The Mass Incarceration of People Living With Mental Illness
Cheryl Roberts
July 12, 2020
Cheryl Roberts is an ex-Judge, currently serving as Executive Director of the Greenburger Center for Social and Criminal Justice, as well as corporation counsel for the City of Hudson.
Her topic was mass incarceration – the criminalization of mental illness and substance disorders. America has the highest incarceration rate of any country. That’s right, of any country. We have less than 5% of the world’s population, but 25% of its prisoners. Our incarceration rate is five to ten times higher than for other democracies.
Is it because we have that much more crime? Of course not [although we do have way more gun crime because of our insane gun culture – FSR]. Roberts noted that U.S. incarceration numbers rose from about 200,000 in 1973 to 2.2 million in 2009. Since then they’ve stayed at about that level. [But during that interval crime rates actually fell dramatically. Imprisonment of dangerous people probably contributed somewhat to that decline. Nevertheless, an eleven-fold increase in incarceration obviously can’t be justified on the basis of crime rates. – FSR]
What it does represent, Roberts said, is not a response to rising crime, but rather a policy choice to use prison as a response to crime; and it’s that policy that’s criminal.
The policy disproportionately affects mainly minority men under 40, who are already disadvantaged, educationally and economically, etc. For all Americans, the lifetime chance of being imprisoned is 6% [a scary enough figure]; for black men it’s 32%. And meantime, over half of the prisoner population suffers from some kind of mental illness. Such people are ten times likelier to see the inside of a prison cell than a psychiatric facility.
For those with untreated mental illness, the risk of dying in interactions with police is 16 times greater than for people not so afflicted. And it’s not because the mentally ill are more likely to be engaged in criminality. Actually, according to Roberts, they are more likely to be victims of crime.
And prison, she said, is the last place they should be, suffering horribly there. [Hard enough to cope with imprisonment even for “normal” people.] Roberts cited a Virginia study of 400 prison deaths, finding 41% associated with solitary confinement, 44% were suicides, 18% were tasered, etc.
How did we get here? Roberts quoted John Ehrlichman (a Nixon confidante, speaking decades later) saying that the Nixon administration wanted to hit two “enemies” – blacks and anti-war leftist protesters. Launching a “war on drugs” with harsh penalties was a way to kill two birds with one stone. It’s the war on drugs that still accounts for the bulk of America’s over-incarceration. [Treating drugs as a public health issue rather than a criminal justice one would go far toward solving the whole problem – FSR.]
Mentally ill people used to be put in asylums; one such gave us the word “bedlam.” They were not indeed pleasant places. Thus a big societal push to get folks out of them. One impetus was adoption of a Medicaid rule prohibiting payment for most hospital care for the mentally ill.
Roberts noted that in the 1960s we had about 560,000 psychiatric hospital beds; four decades later it was down to about 50,000, for a national population double the size. Those beds came to be used for people coming out of the criminal justice system, deemed incompetent to stand trial. While perhaps incongruously, what was originally the psychiatric hospital population was largely shifted into prisons. (And into homelessness.)
Roberts concluded by discussing Hope House on Crotona Park, a North Bronx project of the Greenburger Center to serve as an alternative to incarceration for people charged with crimes who have serious mental illness, which will include treatment for drug problems and other issues.