Illness and Incarceration

There are many reasons to be concerned with how mental illness is being treated in modern society. One of these is the prevalence of those dealing with mental health issues in jail or prison. The population of those with mental illnesses in jails and prisons has grown since the deinstitutionalization movement in the 60's and 70's. In this time, the concept of integrating those with illnesses into society was at the forefront of mental health care. As this occurred, the number of beds available in state hospitals began to drop. In the last 50 years the number of state hospital beds has fallen from 600,000 to 40,000.

Jails and prisons are now administering the majority of mental health treatment in America. Rikers Island is the largest provider of mental health services in the country, housing approximately 3000 people with illnesses. It is estimated that mentally ill inmates on average are incarcerated 8 times longer. The expense to keep mentally ill inmates incarcerated is 7 times that of non-ill inmates. Mentally ill inmates are housed in disciplinary units approximately 6 1/2 times as much as their non-ill counterparts.

I was able to interview a jail superintendent for this article. I asked him pertinent questions related to the treatment of mental illness in jail, its effectiveness and the decriminalization of mental illness. In speaking to him I was able to gain some insight into the subject I would not be able to get from doing research on-line.

I think it is important to understand the experience of others dealing with mental illness for my own personal recovery. I think this article will also be informative for those who are closely related to someone with an illness and to those that are just interested readers.

In the interview I did with the jail superintendent, he gave me a number of reasons why we see so many people with illnesses being incarcerated. 32% of his inmates are mentally ill. He specifically mentioned that he sees people who are undiagnosed or uneducated about their illness. Often times they will be experiencing financial difficulties and do not know how to keep their medication regimen going. He told me a story of a young lady who had no income, and her family had severed their ties with her. Her landlord warned her that if she didn't leave her apartment he would call the police, as she was not paying her rent. She had nowhere to turn and did not want to be left on the streets. She was eventually charged with criminal trespass and put in jail.                     

The superintendent also let me know that he did not feel that proper mental health treatment was as accessible as it should be in the community. There are stricter criteria for being admitted to hospital- much more so than a jail. Also, the option of putting a person in jail rather than bringing them to a hospital where they can be admitted is an "easy" choice for police officers. We would not want to see someone go to jail that could be admitted to a hospital to receive proper care. However, the superintendent told me he has seen people who were diagnosed in jail and given proper medication. In some instances like that he says that he has received phone calls from former inmates who said that the treatment they received in jail dramatically improved their lives.