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.
Filed under: Alternatives, Biological Psychiatry, Criminalization, Discrimination, DSM, Force, Human Rights, Insanity Defence, Law, Mental Health Care, Misdiagnosis, Oppression, Politics, Recovery, Research, State Hospital, Violence |