Mental Illness Editorial #1

Published in Galveston County Daily News, 6/25/02

By Judge Susan Criss

About 16% of the inmates in jails and prisons in this country have a serious mental illness. There are more mentally ill persons in jails and prisons than in hospitals in this country. Jail cells have become substitutes for hospital beds for the mentally ill.

During the 1970's concerns arose over how the mentally ill were being treated in mental institutions. Conditions were all too often inhumane. New medications brought hope that mentally ill persons could be reintergrated back into society and live productive independent lives. That was the hope.

The reality thirty years later is that most mentally ill personsare homeless or incarcerated. The very nature of many mental illnesses makes total independent living an unrealistic expectation for this population. The deinstitutionalization of the mentally ill has been replaced with their crimninalization.

Almost a third of the mentally ill who are incarcerated are locked up for not committing serious crimes but because there is not a place elsewhere for them to go. Tragically there are not enough hospital beds or funding for medications and treatment for most mentally ill persons who desperately need therapy.

Contrary to public perceptions, the mentally ill do not commit a higher percentage of violent crimes than those who are not mentally ill. Most of the crimes for which the mentally ill are arrested for are minor. There definitely are some violent mentally ill offenders who must be incarcerated to protect society. But it is completely unacceptable to systematically incarcerate people simply because they have nowhere else to go.

Prisons and jails are not designed to be therapeutic environments. Although a few inmates receive mental health treatment correctional institutions do not have the staff or resources to adequately treat their mentally ill populations. Mentally ill inmates come out of prison in which much worse condition than when they go in.
Often times they are victimized by other inmates or isolated for their own protection. Isolation results in serious deterioration of the inmates' mental condition. The leading cause of death of inmates is suicide. Inmates with untreated but treatable mental illness commit most prison suicides.

Under ideal circumstances helping the mentally ill is incredibly hard and frustrating. And circumstances are rarely ideal. Often those who need help the most are not capable of cooperating with the very people trying to help them. Law enforcement officers, social workers, medical personnel, lawyers and others in the justice system encounter the mentally ill daily. Frequently those encounters become confrontational. The very nature of their illnesses causes many mentally ill persons to be combative and difficult to communicate with.

The crises faced by the mentally ill seem overwhelming and hopeless. As a society, we have a moral obligation to find solutions for this very vulnerable population.
Ten years ago child abuse victims routinely faced systematic abuses in courts. Finally all of the professions that dealt with child abuse cases came together to search for solutions to reduce the trauma imposed on such vulnerable victims by the justice system. Multi-disciplinary task forces comprised of lawyers, judges, law enforcement, social workers, doctors, nurses, mental health treatment providers were formed. The task forces worked together in a community effort to find ways to make the justice system work better and more effectivley for child abuse victimes. Consequently child advocacy centers were built in communities all across this country. Federal and state laws were passed to address needed reform.

Those professions are the same ones who encounter the mentally ill daily. There is no reason why those same groups cannot work together in an interdisciplinary effort to find solutions for the mentally ill. Such taks forces have already been formed on a federal level and in some other states. Texas can do the same.
Thankfully there are some Texas legislators who are working on legislation to address this much needed reform.This is a community crisis. It demands a community response. We have a moral responsibility to make such a response.