Prison Population, Mental Health, and Drug Reform in the US

Introduction: The Prison Population Crisis

The incarceration rate in the United States is alarmingly high given the advanced nature of the country overall. Indeed, prisons have become the de facto asylums of the current day. While many people in prison should absolutely be there, many others are mentally ill, drug-addicted, or both. If one or both of those conditions were properly addressed, this could serve as a vehicle to significantly drive down the number of people in prison, the rate of recidivism, and the net financial and human burdens — such as loss of life — thrust upon the American public.

While some of the most pernicious patterns have ebbed somewhat, the solutions used thus far are simply not getting the job done. There needs to be a clearer distinction between those who genuinely want to get their lives straightened out and those who are exploiting the mercy of a system that places all blame on society. While it is tempting to blame society, institutions, and other facets of American life for rampant crime, people who want help with drug or mental illness problems should receive it. Those who cannot or will not seek such help need to be otherwise controlled and housed as necessary to protect the public.

Research Question and Hypothesis

The central research question of this paper asks: to what extent can proper social and mental health services for prisoners, parolees, and those on probation improve outcomes through programs focused on mental health improvement, ending drug addiction, and counseling individuals on sound decision-making? There is also room to consider expungements and similar measures for those who remain law-abiding after an initial or minor offense. The question becomes whether there is a net gain for society — in terms of outcomes and taxpayer dollars — when such programs are implemented.

With that in mind, this paper hypothesizes that there would be a net gain in both societal well-being and taxpayer dollars if people were treated for their mental and drug-related conditions rather than being warehoused for a finite period and then released back into the same environments, relationships, and behavioral patterns that contributed to their initial offenses. That said, this argument is not put forward naively as a comprehensive solution to all of society's problems. No single policy could accomplish that. Rather, this is one component of a broader set of reforms that could make meaningful progress if properly funded, resourced, and implemented. Concurrent efforts would need to include appropriate family planning support, better management of homelessness, and eliminating the educational disparities linked to poverty. Poverty is deeply intertwined with all of these issues, as destructive life choices can lead to poverty, and poverty in turn generates a cascade of further problems (Groffen et al., 2008).

Drug Offenders and the Case for Treatment

The data supporting the above research question and hypothesis are extensive and widely available. A key question — alluded to earlier and now stated explicitly — is how to strike the right balance between public safety and maintaining the incarceration rate at an optimal level. There is a point at which too many people are confined unnecessarily, yet releasing too many individuals indiscriminately can lead to increased harm. As Raphael (2014) asks, how can the United States reduce its incarceration rates without simultaneously endangering the public?

Raphael uses the harsh drug sentences imposed on offenders in the United States as a test case for evaluating whether those sentences produce meaningful deterrence or are simply overly punitive. Beyond sentencing policy, it is important to recognize that there are multiple categories of drug criminals: users, dealers and traffickers, and those who occupy both roles. The central dilemma with drug users is that drug use — at least initially — is a matter of choice. Similarly, choosing to acknowledge a problem and seek help is a choice, as is the decision to change one's environment, avoid the people and places associated with prior drug use, and resist relapse.

This paper asserts that those who make the right choices should be given both a legal and a treatment-based opportunity at redemption. Those who do not — and who harm others as part of their pattern of drug use — can and should remain incarcerated, as they pose a danger to others. The claim that drug use is a victimless crime is, to put it charitably, disconnected from reality. To characterize it as a purely moral failing, however, is equally fallacious (Raphael, 2014).

Conclusion

American society has always been rather inadequate in its handling of those with mental health and drug problems. While so much of what is involved reflects voluntary behavior, resorting to quick and expedient solutions is not the right answer. Psychology, psychiatry, and counseling have advanced enormously over the years. That said, the way in which society addresses deviance and its underlying causes needs to change a great deal more before meaningful progress can be claimed.

References

Groffen, D. I., Bosma, H., van den Akker, M., Kempen, G. M., & van Eijk, J. M. (2008). Material deprivation and health-related dysfunction in older Dutch people: Findings from the SMILE study. European Journal of Public Health, 18(3), 258–263.

Hayes, A., Senior, J., Fahy, T., & Shaw, J. (2014). Actions taken in response to mental health screening at reception into prison. Journal of Forensic Psychiatry & Psychology, 25(4), 371–379.

McKenna, B., Skipworth, J., Tapsell, R., Madell, D., Pillai, K., Simpson, A., & Rouse (2015). A prison mental health in-reach model informed by assertive community treatment principles: Evaluation of its impact on planning during the pre-release period, community mental health service engagement and reoffending. Criminal Behaviour and Mental Health: CBMH, 25(5), 429–439. doi:10.1002/cbm.1942

Raphael, S. (2014). How do we reduce incarceration rates while maintaining public safety? Criminology & Public Policy, 13(4), 579–597.