By: Joyce Carmouche
I recently showed a film in one of my classes entitled, “The New Asylum”. The film illustrated in detail, the housing and treatment of the mentally ill in prisons and jails. While the film highlighted one of the better programs in existence in a maximum-security prison, it also brought home the flaws in a system that allows persons who are ill to be confined in a manner that can only add to their mental instability. It always occurs to me, we should be concerned about this.
We should be concerned about this because these individuals are released to our communities, with (sometimes) two weeks of medication. The facility personnel are not able to arrange further care unless the releasee is already being cared for by a mental health professional in the community. This would indeed, be rare. It is not hard to imagine what happens when the two weeks of medication runs out; if they have taken it at all. More likely than not, the releasee either does not have a family or they are estranged from their family and receive no support. These individuals comprise the homeless population in our communities and are what jail and hospital emergency room staff refer to as “frequent fliers”.
How did the mentally ill become the responsibility of prisons and jails? Deinstitutionalization, the move to community treatment for the mentally ill, started to gain real momentum in the 1970’s. By the late 1990’s, many state hospitals had shut down. With these closings, it became increasingly difficult for people who suffer from serious mental illness (SMI), to receive treatment and were left homeless and likely to run afoul of the law. Today the most prominent treatment for the severely mentally ill is within a correctional facility, where mentally ill individuals are not receiving adequate care for their disorder.
Per the National Institute of Corrections, a 2006 Special Report by the Bureau of Justice Statistics (BJS) estimated that 705,600 mentally ill adults were incarcerated in state prisons, 78,800 in federal prisons and 479,900 in local jails. Treatment is expensive and often beyond the budgetary limits on these facilities.
Suggestions for aftercare include, assisting the inmate in applying for Medicaid coverage prior to release. Some states have added this to the inmates’ prerelease program. However, it should be noted that if the repeal of the ACA had gone through, treatment for Substance Abuse and Mental Health care would have been eliminated.