Mentally Ill Offenders: Where Do They Belong?
Written by: Emilee Leach
The United States criminal justice system faces many issues currently; however, one that is often overlooked is that of the treatment of individuals who suffer from a severe psychological disorder, such as schizophrenia or psychosis, both during and after they have been released from detention. As of 2005, prisons and jail held approximately 500,000 mentally ill offenders, a number that is “ten times the 50,000 in psychiatric hospitals”, according to The New Asylums, a documentary produced by the PBS network (Frontline, 2005). This issue extends further than the offender receiving treatment and special attention while incarcerated, as their supervision and care post-release is often the determining factor in whether the individual will return to a correctional facility; according to the Bureau of Justice Statistics, research has found the mentally ill compose an estimated 30% of violent repeat offenders in local jail populations (Bureau of Justice Statistics, 2006).
In discussing the treatment of mentally ill offenders, it is pertinent to gain an understanding as to the why this issue needs to be addressed and resolved as efficiently and effectively as possible. One reason that this lack of supervision and treatment of the mentally ill during and after confinement is of particular concern is due to the fact that findings have illustrated that these individuals are more likely to recidivate than the general adult population. Author Lamberti of Understanding and Preventing Criminal Recidivism among Adults with Psychotic Disorders, denotes that through the examination of “an extensive body of research”, eight factors have been distinguished being highly accurate in “predicting criminal recidivism”; among these characteristics is the presence of mental illness’, such as schizophrenia or related psychological disorders (Lamberti, 2007). The author also notes that findings indicate that those with psychotic disorders compose a third of the homeless population; another risk factor that has been distinguished as elevating the likelihood that an individual will recidivate (Lamberti, 2007).
Secondly, this problem places a financial burden on the federal, state and local facilities as well as tax-payers, as the cost incurred by institutions for housing and caring for the mentally ill is significantly higher than offenders that do not suffer from a psychological disorder; Mental Health Problems of Prison and Jail Inmates reports that most individuals suffering from mental illness not only require treatment, therapy, and medication but also at times hospitalization, an unnecessary, yet large expense to the state (Frontline, 2005). In Broward County, Florida, for example, the average cost to house an inmate without a mental illness is around $80/day, while the cost of housing an individual that does suffer from mental illness is around $130/day, according to the non-profit online organization, Mental Illness Policy; in Texas the cost of general inmate care is a reported $22,000/year, increasing to up to $50,000 annually when detaining the mentally ill, with the costs of prescriptions for psychiatric conditions having “exceeded the costs of feeding inmates” (Mental Illness Policy, 2011).
Finally, the moral dilemma inherent in this issue extends far beyond being a question of business or efficiency, as it pertains to the treatment of human beings and is therefore ethically controversial. According to prison litigation specialist Fred Cohen, due to the fact that these individuals have difficulty adhering to the regulations within a prison a “disproportionate number” of these offenders spend time in solitary confinement; he goes on denoting that when “people who are…so psychologically fragile” are denied “any kind of social support…they just fall apart” (Frontline, 2005). In looking at how this impacts these individuals after being released, one must recognize that they are not in a state of mind in which they are able to care for themselves and it is the responsibility of the United States government, at either a state or federal level, to ensure that those who suffer from a mental illness are provided for and supervised as necessary. This is crucial to ensure the safety of not only the individual, but also the citizens in the community to which they are being released. Just because an individual has served the length of his or her sentence does not imply that he or she is mentally stable and no longer poses a threat themselves or society. This can be seen in the case of Bennie Anthony, a paranoid schizophrenic who was released from prison in 1987; however, “within weeks after being released” was arrested for setting fire to the house of his girlfriend during a schizophrenic episode (Frontline, 2005). Cases like this exemplify the reason that it is ultimately an ethical and moral responsibility of the state and federal government to ensure that these individual’s have access to treatment, housing, and support.
After discussing the numerous problems this issue presents, it is pertinent to examine and address the key factor that has acted to perpetuate the current situation. Deinstitutionalization is one of the main factors contributing to this issue, as since its inception, federal, state, and local correctional facilities have become inundated with prisoners suffering from a variety of mental disorders. Deinstitutionalization refers to the process of transferring individuals out of state run mental institutions and decreasing the availability of “ mental health treatments [that] are delivered in public hospitals”; this involves instead placing more responsibility on the federal government to finance and establish “community-based mental health services” to offer treatment to these individuals (Encyclopedia of Mental Disorders, 2012). The main idea behind enacting this concept is that the patient would benefit through dissipating them “over a wider variety of health care settings”; however, the underlying value that was thought to be inherent in this process is the illustration of evolution in mental health care to be viewed as more humane and modern in its “structure, practice, experiences, and purposes” (Encyclopedia of Mental Disorders, 2011). Unfortunately, the truth is that it is not community-based centers that house the majority of these individuals, but rather “prisons have become the new asylums”, according to Frontline’s documentary; after this policy was introduced and since its initiation, many mentally ill patients have found themselves unable to maintain their regiment of medication or to retain a permanent residence, leading to homelessness and eventually re-arrest after the lack of medication fails to control their behavior (Frontline, 2005).
In consideration of the aforementioned information, it is apparent that to resolve this problem, it must be approached on two levels, within the facility and in the community after being released. One potential measure that may be taken to address this issue is federally mandating that prisons create a board that oversees the cases individuals specifically and has a more intimate knowledge of the case offering a better insight as to the level of risk that this person poses to the community or his/herself. Information collected by this board may also be used to decide whether or not to impose legal restrictions that order the individual to continue treatment and the level to which they will be supervised. In addition states must find a way to secure funding to ensure the establishment of effective community-based treatment facilities and programs. This is just one suggestion of what should be many, as with the depth and severity of this issue, it must be discussed; this is not only a problem facing the criminal justice system, but more importantly, is a question of moral, ethical, and humanitarian values.
Copyright 2012, February