Congress Should Afford the Mentally Ill Healthcare, Not Prison Terms

1. Overview

For a long time, NAMI and other organizations, as well as individuals, have persisted in calling on the Congress to ensure that mentally ill persons who are convicted by the courts are not incarcerated as typical criminals (Pfeiffer, 2007; Torrey, 2002). The Congress should develop alternatives to the imprisonment of the persons. As well, the Congress should ensure that the persons have access to proper treatment and that there is appropriate coordination between the criminal justice system in place and mental wellbeing (Landsberg, 2002; Scheid & Brown, 2010).

Up to the 19^th century, American prisons were often utilized in holding gravely mentally ill persons. Then, the prisons and the system running them were seriously inhumane. Their inhumanity persuaded many advocates in the 19^th century to force reforms in how the state cared for those with mental illnesses. The contemporary public psychiatric hospitals were developed in the last century (Pfeiffer, 2007; Torrey, 2002). State governments have been charging the hospitals with offering mentally ill persons professional treatment as well as rehabilitation.

In recent decades, there have been dramatic changes in state penal and psychiatric populations. According to Lamb and Weinberger (1998), nationally, the institutions’ total population peaked in 1955 at 559,000 prisoners. Up to the 1980s, the mental institutions across America held larger populations than the prisons across the country. Presently, the mental institutions across America hold smaller populations than the prisons across the country.

About a third of all the patients in psychiatric hospitals in USA have been referred to them by different courts. Presently, there are more mentally persons in prisons than in hospitals. In 1998, a survey executed by the BJS (Bureau of Justice Statistics) established that, then, 238,800 persons suffering mental illnesses were in prison (Ditton, 1999). That statistic and related ones are possibly higher as many persons may be unwilling to publicize their psychiatric conditions or are ignorant of the conditions.

1. Why Mental Ill Persons are Going to Jail Rather than to Hospitals

In the 1950s along with 1960s, many states carried out massive programs for deinstitutionalizing patients. Some of the patients had lived with mental illnesses in hospitals for many decades. The development of the programs was motivated by then introduction of various psychotropic medications. As well, the development was motivated by then heightening litigations regarding abuses and poor living conditions within the hospitals. Such programs held marked promise for the reinstating of the patients released from the hospital to neighborhood membership with suitable supports.

Commonly, though, the duty of caring for the patients and the related monetary burden fell on their families. Presently, the institutionalization of a coordinated and comprehensive community mental wellbeing systems, or schemes, still appears remote in many jurisdictions across the country. Certainly, that has contributed considerably to mentally ill persons’ criminalization. Clearly, the country’s mental wellbeing officials and criminal justice regime do not intend to have the persons move from hospitals to prisons in large numbers (Pfeiffer, 2007; Torrey, 2002). Even then, public spending has lagged rather behind in ensuring that the persons do not move from hospitals to prisons in large numbers. The limited spending has seen more and more persons with mental illnesses become captives of prisons without ample chances of getting the requisite treatments. Over the years, the spending has become increasingly limited.

• Criminalizing Mentally Ill Persons is Very Costly

Across the US, there are more mentally ill persons behind prison walls than in public psychiatric hospitals by almost 100 to 20. Each year, tax payers spend at least $40,000 to afford care to just one mentally ill prisoner and at least $60,000 to afford care to just one inmate with mental illness. That is incomparable to the approximately $20,000 required to care intensively for an individual with the illness within a community setup annually. The yearly cost managing imprisoned populations has kept on rising over time (Landsberg, 2002; Scheid & Brown, 2010). Indeed, it has been rising at a higher rate than the cost borne by the public as regards education.

The cost for managing imprisoned populations has been rising rapidly owing to the fact that courts are pronouncing more and more sentences, which are mandatory and lengthy. The cost has been as well rising owing to the elimination of parole options in many states, increased utilization of imprisonment for less grave drug-related offenses, and heightened local, as well as state, criminalization of persons with mental illnesses. Presently, the biggest mental health facility across the US is not a hospital. Rather, it is the prison system in the county of Los Angeles. Generally, the resources available to correctional and probation staff, courts, as well as the police, get strained when more and more persons with mental illnesses are sentenced to serve prison times.

1. Mentally Ill Persons Suffer Many Problems Before Imprisonment

The survey executed by the BJS established that offenders with mental illnesses experience multiple, grave problems prior to their incarceration. Prior to their incarceration, they are more likely to have been destitute than persons devoid of the illnesses. Prior to their incarceration, they are more likely to have been unemployed than persons devoid of the illnesses. Prior to their incarceration, they are more likely to have been dependent on alcohol than persons devoid of the illnesses. Notably, in most cases, alcohol dependence gives rise loss of employment. In addition, prior to their incarceration, they are more likely to have been using hard drugs than persons without the illnesses (Ditton, 1999). Imprisoning them does not help in addressing such challenges in any way.

Populations that are deemed dual diagnosis, which are mentally ill and use hard drugs concurrently, are deemed quite challenging to serve. In many communities, such populations remain underserved. The populations face a higher threat of expressing violent conducts, or behaviors than populations of persons with mental illnesses but who do not abuse the drugs according to Lamb and Weinberger (1998). Various providers have expressed willingness to assist the populations deemed quite challenging to serve. Prisons, emergency rooms within hospitals, and destitute shelters are commonly utilized as de facto centers for serving the populations. A teeming system and inadequacy of healthcare for the populations has considerable impacted on their treatment access.

1. Imprisonment Policy Lacks Discretion and Limits Problem-Solving

In recent times, reforms in how courts sentence convicted persons have reduced the discretion of judges as regards sentencing. The reforms have seen more and more persons with mental illnesses end up in prisons. The reforms have eliminated courts’ reflection on the factors giving rise to criminality and limited the number of sentencing options based within communities. In these ways, the reforms, as they are presently, have inhibited the problem-solving capacity of the judicial system.

Notably, if the capacity is enhanced, it could occasion more suitable dispositions regarding sentencing. The approaches adopted by courts during sentencing should be geared towards reducing cases of unjustified incarceration (Pfeiffer, 2007; Torrey, 2002). As well, the approaches should be geared towards increased reservation of costly jail resources for those presenting imminent danger to their communities. Owing to the mental state of those with mental illnesses, they are highly likely to be persistently recycled through diverse jails given that their criminal activities are motivated by their mental conditions (Landsberg, 2002; Scheid & Brown, 2010). Thus, they should be committed to alternative facilities, ideally hospitals, to get treatment as well as the requisite supervision. Communities may establish localized diversion schemes to manage the offenders with mental illnesses rather than having them imprisoned. Such schemes should have adequate capacity for the offenders’ appraisal, treatment, as well as referral, as required.

1. Conclusion

The Congress should note that, presently, the institutionalization of a coordinated and comprehensive community mental wellbeing systems, or schemes, still appears remote. There are more mentally ill persons behind prison walls than in public psychiatric hospitals by almost 100 to 20. Offenders with mental illnesses experience multiple, grave problems prior to their incarceration, imprisoning them does not help in addressing such problems in any way. A teeming system and inadequacy of healthcare for the populations has considerable impacted on their treatment access. The Congress should enact legislation to ensure that mentally ill offenders are committed to alternative facilities, ideally hospitals, to get treatment as well as the requisite supervision rather than being imprisoned.

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