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May 17, 2010

The shameful state of the Incarceration Nation

mentally ill prisoners The troubling U.S. incarceration rate – a direct result of the governmental policy of overcriminalization – has been a frequent topic on this blog (here, here, here, here, here,here, here, here, here, here and here).

In this post from last fall, Scott Henson notes that Kings College in London now has available here its latest "World Prison Population List" that reflects that the United States remains a world leader in incarceration rate by a large margin:

The United States has the highest prison population rate in the world, 756 per 100,000 of the national population, followed by Russia (629), Rwanda (604), St Kitts & Nevis (588), Cuba (c.531), U.S. Virgin Is. (512), British Virgin Is. (488), Palau (478), Belarus (468), Belize (455), Bahamas (422), Georgia (415), American Samoa (410), Grenada (408) and Anguilla (401).

America’s dubious drug prohibition policy is one of the reasons for the high incarceration rate. However, as this Houston Politics/Chronicle blog post notes, this National Sheriffs’ Association survey (H/T Doug Berman) reports that the United States imprisons many more mentally ill citizens than treating them in hospitals. This press release on the survey summarizes the sad story:

Americans with severe mental illnesses are three times more likely to be in jail or prison than in a psychiatric hospital, according to "More Mentally Ill Persons Are in Jails and Prisons Than Hospitals: A Survey of the States," a new report by the Treatment Advocacy Center and the National Sheriffs' Association.

"America's jails and prisons have once again become our mental hospitals," said James Pavle, executive director of the Treatment Advocacy Center, a nonprofit dedicated to removing barriers to timely and effective treatment of severe mental illnesses. "With minimal exception, incarceration has replaced hospitalization for thousands of individuals in every single state."

The odds of a seriously mentally ill individual being imprisoned rather than hospitalized are 3.2 to 1, state data shows. The report compares statistics from the U.S. Department of Health and Human Services and the Bureau of Justice Statistics collected during 2004 and 2005, respectively. The report also found a very strong correlation between those states that have more mentally ill persons in jails and prisons and those states that are spending less money on mental health services.

Severely mentally ill individuals suffering from diseases of the brain, such as schizophrenia and bipolar disorder, often do not receive the treatment they need in a hospital or outpatient setting. The consequences can be devastating – homelessness, victimization, incarceration, repeated hospitalization, and death.

"The present situation, whereby individuals with serious mental illnesses are being put into jails and prisons rather than into hospitals, is a disgrace to American medicine and to common decency and fairness," said study author E. Fuller Torrey, M.D., a research psychiatrist and founder of the Treatment Advocacy Center. "If societies are judged by how they treat their most disabled members, our society will be judged harshly indeed."

Recent studies suggest that at least 16 percent of inmates in jails and prisons have a serious mental illness. According to author and National Sheriffs' Association Executive Director Aaron Kennard, "Jails and prisons are not designed for treating patients, and law enforcement officials are not trained to be mental health professionals."

Ratios of imprisonment versus hospitalization vary from state to state, as the report indicates. On the low end, North Dakota has an equal number of mentally ill individuals in hospitals as in jails or prisons. By contrast, Arizona and Nevada have 10 times as many mentally ill individuals in prisons and jails than in hospitals.

Among the study's recommended solutions are for states to adopt effective assisted outpatient treatment laws to keep individuals with untreated brain disorders out of the criminal justice system and in treatment. Assisted outpatient treatment is a viable alternative to inpatient hospitalization because it allows courts to order certain individuals with brain disorders to comply with treatment while living in the community. Studies show assisted outpatient treatment drastically reduces hospitalization, homelessness, arrest, and incarceration among people with severe psychiatric disorders, while increasing adherence to treatment and overall quality of life.  .   .   .

More evidence of the myth of American exceptionalism?

Posted by Tom at May 17, 2010 12:01 AM |

Comments

Mental hospitals (particularly state facilities) started to close in the 1960s in favor of "community services," a favorite of liberal thinkers and politicians.

Granted, many of the state mental hospitals were less than ideal, but did provide a means of separating the desperately mentally ill from society, a role now taken by prisons.

Posted by: Rusty Rustbelt Author Profile Page at May 17, 2010 1:37 PM

Great point on the drug prohibition policy. People shouldn't be put in jail for something that is probably less dangerous than alcohol. for example marijuana. I think that fear has been the main driving factor of it all. I am guessing that many fear they or their children will fall prey to drug abuse. It could certainly happen. but now instead of getting help they go to jail.

Posted by: Dwayne Casey Author Profile Page at May 22, 2010 1:04 AM

The mental health system as used in the criminal justice system is sorely out of resources. In Fort Bend County this past week 2 of my mental clients and others had to have force fed orders levied on them as they have set in the county jail awaiting transfer to Vernon State Hospital.

the problem with true mental cases accused of crimes and dealt with as criminals grows each day and with a prospective 18 billion dollar state shortfall budget it will worsen to the sadness of many.

Posted by: steven gilbert Author Profile Page at May 22, 2010 3:01 PM

1. Don't be blaming 'liberals' for de-institutionalization of the psychiatric ill. It's not a bad idea if you actually knew about the conditions in the old mental institutions. (it takes no imagination to point fingers without justification). Do you want to go back to facilities like Crownsville in MD where there were 15,000 'patients' many who died each day?

It was the planners and Govt officials who NEVER followed thru with community services as promised. Some of those were conservatives.

Ok, so it's not a liberal-conservative canard.

2. The mental health services always under0funded in good times are under even more pressure in bad times.

3. Perhaps using some funds or 'liberal' ideas to support good schools, clean up bad neighborhoods, and educate people about birth control would avert some of those criminals over-populating the system now.

Actually this isn't a right-left issue, it has been studied.

3. BTW #2 commenter, drug abuse is no less dangerous and no less deleterious to health and public welfare that alcohol use.

Posted by: GRG51 Author Profile Page at June 5, 2010 11:12 AM

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