Mentally Ill Fill Prison Cells, Says Fed Study
The nation's prisons and jails are becoming dumping grounds for the mentally ill.
In a report confirming what AFSCME has long warned about, the Justice Department’s Bureau of Justice Statistics reported in July that about 16 percent of the inmates held in the nation’s prisons and jails are mentally ill.
AFSCME has sounded off alarms for decades that the de-institutionalization of the mentally ill — throwing them out of hospitals into the streets — would turn prisons into mental wards. Now there is statistical proof that AFSCME was right.
In fact, some experts say the number of mentally ill inmates cited in the report — an estimated 283,800 at midyear 1998 — is actually low. They also say most existing prisons and jails are not equipped to give the mentally ill proper care, and that most corrections officers are inadequately trained.
“There are some [state] systems that have a very well-trained correctional staff” to handle the mentally ill, says Dr. Henry Steadman, president of Policy Research Associates, a New York think tank on criminal justice and mental illness issues. “And there are other states,” he adds, “that have basically ignored it.”
“Basically, there’s no care for the mentally ill” in the nation’s prisons and jails, declares Terry Kupers, M.D., author of the book, Prison Madness: the Mental Health Crisis Behind Bars and What We Must Do About It.
“What happens is the mentally ill take care of themselves,” he says.
Kupers, a psychiatrist and professor at the Wright Institute, a graduate school of psychology in Berkeley, Calif., says mentally ill inmates are often undiagnosed, and many are ill-prepared to survive within the general prison population.
COs, for the most part, are not provided the training to handle mental health problems, he adds. “What they are set up to do is provide security in an institution ... and they do not know what to do with mental patients. Nor should they.”
James Turpin, spokesman for the American Correctional Association in Maryland, agrees. “Correctional officers are not hired to be mental health caseworkers, and it's not fair or appropriate to expect them to perform that role,” he says.
While 16 percent of inmates in both jails and state prisons are mentally ill, only 7 percent of federal inmates fit that classification, according to the report. The survey was based on interviews with inmates who reported either a mental condition or an overnight stay in a mental hospital.
Dean Burke Foster, professor of criminal justice at the University of Southwestern Louisiana, believes the problem is actually more severe in local jails. “Large numbers of homeless people have some kind of mental disorder, and they get into trouble and end up in jail,” he says.
Justice Department statistics confirm that. “During the year preceding their arrest, 30 percent of mentally ill inmates in jail and 20 percent of those in state or federal prison reported a period of homelessness, when they were living either on the street or in a shelter,” the report says.
That compares to about 17 percent of jail inmates and 9 percent of state prison inmates, who reported periods of homelessness in the year before their arrests.
Some states have built or are building special facilities specifically for mentally ill prison inmates. One is the Oakwood Correctional Facility in Lima, Ohio.
Dave Slone, who sits on the executive board of the Corrections Assembly of the Ohio Civil Service Employees Association/ AFSCME Local 11, says there are 150 inmates at the accredited mental health correctional facility.
That's in a state with about 48,000 inmates in 31 facilities.
At Oakwood, specially trained COs work closely with psychologists and physicians. “We have a lot more staff [to handle the mentally ill] compared to normal [correctional] institutions,” he explains. “We also have a nurse assigned to every unit.”
The state also has 10 residential treatment units (RTUs) at its regular prisons, staffed by AFSCME COs. They are set up “just like in a hospital, but there’s more of a multi-disciplinary team kind of approach,” with therapists, psychologists and social workers as well as COs, says Debbie Nixon-Hughes, chief of the Bureau of Mental Health Services for the Ohio Department of Rehabilitation and Correction.
The department “has developed a pretty comprehensive mental health program, due to the number of inmates who have come into our system with some history of mental illness,” she says.
Inmates in Ohio are screened within 24 hours of admission for mental illness and suicidal tendencies, Nixon-Hughes adds. “We try to treat people in the least-restricted environment. Of course, Oakwood is our most restrictive environment.”
The Justice Department report — its first comprehensive study on mental illness among inmates — does not offer solutions to the problems raised by incarcerating the mentally ill. But some lawmakers believe they have found one.
On June 3, the California Assembly voted 79-1 to approve AB-34, intended to save the state money on corrections expenses by treating the homeless mentally ill before they end up behind bars. The bill, sponsored by Assembly member Darrell Steinberg (D), would provide grants to counties to help rebuild local mental health systems.
Gov. Gray Davis (D) has allocated $10 million in the state budget towards that goal. If AB-34 becomes law — it is now pending in a Senate committee — the measure would control how that money is spent, says Andrea Jackson, Steinberg’s chief of staff.
At the federal level, Rep. Ted Strickland (D-Ohio) introduced legislation (H.R. 2594) on July 23 to create 25 “demonstration projects” around the country where nonviolent mentally ill inmates could voluntarily enter a separate judicially supervised program. It also would authorize funds for special training of COs to deal with such inmates.
The Justice Department’s report also raises questions about the trend toward privatizing state prisons. Kupers, co-chair of the Committee on the Mentally Ill Behind Bars of the American Association of Community Psychiatrists, contends private prisons are the worst places for the mentally ill.
“The first thing private institutions do is skimp on staff,” he explains. “That’s how they make a profit. So they will downsize their professional staff, they’ll have a nursing assistant do what a regular nurse was doing in the public system, or — with a psychiatrist — they will have them on-call instead of having them on the premises."
Access report online or through the Bureau of Justice Statistics fax-on-demand by dialing (310) 519-5550, listening to the menu and selecting document number 162.
