Paul Heroux: Mental Illness as Key
Mental Illness in Jail
One particular population in any jail or prison stands out more than any other, and that population is the one afflicted by a mental illness. Jails and prisons are the new asylums.
Consider that when I was working in the Philadelphia prison system, I looked at the percent of inmates who were identified as having a “serious mental illness” and found that 44 percent of such inmates on a random day in 2007 were incarcerated for a most serious charge that was violence-related, which was often resisting arrest, meaning that something less serious precipitated the initial police involvement. Furthermore, 25 percent had a most serious charge related to drugs.
What was even more revealing was that there was a near-perfect correlation between the number of times people were incarcerated and the percent who were suffering from a mental illness. For example, of the people who were incarcerated only once in jail (i.e., for the first time), I found that just over 10 percent were identified as having a serious mental illness. However, of people who were incarcerated 16 times, more than 50 percent had a serious mental illness at one point during their 16 times in jail (view data).
Jail is one of the largest recipients of persons with a serious mental illness. Is incarceration the best our society can do for people in need in America?
Substance abuse is a catalyst for violence in persons afflicted with a mental illness, and by one measure, some 80 percent of persons admitted to prison professed that they were either under the influence of a substance or had been in the 30 days prior to their incarceration. However, absent substance abuse, research shows that rates of violence may reflect factors common to a particular neighborhood rather than symptoms of a psychiatric disorder. Crime in persons afflicted by mental illness is a highly preventable issue.
There was a time when psychiatric institutions were rife with abuses in the pre-1950 era. But in the late 1950s and early 1960s, the introduction of psychotropic medications made such hospitals archaic. But when patients felt good with the use of psychotropic medications, many stopped taking their medication. Often, instability resulted in homelessness and, too often, incarceration. Prison and jail are the new asylums.
Persons afflicted with a condition sometimes need help and sometimes don’t. The point here is that either way, it is incumbent upon the private and public sectors to make sure that help is available. Unless there is a sustained public dialogue and resolve about supporting persons afflicted with mental illnesses, we will find that the words of 19th-century Russian novelist Fyodor Dostoevsky still ring true: “The degree of civilization in a society can be judged by entering its prisons.”