The closure of state hospitals during the ’70s and ’80s has funneled people experiencing psychiatric crises into correctional facilities. A person experiencing a mental health episode is much more likely to encounter police than receive the medical help they need, especially if that person is poor, a member of a minority group, or has a history with law enforcement. Once placed in a correctional facility a person may wait days or weeks before seeing a psychiatrist.
People detained during a crisis experience worsened mental health conditions rather than improvement. They are held longer than their non-mentally ill counterparts and risk victimization by both inmates and correctional officers (CO’s), according to the National Alliance on Mental Illness (NAMI). A detained person may spend up to 23 hours a day locked down in a cell monitored by correctional officers with little to no mental health training.
A 2017 report titled “Emptying the ‘New Asylums’: A Beds Capacity Model to Reduce Mental Illness Behind Bars,” found that about 90,000 US jail inmates were pretrial defendants with serious mental illness who were found incompetent to stand trial (IST). Waits to access IST services, which typically take place in state hospitals, can sometimes take up to a year. In the meantime, inmates typically do not receive treatment, are often victimized and sometimes die.
Correctional environments can aggravate psychosis creating extreme fear, sparking aggression and leading to more criminal infractions and longer detainments. Measures to keep someone experiencing a mental health crisis safe include 24-hour lockdown in a secluded bare cell without sheets, blankets, possessions, or even clothes. Isolation is known to exacerbate mental illness. A 2014 article reports that isolation causes auditory and visual hallucinations, skews perception of time and, if experienced over a long period of time, increases one’s vulnerability to Alzheimer’s disease and dementia.
Two million people experiencing mental illness each year are booked into jail, NAMI states. Historically, state hospitals were called “asylums” because they were associated with long-term care and protection, according to the previously cited 2017 report. The report states that mental illness is now so prevalent behind bars that jails and prisons are routinely called the “new asylums.” The lack of support and resources for people experiencing mental health crises was highlighted for King County when Western State Hospital lost its federal certification and $53 million in federal funds in late June. The 800-plus bed facility, which is Washington’s largest psychiatric hospital, failed to achieve basic health and safety standards. As a Seattle Times article states, "Washington has struggled to comply with court rulings to better care for psychiatric patients — with fines against the state reaching tens of millions."
After exiting detainment many lose their jobs, housing, and access to needed healthcare and benefits. Having a criminal record makes it difficult to reobtain jobs and housing. Without mental health services and support many end up homeless, in emergency rooms, and re-arrested. Our mental health care system is broken. If people of privilege can get adequate treatment for their psychiatric illnesses, then why are the members of our community that are poor and/or marginalized funneled through a system setup for their demise than their success?