Who can write my DB?
Blackbarbie
FSWMentalHealth2019.pptxMental Health and Incarcerated People
Overview of the problem
Carceral institutions are largest providers of mental health care
3 times as many SMI in jails and prisons than hospitals
Some estimates state more than 50% of incarcerated individuals (and 70% of women) qualify for a mental health diagnosis (Fisher et al, 2014; Gonzalez et al, 2014)
16% of inmates have SMI, about as many have experienced homelessness prior to arrest (Fisher et al 2014).
30-40% of people with SMI have been incarcerated (Fisher et al, 2014)
Woefully inadequate care – symptoms worsen with incarceration
MH prisoners 2-3 times more expensive
More likely to be placed in solitary confinement
“In historical perspective, we have returned to the early nineteenth century, when mentally ill persons filled our jails and prisons. At that time, a reform movement, sparked by Dorothea Dix, led to a more humane treatment of mentally ill persons. For over a hundred years, mentally ill individuals were treated in hospitals. We have now returned to the conditions of the 1840s by putting large numbers of mentally ill persons back into jails and prisons.”
(Torrey et al., 2010)
Kevin DeMott
19 years old held in adult prison
Diagnosed bipolar disorder
4 months solitary confinement for throwing things off balcony, breaking lightbulbs for self-harm, suicidal behaviors
NAMI: Criminalization of “crisis proportions”
The National Alliance on Mental Illness warned the U.S. Senate Judiciary Committee in 2016 that criminalization of people living with mental illness has reached "crisis proportions“
They called for support of federal, state and local reforms to overcome failings in both the mental health care and criminal justice systems.
How does criminalization of SMI people happen?
Deinstitutionalization – when asylums were emptied, the needed community based services did not appear, and eventually led to people with serious and persistent mental health problems being swept off the streets by the police
Contributing factors include:
Homelessness
Substance use
Increased police contact with broken windows policing policies
Revolving door of lack of/absence of treatment – homeless and using – swept off streets by police – stress of jail – release ….repeat
Deinstitutionalization
Began in the 1960’s. Let’s consider an example from Michigan
1987-2003: 75% of Michigan’s psychiatric facilities closed
1955: 1 psychiatric bed for every 300 Americans
2005: 1 psychiatric bed for every 3000 Americans
Exacerbated by Institutes for Mental diseases (IMD) exclusion (part of social securities act)
Community care fell far short
Increased homelessness
drug and alcohol use as self-medication (for underlying MI and stress of streets)
Police contact
Behaviors that frequently accompany mental health problems lead to charges of trespassing, indecent exposure, resisting arrest, minor assault, property damage, etc.
Disorderly conduct leads to people being labelled “disordered accused”
1 in 4 police shootings are people with SMI
But this is not only a police problem, people with mental health problems often find that CJ involvement exacerbates their underlying reason for CJ contact – their mental health issues
Effects of Imprisonment
isolation from families and social networks
austere surroundings, loss of privacy and poor physical and hygienic conditions
aggression, bullying, fear, suspicion and the attitudes of unsympathetic and uninformed staff
lack of purposeful activity, of personal control, of power to act and loss of identity;
pressure to escape or to take drugs
shame and stigmatization
uncertainty, particularly among remand prisoners, and concern about re-integration into the outside world.
Women Inmates and Mental Health
Female inmates had higher rates of mental health problems than male inmates
73 percent of females versus of 55 percent of males in state prisons.( Mental Health Problems of Prison and Jail Inmates, Published September, 2006 Bureau of Justice Statistics, US Department of Justice. Note: Based on self report data, not necessarily a formal diagnosis).
Women and Trauma
Sexual Abuse:
57% of females report abuse before admission to state prison versus 16.1 percent of males.
39 % of female state prison inmates report that they were sexually abused before admission to state prison versus 5.8 percent of males. (Prior Abuse Reported by Inmates and Probationers, Published in April, 1999. Bureau of Justice Statistics, US Department of Justice).
Physical or Sexual Violence:
Nearly 6 in 10 women in state prisons had experienced physical or sexual abuse in the past.
69 % reported that the assault occurred before age 18.( Women Offenders, Published December 1999, Bureau of Justice Statistics, US Department of Justice).
Compare suicide rates
Rates of suicide for local jail inmates and U.S. residents, per 100,000
Suicide is leading cause of death in jails
More than a third — 34 percent — of all inmate deaths at local jails are self-inflicted, and the rate is increasing (BJS, 2015 report)
7 times higher in jails than prisons (BJS, 2015 report)
face a first-time “shock of confinement”; they are stripped of their job, housing, and basic sense of normalcy.
Many suicide before they have been convicted at all.
Voice from the field
“One of the most powerful experiences of my professional career was talking to a young woman-through a crack in the steel door of her cell-who had been in prison for five years and isolation for the past eighteen months. She was agitated, panicky, and scared as she was scheduled to be released the following week and had nowhere to go. She was someone who was almost certainly abused as a child; had some degree of mental illness; had not made a meal or done laundry in years; had no high school degree; and had been alone for the last year and a half in a room smaller than my bathroom, and would soon be released without support or assistance. I couldn't imagine that she would not end up in some type of prison or mental health facility. Without extensive support and involvement from social workers both before and after release, which our current system does not allow, this young woman is almost certain to fail.“ (Brown, A., Social Worker and Prison Monitor in IL)
