This article series is designed to raise awareness about the prevalence of persons with mental illness (PMIs) in the criminal justice system and the challenges it creates for organizations, working professionals, and the PMIs themselves. National statistics suggest that:
- 20% of police calls for service involve mental health or substance abuse crises.
- 28% of people in jail report experiencing serious psychological distress in the past 30 days as compared to only 4% of the general population.
- 74% of people serving sentences in state prisons have some type of mental health or substance abuse problem.
- 32.3% of people on probation and 36.6% of people on parole have a mental illness compared to 18.2% in the general population.
What accounts for the overrepresentation of PMIs in the criminal justice system, and how will agencies address their specialized needs? These are just a few of the questions explored within this four-part series.
Defending the Rights of Persons with Mental Illness in our Nation’s Prisons
Throughout my education as a criminal justice major at Eastern Kentucky University, I learned about problems surrounding the treatment of persons with mental illness in our nation’s criminal justice system. Having seen first-hand the challenges that mental illness presents, I was compelled to learn more about the problem. I devoted my honor’s thesis to the examination of legal issues surrounding the treatment of mental illness in our nation’s prisons.
According to the Prison Policy Initiative (PPI) about 43% of persons incarcerated in the U.S. have been diagnosed with a mental disorder. Among persons with mental illness (PMIs) in our state prisons 74% reported that they had not received any mental health care while incarcerated. Without this care, PMIs have more trouble adjusting to prison and may act aggressively in response to a heightened perception of danger. While this perception is often driven by paranoia and hallucinations, their fears are well founded based on research suggesting that PMIs experience a high rate of victimization in prison. In sum, our failure to provide treatment for PMIs creates a dangerous environment for both the suffering individuals and those around them.
Legal Obligations Surrounding the Treatment of PMIs
Inhumane methods of punishment are constitutionally prohibited by the 8th Amendment cruel and unusual punishment clause. Although early Supreme Court cases addressed the most egregious forms of punishment (e.g., torture, methods of execution causing lingering death), more recent Court decisions interpreted the clause to embody “broad and idealistic concepts of dignity, civilized standards, humanity, and decency” (Jackson v. Bishop, 1968). Based on these ideals Justice Marshall, in the majority opinion for Estelle v. Gamble (1976), concluded that “deliberate indifference to serious medical needs of prisoners constitutes the ‘unnecessary and wanton infliction of pain’” that is prohibited by the 8th Amendment. This ruling applies equally to physical and mental health care. Despite this constitutional protection, mental health advocates suggest that proving “deliberate indifference” is a high bar to meet, especially for persons in prison with limited capacity for filing lawsuits.
The Current Status of Mental Health Treatment within Prisons
Several factors converge to undermine the provision of quality mental health care in prisons. Given the stigma attached to mental illness and a lack of compassion for PMIs convicted of crime, there is little public or political will for improving their circumstances in or out of prison. These societal attitudes are compounded by crowded institutions. The institutional staff are often unprepared and lacking the resources to ensure that the needs of PMIs are being met.
I was surprised to learn the apparent dismissal of the problem by system stakeholders as one that was simply unsolvable. For example, in the case of Braggs v Dunn (2017), a US District Court Judge ruled that the rights of PMIs in Alabama prisons were violated based on “horribly inadequate” mental health care that contributed to extraordinarily high rates of suicide. A subsequent court order stipulated improvements including increased staffing levels and safety checks on persons in solitary confinement. At this writing, these stipulations have yet to be met.
I understand that prison administrators and staff have a tough job and that the resource limitations are very real. I also understand that the criminal justice system was not built to treat PMIs. But as a society we have made choices about mental health care that pushed that responsibility onto the system. Therefore, it needs to adapt and provide PMIs with their constitutionally protected rights to mental health care.
The research process for my thesis was not as straightforward as I hoped. I realized it wasn’t a simple legal issue but a question of ethics. During my final semester, I interviewed professionals across the criminal justice system to gain their perspectives on these issues and highlight what is being done within their agencies to address them. I hope you will check back next month to see what I have learned.
By: Sophie Owen, 2023 Graduate of EKU’s Criminal Justice Program
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