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<h1>The Treatment of Persons with Mental Illness in Prisons and Jails:
A State Survey</h1>
<p><b><small><a class="moz-txt-link-freetext" href="http://www.tacreports.org/treatment-behind-bars">http://www.tacreports.org/treatment-behind-bars</a></small></b><br>
</p>
<p>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. <br>
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</p>
<p>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.</p>
<p>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.</p>
<p>"<a
href="http://www.tacreports.org/storage/documents/treatment-behind-bars/treatment-behind-bars.pdf"
class="jce_file">The Treatment of Persons with Mental Illness in
Prisons and Jails</a>" 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?</p>
<p>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:</p>
<ul>
<li>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.</li>
<li>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.</li>
<li>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.</li>
</ul>
<p><a
href="http://www.tacreports.org/treatment-behind-bars/executive-summary/226-summary-of-findings">Click
here for the summary of findings</a>.</p>
<h4 class="color-purple">Recommendations</h4>
<p>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:</p>
<ul>
<li><b>Reform mental illness treatment laws and practices</b> in the
community to eliminate barriers to treatment for individuals too ill to
recognize they need care, so they receive help <i>before</i> they are
so disordered they commit acts that result in their arrest.</li>
<li><b>Reform jail and prison treatment laws</b> so inmates with
mental illness can receive appropriate and necessary treatment just as
inmates with medical conditions receive appropriate and necessary
medical treatment.</li>
<li><b>Implement and promote jail diversion programs</b> such as
mental health courts.</li>
<li><b>Use court-ordered outpatient treatment</b> (<a
href="http://www.treatmentadvocacycenter.org/solution/assisted-outpatient-treatment-laws"
target="_blank">assisted outpatient treatment/AOT</a>) to provide the
support at-risk individuals need to live safely and successfully in the
community.</li>
<li><b>Encourage cost studies</b> 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.</li>
<li><b>Establish careful intake screening</b> to identify medication
needs, suicide danger, and other risks associated with mental illness.</li>
<li><b>Institute mandatory release planning</b> to provide community
support and foster recovery.</li>
<li><b>Provide appropriate mental illness treatment</b> for inmates
with serious psychiatric illness.</li>
</ul>
<p>A <a
href="http://www.tacreports.org/treatment-behind-bars/executive-summary/231-a-model-law">model
law</a> is proposed to authorize city and county jails to administer
nonemergency involuntary medication for mentally ill inmates in need of
treatment.</p>
<div class="moz-signature">-- <br>
Freedom Archives
522 Valencia Street
San Francisco, CA 94110
415 863.9977
<a class="moz-txt-link-abbreviated" href="http://www.freedomarchives.org">www.freedomarchives.org</a>
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