TENNESSEE FAILING INMATES WITH MENTAL ILLNESS, NEW STUDY FINDS
In few places are the consequences of non-treatment more visible than in jails and prisons, said the Treatment Advocacy Center(ARLINGTON, VA.) The first national study to examine the policies and practices under which mentally ill inmates receive treatment was released today by the Treatment Advocacy Center and the National Sheriffs’ Association.
“The Treatment of Persons with Mental Illness in Prisons and Jails: A State Survey” reports that 10 times more individuals with serious mental illness are in state prisons and county jails than in the nation’s remaining state mental hospitals – an estimated 356,000 mentally ill inmates compared with 35,000 patients.
The consequences of failing to treat individuals with serious mental illness in prisons and jails are usually harmful and sometimes tragic, the survey found. Without medication, the symptoms of the inmates’ mental illness become worse, leading them to sometimes behave in disruptive and bizarre ways. Such mentally ill inmates are vulnerable to being beaten, raped or otherwise victimized; are frequently put in solitary confinement for long periods; and sometimes mutilate themselves or commit suicide. Mentally ill inmates also contribute to the overcrowding of prisons and jails and to the increasing cost of corrections for both states and counties.
Tennessee uses a committee procedure allowed under a 1990 U.S. Supreme Court decision for providing involuntary treatment for prison inmates with serious mental illness whose symptoms render them dangerous or likely to deteriorate into dangerousness. This procedure is now sanctioned by law for state prisons in the majority of states and for a few county jails but it is only rarely used. Barriers to similar treatment for county jail inmates who are symptomatic result in the use of restraints, seclusion or observation rather than medication, the report said.
In almost every state, a prison or jail is now de facto the largest mental institution in that state. In Tennessee, the Shelby County Jail in Memphis, with 6,800 inmates, probably holds more individuals with serious mental illness than all four state hospitals combined, according to the study.
“The lack of treatment for seriously ill inmates is inhumane and should not be allowed in a civilized society,” said Dr. E. Fuller Torrey, founder of the Treatment Advocacy Center and lead author of the study. “This is especially true for individuals who – because of their mental illness – are not aware they are sick and therefore refuse medication.”
• Maintain a functional public mental health treatment system so people with mental illness do not end up in prisons and jails
• Reform mental illness treatment laws and practices to eliminate barriers to timely treatment before people commit crimes
• Reform jail and prison treatment laws so prisoners with mental illness receive appropriate and necessary treatment, just as inmates with other medical illnesses already do
• Use court-ordered outpatient treatment – identified by the Department of Justice as an evidence-based practice for reducing crime and violence – to help at-risk individuals live more safely and successfully in the community
• Implement and promote jail diversion programs
• Institute mandatory release planning. A recent study reported that inmates who are not treated following release have an almost four times higher rate of committing additional violent crimes compared to those who receive treatment.
“The mistreatment of inmates in jails in prisons, including the denial of proper medical care, is a national embarrassment and has led to international condemnation,” Torrey said. “Mentally ill individuals who end up in prison or jail should be treated for their mental illness just as they should be treated for their diabetes or hypertension.”
The full report is available at: www.tacreports.org/treatment-behind-bars.
The organization does not accept money from pharmaceutical companies. The American Psychiatric Association awarded the Treatment Advocacy Center its 2006 presidential commendation for "sustained extraordinary advocacy on behalf of the most vulnerable mentally ill patients who lack the insight to seek and continue effective care and benefit from assisted outpatient treatment.”