FROM PILLAR TO POST: INCARCERATING AND ABANDONING THE MENTALLY ILL

Posted on October 24, 2003 by Dave Pollard
mentally ill chart

Quite a few news sources are covering the recent Human Rights Watch report on the incarceration of the mentally ill. Key data in the report:

  • As many as one in every five of the 2.1 million people in American prisons suffer from one of three acute mental illnesses: schizophrenia, bipolar disorder, or severe depression.
  • Since the 1960s, the population of US mental hospitals has dropped from almost six hundred thousand to eighty thousand; there has been an offsetting increase in the number of severely mentally ill Americans in prisons and on the streets.
  • Close to three quarters of a million mentally ill Americans are admitted each year to prisons or jails.
  • In prison, the mentally ill receive little or no treatment, and a disproportionate amount of punishment and solitary confinement.
  • Mandatory and ‘three-strikes’ sentencing legislation catches a lopsided proportion of the mentally ill.

Put this data together with data on the number of mentally ill on the streets, and you get the sorry picture shown in the above chart. It’s a picture of neglect, heartlessness and false economy. Human Rights Watch calls for more money for treatment and therapy of mentally ill prisoners. With the skyrocketing cost of the epidemic of incarceration (quadruple the number of thirty years ago), and a right-wing Attorney-General with an extraordinary taste for blood, don’t hold your breath.

Whatever happened to the concept of ‘not guilty by reason of mental defect’? The right-wing Supreme Court recently upheld a ruling that forces inmates to take medication so that they can be certified sane enough to execute. With 95% of prison suicides committed by the mentally ill, I guess this is what they mean by ‘compassionate conservatism.’

Reader Caveat: The numbers in the chart above are approximations. Some sources put the proportion of mentally ill in prison or on the streets significantly higher or lower than shown; rough average has been used. There is also no universal agreement on definition or diagnosis of ‘severe’ mental illness. The scale on the chart has been ‘broken’ to display the total number of mentally ill while still showing detail of those incarcerated or homeless on one small chart.

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7 Responses to FROM PILLAR TO POST: INCARCERATING AND ABANDONING THE MENTALLY ILL

  1. Lee Bryant says:
    October 24, 2003 at 06:43

    Hi Dave – you’re right this is very worrying. I blogged this yesterday on a project weblog we run at http://www.headshift.com/nimhekc. The webog is part of a project to create a devolved knowledge community to share info about mental illness for the National Institute for Mental Health in England, but which extends beyond “mental health” to include prisons, social care, housing and the police, who all often come into contact with mental health issues. Our approach is somewhat novel in that we will support multiple conflicting perspectives on mental health in the same place at the same time, allowing different people to mark up content according to their world view (and metadata that they control) to create joined up debates – currently practitioners talk to practitioners, service users to service users, etc.Another problem we have which is a big issue right now is institutional racism in the health service (and police .. and prisons…). We are part of a national consultation exercise on this (http://bme.nimhe.org.uk) that hopes to recruit a whole new cadre of black and minority ethnic workers into versy senior positions within the organisation in order to address this issue as positively as possible.I mention this because I guess there is a similar situation in the USA – don’t know about Canada.

  2. Aaron says:
    October 24, 2003 at 09:02

    And if anyone thinks it’s perfect here in Canada, it isn’t. Waiting lists for a family doctor, and referrals that never contact you — or answer their phone or door. I think some GP’s get paid not to refer some of us.I’ll be honest that I suffer from anxiety, but it wasn’t only my brain, my upbringing, me, etc., that finally led to my receiving a proper assessment, it was our waiting lists — for an ongoing eye problem — that pushed me to the edge. I supposedly have Social Anxiety Disorder but who knows what the next docs will say.If I was single, I probably would have done a small crime by now, to hopefully get to the top of the list to receive the good care. The free help sucks, go undercover and test the system. Maybe the private system is terrible as well in Canada, I can’t speak for it at this time. What kind of society is it when fruits and vegetables are so expensive? Why are grocery stores allowed to jack up the prices when the poor get their money? Why isn’t Cognitive Behavioural Therapy available to all? Nope, most GP’s will give you nothing, or Paxil and send you on your way. Talking about things costs a lot more money, but soon Virtual Reality games may replace the doctors. What a world.I’m no expert, having only played the system for a couple of years. I may be receiving treatment very soon, but if I was single I wouldn’t even be typing this diatribe.A combination of medication and CBT sounds like the closest thing we have to a cure, even then it could take years for each individual to find the proper doctor(s) and drug(s). The government should get rid of windows close to our waiting rooms because more and more of us are jumping out of them.Sorry to say this here, but I must spread the word when I can. Delete or edit this message if I went too far.The MI are not all lazy.

  3. Dave Pollard says:
    October 24, 2003 at 09:33

    Lee/Aaron: Thanks for your comments. I don’t think the situation in Canada is much better than anywhere else — although the prison population is much smaller as a % of the total population, I would guess that those with severe mental illness are proportionate (1 in 5) to the US. Canada has homeless people who freeze to death every year, despite vigilent ’roundups’ on designated ‘cold days’. As I’ve said elsewhere, I think treatment of mental illness is medieval everywhere. I don’t think mental hospitals really know how to treat the problem, and I’m sure prisons don’t. I know people who live with mentally ill people, including those with Alzheimers and Autism (which aren’t included in any of the data in this article) and I have huge admiration for them — I don’t think I could cope. The data shows that married people are much less likely to be homeless, or imprisoned, and the sad irony is that the neocons think this is an argument that ‘family values’ work, which shows they have the cause and effect backward. Mental illness puts an enormous strain on married and family life, and when the family can’t take it, and breaks up, the afflicted often end up on the streets or in prison because they’re not getting proper care in any of the institutions that are supposed to support them.The new, liberal, Premier of Ontario said in his inaugural speech: “We’ve seen you neglect your own needs to care for your aging parents or make sacrifices to care for your young grandchildren. Our government will be as selfless as you are.” and “A fundamental purpose of government is to help those who, due to circumstances beyond their control, have reached the point where they simply are unable to help themselves.” I think I’m going to like this guy.

  4. Philip says:
    October 24, 2003 at 09:45

    For the record I am anti-death penalty. I think State sanctioned killing is wrong. To me it is vengence codified. I can understand how friends, family, and a community may feel threatened and fearful of individuals who commit heinous crimes but once they are incarcerated they do not represent an immediate danger to the same. I am conflicted over the concept of justifiable homicide but not to the point where self defense isn’t a viable option. In defense of person or persons charged with your protection, then a life and death struggle is just that.With that said the case David cites is a very specific instance of a man convicted of murder. The facts of the murder case are not being judged, all parties agree upon guilt. A death sentence was pronounced in accordance with the laws of the state the murder took place in. There was no finding of “not guilty by reason of mental defect”, so to answer Dave’s question the concept of “not guilty by reason of mental defect” is still alive and well. I would argue that no sane person can take the life of another human being but that is my own fantasy and not supported by the laws that govern our citizens.In the specific case Dave mentions, the inmate developed symptoms of mental illness after his incarceration. Because of a ruling by the US Supreme Court no person who is unable to understand the punishment or why they are about to suffer such punishment can be executed under our 8th amendment. This ruling came down some time ago and is not a result of the current Supreme Court.The inmate appears to respond to anti-psychotic drugs (or the State contends he will respond). That is to say his mental illness subsides while medicated. So here you see the dilema. The person commits a capital crime while arguably sane, he is sentenced for the crime. While awaiting the appeals process to run its course the convicted person erupts into a full blown psychosis. Being legally insane he cannot now be put to death becausehe is CURRENTLY unable to understand why he is being punished.This is not a case of the State trying to kill someone because they were insane and not responsible for their actions at some point in the past. The death penalty is bad enough but we do not execute people who are “not guilty by reason of mental defect”.This is a case of trying to kill someone who is currently mentally ill and cannot fully appreciate the vengence to be visited upon him by the State. If the person is medicated he becomes competent legally and the execution can proceed, the measure of our vengance demands that the person is lucid and aware of their impending doom.So we have a nice twist on the old Catch-22. Is the person who is competent enough to refuse medication in order to save his life too incompetant to be executed? Is this person refusing medication for another reason, such as the High Priestess of Venus says the rats are trying to poison him?Can a person use insanity to avoid punishment after the facts have been decided?The Supremes have said that the State courts will need to decide this question, they have simply stated that in order to execute a person they should be mentally competant at the time of said execution, the idea of compelling an individual to participate in his own execution is a moot question isn’t it?Compelling someone to take drugs so you can give them more drugs to kill them is logical if the death penalty is logical.This seems absurd to me but then so does “life insurance” but that is a whole nother rant.So we seem to have a crazy way of treating crazy people. Perfectly logical if you ask me.

  5. Fiona says:
    October 25, 2003 at 00:42

    I read this story too and it just made my stomach turn.Dave, I tried to email you via blog but got a message that there had been an error. Please forgive the redundancy if you do get my email. I was trying to tell you that I’d gone to your links posted in EA comments box re: e-voting fraud. On the ‘Link To The Full Stash of Diebold Memos’ page, all the links are dead. I do think Diebold is trying to conceal something. I wrote my senator and rep letters this past week asking them to support HR2239. I liked your thought that perhaps a lefty might hack in. Never occurred to me.

  6. Marijo says:
    October 26, 2003 at 17:34

    Hi Dave– here’s a late comment on this post, which I just read for the first time in ‘Virtual Occoquan’. I missed this study, but I just e-mailed a link to myself at work so that I can read it more closely and share it around. I work with mentally ill patients who have an addiction, and many of them are homeless and many of them cycle through the jails routinely. Although this is not the usual subject of my blog, I do post about work sometimes, and the most recent time it was on this very issue; here’s the link if you’re interested: http://blogs.salon.com/0002889/2003/10/08.html

  7. Marijo says:
    October 26, 2003 at 17:35

    Oops, also, thanks for the article.

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