This week, allegations of abuse emerged from Central Prison. According to the Associated Press:
Lawyers for an inmate who suffers from a serious mental illness say he was abused at North Carolina’s Central Prison by guards who repeatedly doused him with pepper spray while he was locked in a tiny cell.
If true, this is a shocking and deplorable incident that reflects poorly on the Department of Corrections. But this case should be understood in a larger context: Severely mentally ill people are routinely incarcerated instead of treated. A 2005 report by the federal Bureau of Justice Statistics found that 56 percent of state prison inmates suffer from mental illnesses. Approximately 10 percent of prisoners have a severe mental illness.
Before deinstitutionalization, people with severe mental illnesses were treated at state mental hospitals. It was not a perfect system by any means. Abuse of the sort portrayed in One Flew Over the Cuckoo’s Nest led many people to believe that state mental health facilities should be closed. Over the span of decades, states shuttered their hospitals and released former patients back into society. For many people, this was a good thing. But for the severely mentally ill, the system that replaced deinstitutionalization was even worse. Today, many of the people who would have been in a state mental hospital instead find themselves on the street – or in prison.
The inmate at Central Prison, Jerry Williams, is a perfect example of this plight. Williams has paranoid schizophrenia, along with developmental disabilities that classify him as someone with “borderline intellectual functioning.” He also has a lengthy criminal record of trespassing, assault, and burglary. It is hard to identify exactly to what extent Williams’ sickness factors into his criminal record. But as E. Fuller Torrey, an expert in schizophrenia, noted:
…Researchers often find a direct relationship between [a] person’s mental illness and the behavior that led to apprehension. For example, a woman with schizophrenia in New Mexico was arrested for assault when she entered a department store and began rearranging the shelves because of her delusion that she worked there; when asked to leave, she struck a store manager and a police officer… People who suffer from paranoid schizophrenia, in particular, are likely to be arrested for assault because they may mistakenly believe that someone is following them or trying to hurt them and will strike out at that person.
People like Jerry Williams frequently end up in prison as a result of their condition. But prison is no place for mental health treatment. Prisons exist for punishment or “corrections.” They have strict rules designed to enforce the utmost obedience and compliance, and there are penalties for breaking those rules. For example, assaulting a prison guard could mean time in solitary confinement, or even additional time on a sentence. But for people with severe mental illnesses, this structure of incentives is absurd. People undergoing a psychotic break are not capable of making rational judgments and assessments. And yet they are punished as though they could control their actions.
Sometimes those punishments actually worsen their conditions. Solitary confinement, for example, aggravates the symptoms of severe mental illness. It is cruel and senseless to treat mentally ill people in this way.
Spurred on by moral outrage, North Carolina joined the rest of the country in releasing the mentally ill from public hospitals. But there is precious little of that moral outrage today. Deeply troubled people, wracked by mental illness, suffer in silence in jails and homeless shelters, alone and forgotten.
Prison is no place for the mentally ill and neither is the street.The Supreme court ruling that stated a person could only be held if dangerous to themselves or others released thousands from mental hospitals with nowhere to go.Some ended up on the streets others in rest homes and others ping ponged between jail,street and hospitals.Now the Disability Rights Acts bill is being used to make states through the Law provide private housing and care for all deemed mentally ill.Sounds good but is unrealistic.Most require 24 hr supervised care to ensure proper medication administration,doctor appointments,food preparation,bathing and almost all daily functions of normal life.Including paying electric bills,rent,laundry and daily living.A structured environment.The disability rights advocates in NC want the mentally ill placed in apartments complex’s with no more than 12% mentally ill to the complex. How the daily service such as medicine administration will be supervised I don’t know.Or how will they cook food,or do laundry,shop for groceries,prepare the food,do laundry etc.All the things they have been unable to do.And how will the other “normal” residents of the apartment complex feel about mentally ill residents in their communities. The cost alone for all the services to provide this level of care would be astronomical.Just recently an assisted living facility in Candler,NC that housed almost 80 determined by the NC DHHS to be mentally ill was forced to close.The residents were all very happy,the families were happy,the care was appropriate,they were taken to their doctors appointments ontime and were taking their prescribed medications and by all appearances doing very well.But because of court rulings obtained by disability rights groups in NC they had too many considered mentally ill and were closed and the residents had nowhere to go.The cost at this home for care was app. $1,700 per month each.
I was a member of the Study Commission on Aging back in 1990-1991 and this has the potential to cost the state billions when full implemented.