By Linda Weiford, WSU News
PULLMAN, WASH. – A person with schizophrenia shouts incoherently in a city playground; a woman in the throes of a psychotic crisis hurls rocks against a door; a young man with autism in the middle of a busy road pushes the police officer who tries to move him to a sidewalk.
Too often, symptoms like those are viewed as entry points to the criminal justice system instead of the healthcare system, said David Makin, research fellow with the Washington State Institute for Criminal Justice who teaches classes at Washington State University.
It’s a concern echoed in news reports around the country following publication of a new study revealing that 10 times more people with mental illness reside in prisons and jails than in psychiatric hospitals. What’s more, their conditions often deteriorate during incarceration, according to the report by the Virginia-based Treatment Advocacy Center and the National Sheriff’s Association (http://tacreports.org/
Streets, jails and prisons have become “de facto mental institutions,” with police officers, by default, being the first points of contact, said Makin. It’s a worsening problem that he spotlights in his undergraduate-level class, “Realizing Justice in a Multicultural Society.”
“I explain that prior to the defunding of mental health care, by the 1950s we had nearly a half-million people institutionalized in state psychiatric facilities,” he said. “Where did they all go?”
From 100 years ago to the present, he outlines our country’s treatment of people with serious mental illness. Today they average one in 17, according to the National Institute of Mental Health.
Whether his students intend to become cops, lawyers or mathematicians, “their eyes go wide. They had absolutely no clue,” he said.
From asylum to cell
Citing studies and using books, lectures and documentaries, Makin demonstrates that prisons are swelling with people with mental illnesses. That’s not because they’re committing the majority of violent crimes; they aren’t, according to studies suggesting they’re involved in only 4 percent.
Instead, it’s the unintended consequences of a movement that began in the late 1960s to phase out mental institutions that society had come to view as barbaric, Makin tells his students.
“The aim was to provide community-based care to help people with mental illness achieve a high level of freedom and self-determination,” he said. “The problem was, this community-based system never took off the way it was supposed to. That meant many seriously ill patients were consigned to the streets with no support services or follow-up of any kind.”
A little more than a decade ago, the problem got worse when slashes made to public mental health budgets shut down shelters, community clinics and mental health crisis centers.
“The irony is that we used to lock them up in mental institutions,” Makin said. “Today, we lock them up in jails and prisons – often for relatively minor offenses and aberrant behavior related to their disorders.”
Patients, not prisoners
When mentally ill people are locked up, corrections facilities – coined the “new asylums” by authors of the recently released report – are often ill-equipped to provide treatment. This leaves inmates vulnerable to physical and sexual abuse or, after they are released, more likely to commit another offense and be sent back.
“There’s this belief that if we lock away the mentally disturbed, they’ll no longer be a problem,” said Makin. “But the stark reality is, we’re making the problem far worse.”
More training for police officers to recognize and respond to signs of mental illness would help defuse, not escalate, confrontations with the mentally ill, Makin tells his class.
But the bigger goal should be keeping psychotic people whose criminal offenses stem from their illness out of jails in the first place, he emphasizes. Mental health courts, which divert certain defendants into supervised community-based treatment programs, are a good start (Washington state has 10 such courts, including one in Spokane and another in Yakima).
Justice over jails
Throughout Makin’s class, the question, “What is justice?” lingers. “By the end of the course, I hope students see that the answer is fairness. Justice should be fair,” he said.
“But our nation responding to challenges of the mentally ill with handcuffs and jail time?” he said. “No. That’s not fair; that’s not justice.”
David Makin, WSU criminal justice and criminology, 509-509-335-2455, firstname.lastname@example.org
Linda Weiford, WSU News, 509-335-7209, email@example.com