Jersey Devil
16th May 2005, 20:38
Indeed, Frontline hits the nail on the head with this documentary. It was very well done and discusses the large amount of mentally ill prisoners in a prison in Ohio with interviews with the officers that work in the prison, psychologists, and the mentally ill prisoners. One of the biggest points that it brings up is the fact that many of these mentally ill prisoners can't find adequate mental healthcare outside the prison system. There was even one case where one of the prisoners deliberately did something illegal to get back in jail to receieve treatment.
Also what happens is that as soon as they get out, they stop using their medication, and eventually return to jail. The system seems ridiculous and was criticized by pretty much all of the officers in the prison. They give them enough medication for two weeks and then expect these people who can barely manage their lives to be assertive enough to find adequate care on the outside.
Furthermore the documentary also showed the stark contrast between the actual prison and these "asylum"-like hospitals that they had in them. What would happen is that if one of the mentally ill prisoners would act up they would send them to the hospital, then with medication and constant oversight from mental health professionals they would get better and then eventually be returned to the prison. What it brought up with this is that the atmosphere in the hospital was better then that in the prison for the mentally ill prisoners and that it helped them cope with their illness. So why not just keep them in these hospitals full-time?
What is interesting is that the Ohio prison in which they did this documentary from is really one of the best in the nation with regards to treating mentally ill prisoners. Unfortunately there seems to still be many states which still do not realize that these people need treatment and just treat them as they would any other prisoner.
This is the link to the documentary page, you can also check out a small piece on the situation in your state regarding the mentally ill in the prison system.
http://www.pbs.org/wgbh/pages/frontline/shows/asylums
New Jersey
12 percent of New Jersey's total prison population of 27,246 was diagnosed as mentally ill as of 2003. Corrections officials surveyed considered the 198 therapists on staff in 2004 to be an adequate number. Correctional officers and supervisors are required to receive special training in the management of mentally ill inmates, including suicide prevention. Mental illness is taken into consideration when inmates are sanctioned for committing acts of violence in prison.
The FAQ's page is very informative as well:
http://www.pbs.org/wgbh/pages/frontline/sh...s/etc/faqs.html (http://www.pbs.org/wgbh/pages/frontline/shows/asylums/etc/faqs.html)
What percentage of the U.S. jail and prison population is mentally ill?
Of the nearly 2 million inmates being held in prisons and jails across the country, experts believe nearly 500,000 are mentally ill. According to the National Alliance for the Mentally Ill (NAMI), 16 percent of the prison population can be classified as severely mentally ill, meaning that they fit the psychiatric classification for illnesses such as schizophrenia, major depression, and bipolar disorder.
---------------------------------------------------------------------------------------------
Why are so many mentally ill people ending up behind bars? Who is to blame?
Most experts agree that the increasing number of imprisoned mentally ill people is due to two major policy shifts over the past decades. One was deinstitutionalization, or the process of closing down mental hospitals throughout the country that began in the 1950s. The idea was that the mentally ill would do better living back in the community with a community-based mental health care system in place to handle their needs. But adequate funding, coordination and commitment didn't follow this change and the lack of resources and commitment to a community-based system of care continues to be a problem in the vast majority of American communities.
The other policy shift behind the rise in mentally ill behind bars was the tougher sentencing laws implemented in the 1980s and '90s that have resulted in a large increase in the prison population.
"Unfortunately, I do believe that some of the mental health treatment that we provide in prisons is better than what one might get in the community," says Dr. Reginald Wilkinson, the head of the Ohio prison system. "I've actually had a judge mention to me before that, 'We hate to do this, but we know the person will get treated if we send this person to prison.' When you know the courts are more apt to send a person to prison because they are going to get treated, there's something disconcerting about that."
"I just think that there's a population that's not at times desirable, and it's expensive to provide services [for them] in the community," says Debbie Nixon-Hughes, chief of the Ohio Department of Rehabilitation and Corrections' Bureau of Mental Health Services. "… There's no secret: This is the age where no one wants new taxes, and it's going to cost money to provide the level of services to decrease the prison and jail population."
---------------------------------------------------------------------------------------------
How difficult is it to provide mental health treatment inside a prison?
According to the Human Rights Watch report Ill-Equipped:
Our research suggests that few prisons accommodate [mentally ill prisoners'] mental health needs. Security staff typically view mentally ill prisoners as difficult and disruptive, and place them in barren high-security solitary confinement units. The lack of human interaction and the limited mental stimulus of twenty-four-hour-a-day life in small, sometimes windowless segregation cells, coupled with the absence of adequate mental health services, dramatically aggravates the suffering of the mentally ill. Some deteriorate so severely that the must be removed to hospitals for acute psychiatric care. But after being stabilized, they are then returned to the same segregation conditions where the cycle of decompensation begins again. The penal network is thus not only serving as a warehouse for the mentally ill, but, by relying on extremely restrictive housing for mentally ill prisoners, it is acting as an incubator for worse illness and psychiatric breakdowns.
According to Dr. Gary Beven, the regional medical director of the Ohio prison system, "Providing effective psychiatric care in a maximum-security prison is extraordinarily difficult. Many patients decompensate and become extremely depressed, hopeless, suicidal. Many turn to severe self-mutilation or acts of self-injury. And many inmates that also suffer from severe mental illness become delusional and hallucinate."
Another issue in treating mentally ill prisoners is malingerers, or those who exaggerate or fake problems in order to receive treatment. Beven says that one of the risks in treating potential malingerers is that the staff becomes desensitized to the truly sick. "… [T]he worst thing you could do is to assume everyone is a malinger," he says. "That's the worst thing you can do because eventually you're going to ignore somebody who's very, very sick."
But Beven says that there are also success stories. "… [W]e work with patients on such an intensive, long-term basis that over time, perhaps several years, they begin to trust you and they can show you that they have earned some trust that they've never had before," he explains. "And in that setting, you can have some genuine success. There's been some miracle cures for patients that other people have believed in the past -- even their own families, school systems, private psychiatric agencies have thought, 'This person's completely hopeless.' And then when they come here, they turn around entirely and it's almost a miracle."
---------------------------------------------------------------------------------------------
What is segregation and how does it affect the mentally ill?
Segregation is when prisoners are sent to solitary confinement, usually because of discipline problems. According to Human Rights Watch, the mentally ill are disproportionately represented in segregation units and in most prison systems, the mental health services in segregation is lacking.
"If you're mentally ill when you go into segregation, you're going to become worse invariably," says Fred Cohen. "If you're not mentally ill, the risk of becoming mentally ill is very high from isolation. Some people dispute that, but in my experience, the people who are just so unsocialized and so psychologically fragile to begin with are deprived of any kind of social support, any kind of psychological stimulus. And they just fall apart."
Judges in California, Wisconsin, and Texas have ruled that holding the mentally ill in segregation is unconstitutional and violates the Eighth Amendment's prohibition against cruel and unusual punishment.
Also what happens is that as soon as they get out, they stop using their medication, and eventually return to jail. The system seems ridiculous and was criticized by pretty much all of the officers in the prison. They give them enough medication for two weeks and then expect these people who can barely manage their lives to be assertive enough to find adequate care on the outside.
Furthermore the documentary also showed the stark contrast between the actual prison and these "asylum"-like hospitals that they had in them. What would happen is that if one of the mentally ill prisoners would act up they would send them to the hospital, then with medication and constant oversight from mental health professionals they would get better and then eventually be returned to the prison. What it brought up with this is that the atmosphere in the hospital was better then that in the prison for the mentally ill prisoners and that it helped them cope with their illness. So why not just keep them in these hospitals full-time?
What is interesting is that the Ohio prison in which they did this documentary from is really one of the best in the nation with regards to treating mentally ill prisoners. Unfortunately there seems to still be many states which still do not realize that these people need treatment and just treat them as they would any other prisoner.
This is the link to the documentary page, you can also check out a small piece on the situation in your state regarding the mentally ill in the prison system.
http://www.pbs.org/wgbh/pages/frontline/shows/asylums
New Jersey
12 percent of New Jersey's total prison population of 27,246 was diagnosed as mentally ill as of 2003. Corrections officials surveyed considered the 198 therapists on staff in 2004 to be an adequate number. Correctional officers and supervisors are required to receive special training in the management of mentally ill inmates, including suicide prevention. Mental illness is taken into consideration when inmates are sanctioned for committing acts of violence in prison.
The FAQ's page is very informative as well:
http://www.pbs.org/wgbh/pages/frontline/sh...s/etc/faqs.html (http://www.pbs.org/wgbh/pages/frontline/shows/asylums/etc/faqs.html)
What percentage of the U.S. jail and prison population is mentally ill?
Of the nearly 2 million inmates being held in prisons and jails across the country, experts believe nearly 500,000 are mentally ill. According to the National Alliance for the Mentally Ill (NAMI), 16 percent of the prison population can be classified as severely mentally ill, meaning that they fit the psychiatric classification for illnesses such as schizophrenia, major depression, and bipolar disorder.
---------------------------------------------------------------------------------------------
Why are so many mentally ill people ending up behind bars? Who is to blame?
Most experts agree that the increasing number of imprisoned mentally ill people is due to two major policy shifts over the past decades. One was deinstitutionalization, or the process of closing down mental hospitals throughout the country that began in the 1950s. The idea was that the mentally ill would do better living back in the community with a community-based mental health care system in place to handle their needs. But adequate funding, coordination and commitment didn't follow this change and the lack of resources and commitment to a community-based system of care continues to be a problem in the vast majority of American communities.
The other policy shift behind the rise in mentally ill behind bars was the tougher sentencing laws implemented in the 1980s and '90s that have resulted in a large increase in the prison population.
"Unfortunately, I do believe that some of the mental health treatment that we provide in prisons is better than what one might get in the community," says Dr. Reginald Wilkinson, the head of the Ohio prison system. "I've actually had a judge mention to me before that, 'We hate to do this, but we know the person will get treated if we send this person to prison.' When you know the courts are more apt to send a person to prison because they are going to get treated, there's something disconcerting about that."
"I just think that there's a population that's not at times desirable, and it's expensive to provide services [for them] in the community," says Debbie Nixon-Hughes, chief of the Ohio Department of Rehabilitation and Corrections' Bureau of Mental Health Services. "… There's no secret: This is the age where no one wants new taxes, and it's going to cost money to provide the level of services to decrease the prison and jail population."
---------------------------------------------------------------------------------------------
How difficult is it to provide mental health treatment inside a prison?
According to the Human Rights Watch report Ill-Equipped:
Our research suggests that few prisons accommodate [mentally ill prisoners'] mental health needs. Security staff typically view mentally ill prisoners as difficult and disruptive, and place them in barren high-security solitary confinement units. The lack of human interaction and the limited mental stimulus of twenty-four-hour-a-day life in small, sometimes windowless segregation cells, coupled with the absence of adequate mental health services, dramatically aggravates the suffering of the mentally ill. Some deteriorate so severely that the must be removed to hospitals for acute psychiatric care. But after being stabilized, they are then returned to the same segregation conditions where the cycle of decompensation begins again. The penal network is thus not only serving as a warehouse for the mentally ill, but, by relying on extremely restrictive housing for mentally ill prisoners, it is acting as an incubator for worse illness and psychiatric breakdowns.
According to Dr. Gary Beven, the regional medical director of the Ohio prison system, "Providing effective psychiatric care in a maximum-security prison is extraordinarily difficult. Many patients decompensate and become extremely depressed, hopeless, suicidal. Many turn to severe self-mutilation or acts of self-injury. And many inmates that also suffer from severe mental illness become delusional and hallucinate."
Another issue in treating mentally ill prisoners is malingerers, or those who exaggerate or fake problems in order to receive treatment. Beven says that one of the risks in treating potential malingerers is that the staff becomes desensitized to the truly sick. "… [T]he worst thing you could do is to assume everyone is a malinger," he says. "That's the worst thing you can do because eventually you're going to ignore somebody who's very, very sick."
But Beven says that there are also success stories. "… [W]e work with patients on such an intensive, long-term basis that over time, perhaps several years, they begin to trust you and they can show you that they have earned some trust that they've never had before," he explains. "And in that setting, you can have some genuine success. There's been some miracle cures for patients that other people have believed in the past -- even their own families, school systems, private psychiatric agencies have thought, 'This person's completely hopeless.' And then when they come here, they turn around entirely and it's almost a miracle."
---------------------------------------------------------------------------------------------
What is segregation and how does it affect the mentally ill?
Segregation is when prisoners are sent to solitary confinement, usually because of discipline problems. According to Human Rights Watch, the mentally ill are disproportionately represented in segregation units and in most prison systems, the mental health services in segregation is lacking.
"If you're mentally ill when you go into segregation, you're going to become worse invariably," says Fred Cohen. "If you're not mentally ill, the risk of becoming mentally ill is very high from isolation. Some people dispute that, but in my experience, the people who are just so unsocialized and so psychologically fragile to begin with are deprived of any kind of social support, any kind of psychological stimulus. And they just fall apart."
Judges in California, Wisconsin, and Texas have ruled that holding the mentally ill in segregation is unconstitutional and violates the Eighth Amendment's prohibition against cruel and unusual punishment.