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William Fullam Intro to Corrections Professor Poulsen May 22, 2011

Mentally Ill and Corrections: Right or Wrong?

As of 2006, there were a reported 1.25 million inmates, in either prison or jail, diagnosed with some type of mental illness, quadrupled from 283,000 inmates in 1998. (Federal Bureau of Justice Statistics 1998, 2006) Mental illness, classified as either schizophrenic, bi-polar, manic depressant, mania or other psychotic disorders is growing in society and working its way into the prison system. Whether or not a mentally ill person is placed in a prison or jail is for the criminal court system to decide. If there is a plea of insanity and the judgment is deemed as such then the person will most likely be sent to a facility that is equipped to handle such persons and handicaps. For the most part prisons and jails are designed to hold inmates that are deemed a danger to society and the punishment is incarceration from the public at large, it is not a mental facility and there is a lack of proper training and personnel to handle such cases. Prison conditions are hard on mental health in general, because of overcrowding, violence, lack of purposeful activities, isolation from family and friends, and inadequate health services. The impact of these problems is worse for prisoners whose thinking and emotional responses are impaired by schizophrenia, bipolar disease, major depression, and other serious mental illnesses. In addition, poor mental health services leave many prisoners receiving poorly prescribed

medications that either are not enough or administered too much, in either case is not good for the inmate. As a presidential advisory commission in recent years reported, the mental health system is in disarray. It is fragmented, chronically under-funded, and rife with barriers to access, particularly in minority communities. As a result, too many people who need publicly financed mental health services cannot obtain them until they are in an acute psychotic state and found to be a danger to themselves or others. Left untreated and unstable, people with serious mental illnesses particularly those who are also poor, homeless, and suffering from untreated alcoholism or drug addictionmay break the law and then enter the criminal justice system. The failure of mental health systems has led to what some have called the criminalizing of the mentally ill. (Presidents New Freedom Commission on Mental Health, Achieving the Promise: Transforming Mental Health Care in America 3 (2003). The numbers of mentally ill are dominating the prison system and there is an inadequate supply of support and/or treatment. The prison system treats the mentally ill inmate the same as the other inmates and are required to follow directions and rules as such. The problem with the mentally ill inmate is that they do not understand the same way as an inmate that does not have the same problems. There are problems adapting and/or understanding, also they are ten times more likely to have discipline problems based on not following the rules or directions place on them by corrections officers. In Washington State, offenders with serious mental illness constitute 18.7 percent of the prison population but account for 41 percent of the infractions. (David Lovell & Ron Jemelka, When

Inmates Misbehave: The Cost of Discipline pg. 165, 167 (1996). The Federal Bureau of Justice Statistics shows mentally ill prisoners are more likely to have been involved in a fight or to have been charged with breaking prison rules. There are many reasons why mentally ill inmates are involved in many disputes, but I will generalize it into misunderstandings and lack of communication with all parties involved. If there was an implementation of specific, mental health programs such as individual counseling, addiction services, proper medical training and implementing stronger medication standards, growth in society programs, and family involvement, there could be a change in the attitudes and adjustment for the mentally ill in the prison system. I do not believe that there should be separate facilities created specifically for those inmates with mental problems but with mentally ill specific programs designed and operated by mental health professionals could have a big impact on the system as a whole.

There is very little classification in the prison system in dealing with the mentally ill. The main goal of the system is to maintain security of the public, the inmates and the employees of the facility. Most mentally ill inmates that have problems adapting, following directions, and/or having disciplinary problems are sent to segregation. This supplies security to the facility as a whole and to society. Segregation is broken down into two categories, disciplinary segregation, in which the isolation is imposed as punishment for disciplinary infractions; and administrative segregation, in which corrections officials exercise their management discretion to classify inmates as requiring confinement isolated from the general population. Data from different states

reveal, The mentally ill typically account for one quarter or more of the segregated population; in some states, they account for one-half. Inmates with mental illness account for the following percentages of state high security or segregated units: Oregon, 28; New York, 23; California, 85; Indiana, between 33 and 50; Washington, 29; Iowa, 50. (Federal Bureau of Justice Statistics (2006).

The problem with segregation and the mentally ill is, when you take a person who has mental problems and remove him from stimuli, either positive or negative, there will be repercussions. The stresses, social isolation, and restrictions of segregated confinement can aggravate their illness or provoke a recurrence, immeasurably increasing their pain and suffering. According to psychiatrist Dr. Terry Kupers, the conditions in segregation can cause someone with a vulnerability to psychosis: to go off the deep end. People who are vulnerable to psychosis have a relatively fragile or brittle ego. When they are made to feel very anxious, very angry, or very distrustful, their ego tends to disintegratein other words, as anger or anxiety mounts, their ego falls apart. They regress, lose control, and cannot test reality. This is the beginning of a psychotic de-compensation . . . . If theres nobody to talk to then one is left alone to sort out ones projections, the reality-testing is more difficultand paranoid notions build up. It has since been addressed, through litigation that in some cases the punishment of segregation can have damaging and long term effects on mentally ill inmates. Californias penal system has reversed and released inmates from segregation bases on violations of the Eighth Amendment, stating the

failure to provide mental health care could be held unconstitutional if it involves the unnecessary and wanton infliction of pain and reflects corrections officials deliberate indifference to serious medical needs of prisoners. Gregg v. Georgia, 428 U.S.153, 173 (1976). I believe that there is help available to the mentally ill placed into the United States Prison System. The problem arising most of the time is the availability of funding. In a prison system with population on the rise and a mentally ill population taking over the prisons themselves the only way to get the proper help, which involves education, medical staff, counselors, active programs and the like is through funding.

1) Presidents New Freedom Commission on Mental Health, Achieving the Promise: Transforming
Mental Health Care in America (2003) http://www.mentalhealthcommission.gov/reports/FinalReport/toc.html.

2) David Lovell & Ron Jemelka, When Inmates Misbehave the Costs of Discipline, (1996)

3) Terry A. Kupers, Prison Madness: The Mental Health Crisis Behind Bars and What We Must Do About It (1999). http://www.hrw.org/legacy/english/docs/2003/10/22/usdom7148.htm

4) http://www.prisonlaw.com/pdfs/AdministrativeSegregation,Jun10.pdf

5) Jaime Fellner A Corrections Quandary: Mental Illness and Prison Rules (2006) , Director, U.S. Program, Human Rights Watch, New York, NY. J.D., Boalt Hall School of Law, University of California at Berkeley http://www.law.harvard.edu/students/orgs/crcl/vol41_2/fellner.pdf