Study backs view of prisons as the new mental hospitals

16% of inmates found to have severe disorders


The first comprehensive study of the rapidly growing number of emotionally disturbed people in the nation's jails and prisons has found that 283,800 inmates have severe mental illness, about 16 percent of the total jail population. The report confirms the belief of many state, local and federal experts that jails and prisons have become the nation's new mental hospitals.

The study, released by the Justice Department yesterday, paints a grim statistical portrait, detailing how emotionally disturbed inmates tend to go through a revolving door from homelessness to incarceration and then back to the streets with little treatment. Many of them are arrested for crimes that grow out of their illnesses.

According to the report, mentally ill inmates in state prisons were more than twice as likely to have been homeless before their arrest than other inmates, twice as likely to have been physically and sexually abused in childhood and far more likely to have had drug or alcohol problems.

In another reflection of their chaotic lives, the study found that emotionally disturbed inmates had many more previous incarcerations than other prisoners. More than three-quarters of them had been sentenced to jail or prison before, and half had served three or more prior sentences.

Many of them were arrested for bizarre public behavior or petty crimes such as loitering or public intoxication. But the report also found that mentally ill inmates in state prisons were more likely than other prisoners to have been convicted of a violent crime.

Once incarcerated, emotionally disturbed inmates in state prisons spend an average of 15 months longer behind bars than other prisoners, often because their delusions, hallucinations or paranoia make them more likely to get in fights or have disciplinary problems.

"This study provides data to show that the incarceration of the mentally ill is a disastrous, horrible social issue," said Kay Redfield Jamison, a professor of psychiatry at the Johns Hopkins School of Medicine. "There is something fundamentally broken in the system that covers both hospitals and jails."

With the wholesale closings of public mental hospitals in the 1960s, and the prison boom of the past two decades, jails and prisons are often the only institutions open 24 hours a day and required to take the emotionally disturbed.

The hospitals were closed at a time when new anti-psychotic drugs made medicating patients in the community seem a humane alternative to long-term hospitalization. From a high of 559,000 in 1955, the number of patients in state hospitals dropped to 69,000 in 1995.

But drugs work only when taken, and many states failed to build promised networks of clinics to monitor patients. To compound the problem, for-profit hospitals began turning away the psychotic.

"Jails have become the poor person's mental hospitals," said Linda A. Teplin, a professor of psychiatry and director of the psycho-legal studies program at Northwestern University.

All previous estimates of the number of emotionally disturbed inmates have been based on research by Teplin in the Cook County Jail in Chicago. She found that 9.5 percent of male inmates there had experienced a severe mental disorder.

Teplin said that while she welcomed the Justice Department count, it was open to question because the study relied on reports by the inmates themselves. People with emotional disorders often are not aware of them, or do not want to report them, she said.

Pub Date: 7/12/99

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