One in six U.S. prisoners is mentally ill. Many of them suffer from serious illnesses such as schizophrenia, bipolar disorder, and major depression. There are three times as many men and women with mental illness in U.S. prisons as in mental health hospitals.

The rate of mental illness in the prison population is three times higher than in the general population.

According to the 215-page report, Ill-Equipped: U.S. Prisons and Offenders with Mental Illness, prisons are dangerous and damaging places for mentally ill people. Other prisoners victimize and exploit them. Prison staff often punish mentally ill offenders for symptoms of their illness – such as being noisy or refusing orders, or even self-mutilation and attempted suicide. Mentally ill prisoners are more likely than others to end up housed in especially harsh conditions, such as isolation, that can push them over the edge into acute psychosis.

“Prisons have become the nation’s primary mental health facilities,” said Jamie Fellner, director of Human Rights Watch’s U.S. Program and a co-author of the report. “But for those with serious illnesses, prison can be the worst place to be.”

Woefully deficient mental health services in many prisons leave prisoners undertreated – or not treated at all. Across the country, prisoners cannot get appropriate care because of a shortage of qualified staff, lack of facilities, and prison rules that interfere with treatment.

According to Human Rights Watch, the high rate of incarceration of the mentally ill is a consequence of underfunded, disorganized, and fragmented community mental health services. State and local governments have shut down mental health hospitals across the United States, but failed to provide adequate alternatives. Many people with mental illness – particularly those who are poor, homeless, or struggling with substance abuse problems – cannot get mental health treatment. If they commit a crime, even low-level nonviolent offenses, punitive sentencing laws mandate imprisonment.

“Unless you are wealthy, it can be next to impossible to receive mental health services in the community,” said Fellner. “Many prisoners might never have ended up behind bars if publicly funded treatment had been available.”

The Human Rights Watch report is based on more than two years of research and hundreds of interviews with prisoners, corrections officials, mental health experts and attorneys.

It describes prisoners who, because of their illness, rant and rave, babble incoherently, or huddle silently in their cells. They talk to invisible companions, living in worlds constructed of hallucinations. They lash out without provocation, beat their heads against cell walls, cover themselves with feces, mutilate themselves until their bodies are riddled with scars, and attempt suicide.

The Human Rights Watch report documents how prisoners with mental illness are likely to be picked on, physically or sexually abused, and manipulated by other inmates, who call them “bugs.” For example, a prisoner in Georgia, who is both mentally ill and mildly retarded, has been raped repeatedly and exchanges sex for commissary items such as cigarettes and coffee.

Mentally ill prisoners can find it difficult if not impossible to comply with prison rules, and end up with higher than average rates of disciplinary infractions. Security staff – who usually lack training in mental illness – do not distinguish between the prisoner who is disruptive or fails to obey an order because of illness and a prisoner who causes problems for other reasons.

Mentally ill prisoners have been punished for self-mutilating (“destroying state property”); attempting suicide with a torn sheet (“destroying state property”); for yelling and kicking cell doors because of hearing voices (“creating a disturbance”); for throwing papers at a guard while delusional (“battery”); and for smearing feces on the cell door (“being untidy”). Untrained staff escalate confrontations with mentally ill prisoners, sometimes using excessive force. Several mentally ill prisoners have died from asphyxiation after struggling with guards who used improper methods to control them.

Over the past two decades, prison mental health services in the United States have improved – usually because of prisoner litigation. But the surging number of mentally ill men and women entering prison has outrun the availability of services. Public officials have been unwilling to provide the funds necessary to ensure adequate treatment for all the mentally ill offenders who need it.

“Prison officials are being asked to do something they aren’t equipped to do,” said Fellner. “Prisons are designed for punishment, not as places to provide comprehensive mental health treatment. If people with mental illness must be incarcerated, they should be housed in facilities designed and funded to meet their mental health needs.”

Human Rights Watch urged the U.S. Congress to enact legislation proposed by Senator Mike DeWine (R-Ohio) and Congressman Ted Strickland (D-Ohio) that would provide federal grants to divert mentally ill offenders into treatment programs rather than jail or prison, and to improve the quality of mental health services provided to jail and prison inmates.

Human Rights Watch also recommended the use of independent mental health experts to assess mental health services in each prison system, urged elected officials and the heads of correctional agencies to ensure that mentally ill prisoners receive mental health services consistent with community standards of care, and called for rules to prevent housing prisoners with mental illness in isolated confinement or super maximum security prisons.

Yea I'd jump on this boat for my son DOES have a mental illness and has been wrote up for disobeying a written order!!! YA right

Kyla,

You have presented this problem very clearly. I just wish that these lawsuits against local jails and the prision system itself could make people see that this is a topic that merits in depth discussion. We are losing our brothers, sisters, etc., at an alarming rate due to the negligence of those who are not properly trained to deal with the mentally ill. You would think that the statistics would reveal to those running the system that something is amiss.

I want nothing more than to see improvements within the system, as I just recently lost a friend to suicide while he was incarcerated. Such a devastating turn of events for all of us close to him. How many people must die before this subject is dealt with accordingly? You hear those in charge of the jails and prisions talk about the issues, but what real initiatives are they taking? There are so many circumstances leading up to an inmate's suicide, but as it has been said time and time again...not being trained to deal with the mentally ill. Sub-standard medical, psych assesments, treatment, etc., will always give the system the same results.

I guess my only question is...What is the actual cost of such an endeavor compared to the loss of human life:confused:

Prison staff often punish mentally ill offenders for symptoms of their illness – such as being noisy or refusing orders, or even self-mutilation and attempted suicide. Mentally ill prisoners are more likely than others to end up housed in especially harsh conditions, such as isolation, that can push them over the edge into acute psychosis.

Mentally ill prisoners can find it difficult if not impossible to comply with prison rules, and end up with higher than average rates of disciplinary infractions. Security staff – who usually lack training in mental illness – do not distinguish between the prisoner who is disruptive or fails to obey an order because of illness and a prisoner who causes problems for other reasons.

Human Rights Watch also recommended the use of independent mental health experts to assess mental health services in each prison system....and called for rules to prevent housing prisoners with mental illness in isolated confinement or super maximum security prisons.

My man is a living example of the issues presented in this article.

Diagnosed as bi-polar and suffering from severe depression, he had spent the last 2+ years in administrative segregation...where he was isolated for 23 hours a day, 7 days a week. He has self-mutilated since the age of 9 (when he was introduced to "the system" through a state-run group home), and "riddled with scars" is an apt despcription of his arms and legs. When he cut himself, he was examined, then promptly given more seg time (classified as "OSR"--Other Security Risk). The longer he spent in isolation, the more his moods escalated out of control...inevitably, he ended up in a severely manic state. It's a vicious cycle, one which could have very well cost him his life during this last 'go-round with the Kansas DOC.

He has a frighteningly lengthy disciplinary file from 1997 until a few months before we met in 2002....and while the KDOC (especially the staff at El Dorado CF) would rather portray him as a violent predator, I can't help but wonder how many of those infractions are the direct result of lack of proper medication/treatment, and the corresponding inability to function under the prison's rules when he is in a manic phase.

At the beginning of March, after yet another suicide attempt (during which he was given a disciplinary writeup for "disruptive behavior"), he was transferred to a correctional mental health facility...and the difference is nothing short of amazing. He is taking his meds, working out daily, attending counseling sessions, and progressing through the security levels in a timely manner. His thought and speech patterns are clear and concise. Two weeks ago, he was finally released from ad-seg (placement followed him from the previous facility) into general population. There have been no fights or disruptions, no problems with any staff members. I have spoken at length with his counselor, and he has the highest praise for Shawn's efforts to rehabilitate himself. There are still rough days, and those will probably always be a part of our life together, even when he is home.

But with the right combination of meds, counseling, and a few caring staff members, my man finally has a chance to move forward....and prove that behind the face of depression exists a good man who made a horrible mistake. If the state would have me believe that he is nothing more than a manipulative, violent monster--then they need to step up to the plate and accept their share of the responsibility for creating such a being. Since they refuse to do that, I will instead believe that change is possible, even in an antiquated, overburdened system.

One of the biggest problems with "the system" is its short-sightedness. Budgetary concerns play a role in that, of course....but as another poster mentioned, what IS the cost of a human life? When mentally ill prisoners are eventually released back into society, without the benefit of proper treatment, there are multiple risks for all involved. The prisoner, his community, his family and friends....potential for disaster abounds.

Prevention of a tragedy should never come down to dollars and cents, IMO.


Climbing off my soapbox, now...Kyla, great thread :thumbsup: