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Shelf Life: A Criminally Insane System
Forget the sensational headlines about the mentally ill. The truth is in the alternative media.
Based on what the mainstream media and an ever-growing spate of TV crime shows have to say about mental illness, one could easily sketch a sinister profile of the average specimen: He's a murder convict, schizophrenic or perhaps bipolar, who snapped after he went off his meds and brutally killed someone with a baseball bat or an apple corer. Oh, and don't forget the takeaway lesson: Why was he roaming the streets in the first place? He should have been in a hospital somewhere.
"The fact is that the mentally ill are rarely violent and contribute very little to overall violence in the United States," writes psychiatrist Richard A. Friedman in "The Politics of Mental Illness," an outstanding 24-page special report in the July-August issue of the American Prospect. But it's easy to see why this myth needs dispelling: Friedman points to a 2005 study of 70 major newspapers that found that 39 percent of stories about mentally ill people "focused on dangerousness."
The media would be better off reporting on the dangers to which we subject the mentally ill. Our fragmented system isn't terribly effective or humane, and it's not doing much more for its clients-or for the country as a whole-than the shackles and electrodes of a century ago. Today's seriously mentally ill, particularly those who don't have access to high-quality care, often end up bouncing between the criminal justice system, the mean streets, and overfull emergency rooms-deeply unconnected organisms that don't play well together. Subjecting people to this scattershot system takes its toll: According to the American Prospect report, adults with mental illness who rely on public health programs have, on average, a life expectancy that's about 25 years shorter than that of the general population.
We may have shuttered our insane asylums, but other institutions have risen in their stead: jails and prisons. Some 20 percent of adults behind bars have mental health problems-in Washington's Spokane County jails, that's closer to 60 percent, reports Prison Legal News (May 2008)-and, just like the rest of the incarcerated population, many are put away for nonviolent and petty offenses. But being locked up is far from a rehabilitative boon, and in a system in which rewards and punishments are based on behavior, a mentally ill individual's sentence can easily grow longer. The Houston Press (Aug. 21, 2008) profiled the case of Alexander Hatcher, who was arrested for "criminal mischief" in 2006. Hatcher, who is diagnosed with schizophrenia and bipolar disorder, racked up a whopping 53-year sentence for assault and harassment charges he accumulated in jail.
While men like Hatcher, whose history of mental illness should have made him eligible for psychiatric treatment in jail, are swept under the rug of a swelling prison population, dubious new laws are using mental illness as a way to keep sex offenders locked up indefinitely.
The Nation (Dec. 31, 2007) reports that civil commitment laws in 20 states have declared more than 4,000 sex offenders mentally unfit, which keeps them in jail or sends them to psychiatric facilities when their sentences are up. This happens despite the fact that "most psychologists agree that mental illness is not a prerequisite for sexual violence," the Village Voice notes in "To Catch-22 a Predator" (July 16, 2008). Furthermore, attaching the language of mental illness to some of society's most reviled members isn't likely to help erode the misconception that mentally ill people are prone to violence.
There is a growing recognition that the criminal justice system, from arrest to court date to incarceration, simply does not work for many people with mental illness. In cities and counties across the country, mental health courts are springing up to help close the revolving door between jail and street.
Pennsylvania is currently the model state on that front, writes Sasha Abramsky for the American Prospect. Five of its counties have implemented mental health courts, which work intensively with nonviolent offenders to connect them with treatment, employment, and frequent supervision, all with an eye toward keeping them out of jail. Police officers are trained to recognize when they're dealing with mental illness, and in Allegheny County they can take people to a 24-hour crisis center instead of lockup. "Graduates" of these programs also have much lower rates of recidivism: In Allegheny County, it's just 10 percent, compared to the statewide rate of 55 percent.
These programs aren't cheap-Westword reports (May 29, 2008) that a Denver pilot program costs around $12,000 per person-but this up-front investment jibes with the Council for State Government's Consensus Project, which recognizes the potential for long-term cost savings from lower incarceration rates. In Portland, Oregon, mental health advocates eagerly await the start of their own pilot project, says the Portland Mercury (May 1, 2008). "If we actually provided effective, outcome-based treatment on demand for mental health clients in Oregon," mental health advocate Jason Renaud told the Mercury, "you could probably shut down one hospital and two prisons within two years."
The American Prospect puts forth a decidedly wonky but commonsense proposal: Let the new president create a federal Office of Mental Health Policy. It seems ridiculous that one doesn't already exist, given that close to half of all Americans experience some form of mental illness or substance-abuse disorder at one time or another. It's clear that the disjointed, disconnected systems allow "far too many opportunities" for people to slip in and out of well-being.
Writing for High Country News (March 31, 2008), Ray Ring dreams of something a bit more ambitious, and controversial, than mental health courts and new federal agencies. In an unreserved and heartrending essay, Ring leads the readers of the Western politics magazine through the story of his "crazy brother" John, who drifted in and out of treatment, jail, and coherence until he committed suicide at 47. "If I were in charge," Ring writes, "my program for crazy people would include a decent apartment, a good burrito, movies, hikes. And cats and dogs and whores, so the crazy people can touch and be touched physically, without judgment. And a place for hammering things to smithereens, without endangering other people."

10 Comments so far
Show AllOur Criminally Insane System fits right in with our Criminally Insane Judicial System. In our system mentally ill people are treated as defective products. We recall them and change a part and say go away. Once they hit out judicial system it doesn't matter anymore what their mental capacity is, so the problem goes away. What a country.
Hoa binh
since 1492: yes, treated like defective products. But about: "change a part". I'd like you to please expand on that. I am curious. And interested.
WRM
Anyone interested in a serious discussion of this subject should read Thomas Sasz, especially his "Manufacture of Madness". It's all there, how we scapegoat and persecute the mentally ill, just as we persecuted witches and heretics during the Inquisition. I know. As a mental health worker I had numerous patients involuntarily commited in PA in the 1980s, until my wife at the time tried to have me commited upon my burnout.
Thank you Ms. Maestretti. A couple of examples of how pervasive language using behavior and mentally ill as "bad": in the election campaigns for over a century, political opponents are called "crazy" "nutty" and variations on that. Another example of myth of violence being destructive of the lives of mentally ill and mentally disabled is the number of people killed by police instead of being subdued. Most recently the NYPD tasered a young man, with mental illness, who was on a shallow ledge, where he could only fall 10 feet to the ground. He landed on his head and died,hitting the pavement. (That the police Lt. who ordered the officer to taser the ill young man, who was without a weapon, unless you count a long light bulb, then committed suicide, is further waste of human life based on ignorance.) The warrantless fear of the mentally ill leads to abuse of the mentally ill.
Nietzsche
If you have a mental problem do whatever you have to do but don't let the system get it's hands on you. If you do you will have more problems than you ever thought possible.
"If you have a mental problem do whatever you have to do but don't let the system get it's hands on you. If you do you will have more problems than you ever thought possible."
I can't tell you how true this is. If you are depressed going to your local city or county mental health clinic is the short way to become suicidal. It's apparent from the moment they answer the phone or the moment you walk into the door that the person seeking help is nothing more than freight to be processed.
There are herbal regimens, herbs from the Amazon, that can treat, and sometimes cure depression. Sometimes with a single dose. Stay away from SSRI's;THEY DO NOT WORK AS ADVERTISED!! Do your own research or get a friend to help. Exercise, travel, simplify your diet, seek religious counseling but be wary of the pill bottles.
Fighting the forces of rather dim lighting wherever they may be found!!
Writing for High Country News (March 31, 2008), Ray Ring dreams of something a bit more ambitious, and controversial, than mental health courts and new federal agencies. In an unreserved and heartrending essay, Ring leads the readers of the Western politics magazine through the story of his "crazy brother" John, who drifted in and out of treatment, jail, and coherence until he committed suicide at 47. "If I were in charge," Ring writes, "my program for crazy people would include a decent apartment, a good burrito, movies, hikes. And cats and dogs and whores, so the crazy people can touch and be touched physically, without judgment. And a place for hammering things to smithereens, without endangering other people."
That sounds so damm nice and humane!
Instead, we have a Judao/Christian punishment machine that seems to take every opportunity to suck millions of poor soul into cages and torture them by depriving them of their human rights as described up above. This we pay for and call justice.
Sioux Rose
I wonder if the statistic that half the population will suffer from substance abuse and/or mental illness at some time is true?
I also recall a radio program (on NPR, I think?) about the high degree of rape that occurs in prison, and how it's understood by those who conduct the "criminal justice" system. I can only imagine that a male being raped would lead to some pretty serious mental issues after, and since so many are convicted of non-violet minor drug offenses, by the times these guys get out, they could easily be far more twisted than when they entered. It is a punitive mess!
Sioux Rose: some years ago, the statistic for women being raped, in US was 25%. I don't think most women are "twisted" afterwards, although fearful of repeat attack is always present.
I agree the mentally ill are often horribly treated and the system that serves them is underfunded. I think we should be careful making extreme statements to people who are often in desperate straights. While there are plenty of real horror stories involving police, case workers and others, there are also people in the same professions that provide remarkable services. If you need help, make careful choices and utilize any supports and advocates you have available. Don't be too quick to write off medication either. Many psychotropic drugs are very powerful and need to be monitored closely and adjusted or discontinued if necessary; the way people react to them is very individual. Some people get only partial relief from meds and need additional ways of coping. Some find meds that help only after long trials of many medications. Unfortunately some people end up being unable to benefit from meds much at all. On the more positive side, I have seen some, in fact many, that have had dramatic improvements with meds. For some meds are the only thing that enables them to independently.