Correctional Systems: Implications For Service Planning." Journal Of Behavioral Health Services & Research 28.2 (2001): 177. Psychology and Behavioral Sciences Collection. Web. 25 Feb. 2015.
Edwards, Haley Sweetland. “Dangerous Cases.” Time 184.21/22 (2014): 54-59. Academic Search Premier. Web. 23 Feb. 2015.
Ingmire, Jann. "New Approaches Needed for People with Serious Mental Illnesses in Criminal Justice System." New Approaches Needed for People with Serious Mental Illnesses in Criminal Justice System. University of Chicago, 13 Oct. 2014. Web. 25 Feb. 2015.
Johnson, Kevin. "Mental Illness Cases Swamp Criminal Justice System." USA Today. Gannett, 21 July 2014. Web. 25 Feb. 2015.
Man behind bars. Digital image. Fast Company. Mansueto Ventures, LLC, n.d. Web. 25 Feb. 2015. <http://g.fastcompany.net/multisite_files/fastcompany/imagecache/1280/poster/2014/01/3024452-poster-p-1- google-invite-lands-man-in-jail.jpg>.
Sarteschi, Christine M. "Mentally Ill Offenders Involved With the U.S. Criminal Justice System." Mentally Ill Offenders Involved With the U.S. Criminal Justice System. Sage Open, 16 July 2013. Web. 25 Feb. 2015.