The Overrepresentation of Mentally Ill People in US Prisons

This essay delves into the critical issue of mental illness within the US prison system. It highlights the disproportionate number of mentally ill individuals incarcerated compared to the general population, exploring the historical context of mass incarceration and the decline of mental health facilities. The paper investigates the causes of this overrepresentation, including deinstitutionalization and the criminalization of mental illness, and examines the current state of mental health care within correctional facilities. The essay also discusses the challenges faced by mentally ill inmates, such as lack of adequate treatment, solitary confinement, and the difficulties they face upon release. Finally, the paper provides recommendations for improving the criminal justice system's approach to mental health, including institutionalizing mental health care, improving infrastructure, providing better training for prison personnel, and promoting community resources, to ensure the wellbeing and fundamental rights of all inmates.

Running head: PEOPLE WITH MENTAL ILLNESS IN US PRISONS
People with Mental Illness in US Prisons
Student’s name
University

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Executive Summary
The present paper deals with a significant aspect of the American criminal justice system,
namely the issue of mental health and mental illness of the prison inmates. Following the mass
incarceration in the US, scholarly researches have proved that there is a disproportionate
overrepresentation of mentally ill people in the state jails and prisons as relative to the general
population of the country. However, the existing infrastructure and practices in the US criminal
justice cannot deal with such people adequately. To this end, the paper tries to explore the
current scenario inn depth, bringing out the causes of such intensification mental health related
issues and existing state of mental health assistance in correctional facilities. Thereby, it attempts
to identify possible areas of improvement and recommends potential measures to develop the
criminal justice system offering wellbeing and protection of the fundamental rights of the prison
inmates.

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Table of Contents
Introduction......................................................................................................................................3
Background..................................................................................................................................4
Justification..................................................................................................................................4
Mental Health and Related Illnesses among Prison Inmates...........................................................5
Causes of Increase in Mental Illness in Incarceration.....................................................................6
Mental Health Care in Prison..........................................................................................................6
Recommendations and Conclusion..................................................................................................7
References........................................................................................................................................8

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Introduction
Incarceration is usually regarded as a form of punishment, which is utilized by every
civilized nation. However, the underlying approach in prison system differ from society to
society. For the United States, prison system is more like a correctional facility, where
perpetrators and wrongdoers are deployed not to just deter them from crime, but with the
intention to bring in a positive transformation in their behaviour and place them back in the
mainstream of the society in whichever case possible. Human rights and civil rights are supposed
to be secured in terms of prisoners’ cases as well, although this ideal is limited in its actual
optimized execution given the situation in American prisons (Hawes, 2017).
The recent trend of mass incarceration in the United States has brought forward several
ethical and practical challenges to be addressed with immediate effect. The extreme rates of
imprisonment has made it difficult to provide proper infrastructure and facilities to the prisoners.
The importance of such infrastructure is necessary for ensuring the prisoners’ wellbeing and
secure their fundamental rights (Rothschild, 2019).
In the light of the apparent drawback of the American prison system, the present research
wishes to shed light on a significant group, namely the people with mental illness and conditions.
Several researches and studies have confirmed that mentally ill people are indeed
overrepresented in the American prisons relative to the general population. However, the lack of
infrastructure and inadequate management have made it more problematic to deal with the
specific group while keeping their interest in the contexts of wellbeing and fundamental rights.
Moreover, the reason of such overrepresentation is also disputed among scholars, which has

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made it even more difficult to provide proper care and mental health assistance to the inmates.
Therefore, the present study will devote itself to review the matter and seek appropriate measures
to correct the prison management in the favour of mentally ill prisoners.
Background
In the 44 states of the United States, jails and prisons together contain way more mentally
ill people than mental health facilities and hospitals. The review report of the US Department of
Justice, published in 2006, presents a clear picture of the current state of mentally ill people in
incarceration. According to the report, the estimated number of prison inmates with some form
of psychotic disorder or disease is around 149,000 as of 2005, which indicated a proportionate
growth by each following year. As of 2014, the Department of Justice recorded over 156100
inmates with same condition in the state prison across the country, which proves the forecast
undeniably. Moreover, the same study reports that the overall estimation of people with
psychotic disorders and illness in state prisons are around 383200, whereas in the mental
hospitals and asylums, only 38000 a population with similar condition remain, making the
incarcerated population 10 times bigger than the institutionalized population (Justice.gov., 2014).
Justification
It is observed that hospitals and institutions for mental illness has mostly disappeared,
and people availing the services and assistance from those centers have decreased by a
staggering amount of 50,000. However, this does not indicate that the prevalence of mental
illness has come down, rather these people are mostly incarcerated for some reason or another.
Hence, the correctional facilities have become the default mental health institutes, although they
lack in the adequate infrastructure and training in providing mental health care.

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The deinstitutionalization of mental health care and lack of community psychiatric health
care have added more pressure to the problem at hand, as the correctional facilities have to
manage the situation all by themselves. Therefore, the prison system in America has drawn
significant political and scholarly attention of researchers, policymakers, administrators,
advocates of human and civil rights as well as mental health practitioners. Upon considering the
background of the issue, the evident infrastructural shortcoming and concerns of significant
actors of public interest, it can be affirmatively claimed that the issue of mental illness among
prison inmates is indeed an area that requires special attention and has ample scope of correcting
and developing the judicial system (Perry, 2016).
Mental Health and Related Illnesses among Prison Inmates
Bryan Stevenson, notable lawyer and human rights activist, mentioned in his Just Mercy
(2015), mentioned that one in every five prison inmates in US correctional facilities is diagnosed
with serious mental illness. According to the reports of the US Department of Health and Human
Services, the definition of mental illness among jail and prison inmates generally refers to
bipolar disorder, schizophrenia and depression (Mentalhealth.gov. 2018). And it subsequently
affects every aspects of the criminal justice and reform. Moreover, it has a prolonged effect on
the process of naturalizing former prisoners in the mainstream of society, as they keep going
back and forth between prison and normal societal life, owing to their inability to cope up (Fazel
et al., 2016).
Needless to mention that people with mental disorders and illnesses are the most deprived
section of the society, mainly because they can neither voice their concerns in proper manner,
nor could stand by their rights and interests. Hence, as they end up in prison or jails, they are
most unlikely to make parole (Hirschtritt & Binder, 2017). Besides, not just mentally ill people

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face the problem while in incarceration, the torture, deprivation and mistreatments received in
prison take a toll on the inmates’ mental health, making them psychologically unstable. And the
existing prison management is unable to deal with their issues or control their behavioural
disorders. In most cases, such people receive solitary confinement and even end up in
committing suicide (Hoke, 2015).
Causes of Increase in Mental Illness in Incarceration
Deinstitutionalization is most commonly referred as one of the most significant causes to
the issue. (Kim, 2016). However, there are other contributing factors to the faltering
infrastructure for mental illness management. Hokes (2015) holds that the lack of resource
accessibility within communities leads to a high arrest rates among drug offenders, homeless
people and low-income groups. Most importantly, the criminalization of mental illness itself
leads to a higher arrest rates instead of proper referrals and psychiatric interventions. However,
legal practitioners claim that often criminals feign mental diseases to escape charges, making the
police unable to determine the course of action in distinguishing such offenders from the actually
needy ones (Galanek, 2015).
Mental Health Care in Prison
There has been a significant increase in prison management in the context of mental
illness. Researchers report that one in every eight prisons in the US offer psychological
counselling or therapy to their inmates. And based on specialized referrals, the offenders are
categorized to general confinement or specialized facilities. However, due to the tendency of
underreporting, fear of being ostracized, toxic masculinity or simply hatred towards the criminal
justice system, inmates try to resist clinical assistance. On the other hand, the prisons with no
proper mental health facility fail to take care of such prisoners. Moreover, using solitary

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confinements for managing mentally ill inmates eventually create more psychological distress.
Besides, emergency detention, being a significant point of debate among criminal justice experts,
is still attributed to be a hindrance to the welfare of mentally ill prisoners (Al-Rousan et al.,
2017)
Recommendations and Conclusion
Reviewing the issue of mental health and illnesses among prison inmates in the US jails
and prisons, it is evident that the matter is neither ignored nor given less importance by relevant
authorities and practitioners. However, there is still scope of improvement in the criminal justice
system regarding the matter at hand. To this end, the paper recommends the following measures:
i) Institutionalize mental health care facilities and reduce the burden from the jails and
prisons.
ii) Ensure mental health care and assistance in every correctional facility.
iii) Develop better infrastructure and training to prison personnel to deal with mentally ill
people with expertise and care
iv) Emphasize the importance of community resources accessibility and assistance to
ensure law and order.
v) Stop criminalizing mental illness and promote awareness in the community regarding
mental health.

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References
Al-Rousan, T., Rubenstein, L., Sieleni, B., Deol, H., & Wallace, R. B. (2017). Inside the nation’s
largest mental health institution: A prevalence study in a state prison system. BMC public
health, 17(1), 342.
Fazel, S., Hayes, A. J., Bartellas, K., Clerici, M., & Trestman, R. (2016). Mental health of
prisoners: prevalence, adverse outcomes, and interventions. The Lancet Psychiatry, 3(9),
871-881.
Frost, N., & Monteiro, C. (2016). Administrative segregation in US prisons. Washington, DC:
US Department of Justice, Office of Justice Programs, National Institute of Justice.
Galanek, J. D. (2015). Correctional officers and the incarcerated mentally ill: Responses to
psychiatric illness in prison. Medical anthropology quarterly, 29(1), 116-136.
Hawes, D.P. (2017). Social Capital, Racial Context, and Incarcerations in the American States.
State Politics & Policy Quarterly, 17(4), pp.393-417.
Hirschtritt, M. E., & Binder, R. L. (2017). Interrupting the Mental Illness–Incarceration-
Recidivism Cycle. Jama, 317(7), 695-696.
Hoke, S. (2015). Mental illness and prisoners: Concerns for communities and healthcare
providers. Online journal of issues in nursing, 20(1).
Justice.gov. (2014). Retrieved 19 December 2019, from
https://www.justice.gov/sites/default/files/criminal/legacy/2014/08/01/2014annual-letter-
final-072814.pdf
Kim, D. Y. (2016). Psychiatric deinstitutionalization and prison population growth: A critical
literature review and its implications. Criminal Justice Policy Review, 27(1), 3-21.
Mentalhealth.gov. (2018). Home | MentalHealth.gov. Retrieved 19 December 2019, from
https://www.mentalhealth.gov/
Ojp.gov. (2006). Retrieved 19 December 2019, from
https://www.ojp.gov/newsroom/pdfs/06_ojp_annual_report.pdf

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Perry, B. L. (Ed.). (2016). 50 years after deinstitutionalization: mental illness in contemporary
communities. Emerald Group Publishing.
Rothschild, C. (2019). The Incarcerated State (s) of America: The Causes, Consequences, and
Solutions to Mass Incarceration in the United States. The Rice Examiner, 2(1), 103-129.
Stevenson, B. (2019). Just mercy: A story of justice and redemption. Spiegel & Grau.