The number of incarcerated individuals in the United States’ jails and prisons with psychiatric disorders has been steadily increasing since the mid-1950s, with the upsurge stemming mostly from the deinstitutionalization movement that gained considerable momentum throughout the nation, particularly within the 1960s (Pittaro, 2015). While well-intended, the movement did not produce the desired expectations. In response to the deinstitutionalization movement, our nation’s jails and prisons have now become “the new psychiatric asylums,” the de facto state psychiatric hospitals, responsible for confining and caring for mentally ill offenders (Pittaro, 2015). As a correctional administrator and professor, I can assure you prisons and jails were never designed nor intended to serve in this capacity. Despite vast improvements made, especially over the last decade, our correctional system is still ill-equipped to adequately provide the resources and care that these men and women deserve.
Today, nearly half the people in US jails, and more than a third of those in US prisons, have been diagnosed with a mental illness, not to mention the prevalence of cooccurring disorders (namely mental illness and addiction), which, by most accounts, increases the likelihood of criminal justice involvement (Yohanna, 2013).
Of course, the deinstitutionalization movement also had several noteworthy successes, one of the most significant outcomes of deinstitutionalization was that it placed the focus on individualized treatment. Deinstitutionalization also led to increased independence and improved quality of life for many individuals who would have typically been institutionalized. Deinstitutionalization has also led to the relocation of many formerly institutionalized individuals to community-based housing, increased socialization, and it is believed to have improved the adaptability to change of many of those formerly institutionalized. These successes highlight the potential benefits of deinstitutionalization when it is accompanied by adequate support and resources in the community (Yohanna, 2013). Nevertheless, while well-intended, deinstitutionalization, for all intents and purposes, at least from a corrections perspective, failed to fulfill its intended goals.
The Largely Unanticipated Consequences of the Deinstitutionalization Movement
Today, the U.S. correctional system has 10 times the number of mentally ill individuals than any state psychiatric hospital (Stringer, 2019). There are now more seriously, and persistently, mentally ill individuals imprisoned in correctional institutions today than in all U.S. state psychiatric hospitals combined, and the number of state prisoners with mental illnesses of varying degrees and severity is estimated to be around 1.25 million (Nishar, 2020). To further illustrate this point, three of the nation’s largest jails (Rikers, LA County, and Cook County) are providing largely unbridled psychiatric care for individuals who would be better served in psychiatric facilities (Nishar, 2020). To compound matters, the research has consistently shown that being incarcerated in a correctional facility is far more likely to worsen, not lessen, the mental health conditions of those individuals, which suggests that when they are eventually released into society, their psychiatric issues have likely intensified, not weakened. Therefore, the likelihood of being reincarcerated shortly after release from confinement is incredibly high.
Psychiatric care within a typical correctional institution is more likely to involve a medicine regimen of antipsychotic medication along with stringent punitive measures such as segregation, the use of physical restraints, and the removal of the inmate’s privileges and amenities, which are already limited simply due to being incarcerated.
An Unintended Criminal Justice Response to a Social Problem
The most common mental illnesses among inmates are depression, anxiety disorder, bipolar disorder, schizophrenia, and post-traumatic stress disorder (PTSD). While these conditions are not necessarily correlated with criminality, the frequency and intensity of these disorders are significantly higher among U.S. prisoners than in the general population, suggesting that such psychological/psychiatric disorders contribute, in part, to criminality (Pittaro, 2015). Furthermore, a higher percentage of prisoners have a personality disorder, particularly antisocial personality disorder, a diagnosis commonly associated with criminal behavior that it is characterized by a disregard for, and violation of, the rights of others. Additionally, prisoners are also more likely to be diagnosed with co-occurring disorders. Co-occurring disorders tend to be more difficult to address because the illnesses can interact with each other, and treatment strategies for the varying disorders may conflict with one another. It is obvious that the prevalence of mental illness among the nation’s correctional population presents numerous challenges to correctional administrators, program staff, and officers.
Victimization and Exploitation
For instance, mentally ill inmates may engage in self-harming behavior, such as self-mutilation or the intentional ingestion of nonedible items that then require medical intervention or disrupt or frighten other inmates with bizarre and inappropriate behavior and outbursts (Torrey et al., 2014). This particular population of inmates may also be prone to aggression, violence, or bizarre, threatening outbursts, particularly if they suffer from delusions or what DeAngelis (2022) refers to as, “command hallucinations,” telling them to hurt others. Mentally ill inmates are also more likely to be victimized by other inmates, are more likely than inmates without mental illness to be placed in segregation, and are more likely than inmates without mental illness to attempt suicide. Mentally ill inmates also tend to stay incarcerated longer than other inmates, which contributes to jail and prison overcrowding. Reasons for these longer stays include difficulty in understanding and following an institution’s basic rules.
A consensus exists among criminal justice practitioners, especially those who work in corrections like me, that individuals who are severely mentally ill would be better served in psychiatric hospitals, not prisons or jails. However, the reality of the situation is that offenders with severe mental illness are currently more likely to occupy a bed inside a correctional institution rather than one in a psychiatric hospital, an unfortunate trend that will likely continue without intervention.
This post was originally published on this site be sure to check out more of their content.
