Mental Health and the Criminal Justice System

The deinstitutionalization trend that began during the 1960s was based on the notion that people suffering from mental illness would be able to receive better treatment for their disorder in community-based facilities while also saving the state and federal governmental tens of millions of dollars in the process (Lamb & Weinberger, 2019). This movement, however, ultimately backfired and the incidence of individuals with mental illness that become involved with the criminal justice system remains a serious problem for American policymakers and citizens alike today. The purpose of this paper is to review the relevant literature to determine the types of problems that are typically experienced by the criminal justice system in the provision of timely and effective treatment for incarcerated mentally ill offenders and what moral dilemmas arise as a result. In addition, an analysis concerning the costs that are associated with treating mentally ill prisoners is followed by a discussion concerning promising initiatives that are designed to address this problem. Finally, a summary of the research and important findings concerning the treatment of mentally ill prisoners are presented in the paper’s conclusion.
Review, Analysis and Discussion
The moral dilemmas associated with treating mentally ill prisoners
Notwithstanding the need to provide incarcerated individuals with the maximum opportunities for rehabilitation as possible, razor-thin law enforcement budgets and an increase in the prevalence of mental health disorders has created a scenario in which the best most prisons can expect to accomplish is keeping staff and prisoners safe and healthy. Moreover, the prevalence of mental health disorders has been on the rise in recent months due to the combination of the existential threats of a once-in-a-century global pandemic, a nation confronted with violent civil unrest and a devastating economic downturn which have strained the ability of the health care community to its limits. Against this backdrop, it is clear that mentally ill prisoners are at a severe disadvantage in terms of receiving the health care interventions they need due to a fundamental scarcity of taxpayer resources. This situation also means that criminal justice authorities are faced with a moral dilemma in terms of selecting which prisoners receive what mental health treatment resources are available and what criteria should be applied for eligibility.
The costs associated with treating mentally ill prisoners
The costs that are associated with treating mentally ill prisoners are staggering, and even minimal mental health care can rapidly drain a prison’s entire budget for medical services. Indeed, providing incarcerated individuals who are suffering from mental disorders costs around $31,000 per year but providing these same people with community-based mental health services only runs about $10,000 annually (Gilbert, 2015). These are important considerations since current estimates indicate that as many as one in every six people that are incarcerated each year already suffers from a serious mental disorder, and incarceration invariably worsens these conditions over time (Addressing mental illness in the criminal justice system, 2009).
Furthermore, due to the traumatic exigencies of imprisonment including far higher rates of physical violence, suboptimal nutritional offerings and the isolation that are characteristic of many prisons in the United States today, even individuals who enjoy comparatively sound mental health upon being incarcerated may develop serious mental disorders which will then require the allocation of even more scarce resources for treatment. In this regard, the U.S. Department of Justice (2009) emphasizes that:
Many offenders with mental illnesses don’t receive treatment during incarceration. Without treatment, conditions can worsen. Offenders can become a greater threat to themselves and to others when they leave jail or prison. This is not only a disservice to the offenders and their families; it is a threat to public safety. (Addressing mental illness in the criminal justice system, 2009, p. 1).
In sum, providing adequate treatment for incarcerated individuals suffering for mental health disorders represents a daunting enterprise, but there are some promising initiatives available that can help alleviate this drain on criminal justice resources as discussed below.
Promising policies or programs aimed at alleviating this problem
The responses to crime rates and corresponding initiatives that are designed to address the problem of treating mentally ill prisoners have varied across the country, but most have focused on group-based interventions for incarcerated prisoners and community-based resources post-release. Because the types and severity of the mental disorders that this population experiences is far greater than the general population, it is not surprising that there have been mixed results in terms of their respective effectiveness (Ireland & Ireland, 2011). Some of the more promising evidence-based initiatives that have been implemented in recent years include specialized housing for mentally ill prisoners. Specialized housing alternatives also differ from state to state and even prison to prison, but generally include the provision of inpatient mental health care and crisis beds for short-term mental health episodes as well as long-term residential units (Interventions for adults with serious mental illness who are involved with the criminal justice system, 2012).
Conclusion
The research showed that mentally ill individuals tend to become involved with the criminal justice system at much higher rates than the general population, and the economic and social costs that are associated with treating this population extend far beyond cellhouse bars. Indeed, the research also showed that even otherwise mentally healthy individuals may develop serious mental disorders due to the deleterious effects of incarceration and the ongoing Covid-19 pandemic is expected to further exacerbate mental health disorders among the general population well into the foreseeable future. Taken together, it is reasonable to conclude that this is one of the most pressing problems facing the citizens of the United States today, but it remains largely hidden from public scrutiny. Based on the foregoing, it is reasonable to conclude that the next stimulus package must include adequate funding for this critical need before it too spirals out of control.



References
Addressing mental illness in the criminal justice system. (2009). U.S. Department of Justice. Retrieved from https://www.justice.gov/archives/opa/blog/addressing-mental-illness-criminal-justice-system.
Gilbert, M. (2015, May 5). Treatment, not jail: It’s time to step up. National Alliance on Mental Illness. Retrieved from https://www.nami.org/.
Interventions for adults with serious mental illness who are involved with the criminal justice system. (2012, September 13). U.S. Department of Health & Human Services. Retrieved from https://effectivehealthcare.ahrq.gov/products/mental-illness-adults-prisons/research-protocol.
Ireland, J. L. & Ireland, C. A. (2011). Personality structure among prisoners: How valid is the five-factor model, and can it offer support for Eysenck’s theory of criminality? Criminal Behavior and Mental Health, 21, 35–50.
Lamb, R. & Weinberger, L. E. (2019, October 10). Deinstitutionalization and other factors in the criminalization of persons with serious mental illness and how it is being addressed. CNS Spectrums, 25(2), 173-180.