[Pnews] US Prisons confine 10 times more mentally ill than state hospitals

[Prisoner News]

  The Treatment of Persons with Mental Illness in Prisons and Jails: A
  State Survey

*http://www.tacreports.org/treatment-behind-bars*

It has been known for almost 200 years that confining mentally ill 
persons in prisons and jails is inhumane and fraught with problems. The 
fact that we have re-adopted this practice in the United States in 
recent years is incomprehensible. Prison and jail officials are being 
asked to assume responsibility for the nation's most seriously mentally 
ill individuals, despite the fact that the officials did not sign up to 
do this job; are not trained to do it; face severe legal restrictions in 
their ability to provide treatment for such individuals; and yet are 
held responsible when things go wrong, as they inevitably do under such 
circumstances. This misguided public policy has no equal in the United 
States.

_______________________________________________________________________

Prisons and jails have become America's "new asylums": The number of 
individuals with serious mental illness in prisons and jails now exceeds 
the number in state psychiatric hospitals tenfold. Most of the mentally 
ill individuals in prisons and jails would have been treated in state 
psychiatric hospitals in the years before the deinstitutionalization 
movement led to closing the hospitals, a trend that continues even today.

The treatment of mentally ill individuals in prisons and jails is 
critical, especially since such individuals are vulnerable and often 
abused while incarcerated. Untreated, their psychiatric illness often 
gets worse, and they leave prison or jail sicker than when they entered. 
Individuals in prison and jails have a right to receive medical care, 
and this right pertains to serious mental illness just as it pertains to 
tuberculosis, diabetes, or hypertension. This right to treatment has 
been affirmed by the US Supreme Court.

"The Treatment of Persons with Mental Illness in Prisons and Jails 
<http://www.tacreports.org/storage/documents/treatment-behind-bars/treatment-behind-bars.pdf>" 
is the first national survey of such treatment practices. It focuses on 
the problem of treating seriously mentally ill inmates who refuse 
treatment, usually because they lack awareness of their own illness and 
do not think they are sick. What are the treatment practices for these 
individuals in prisons and jails in each state? What are the 
consequences if such individuals are not treated?

To address these questions, an extensive survey of professionals in 
state and county corrections systems was undertaken. Sheriffs, jail 
administrators, and others who were interviewed for the survey expressed 
compassion for inmates with mental illness and frustration with the 
mental health system that is failing them. There were several other 
points of consensus among those interviewed:

    * Not only are the numbers of mentally ill in prisons and jails
      continuing to climb, the severity of inmates' illnesses is on the
      rise as well.
    * Many inmates with mental illness need intensive treatment, and
      officials in the prisons and jails feel compelled to provide the
      hospital-level care these inmates need.
    * The root cause of the problem is the continuing closure of state
      psychiatric hospitals and the failure of mental health officials
      to provide appropriate aftercare for the released patients.

Click here for the summary of findings 
<http://www.tacreports.org/treatment-behind-bars/executive-summary/226-summary-of-findings>.


        Recommendations

The ultimate solution to this problem is to maintain a functioning 
public mental health treatment system so mentally ill persons do not end 
up in prisons and jails. To this end, public officials need to:

    * *Reform mental illness treatment laws and practices* in the
      community to eliminate barriers to treatment for individuals too
      ill to recognize they need care, so they receive help /before/
      they are so disordered they commit acts that result in their arrest.
    * *Reform jail and prison treatment laws* so inmates with mental
      illness can receive appropriate and necessary treatment just as
      inmates with medical conditions receive appropriate and necessary
      medical treatment.
    * *Implement and promote jail diversion programs* such as mental
      health courts.
    * *Use court-ordered outpatient treatment* (assisted outpatient
      treatment/AOT
      <http://www.treatmentadvocacycenter.org/solution/assisted-outpatient-treatment-laws>)
      to provide the support at-risk individuals need to live safely and
      successfully in the community.
    * *Encourage cost studies* to compare the true cost of housing
      individuals with serious mental illness in prisons and jails to
      the cost of appropriately treating them in the community.
    * *Establish careful intake screening* to identify medication needs,
      suicide danger, and other risks associated with mental illness.
    * *Institute mandatory release planning* to provide community
      support and foster recovery.
    * *Provide appropriate mental illness treatment* for inmates with
      serious psychiatric illness.

A model law 
<http://www.tacreports.org/treatment-behind-bars/executive-summary/231-a-model-law> 
is proposed to authorize city and county jails to administer 
nonemergency involuntary medication for mentally ill inmates in need of 
treatment.

-- 
Freedom Archives 522 Valencia Street San Francisco, CA 94110 415 
863.9977 www.freedomarchives.org
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