The Myth of The Jail and Prison Treatment Facility

One Deinstitutionalization Is Not Two Deinstitutionalizations

Much bad ink has been spilled over calling the nation’s jails and prisons mental health facilities because of the number of people within their walls who have also been given psychiatric labels. The latest report along these lines claims there are something like 10xs more mental patients who reside in criminal justice facilities than in state hospitals. These numbers come from a study conducted by the Treatment Advocacy Center, the USA’s number one lobbyist for more forced psychiatric drugging, and the National Sheriffs Association. The culprit in this debacle is said to be deinstitutionalization.

Let me start off by saying people don’t go to jails and prisons because they are sick and because they wish to receive medical attention. People are sent to jails and prisons by the courts to receive punishments because they broke the law of the land. Second, state hospitals have traditionally been psychiatric jails and prisons. Merely trading this kind of prison for the other kind of prison doesn’t make a hospital in actual fact. I would say that, given the prison overcrowding problem that comes of three strikes laws, America has grown increasingly intolerant of difference, and law crazy itself. If your way of dealing with bizarre behavior is to outlaw it, your jails and prisons are going to fill with people behaving bizarrely. Bizarre behavior may be a crime, but it is only a disease by a wild stretch of the overactive imagination.

Statistics tell us their own story. For statistics, before we look at those coming from the recent study, let me refer to the Preface of the 2006 book crazy authored by journalist Pete Earley. Earley is another apostle of this blame deinstitutionalization religion. According to Earley, in 1955, there were 560,000 people in state mental hospitals. He speculates not about the numbers of people who might have been referred to as “mentally ill” in prison or jail at that time. Between 1955 and the year 2000, the population jumped from 166 million people to 276 million people. Given this population increase, and no change, the numbers of people in state mental hospitals would have been something like 930,000. Earley gives the present number of people, from maybe a 2002 or thereabouts survey, with “mental illnesses” in jails and prisons at 300,000. He gives the present number in state mental hospitals at 55,000.

Hmmm. Something peculiar is going on here. 500,000 people are unaccounted for. These are the people who, with the population increase figured in, would be in the state mental hospital system if we were still doing business the way we had in 1955. 500,000 people is more than half the number of people we are dealing with in the stats for a later year. You add 55,000 to 300,000 and you are still lacking 205,000 people from the 1955 figure. This is not the kind of figure that supports the contention that deinstitutionalization was a mistake, or that it was a disastrous failure. Instead it would seem to indicate that more and more people described as “mentally ill”, if not fully recovering, are being better integrated into the communities from which they came. This is a coup for least restrictive care, and least restrictive care is something that nobody receives as a prisoner on the locked ward of a state mental hospital.

According to the TAC and NSA research, there are 35,000 people in state hospitals, a 2012 stat, and 356,000 in jails and prison. Wow. We’ve got 20,000 fewer people, referencing the Earley stats, in state mental hospitals than we had 10 or so years earlier! If we’ve got more in jails and prison, too, part of that increase can be explained by population increase. What Earley gave us was something of an estimation based on statistics anyway, but we’re still minus a great number of people who would be “hospitalized” in the year 1955. All in all, I’d call deinstitutionalization a major success story. We’ve still got a lot of people in jails and prisons, given stiffer sentences and overcrowding, who don’t need to be there. One deinstitutionalization success story doesn’t justify an increased amount of institutionalization for another sort of institution.

Blaming violence on “mental illness” is the latest media and political trend. I’d like to remind people that the court of public opinion is not a court of law. We have a supply of the kind of acts, in the present climate, that the media circus demands. Should we look at the number of violent acts committed by people with no experience in the mental health treatment system, I’m sure that those crimes are not decreasing dramatically in number either. Violence is not a symptom of any “mental disorder” in the Diagnostic and Statistical Manual (DSM). When it comes down to it, death is much more likely to be a result of gun fire than it is to be a result of any psychiatric diagnostic label in a mental health professional’s repertoire. I suggest that we will have more success with the problem if we deal with the causes, and I don’t see “illness”, physical nor mental, as one of the primary causes. I would, on the other hand, do something about the climate of suspicion, hatred, and indifference that breeds crime, hardship, and troubles. Here, I think we can actually make a difference if we tried, and that is exactly what we should do.



3 Responses

  1. I’ve been flip flopping a bit on this lately. What about the increasing number of people who mess up big time and for the first time after having been “diagnosed” and put on psych drugs.

    • No waffling here. Forced drugging won’t end imprisonment. The authorities are not going to be giving real breaks to people who commit real crimes, say, armed robbery or murder one. It just doesn’t happen. There’s one prison, or there’s the other. Misdemeanors and low level felonies, say, the things that arise from an excessive law and order mentality anyway, are another thing. That other thing is the reason you get jail diversions. Change the law, and you get rid of the problem.

      I’m against the forced drugging of people in the criminal justice system and in the mental health system. Psychiatric drugs are harmful. It just shouldn’t be done. If a person wants to give his or her head a whack with a hammer. Okay. I can’t stop he or she from doing so, but I wouldn’t have the authorities hitting them in the head with hammers, and calling that hammering proper “treatment” or “punishment”. Doing so just wouldn’t be right.

      Both the criminal justice and the mental health systems will kill you if you’re not careful. I’d call that a good case for wising up. I’m really not out to increase the arsenal they have presently got for doing so.

      • Rod, I don’t think I really responded the way I should have done, and so I’m returning to your comment.

        The flip side of deinstitutionalization, the thing these people oppose, is reinstitutionalization, the thing these people support. The argument goes that given mental patients in jails and prisons we are right back where we were before the great asylum building boom of the 19th century. Given a loony bin building binge, you are going to get more loony birds numerically. Dorothea Dix, in my book, was a villainess, not a heroine. We’ve got that 500,000 figure above on the side of deinstitutionalization. I’m against forced treatment period. Break the law, and you’ve got a different situation. I’d like to see all state hospitals shut down. I don’t think there is a GOOD argument to be made in favor of reinstitutionalization. For myself, I am certainly not going to a make any argument supporting psychiatric imprisonment. Abolition of all involuntary mental health treatment, for me, is the only solution. “Stigma”, or prejudice and discrimination, as some prefer to call it, go with the territory.

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