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New Report Confirms Mentally Ill Prison Inmates Receive Inadequate Services and are Abused

Human Rights Watch (“HRW”) recently issued a new Report finding that mentally ill inmates in US prisons are frequently mistreated, neglected and abused.  The Report also contains a lot of information concerning the role of prisons in the mental health system in this country.

First, according to the HRW Report, prisons have become the primary mental health care facilities in the United States.  One in every six inmates is mentally ill.  In fact, there are three times as many mentally ill prison inmates as there are patients in mental health care facilities.  The rate of mental illness in our prison population is three times higher than in our general population.  Figures gathered by the US Justice Department buttress these findings.  According to a DOJ study, 75% of women and 50% of men in State prisons, and 75% of women and 63% of men in local jails, will have a mental health problem requiring services in any given year.

Mentally ill inmates experience mistreatment and abuse on two different fronts.  First, inmates who do not suffer from mental illness routinely exploit them.  Additionally, their mental illness frequently leads them to violate institutional rules (e.g., making excessive noise, failing to comply with orders, cursing, banging on cell doors), with the result that they are punished for displaying the symptoms of their respective illnesses.  Depending upon the facts and circumstances surrounding a given violation, an inmate can be punished with placement in administrative segregation (the “hole”).  A sufficiently long period of time in such an environment can cause their illness to worsen significantly.  Inmates have also been subjected to excessive force by corrections officers, and some have even died from asphyxiation because of the manner in which guards have tried to control them.

The HRW Report asserts that the increasing number of mentally ill inmates stems from underfunded and poorly organized community mental health services.  State and local governments have closed mental health facilities without replacing them with treatment options.  Further, the mental health care services in prison facilities are extremely poor, lacking qualified staff and other resources.  Prison rules and procedures frequently interfere with treatment.

The Report notes that prison mental health services have improved over the past two decades.  However, such improvement has typically not resulted from government action, but from lawsuits commenced by inmates.  Despite the growing number of mentally ill inmates, governments have been unwilling to provide resources for inmate mental health treatment.

There is proposed legislation in Congress which, if passed, would provide federal grants to divert mentally ill offenders into treatment programs as opposed to prison.  It would also fund more effective mental health services to inmates who need them.

New Jersey is trying to address this issue, at least in part, with mental health courts.  These are specialized courts designed to handle the cases of offenders who are in the system because of mental health problems and issues that caused them to engage in criminal conduct.  Mental health courts are modeled on drug courts, and are designed to provide treatment and services in addition to any sanction that may be necessary.  However, they are not “courts” in the sense that they have been created by legislation and operate according to formally enacted court rules.  Currently, they are programs run by the County Prosecutor.  Additionally, not every County has a mental health court program.  Thus, similarly situated mentally ill offenders may not be treated consistently on a State-wide basis.

Many people reading this post will ask why they should care about mentally ill inmates.  The answer is money.  Providing them with needed treatment and services will probably reduce the recidivism rate among this portion of the inmate population, thereby reducing the overall operating costs of our Federal and State prison systems.  Further, and as noted above, some mentally ill inmates have died as a result of the manner in which guards have dealt with problems arising from their behavior.  If such an inmate’s family commences a wrongful death action, the government must satisfy any judgment with tax dollars.  Thus, while it may seem that the problems associated with mentally ill inmates are far removed from the lives of most people, the public spending aspect of this issue certainly affects each of us on a very practical level.