Study Finds Hundreds of Thousands of Inmates Mentally Ill

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October 22, 2003Study Finds Hundreds of Thousands of Inmates Mentally IllBy FOX

BUTTERFIELD

 

As many as one in five of the 2.1 million Americans in jail and prison are

seriously mentally ill, far outnumbering the number of mentally ill who are in

mental hospitals, according to a comprehensive study released Tuesday.

 

The study, by Human Rights Watch, concludes that jails and prisons have become

the nation's default mental health system, as more state hospitals have closed

and as the country's prison system has quadrupled over the past 30 years. There

are now fewer than 80,000 people in mental hospitals, and the number is

continuing to fall.

 

The report also found that the level of illness among the mentally ill being

admitted to jail and prison has been growing more severe in the past few years.

And it suggests that the percentage of female inmates who are mentally ill is

considerably higher than that of male inmates.

 

" I think elected officials have been all too willing to let the incarcerated

population grow by leaps and bounds without paying much attention to who in fact

is being incarcerated, " said Jamie Fellner, an author of the report and director

of United States programs at Human Rights Watch.

 

But, Ms. Fellner said, she found " enormous, unusual agreement among police,

prison officials, judges, prosecutors and human rights lawyers that something

has gone painfully awry with the criminal justice system " as jails and prisons

have turned into de facto mental health hospitals. " This is not something that

any of them wanted. "

 

Reginald Wilkinson, director of the Ohio Department of Rehabilitation and

Correction, said the " mere fact that this report exists is significant. "

 

" Some people won't like it, and the picture it paints isn't pretty, " Mr.

Wilkinson said. " But getting these facts out there is progress. "

 

Many of the statistics in the study have been published before by the Justice

Department, the American Psychiatric Association or states. But the study brings

them together and adds accounts of the experiences of dozens of people with

mental illness who have been incarcerated.

 

The study found that prison compounds the problems of the mentally ill, who may

have trouble following the everyday discipline of prison life, like standing in

line for a meal.

 

" Some exhibit their illness through disruptive behavior, belligerence,

aggression and violence, " the report found. " Many will simply — sometimes

without warning — refuse to follow straightforward routine orders. "

 

Where statistics are available, mentally ill inmates have higher than average

disciplinary rates, the study found. A study in Washington found that while

mentally ill inmates constituted 18.7 of the state's prison population, they

accounted for 41 percent of infractions.

 

This leads to a further problem — mentally ill inmates who cannot control their

behavior are often, and disproportionately, placed in solitary confinement, the

study found.

 

Solitary confinement is particularly difficult for mentally ill inmates because

there is even more limited medical care there, and the isolation and idleness

can be psychologically destructive, the report says.

 

Medical care for mentally ill inmates is often almost nonexistent, the study

says. In Wyoming, a Justice Department investigation found that the state

penitentiary had a psychiatrist on duty two days a month. In Iowa, there are

three psychiatrists for more than 8,000 inmates.

 

There is no single accepted national estimate of the number of mentally ill

inmates, in part because different states use different ways to measure mental

illness.

 

The American Psychiatric Association estimated in 2000 that one in five

prisoners were seriously mentally ill, with up to 5 percent actively psychotic

at any given moment.

 

In 1999, the statistical arm of the Justice Department estimated that 16 percent

of state and federal prisoners and inmates in jails were suffering from mental

illness. These illnesses included schizophrenia, manic depression (or bipolar

disorder) and major depression.

 

The figures are higher for female inmates, the report says. The Justice

Department study found that 29 percent of white female inmates, 22 percent of

Hispanic female inmates and 20 percent of black female inmates were identified

as mentally ill.

 

One reason some experts have suggested for the higher numbers among female

prisoners is that psychologists and psychiatrists working in prisons tend to be

more sympathetic to women, finding them mentally ill, while they tend to

evaluate male inmates as antisocial or bad.

 

But Mr. Wilkinson said, " I think the differences are real; more female inmates

are mentally ill. " He suggested that prisons were seeing more severely mentally

ill inmates now " only because the volume is greater, " meaning that the number of

people in prison has increased.

 

Copyright 2003 The New York Times Company

 

 

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