Student Models for Essay #3

Patients not Prisoners: The Mentally Ill Prisoner in the United States

by Youssef I. Alhussain

Spring 2010
English 302N13
Dr. Ellen Moody


Everybody assumes that the government has set up prison areas that would help inmates rehabilitate and return to society, understanding the customs and their duty towards others and obeying the law will have its own rewards; however, this is not the case. Besides the stress of imprisonment, there are many deleterious conditions that affect a prisoner's outlook. A lack of sanitation, prisoners' maltreatment, misdiagnoses and malnutrition all have an effect on the sanity of prisoners. Consequently, many develop mental illnesses while in prison Some of the known psychological diseases and conditions these inmates are diagnosed with include psychosis, clinical depression, dysthymia, schizophrenia and bipolar disorders. On top of this often no aid is given a prisoner when he or she returns to society, no new job, new group to join with. As a result of this negligence, after their release from prison, these mentally troubled people who are given no new thoughts or recourse return to the behaviors that got them into prison in the first place.

Patients, not prisoners

Prison for inmates is just a feeding and control ground for their disturbed and unsteady behavior. Inmates are the outcasts of society. It is easy to justify their behavior by blaming the broken homes they grew up in, their low self-esteem, or even their lack of self control and discipline. Moreover, their insecurities force them to struggle with society's norms which causes them to retaliate. Their sense of detachment from their society, whether it was due to immoral values or unusual behaviors, causes them to react by committing crimes. These criminals, or societies' outcasts, almost always return to prison after their release. With thousands of dollars from the taxpayer's money, we would assume that the government has set up a prison ward that would help these inmates rehabilitate and return to the general public, teaching them to the custom of their society and their duty towards it. Yet, that is not the case. Instead, prison is considered to be a hard place that makes inmates even harder to break. This only creates a vicious cycle of breaking the broken. (US. GAO, 1979)

In this cycle, we can see some truths about inmates and criminals. What we still lack of knowledge is a large number of these inmates are mentally ill. There are about 200,000 to 300,000 inmates, both male and female, who suffer from at least one mental disorder. An estimated 7% of people with serious or persistent mental illnesses are put in jailor prison each year. (Criminal Justice and Mental Illness). As "Prison Statistics" (2009) points out, while compared to the average of 2.3 million prisoners the number of the mentally ill seems to be low; in Florida, Miami-Dade County a jail will hold 5 times the amount of mentally ill inmates than the state psychiatric hospital (Criminal Justice and Mental Ill). Inmates with mental illness are often punished for their symptoms. Being disruptive, refusing to obey orders, and engaging in acts of self-mutilation and attempted suicide can all result in disciplinary action. As a result, prisoners with mental illness often have a lot of corrective past histories. Many mentally ill have not been able to seek proper treatments mostly because of economical reasons. This has caused to them to hurt others around them and force the law to incarcerate them.

There are a number of different kinds of mental illnesses. Sometimes inmates have a temporary breakdown and while this temporary melt down should be monitored for future incidents, it is the enduringly mentally ill inmates that we should really take into consideration. Some of the psychological diseases that these inmates are diagnosed with include Psychosis, Clinical Depression, Dysthymia, Schizophrenia and Bipolar Disorders. It is important to understand these disorders and to understand the injustice of imprisoning mentally ill criminals without attempting to help them. (Prell, 2009) "As of ye lend 2008, about 41.2% of inmates had at least one diagnosis of a mental illness. The prevalence of mental illness among female offenders is higher than for men. However, it is important to look beyond these numbers to obtain a more accurate picture of the mentally ill inmate population and the challenges they pose for the Department of Correctiosn" (Prell, 2009)

Many inmates have been diagnosed with various psychological disorders. Psychosis occurs when an individual loses touch with reality. Individuals develop false ideas about the things that are taking place around them. In other words, psychosis is a delusional state. Individuals who are diagnosed with this disorder are having hallucinations aboug who someone is or/and about what they are hearing or seeing. This is a real disease of perception, a dangerous disorder because someone can then commit a crime unknowingly. Some of the symptoms of this disorder incldue abnormal displays of emotion, confusion, depression, sometimes suicidal thoughts, disorganized thought and speech, hysteria, delusions, extreme fear and suspicion. There are different reasons for the disorder: hwoever, all individuals diagnosed need proper monitoring by professionals and kindness too to guarantee their safety and the safety of those around them. Inmates who get no treatment get worse and this is a disorder often caused by the conditions of imprisonment in the US.

Antother disorder that has had a major influence on criminal activities is schizophrenia. Like Psychosis, Schizophrenics have a hard time telling the difference between what is real and unreal. They find it difficult to think logically and to have common emotional behaviors. Schizophrenia can take years to develop.Some of its symptoms include showing no emotions, strange motor behaviors that illustrate detachment from the environment, delusions, hallucinations, disordered thinking. While many believe schizophrenia are violent people, that is not the case. Studies show that they withdraw from society and the only harm they may cause is to themselves; outside factors might, however, lead them to violent behaviors. Often the media links ~ schizophrenia to criminal violence but that is not the case with the mental illness. People with schizophrenia withdraw from society and prefer to be by themselves. When schizophrenia is mixed with drug or alcohol, then there is risk of violence.

Clinical Depression is another disorder that affects a number of inmates. This disorder has a negative response to an individual's feelings, thoughts and actions. This affects the individual's functions. Often times, individuals diagnosed with its symptoms lose interest in life and activities they once enjoyed. It is a condition that is more than sadnessft clinical depression affects a person's life style. It changes their eating habits, their moods, thoughts, body and behavior. It can cause an individual to lose his or her ability to work and communicate with others. Inmates with this diagnosis can retreat further into their disorder, making it harder for them to return back to reality which may lead to suicide. (Rother, 1995)

Dysthmia is another form of depression. Individuals diagnosed with Dysthmia feel that their life lacks excitement and happiness. They are constantly worried and are often withdrawn from society. Their detachment can cause serious violent or unlawful reactions. They will feel guilt but also irritation. Unlike other types of depressions, dysthrnia is often recognized but its severity and its length. Some of the symptoms include~negative thoughts, social withdrawal, conflicts with family and friends and irritability or hostility. These symptoms can often be read as an indication of a criminal. Individuals with this disorder, like any other disorder, need to be treated before the situation gets worse by living in the atmosphere of a prison. (Rother, 1995)

Bipolar disorder is an altering in moods, commonly between depression and excitement. They are major and abrupt mood swings. These mood swings can go on for days or even months. The symptoms of this disorder include: agitation or irritation, hyperactivity, increased energy, lack of self-control, racing thoughts, poor temper control, reckless behavior like impaired judgment and sexual promiscuity, and a tendency to be easily distracted. These symptoms are a cause for criminal activities. While mood swings with some might not be as apparent as others, this does not mean to disregard this disorder at a whole. Like a majority of mental illnesses, disregarded the symptoms can result in dangerous behaviors. Some of their behaviors in result of this disorder include; thoughts of death and committing suicide, withdrawal from society and activities and eating problems.

While a number of these disorders can be taken care of while the mentally ill person is in prison, the current conditions of these facilities are so bad in many ways for any living human being and create a number of these illnesses to develop further. The sanitation, prisoners' maltreatment, malnutrition all have effects on the brain and sanity. Many believe that prisoners are the scum of the earth, an do not deserve to be treated any better than how they are currently treated. However, poor treatment means that they only grow negative feelings toward society causing them to continue in criminal activities once they are out in the world. No one knows what the length and extent of their next crime might be.

It is startling how so much money is put into the rehabilitation programs (are these are salaries?), yet criminals come out exactly the same as they entered if not worse. There are programs that were designed in order to see a change in the criminal activities in society. Yet every year the amount of criminal activities rise higher. While the problem can never be solved, a significant reduction in crime rate can be made. This can easily start with paying more attention to the mentally troubled individual for real. It is reasonable to arrest a criminal, but once in the custody of the government it becomes their responsibility to take proper care of each individual in order to ensure that the criminal has a full recollection of his actions and his mistake. It is also their responsibility to make sure those who need proper medications to stay stable receive it. (US. GAO, 1979)

As well as their proper medications, socialization is a key to get help them find their sanity. Atul Gawande, an American journalist and doctor, argues (rightly) that humans are social creatures; without the ability of expressing our feelings, we will be permanently secluded and withdrawn from the public. He also mentions that " ... on the effect oftotal isolation from birth, the researchers found that the test monkeys, upon being released into a group of ordinary monkeys, usually go into a state of emotional shock, characterized by ... autistic self-clutching and rocking." (Gawande, 2009)

Coming to the financial aspect of this area, studies show that inmates with mental illnesses cost nearly twice as much per day compared with other inmates in the prison population. This is the real reasoning behind decisions to keep inmates from receiving proper treatment. With already a high rate of the prison population diagnosed with mental illness (according to Criminal Justice and Mental Illness that number is 16% compared to 5% ofthe U.S. population) diagnosing more will only cost more for prison facilities. It is also proven that today in prisons there are three times more people that are mentally ill than in psychiatric hospitals. Thus, proper monitoring, sanitization and treatment is not received insuring that the illness will only continue.

Today the current situation in prison facilities in America is unlivable even for the mentally well. Prisons lack hygiene facilities and proper meals. There is constant abuse from the guards and other inmates, both and mental and physical. These tough living conditions make it hard for any to get proper treatment, much less a mentally ill person. Every inmate should given proper evaluation to determine a proper facility to place them in. Some things to consider upon evaluation are the age, criminal action and their race. In order to assure proper assessment and evaluation as well as proper treatment of both guards and prisoners, only trained professionals should hired to work in these facilities. By giving them proper and fair treatment, a number of inmates will begin to lose their emotional troubles that causes them in the current living conditions of the prison facilities to make problems. Also, by providing them with ways to pass time, like extra activities and work opportunities, inmates would be able to relax and pass time quickly. The feeling of being in a prison cell for a long period oftime can cause any individual to panic and develop hysteria.

A routine check up and cavity search should be part of the agenda. While it is important for the safety of the guards and inmates from one another, it is just as important for inmates who have mental illness. These individuals have a high risk of hysteria and delusions. They can imagine something happening that in reality is not. They can become irritated from other inmates and because they lost all sense of rationality, they can harm others around them. They can also fall deep in depression and begin to think thoughts of suicide. It is important at any prison facility that they keep in mind that the inmate's mental and physical health is a necessary part in running a prison. It is obvious that they should be fed properly, but it is just as important that their emotional needs are satisfied as well. Prison facilities should work closely with physicians and psychiatrists. They should receive proper treatment and even after the sentence is done the doctors that were responsible for them during their time in prison should also make sure they are attending proper treatment outside the facility.

We need to do something pro-active on behalf of all prisoners, and especially the mentally ill. One specific area of mental illness seen in prisoners are those imprisoned for drug abuse. This specific population, whom usually get draconian sentences, are especially at risk within the prison and when they are released. While the federal government has proven during its war on drugs that the mentally ill are the majority of users and abusers of drugs (they have cleared more mentally ill from the streets than the general population) these drug abusers need proper medications in order to get better. And although they get minimum treatment while in holding cells, it is hard to believe how they leave with a few weeks amount of prescription and - do not find or do not look for a proper doctor to treat them before the medication is finished. Once they go back to normal they begin to retreat again and find it difficult togetproper treatment. They go back to their normal neurotic behaviors which got them into the mess in the frrstplace. (US. GAO, 1979)

Annotated Bibliography

  1. "Criminal justice and mental illness." Mindsontheedge. Fred friendly seminars, inc. Web. .
    This source has very easy and had useful statistics especially since it is in a question­answer format. It was often used in my paper since those numbers that backed up my hypothesis. It mentions the enormous number of mentally ill people that are thrown into jails every year. In addition to this, it also states that many prisons hold up to five times the number of mentally ill people than psychiatric hospitals. This source had no major drawbacks since it was clear and straight to the point.
  2. Gawande, Atul. "Is Long-term Solitary Confmement Torture?" The New Yorker. 30 Mar. 2009. Web. 10 May 2010. .
    This essay written by Atul Gawande was meant to explain the consequences of imprisonment and isolation also called "Hellhole". It was very germane to this topic and many of his experimental results clearly s~pport my h))'othesis. It had no drawbacks.
  3. Prell, Lettie. "Seriousness/Acuity of Mentally m Offenders in Prison." Iowa Data of Corrections, July 2009. Web. .
    This is a pdf from the Iowa department of corrections that mainly describes the difference possible diagnoses that mentally ill inmates suffer from. It has useful graphs and pie charts that can also be used as statistical reference. Its main drawback that it is only two pages long without in depth explanation for the different types of diagnosis.
  4. "Prison Statistics." US Department of Justice. Bureau of Justice Statistics, 8 Dec. 2009. Web. .
    This is a brief description of Prison Statistic from the US Department of Justice. It is useful for finding out quick statistics and charts. However, it is a little too brief and doesn't have thorough and enough information.
  5. Rother C. "For jails and the mentally ill, a sentence of growing stress." San Diego Union Tribune. March 30, 1995.
    This article is about de-institutionalization, which is the moving of the severely mentally ill out of the state institutions, and the closing of part or all of those institutions. In addition to this, it summarizes how those patients are put back to jail because of an action that was triggered or became a result of their illness. This was an extremely helpful source full of details and information. It had no drawback whatsoever since it included stories, reasoning, charts and even statistical information.
  6. United States. General Accounting Office. (1979, November 23). Prison mental health care can be improved by better management and more effective Federal aid: report to the Congress/ by the Comptroller General of the United States. Retrieved October 22, 2009, from George Mason University.
    This is a number from a journal publication found in the GMU database that was pretty useful. It explained that if prisons could improve their management, administration and get more funding from the Federal government, then it will be easier to identify those illnesses and treat those helpless patients. As a result of that the number of mentally ill prisoners will decrease by a vast number. It was very complete and thorough; however, it was too long and many complicated words were used which made the text harder to understand.

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