In the session on mentally ill inmates at last week's H.F. Guggenheim Symposium, Dr. Fred Osher, Director of Health Services for the Council of State Governments Justice Center (CSG) , said the majority of mentally ill people in prisons and especially in jails are serving time for non-violent offenses, including minor drug offenses and so-called "quality of life" crimes associated with homelessness and substance abuse, As a report from the CSG's Criminal Justice/Mental Health Consensus Project in 2002puts it, many "have been incarcerated because they displayed in public the symptoms of untreated mental illness." Osher said that the prison environment--noisy, overcrowded, predatory--inevitably causes these symptoms to get worse.
While corrections systems need to improve the ways they assess and treat mentally ill people, the fact of their incarceration in large part represents a failure of the mental health system.
Many end up in jail only because they are overlooked, turned away, or intimidated by an overburdened, underfunded, and inadequate network of mental health services. "People with mental illness," the project's report says, "are falling through the cracks of this country's social safety net and are landing in the criminal justice system at an alarming rate."
Also present at the H.F. Guggenheim Symposium was Robert Carolla, Director of Media Relations for the National Alliance on Mental Illness (NAMI). Carolla agreed that the problem of the incarcerated mentally ill has its roots in the American mental health care system. Following widespread de-institutionalization, he said, budget restrictions kept the mentally ill from getting the community-based services that were supposed to replace inpatient psychiatric care.
"Without state and local mental health services," said a NAMI fact sheet issued last month, "too many people living with mental illness end up in encounters with police or warehoused unnecessarily in jails and prisons."
In other words, the prison became the new asylum. And the money withheld from mental health services, Carolla said, was simply pumped into law enforcement and corrections--along with much more, since the transition from asylum to prison is anything but cost-effective. State corrections spending has more than tripled in the last 20 years, when "what is needed instead," the NAMI publication argues "is investment in mental health treatment and recovery services to minimize costly criminal justice involvement of persons living with serious mental illness."
Such funding for mental health services, as NAMI puts it, "also is an investment in recovery and saving lives of persons who struggle with medical illnesses." Even more than the modest corrections reforms won in New York and elsewhere, this shift in priorities might serve to reduce the number of tortured, anguished hours lived by people with mental illness, alone in their solitary cells.
James Ridgeway, a veteran investigative journalist, is senior Washington correspondent for Mother Jones. Ridgeway and Jean Casella, a freelance writer and editor, recently launched the web site Solitary Watch News, aimed atproviding the first centralized source of information on solitary confinement in the United States.
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