COLUMN: Mentally ill have only prison to turn to for care

From Nadia Dowshen's, "Urban Guerrilla," Fall '99 From Nadia Dowshen's, "Urban Guerrilla," Fall '99Living across the street from a mental health facility at 40th and Pine has drastically increased my awareness of mental illness. Every morning, I walk by the same gray-haired woman asking me for a quarter or a cigarette and then pass her on the way home as she screams incomprehensibly to someone that I cannot see. I often worry that she, like so many people with biologically based brain illnesses, will end up in jail or homeless. Not only are the mentally ill ending up homeless but many are incarcerated, costing taxpayers billions of dollars annually and leading to inhumane treatment. In California alone, the government spends over $1.5 billion annually on corrections, law enforcement and court costs for the mentally ill. Clinical studies suggest that 6 to 15 percent of persons in city and county jails and 10 to 15 percent of people in state prisons have a severe mental illness. And a greater portion of mentally ill people are arrested and incarcerated than in the general population. Once incarcerated, prisons fail to meet the special needs of mentally ill inmates. Ninety-five percent of the mentally ill persons who are incarcerated were receiving no treatment at the time of their arrest. In jail, rules and policies are focused on punishment rather than rehabilitation. Few prison guards receive special training to deal with mentally ill inmates and consequently do not know how to respond to inmates who are incapable of comprehending and following the rules because of mental illness. As a result, many mentally ill inmates find themselves in solitary confinement. Also, it may take weeks for a mentally ill inmate to see a psychiatrist, during which time their medication is typically discontinued. These kinds of conditions can make mental illness substantially worse for many inmates. And incarceration may have even more deleterious effects on young mentally ill persons, who are estimated to comprise over 20 percent of juveniles in prison. So why are so many of our nation's mentally ill falling through the cracks? Some blame the failure of deinstitutionalization at the state level, pointing to the 79 percent decline in the population of mental hospitals, primarily triggered by the creation of federal funding for community mental health centers in 1963. The discovery of anti-psychotic drugs facilitated the shift to community-based mental health services and increased concern over the comparatively inhumane conditions at state mental hospitals. Due to the lack of funding, jails have become the primary institutions open 24 hours to those who are both mentally ill and poor. People with mental illnesses deserve treatment, not punishment and life on the streets. Mentally ill people need comprehensive, coordinated services and they need to be treated with dignity and respect.

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