In a controversial decision last week, the Supreme Court has ordered California to release 33,000 prisoners from its prison system. The decision ruled that many of the prisoners’ civil rights were being violated through “cruel and unusual” punishment. The ruling cited overcrowding as the principal reason behind the fact that prisoners do not receive adequate physical and mental health services, resulting in abysmal conditions; some prisoners, for example, being forced to stand upright in their own urine and feces in cages no bigger than telephone booths for hours on end while waiting for a mental-health-crisis bed.
The ruling highlights a nation-wide problem with prison overcrowding and the fiscal crisis it may cause in other states, not to mention the impact it will have on the communities left to absorb the criminally insane. The problem traces its roots to the 1960’s, when well-meaning legislators and reformers enacted laws aimed at closing state mental hospitals and returning the mentally ill to the community. The idea was not to simply let the mentally ill loose out into the public, but to integrate them into the community by means of supportive community mental health programs. The noble ideal behind this project was to do away with the medieval psychiatric hospitalization practices which notoriously institutionalized, often for life, individuals who were only mildly disabled, or whose conditions wer then poorly understood. The reformers succeeded remarkably well, and the pendulum has swung into the opposite extreme, making it extremely hard to hospitalize the mentally ill and appallingly easy to discharge them. They also made it very easy for those discharged to refuse outpatient treatment. As a result of these “progressive” reforms, California has an enormous and highly visible homeless population, of whom 30 to 50 percent are estimated to be mentally ill. These people often then commit crimes, with prison the inevitable next step.
An exacerbating factor in the current crisis is that state funds for community mental health programs are drying up ever faster with each looming state budget crisis. Community programs serving the mentally ill and the poor are notoriously one of the first to be put on the budgetary chopping block. This leaves both the mentally ill, the poor and the communities in which they live vulnerable to crime and violence.
When all is said and done, our current policies make little sense when we consider that the average cost of supporting an inmate is $48,000 annually, compared to $26,000 cost for community mental health programs for one such individual. It is clear that two things are urgently needed to remedy the problem: returning treatment of the mentally ill to the mental-health system, and revising some of the extremely lax standards for mandated mental health treatment. The first reform would help intervene in a mentally ill person’s life before they ever hit the prison system. The second reform would help to prevent repeated incidences of violent and/or criminal behavior, thereby making our communities safer and helping those who suffer from mental illness from further deterioration.
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