The Return of 19th Century Mental Hospitals

Prisons and jails in the United States have become de facto mental health institutions, with rates of incarcerated individuals with serious mental illness being 10 times higher than state mental health hospitals. However, prisons and jails are ill-equipped to provide proper care for the mentally ill, leading to a public health crisis. Humanized Justice is an advocacy group working to implement change and provide appropriate mental health care in prisons and jails. The use of force, victimization, and lack of treatment contribute to the challenges faced by mentally ill inmates. The deinstitutionalization of mental health hospitals and the rise in incarceration rates are also connected. Prisons and jails need better training and resources to manage mental health crises. The current system fails to achieve rehabilitation and increases the risk of recidivism. Mentally ill inmates also face higher costs and risk of victimization. The case of Carl Taylor highlights the issues faced by mental Hi, my name is Rachel Marsh. For my sociological analysis and podcast, the topic of discussion is the proxy of our prisons and jails as mental health institutions. With rising rates of incarceration, prisons and jails have replicated 19th century mental hospitals and have indirectly been adopted as contemporary mental institutions. The United States of America has the highest rate of incarceration in the world. The current rate of incarcerated individuals with a serious mental illness is 10 times higher than state mental health hospitals. In current standing, our jails and prisons are ill-equipped to manage and care for the mentally ill population adequately. As a result, it has become a public health crisis. Unpublished data from 2004 to 2005 suggests that the jails and prisons in the United States house more than three times the serious mentally ill than mental institutions and hospitals. In more recent studies, it has been found that approximately 16% of incarcerated individuals suffer from serious mental illness, which is 10% more than the 1983 study, correlating 6.4%. After the deinstitutionalization of mental health hospitals, society has reconditioned the abysmal conditions of the 1950s and implemented U.S. prisons and jails into new mental health facilities. The increasing rate of suicide and victimization of mentally ill individuals in prisons and jails has drawn societal attention and called for the advocacy of humane treatment. Equal opportunity for mental health care, reintegration programs, and a hard look at the individuals who assess, manage, and cultivate our judicial system. Prison is intended for punishment of criminal acts. However, research suggests that it repeatedly fails to achieve its intended goals of punishment and rehabilitation. Using Robert Merton's structural strain theory, the discrepancies in the culturally defined goals for rehabilitation of mental illness and the institutionalized means of achieving rehabilitation of mental illness have fluctuated a strain in the reentry into society and victimized conditions within the prison system. The institutionalization of strain theory correlates with the just desert theory as victimization of prisoners, specifically the mentally ill, is often a product of vulnerability. Humanized Justice is an advocacy group committed to implementing change and spreading awareness for mental illness in the United States prisons and jails. We bring light to the inadequate conditions of our prisons and jails and their inability to manage the rising population of mentally ill inmates. As many of our prisons and jails house a wide population of mentally ill individuals, we strive to implement programs that seek to aid our justice system in circulating appropriate mental health care for individuals with serious mental illness. Programs such as Helping Hands have been a model for the change we wish to instill nationwide. Our work is dedicated and directed at staffing prisons and jails with the appropriate mental health professionals and providing reintegration programs to release prisoners to reduce the rate of recidivism and engage in community action. We strive to bring awareness to the developing rate of mental illness in prisons and jails because of staff-inflicted victimization and provide appropriate mental health care to individuals who have developed mental illness as a result of the conditions they are subjected to while incarcerated. Humanized Justice works to instill equal care and treatment of mental illness in individuals who deserve humane treatment and living conditions, regardless of criminal history, race, gender, culture, and more. Considering past and recent data, it has been concluded that American jails and prisons have become the new mental institutions. Mental illness is a serious issue among citizens of the United States and other countries. It is an issue that affects individuals and society as a whole. Jails and prisons are not equipped to handle the medical and psychiatric capacity needed for serious mental illnesses like schizophrenia. Beyond the scope of medication and psychiatric diagnosis, they cannot provide individuals with appropriate mental care for their disorders and illnesses. In addition, they are not a long-term solution, which correlates to higher risk of suicide, recidivism, and risk to society. The purpose of Humanized Justice is to generate awareness for the mentally ill and incarcerated population and promote the transformation of U.S. prisons and jails to accommodate mental illness more adequately. Furthermore, Humanized Justice will strive to instill community change through volunteer programs such as Helping Hands to aid in reintegration, lower the risk of recidivism, and provide appropriate continued care for individuals suffering from serious mental illness. The common conception in mainstream media has assumed the perspective of victimization of mental health care in prisons and jails. But the academic perspective looks at how society responded to stigmatized mental health, how the stigma results in the overpopulation of mental disorders in correctional facilities, and the correlation between the deinstitutionalization of mental health facilities and the rise in the U.S. incarceration rate. Using data found in various studies, it can be correlated that the academic perspective and the public perspective are both referential to the current state of prisons and jails being party to trans-institutionalization. In an academic journal published in January of 2013, the impact of deinstitutionalization is assessed in correlation to the growth in the population of U.S. prisons and jails, which distinguished that the majority of individuals who would have been placed in psychiatric hospitals have been trans-institutionalized into U.S. jails and prisons. Expanding on the ideology that prisons and jails are ill-equipped to handle the mentally ill population, a 2008 survey per capita found that roughly 316 individuals in prisons and jails suffered from serious mental illness with an extreme lack of care and equipped staff to accommodate the illness. The data derived from the survey provided a correlation between the ability of the criminal justice system to care for the mentally ill and the rise in incarceration rates and recidivism rates. Statistically speaking, this survey demonstrates nearly 80% more than the mentally ill population of 60,000 from inpatient mental hospitals who experience a lack of care or treatment or have an inability for the facility to accommodate the illness or disorder. The conditions within prisons and jails have replicated the 19th century mental health hospitals' abysmal conditions, ultimately leading to deinstitutionalization. The intersection between the prison system and the treatment of the mentally ill in America has become a prominent issue. Though prisons have become a more integral part of the treatment of mentally ill individuals, a prison's primary purpose was never to rehabilitate the mentally ill. A vast portion of research involving the U.S. prison rate holds a strong correlation with mental illness, which further supports the understanding that jails and prisons have become the new psychiatric hospitals of today. In most situations, mentally ill prisoners who refuse to comply with prison rules are often compelled to comply through physical force and are further subject to methods such as chemical sprays, electric shocks, and long-term physical restraints. The conditions of the prisons and jails, as well as the conduct of the correctional officers, do hold a high degree of responsibility in the issues of mental illness in the criminal justice system. As deinstitutionalization was supercharged by the horrifying conditions and treatments subjugated to patients in the 19th century mental health hospitals, it is discouraging at best to acknowledge the replication of these conditions in prisons and jails, as they now house the majority of mentally ill incarcerated. In a study sample of 3,986 incarcerated individuals, it was examined how mental illness and race correspond to the risks related to staff-inflicted victimization. The study found that staff violence is the second most common form of staff misconduct in correctional facilities, amplified by the understanding that staff-inflicted victimization and violence is more common in inmates with mental conditions or racial disparities. Furthermore, in a study using semi-structured, in-depth interviews, the degree of psychological distress for individuals in solitary confinement was assessed using a Brief Psychiatric Rating Scale, or BPRS. Administrative data derived from this study correlated inordinately high rates of severe mental illness and self-harming behaviors compared to general prison populations. The nature of mental illness and the stigma surrounding it has evolved in general society. However, the care and treatment available outside of the bars has not permeated the population within them. Most prisoners suffering from serious mental illness are not made available the necessary treatment to rehabilitate their behavior for social reintegration. Without proper therapies outside of medications, prisons and jails are not equipped to protect society from a relapse of the same behavior, which increases the risk of recidivism, increases economic strain, and further contributes to the crisis of overcrowding, among other things. Not only does funneling the mentally ill into the unsuited prison system hurt prisoners, but it's also financially inefficient. Mentally ill inmates tend to cost the state more than non-mentally ill inmates, as they tend to be incarcerated for longer and have a higher recidivism rate. In some circumstances, the use of force is justifiable to protect oneself or the safety of others. However, in some circumstances, the use of force is an indirect result of the symptoms of mental illness, such as the use of force as a result of urinating on the floor or cursing at a guard. Carl Taylor, convicted of rape in 1995 and serving a sentence of 27 years, has been a banner for criminal justice reform for mentally ill inmates. After Carl's conviction in 1995, he was diagnosed with delusional disorder and paranoid personality disorder. Following the next 20 years, Taylor was frequently transferred to maximum security prisons in northern and western New York. Within his transfers, he was frequently prescribed antipsychotics, such as Risperidol, which was used to calm his behaviors. This demonstrated a lengthy imbalance in his mental instate. On April 13, 2015, a correctional officer at Sullivan Correctional Facility began hounding Taylor to clean his dirty cell. However, he argued for weeks about cleaning it, as he insisted it was a product of ongoing harassment from the prison guards trashing it. Taylor shouted to be left alone and returned to the observation unit. While in transfer, a fight ensued, and Taylor and various other guards began wrestling. Taylor grabbed a baton and thrashed a guard breaking his arm. Following this altercation, Taylor was bombarded by several guards. Inmates who witnessed the altercation stated that they heard Taylor rasp that he couldn't breathe. Once Taylor was taken to observation, he died shortly after arrival. His death was confirmed, and although technically it was a homicide, it resulted more from his poor health. On the final report, it was found to be a result of the heart attack. The DA told the press the officers acted in self-defense and further questions were denied. Taylor had presided in a cell block for inmates with behavioral issues. He had a longstanding history of mental illness, and it was well documented that he had several episodes of psychosis. Carl Taylor's death sparked social change and representation from the advocacy group, The Marshall Project. The Marshall Project is a nonprofit, nonpartisan journalism organization that pursues to establish and sustain the need for national urgency for the issues surrounding the criminal justice system. Several prospects for change call upon the community to aid in reintegration programs, intervention programs, and awareness of the issue, as mental illness is prominent in society outside of bars and inside. An initial step to addressing the use of prisons and jails as mental institutions are to address the ability of the correctional system to manage these conditions. Most prisons and jails do not have the appropriate training, staff, or procedures in place for a mental health crisis. Therefore, if we are to utilize prisons and jails as mental institutions, these institutions need to hold the appropriate staff, reevaluate their training, and reassess the level of force and response to inmates experiencing an episode. During the Civil Rights Movement, deinstitutionalization as a state mental hospital policy began sweeping the nation. Deinstitutionalization was surcharged by the belief that mental institutions were cruel and inhumane, there's new psychotropic drugs that were at the cusp of innovative treatment for mental health disorders, and the prospect of saving money on a state and federal level. Despite efforts, the policy has not had the intended result on all three fronts. Individuals with serious mental health conditions are often found in deplorable conditions, and the scope of medication does not assume the improved function of patients with serious mental illness, despite the improvement in symptoms. Furthermore, the institutional changes allocated more responsibility to underfunded communities through the remittance of a population who is ill-equipped to manage it. In addition, the changing of federal laws contributed to the reduction in available beds in state facilities, which has transferred individuals with mental illness to incarceration rather than receiving care from equipped state-funded facilities. In a 2015 academic journal, the mental health screening procedures and suicide prevention measures of state prisons and jails were scrutinized and examined following the death of Sandra Bland in July of 2015. Bland committed suicide three days after her arrest for a traffic violation. However, the prison staff, among other failures, neglected to complete a high-fidelity mental screening for Bland, as well as failed to follow the minimum suicide prevention protocols for jails and prisons. The journal allocates the deinstitutionalization of mental health facilities in the 1950s to attribute to the rise in mentally ill populations in prisons and jails as a result of deteriorating conditions due to a lack of access to appropriate psychiatric treatment. Sandra Bland's death opened an investigation into the policies and procedures maintained for processing new inmates, as well as the policy and procedures in place for individuals showing symptoms of mental illness. The journal further elaborates on the lack of appropriate care and treatment available in incarcerated individuals, which leads to behaviors and a higher rate of recidivism after release. From the perspective of Merton's strain theory, it is argued that crime is the result of fraternization into expected success, but not achieving success as a result of limited opportunity. From the perspective of mental health, as it correlates to the prison system, individuals with mental illness are expected to achieve an expected level of rehabilitation before reintegration into society. However, the level of success expected is often not met due to the limited amount of resources and treatment available within the criminal justice system. Considering Sandra Bland's death, she was not provided with an appropriate screening measure for suicide risk and mental illness, which ultimately led to her lack of success in rehabilitation and her suicide. As the availability of proper treatment for mental health is lacking within the criminal justice system, the expectation to achieve societal expectations for rehabilitation is not met with the institutional availability for rehabilitation, resulting in a strain between societal and institutional goals. As a result, the likeliness of reintegration and rehabilitation is diminished and victimization and recidivism are at a higher risk. In contemporary society, when an individual is suffering a mental health crisis in America, it is frequently responded to by law enforcement, not a mental health professional. As most individuals of law enforcement backgrounds are not adequately trained in mental health, it has become quite easy to arrest individuals and deem them harmful to themselves or society. As a result, policing and arrests have overtaken our mental health institutions and implemented prisons and jails as the new asylums of tomorrow. From the internal prison perspective, many individuals assume that correctional officers are solely responsible for mental illnesses associated with the prisons and jails. However, the reality is that mental illness does develop due to the circumstances of some prisons. Despite this, there are other prisons who are working with their state legislature and community to implement programs and funding to aid in the housing of mentally ill individuals as well as aid in reintegration. Utilizing a series of first logistic regression models, it was correlated that racial disparity was found in individuals of Hispanic and African American ethnicity and are more likely to be victimized by correctional staff than their white counterparts. This further correlated that Hispanic and African American individuals were more likely to have or develop mental illness on behalf of staff-inflicted victimization. However, the victimization of mentally ill inmates is not strictly confined to the treatment of guards, but it is also attributed to their fellow inmates. In a 2007 survey of male prisoners, one in 12 mentally ill inmates reported at least one instance of sexual abuse over a six-month period, compared to the rate of non-mentally ill prisoners, one in 33, with the victimization rate in females even higher at one in four. As offenders with serious mental illness are at a higher risk of suffering physical and sexual assault, being confined to solitary confinement and experiencing psychological deterioration while incarcerated, the Just Dessert Theory examines the ordinal and cardinal ratios factoring into the vulnerability to serious harm during sentencing. The victimization of prisoners with mental illness is higher than those without. As there are procedures in place to screen for suicide and mental illness during processing, the Just Dessert Principle suggests that the sustainability of conflict theory and the ploy for dominance and power should contribute to the application of appropriate punishment for the crime. As individuals with mental illness are supposed to be identified during processing, conflict theory assumes a role of dominance in victimization, as victimization is often a product of symptoms of mental illness. A majority of solitary confinement and the show of force is a result of the symptoms of mental illness, such as, again, urinating on the floor or showing disrespect to correctional officers. From the perspective of Karl Marx, conflict is assumed when individuals in power create laws and rules to protect their rights and best interests. As correctional officers are given the permissibility to show force or assign solitary confinement, the victimization of prisoners with mental illness increases due to the likelihood of increased symptoms and the deteriorated function, paired with the conflict of power. Since the deinstitutionalization of state mental health policy in the 1950s, individuals with serious mental illness are incarcerated due to disruptive behavior problems that presume them to be a danger to themselves and society. Despite the need for intervention, prisons and jails are not adequately equipped to manage the population of mentally ill inmates. With a lack of appropriate training, staff, funding, and psychiatric treatment, mentally ill inmates are at a higher risk of recidivism, suicide, victimization, and psychological deterioration. With the increasing rates of incarceration in the U.S., it is now a greatly underrepresented public health crisis. The need for advocacy for mental illness within our criminal justice system is vital to the progression of society and addressing the need for community involvement in accommodating mental illness inside and outside of bars.