At the intersection of criminal justice and mental health care, there is vast ineffectiveness and inefficiency. The consequences of this range. Some in need of care don't get it or get enough of it. Others face the manifestation of their mental illness through a cycle of incarceration or with prolonged psychiatric hospital stays.
Mental Health America projects that 1.2 million incarcerated prisoners suffer from mental illness. The treatment they receive is inadequate and/or ethically unsound. Moreover, they suggest a strong correlation between a state's lack of access to mental health services and the number of adults in prison. According to Mental Health America, six out of the ten states with the least access to mental health care (Alabama, Arkansas, Mississippi, Florida, Texas, and Georgia), also have the highest rate of incarceration in America. Those mentally incapable of being held responsible for their crimes often entire state asylums. Yet, the issue of inadequate access to mental health also permeates through the prison walls to affect the prisoners who are dependent on their prisons for healthcare, which more often than not falls short.
The New York Times Magazine published a piece on September 27, 2017 titled "When Ã¢â‚¬ËœNot Guilty' is a Life Sentence" by Mac McClelland. The point of the piece isn't only to communicate the story of a man spending his life within prison walls as a result of a not guilty by reason of insanity charge. Rather, it is to convey that for many who find themselves incapable to stand trial or be held accountable for their actions, the mental health treatment they receive often ends up acting as a conviction instead of being the acquittal it's supposed to be. The criminal justice system looks to mental health hospitals to confine the "criminals" prisons can't. While in most states it is against the law to hold patients against their will once they are no longer deemed a threat to themselves or society. The article suggests that mentally ill patients serve longer stints in mental hospitals than they would actually incarcerated. Policymakers should be studying past patients and their experiences to develop a model that better calculates how long patients need to remain patients. This would help facilitate the inflow of patients and better manage the quality of care they receive. Moreover, it would help ensure that patients are being treated and are not being held against their will to substitute an actual incarceration. This is significant because when mental health care as treatment results in a longer stint than a conventional conviction would, law and justice are being violated, and the criminal justice system's poor resources are being mismanaged
Our focus should be both preventative and reactive, aiming to treat mental illness before it overcomes the individual while treating it appropriately and responsibility when it does. This applies to mental health patients everywhere, but it is those who were implicated in crimes that are most at the mercy of the individuals around them.
First and foremost, mental health care access needs to be widespread and accessible. This ambition can be attained through a variety of ways. Free or low cost clinics are one option. Expanding our health care system to provide adequate coverage for mental illness support is another. These initiatives require making healthcare accessible and affordable. The likelihood of this happening under the current administration is slim, considering the the recent approaches it has taken towards healthcare. However, we have other models to look at in other countries where healthcare is available to all and their prison industry is much less an industry and more a reform system.
Those in prison with a mental health illness and those deemed not guilty by reason of insanity but in treatment centers should both be receiving the appropriate treatment towards their ailments. Putting mentally ill prisoners back on the streets does nothing to prevent a cycle of incarceration. The state of New York has recently produced legislation that offers mental health treatment to prisoners who have had this type of care while in prison. More states should follow suit. Moreover, properly treating one person opens up opportunity for care for another. It is estimated that there is one psychiatric bed for every three thousand people in need of medical care.
The economical costs of the inefficiencies in mental health care within the criminal justice system is reason enough for reform. A study of the Ohio prison healthcare system shows that there were 28-29 million dollars spent on pharmaceutical drugs in 2010. The average patient costs $4,780 in health services each year. It seems like a lot of money and it is. Perhaps it's because of the for-profit prison system or because healthcare isn't sufficiently funded, but some prisons in Ohio have been forcing prison patients to pay for their medication themselves. When a patient cannot afford to do so, they often go without the needed medication, exacerbating their conditions and piling on the costs.
Mental health patients aren't prisoners but in this context that line tends to blur. Regardless of patient or prisoners, mental health care needs to be treated as a priority.