In a society where individual differences are accepted more than ever, the stigma of mental illness still weighs heavy on our nation. The cost of treating mental illness is a staggering $100 billion each year, yet resources are limited for comprehensive mental health treatment.
A significant percentage of severely mentally ill individuals can become productive members of society, but they are narrowly given the tools and resources to succeed. For the few that receive stabilization services, rarely do they acquire supportive services that empower their continued behavioral health wellness.
So it should not be a shock to discover that there are now three times more mentally ill persons in our jails and prisons than in mental hospitals. At least 16 percent of inmates in jails and prisons have a serious mental illness, and reports indicate that 40 percent of individuals with serious mental illnesses have been in jail or prison at some time in their lives.
It appears we have returned to the early 19th Century when mentally ill persons filled our jails and prisons. A reform movement sparked by activist Dorothea Dix led to more humane treatment of mentally ill persons. In 1850 there was approximately one public psychiatric bed available for every 5,000 people. As of 2010, there was one bed available for every 3,000 people, including the beds in private psychiatric hospitals and on psychiatric units of general hospitals. These statistics are alarming and indicate that despite increased public awareness, comprehensive behavioral health treatment is still limited.
Some may say this is not worrisome because while housed in a correctional facility, the individual is receiving treatment and is kept off the streets. However, as any person working in a correctional facility will tell you, jails and prisons are not created to be mental hospitals. Despite attempts by correctional advocates to retrofit housing cells, correctional facilities are not structurally appropriate for mentally ill patients. And correctional staff are not recruited as psychiatric caretakers.
Not only are mentally ill offenders known to be repeat offenders, they also cost more to care for while incarcerated. Mentally ill detainees stay longer in the correctional system and find it difficult to follow jail and prison rules. In one study, mentally ill inmates were twice as likely to accrue additional charges while detained for facility rule violations. They frequently become behavioral management problems requiring additional medical personnel and security staff to intervene. In addition, multiple studies have shown that approximately half of all inmate suicides are committed by individuals who are seriously mentally ill.
So what does this mean and is there a solution to help deter our nation from incarcerating the mentally ill?
Simply put, Yes. But the solution must come from many different sources and cannot be implemented with simplicity. If we think on a basic level, there are three levels to prevention that have been known to be effective in our health-care system. Why should mental illness be any different? Proper education as to what mental illness is while supporting treatment and wellness will have an impact.
Mental illness disrupts an individual’s thinking, awareness, mood, ability to relate to others and daily functioning. Just as hypertension is a disorder of the heart, mental illnesses are medical conditions that often result in diminished capacity for coping with day-to-day activities. It would be downright neglect if a medical provider turned away a diabetic with uncontrolled glucose levels. Why should treating mental health illnesses be any different?
Many people are familiar with serious mental illnesses, but are often misled by their causes and types of effective treatments. The good news is that recovery and mental wellness are possible. However, early identification and treatment is vital. By ensuring access to treatment and recovery, individuals with mental illness will be more productive members of society and will not be overrepresented in our correctional systems.
Maria A. Brooks is Corporate Clinical Coordinator for Behavioral Health at Armor Correctional Health Services, a minority-owned enterprise that provides comprehensive medical, dental and mental health services exclusively for inmates in jails and prisons.