Mentally ill offenders in prison
Mental illness in prisons has been sort of a pandemic for correctional systems in the United States for over the last 10 years. The number of men and women who come to prison with some form of mental illness continues to grow by the day. Offenders who do not come to prison mentally ill, will most likely release from prison with some form of mental illness at the end of their incarceration. How this population of prisoners adapts when they come to prison, how they are viewed by the community will be examined here along with some insights on what should be done along with why I chose this topic.
Many mentally ill offenders come to prison with a variety of disorders schizophrenia, manic depression (bi-polar) or major depression (Schizophrenia.com - Crime, Poverty Violence., n.d.). Schizophrenic inmates probably account for the largest segment of offenders who enter the correctional system every day and have a difficult time adapting to the confines of a correctional environment. By definition schizophrenia is an inability to think, process emotions where people tend to behave in an unacceptable manner because their mind is not able to react to the stimuli from every day life; the name schizophrenia comes from the Greek root "split mind" (Skitzophrenia., n.d.). Hallucinations, hearing voices, paranoia are just some of the symptoms exhibited by mentally ill offenders. These issues will many times keep offenders from acting in a rational manner, causing them to overreact to situations that for people who have no mental illness handle just fine. Schizophrenia is a disorder that can be treated with medications in most instances. When left untreated however a schizophrenic can have hallucinations, delusions, and exhibit bizarre behavior.
Many people who come to prison with a mental illness will ultimately find themselves living in precisely the conditions which can make or contribute to their condition worsening. Conditions like segregated isolation, where offenders may be required to live in a cell by themselves without much if any interaction with other human beings due to their disruptive behavior exhibited in population settings. The paranoia and hallucinations are often made worse by living in cells with up to 3 offenders, where privacy is virtually non-existent, cells are crowded, containing toilet fixtures with no privacy and no place for the few personal items that are allowed to be retained (Brichford, C. , 2009). Many people come to prison after living homeless or from a life where they are used to having their privacy. Adapting to prison life for the mentally ill can become very challenging, where on top of dealing with hallucinations, paranoia; they must deal with the added stress of living with strange and sometimes dangerous people. Mentally ill inmates who feel cornered may react, in most cases violently to what is perceived by them as a threat to their safety and security or what the voices in their head are telling them to do.
Offenders who routinely commit violent acts towards others are often placed into segregated housing units. Living in a four by six foot cell, with a bunk, mattress, bedding, and limited hygiene and personal items offenders are isolated from contact with other people. Interactions with staff are usually very short and on an as needed basis. This may be for such activities as being taken to yard, or showers. Interactions with other offenders are limited to the conversation you can have yelling back and forth. Spending large amounts of time alone in isolation has proven to be negative for almost any person whether mentally ill or not. For those who are not mentally ill, they will surely develop some form of mental illness by the time they are through with prison or living for an extended period of time in segregation. For those who already are mentally ill, they only become worse. The isolation feeds on mental illness magnifying the hallucinations and the paranoia. The danger changes from what they may do to others to what they may do to themselves. Suicidal and self harming behavior, cutting on oneself, chewing chunks of flesh from their arms, banging their head on the wall to make the voices stop are some of the behaviors exercised by mentally ill offenders.
The services afforded the mentally ill is usually dependant on the resources that are available in treating them. For many prison systems this is little. On average it costs prisons $20, 000 a year to house an inmate (Muraskin, R., 2009). This does not account for the additional costs associated with housing mentally ill offenders who require specialized housing (Sigurdson, C., 2000). Prisons are meant to punish, not as mental health treatment facilities though this has been the role that more and more correctional systems are taking on without the needed funding. Prisons depend on funding and resources in the community. The problem with this dependence is that the community lacks such funding itself and what funding they do have is dedicated to those who are not locked up.
As stated by Sigurdson, C. (2000), "Some state medical boards issue licenses restricted to work in corrections. Previously impaired physicians who are considered too unsafe to practice in the community are given licenses to practice in prisons and jails". This certainly speaks to some degree the position and value some states place on treating the mentally ill.
With ten to twenty percent of many budgets accounting for medical and healthcare in prisons, budget cuts that states experience suffer as does funding for many of these basic services. The cost of medications needed to effectively treat many of these disorders has become so high, that many correctional systems have stopped using them or opt for medications that are less effective in treating offenders properly. Services then become limited to the basics required by law: screening within a set amount of time usually one to two weeks; examination and risk assessments; addressing symptoms and addressing mental health emergencies that are of life threatening nature (Brichford, C., 2009).
There are approximately 200,000 people out of 600,000 homeless who suffer from some form or mental illness (Schizophrenia.com - Crime, Poverty Violence., n.d.). Many of these people may have come from a loving home. Due to the decline in resources available, many of these people have ended up on the streets, jobless, addicted to drugs or alcohol in an attempt to cope with their conditions. Mental health services have been hampered by the closing of mental health facilities and reliance on health care insurance to address the needs of those who require treatments necessary in order to enable them to function in society on a normal level. Since not all insurance plans are treated equal and the fact that most treatment for mental illness is done on an outpatient system, it is seldom intense enough to bring those who have become unstable stable (Sigurdson, C., 2000).
Early in our history, the mentally ill were frequently locked up in prisons. In the 1960's there were a great number of mental facilities in operation and the number of mentally ill locked in prisons was not so prevalent. We as a society seemed to have taken several steps backwards and returned to the practice of locking up the mentally ill up in prison while closing mental facilities over the years. Whether this is reflective of a change in position by society as to how the mentally ill should be treated or strictly a result of no available funding remains to be seen. Currently many correctional facilities are working diligently with the community in bridging some of the gaps, and making continuity of treatment a priority in an attempt to minimize those from coming to prison.
An example that demonstrates the lack of treatment available is in a case where an offender signed papers to be committed to a mental health facility. But on the day he intended to do this there were no vacancies. Struggling with what to do, and not coping well with his illness, he went into the forest and hung himself, only to be found a week later, ironically that same time a vacancy occurred that would have allowed his admittance (Bazelon, D. L., n.d.). Another example is when offenders who are picked up on a violation are sanctioned to time in a prison; arrive under the influence of drugs; they are de-toxed, treated for their condition and released from prison with a limited supply of medication and referral to services that usually are unobtainable by the offender (Sigurdson, C., 2000). Cases like this are repeated all too often and evidence as to where on the social scale these people sit.
I have personally over my fifteen years in corrections witnessed many of the scenarios discussed in this paper. I chose this population because as a unit manager for a maximum custody unit in my facility, I see and work with the mentally ill, mental health professionals and staff who deal with them on a daily basis. Though many of the offenders locked up in isolation are there due to their behavior in population, i.e. assaults, fights, or the threats they present to the population within the prison. These offenders are not without some form of mental illness. And for those who do not exhibit signs of mental illness at the beginning of an IMS (Intensive Management Status) program, usually develop them before they leave. Isolation is necessary in ensuring those who cause harm to other cannot do so, but comes at the expense of creating something far worse.
I believe that mentally ill offenders need to be afforded the care necessary to enable them to function on a level that will allow them to live among other offenders. Prisons are negative enough without further negativity being imparted on offenders by housing them in isolation for what really amounts to their mental illness. Communities need to step up to the plate, and be ready to accept offenders who have completed their debt to society for their crimes back into those communities. Prisons are for punishment not the mentally ill. Mental illness is a reality that must be accepted by society and accounted for by providing the necessary treatment facilities and assistance to keep these people from becoming offenders in the first place.
I believe my beliefs concur with current practices within the correctional system I currently work within. With the re-entry initiatives being at the forefront of what my department strives to work with, they are finding ways to bridge the gaps that have been so prevalent in the last few years. I also believe that successful reduction in recidivism must incorporate those services necessary to enable an offender to become productive. Otherwise they will always resort to what will get them by, drugs, alcohol, or the commission of a new crime, knowing that once they are again sent to a correctional facility, they will receive the treatment they need and want.