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Wed, July 24, 2013
Mental Illness in Prisons
Recently I received a call at the helpdesk at NAMI Michigan from a retired police officer.  He needed help.  His daughter is mentally ill and is currently being held in solitary confinement, not receiving any medication or other treatment.  Her crime: disorderly conduct and resisting arrest during an unmedicated “psychotic” episode.  He wanted to know why his daughter wasn’t in a hospital, being treated for her medical condition.  Had she been acting strangely due to a diabetes reaction, she would have needed emergency care and might have died in custody.
 
Such tragedies are not rare anymore.  Prisons and jails are the de facto mental health “treatment” facilities of America.  He was outraged.  It is an outrage.
 
A man was taken to jail for “acting strangely” on a city bus.  He is now dead.  Shot to death by police because he was acting “strangely,” resisting the officers, not following the rules.  He had a form of epilepsy—and his relatives brought his medications for him—but because they only spoke a dialect of Spanish for which there was no translator, the pills were put aside.  He never received his medicine.  This is a true story.
 
This article is meant to address the folly of our age and rouse you, the health-caring populace, to the horror within our borders.  One in four members of our society will experience a mental illness during his or her lifetime.  This is not some “stranger.”  This is your Mother with Alzheimer’s, your Dad grieving the end of his career, your Brother with Post-Traumatic Stress Disorder from the Iraq War, your Sister with Post-Partum Depression.  This is your Best Friend whose son has Autism, your Neighbor with Bipolar, or your Buddy from college who can’t stop drinking every day.  This is about all of us.  We can all end up on the wrong side of the jailhouse wall or the hospital critical-care ward.  Mental illness affects everyone.
 
From 2003 through 2006 I went inside Michigan’s medium- and maximum-security prison “Residential Treatment Programs” and prison hospitals and the Michigan “Center for Forensic Psychiatry” teaching leadership skills to convicted “prisoner-patients.” I worked along with Forensic Security Aides (specially trained Corrections Officers) so they could help start and maintain self-help support groups within the walls of these facilities.  Some of these groups still exist today.  What?  Support groups in prisons?  Why weren’t these mentally ill folks just put into hospitals in the first place?
 
The sad truth is they closed most of the state hospitals and psychiatric wards.  There are not enough hospital beds or enough community mental health centers to care for our need.  Our government cut spending on mental health care, easily slashing funds.  But nobody wants to cut funds to lock people up.  Even sick people.
 
In the past three years alone, $4.35 billion in funding for mental health services was cut from state budgets.  What we pay for is what we get.   It costs $2,165 per year to treat someone in case management in community mental health care in Michigan.  It costs $34,000 to house the average inmate in a cell.  This is dollars and no sense.
 
So suicide is now the top cause of death among inmates in local jails.  Suicide ranks in the top five causes of death for our nation’s state prisons.  Corrections employees aren’t trained to recognize or handle mentally ill inmates.  They aren’t trained to understand the symptoms of mental illness or the side effects of psychiatric medications.
 
Another example: in bipolar, folks like me often become irritable and restless.  My own diagnosis gives me an edge that fuels my creativity but makes me hard to live with sometimes.  In a jail cell, I wouldn’t have any outlet for my “jitters.”
 
My medications also make me restless—this can be a waking nightmare.  For someone in solitary confinement the restlessness drives him/her to break the rules, earning “tickets:” extra time inside for “bad behavior.”  The system isn’t geared for simple understanding of mental illness.  I know folks who punch walls at home.  If they were in jail or prison—think it through. This isn’t an excuse.  It is a brain disease—this is mental illness!
 
When an inmate is put in solitary confinement, they are supposed to only spend 23 hours a day in their cell.  Don’t hold your breath waiting for the rules to be followed in prisons!  This year Dick Durbin (D-IL) announced the FBI agreed to an independent assessment of solitary confinement in U.S. prisons—this is being considered a breach of the 8th Amendment to the Constitution against “cruel and unusual punishment.”  Call it torture. New research (November, 2012, University of Buffalo) shows that in social isolation, the brain’s production of the myelin sheath that acts as insulation among brain cells breaks down.  This is similar to what happens in Alzheimer’s disease and similar nervous disorders.  Right now there are thousands of teenagers, hundreds of thousands of adults in solitary confinement—“administrative segregation” being the government doublespeak for this form of torture.  When these prisoners emerge from their cells, what lesson will they have learned?  “Don’t get caught?”  What will their brains be capable of when they return to society, broken in mind and spirit and unable to contribute?
 
When an individual is mentally ill in jail or prison, their chances of being correctly medicated: slim, of seeing a doctor: nearly impossible, their chances of earning early parole for “good behavior:” a pipe dream.
 
The neurological conditions involved in bipolar and schizophrenia impact the brain’s ability to read and understand subtle social situations—conversations are often confusing; simple directions beyond comprehension because the brain cannot get past the social cues that most folks take for granted.  In jails and prisons where you obey the guards or do more time, mentally ill folks are more likely to “max-out” and serve the entire term of their sentence plus their tickets.  It is the antisocial thugs who play up to the officers and do what they are told who earn their way out early.
 
When mentally ill folks are told by police to, “Put your hands up.  You heard me.  Drop the weapon!”  They try to respond to all three messages at once—and can’t get any of them right.  So the “weapon” might have been a hairbrush or a bottle of beer, but the poor kid with schizophrenia is scared, confused… And ends up in jail with charges of resisting arrest.
 
NAMI: the National Alliance on Mental Illness stands against cuts in spending on healthcare—including mental health care.  Will you stand with us, stand up against the torment and abuse against our psychiatrically suffering brothers and sisters, including our returning traumatized war veterans who desperately need mental health treatment, not punishment?  Contact your legislators today.  We need more adequate mental healthcare.  Not more prisons.  The Life you save may be your Best Friend, your Brother, your Sister or your Child.

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