'Criminalizing the most vulnerable': Should the mentally ill be behind bars?

Illustration by Blake Cale
Illustration by Blake Cale

“The 360” shows you diverse perspectives on the day’s top stories and debates.

What’s happening

In the United States, jails and prisons are one of the largest mental health care providers in the country. For decades, those with mental illness have been overrepresented in jails and prisons as roughly 2 in 5 people who are incarcerated have a history of mental illness, according to the National Alliance on Mental Illness.

“Those people do not belong in jails or prisons,” Azza AbuDagga, health researcher for Public Citizen, told Yahoo News. “Our research [from 2016] showed that county jails have been turned into dumping grounds for people with serious mental illness due to the failure of the mental health system.”

Civil rights leaders and advocates are highlighting the impact of putting those with mental illness behind bars.

Most recently, in May, the family of Lashawn Thompson, a Black man who was in custody at Fulton County jail and suffered from schizophrenia, released the findings of an independent autopsy. According to the family’s autopsy, Thompson didn’t receive treatment before he was reportedly found “eaten alive” by bed bugs and insects last September.

In March, the death of Irvo Otieno, a 28-year-old Black man who died during intake at the mental health facility in Virginia, sparked outrage, and 10 people have been charged with second-degree murder in his death.

“Irvo Otieno DIDN’T deserve to be smothered to death when he needed help with a mental health crisis! He isn’t the first & likely won’t be the last person with mental illness to be brutally victimized by police,” Attorney Ben Crump said on Twitter.

Three days before Otieno died, 31-year-old Najee Seabrooks was shot and killed by police in Paterson, N.J., after he called 911 during a mental health crisis.

Incidents like this and others have caused leaders to question if jails and prisons are equipped to adequately care for those with mental illness, especially for Black Americans, who are 2.9 times as likely as white people to be killed by police.

“That should be alarming to people to realize that we are not handling mental health crises with support, care and compassion. We're handling it with trauma, violence and even fatalities,” Zellie Thomas, lead organizer of the Black Lives Matter chapter in Paterson, told Yahoo News in March following the death of Otieno.

Why there’s debate

As 1 in 5 American adults live with a mental illness, according to the National Institute of Mental Health, the debate surrounding mental health behind bars continues to intensify. But not everyone agrees with the contention that inmates who are mentally ill and incarcerated don’t get the resources or help that they need.

“In my opinion, and experience, they are getting good mental health care,” Charles Lee, president of the American College of Correctional Physicians and the former medical director at a maximum security prison in California, told Yahoo News. “Many of them don’t get any mental health care on the outside, [and] there’s a fair number of those that are homeless, who don’t have insurance, or don’t, for whatever reasons, seek to get mental health care.”

Some say that if a mentally ill person commits a crime they must serve their time behind bars. But in many cases, “people with serious mental illness end up in jails and prisons for the same kinds of symptoms that might just as easily have [landed] them ended in psychiatric hospitals or places of treatment,” Christine Montross, associate professor of psychiatry and human behavior at Brown University, told Yahoo News.

Even though advocates say incarceration is not the answer for the mentally ill, critics question where else they would go. “There are not enough mental health facilities in the communities and this is all over the country,” Lee said. More than one-third of Americans live in areas that lack mental health facilities and services.

While there’s no immediate solution, advocates say the bottom line is that U.S. jails were not built with the mentally ill in mind.

“There are all kinds of factors that complicate the treatment that someone might receive once they are behind bars. People who serve time in jails and prisons become less psychologically well, just by virtue of living in these dehumanizing conditions,” Montross said.

What’s next

In April, Democratic Sen. Jon Ossoff of Georgia launched an inquiry into the conditions of incarceration following the death of Thompson and of Joshua McLemore, an Indiana inmate who allegedly suffered from malnutrition and dehydration before he was found dead in his cell.

“The Department of Justice has an affirmative obligation to safeguard the civil rights of incarcerated people, whether they are held in federal, state, or local custody,” Ossoff wrote to Attorney General Merrick Garland.

California Gov. Gavin Newsom recently announced efforts in his state to modernize the Mental Health Services Act and require a yearly $1 billion contribution for behavioral health housing and care for those with mental illness.

“This is the next step in our transformation of how California addresses mental illness, substance use disorders, and homelessness — creating thousands of new beds, building more housing, expanding services, and more. People who are struggling with these issues, especially those who are on the streets or in other vulnerable conditions, will have more resources to get the help they need,” Newson said in a press release.

But Thomas says changes to the mental health system for the incarcerated are needed immediately. “Until America realizes that policing is failing people going through a mental health crisis, they will be able to continue to create more hashtags,” he said.

Perspectives

‘Drowning’ in a mental health crisis

“I think prosecutor offices are drowning. I think defense attorneys are drowning. I think the court system is drowning in a mental health crisis. This isn’t just an issue. It’s a crisis.” — Clayton County District Attorney Tasha Mosley to Fox5 News.

Mentally ill people face dehumanizing conditions

“Reports from jails across the country, from Rikers in New York to Santa Clara County’s main jail comple in San Jose, Calif., have shown that mentally ill people are frequently mistreated. Families have filed lawsuits alleging that corrections officers have severely beaten mentally ill people, or let them starve or freeze to death,” Christopher Blackwell, incarcerated writer, in the New York Times.

Can police properly respond to those with mental illness?

“The training [for a correctional officer] really suggests that you should take control, you should maintain control and when you feel like a situation or a person is getting out of control the response is to escalate. For a person with a mental illness, particularly one who is paranoid, this is absolutely terrifying. It’s terrifying for anybody. It’s intended to be frightening, but for a person with mental illness it’s incomprehensibly terrifying, and so the result is often that the person with mental illness responds in exactly the opposite fashion ... by lashing out or fighting back,” Alisa Roth, author of “America’s Criminal Treatment of Mental Illness,” to NPR.

Mental health and the criminal justice system go hand in hand

“America has gone without a real system of mental health care for so long that mental illness is often seen as a permanent feature of the criminal justice system. In many prisons and jails, the urgent question is not how to reduce this surging population but how to build larger and better psychiatric units and treatment facilities inside the walls.” — Alisa Roth, the Atlantic.

Caring for mentally ill inmates is ‘expensive’ for correctional facilities

“Mental health problems are rampant in local jails, often because the illness was a primary factor in the offensive conduct. The cost of caring for and supervising mentally ill inmates makes them two to three times more expensive to house. Once released, they often stop taking their medications, which lands them in trouble with the law and back behind bars,” Editorial, New York Times

‘Criminalizing the most vulnerable’

“This six-decade problem of criminalizing the most vulnerable segment of our society will continue to get worse unless it is taken seriously by public officials at all levels. It is morally unacceptable to keep ignoring it. In the first place, screening programs that prevent people with serious mental illness from ending [up] in the legal system are critically needed. Furthermore, diversion programs to channel those people to the community where they can receive proper treatment and support services are urgently needed.” — Azza AbuDagga, health researcher for Public Citizen, to Yahoo News.