More than a quarter million mentally ill in America's jails and prisons

A report from the US Department of Justice finds that as of mid-1998 there were an estimated 283,800 mentally ill in the nation's prisons, and 547,800 on probation. Results of surveys conducted by the Bureau of Justice Statistics show that 16 percent of state prisoners, 7 percent of federal prisoners and 16 percent of those in local jails reported mental health problems or overnight stays in a mental facility. Figures are likely much higher, as the survey relied solely on information provided by the prisoners themselves.

What emerges is a picture of a prison system which habitually incarcerates mentally ill members of society. In 1955 there were an estimated 559,000 mentally ill patients in state hospitals. By 1995 that number had dropped to 69,000. Today, for-profit hospitals routinely turn away psychotic patients who are without medical insurance and are unable to pay for treatment. Those who are covered by health insurance and health management organizations (HMOs) have seen their mental health and psychiatric benefits slashed. As a result, prisons and jails, oftentimes the only facilities open 24 hours a day, have become the destination of last resort for thousands of mentally disturbed individuals.

During the same period that saw mental health facilities drastically reduced, there has been a boom in the prison industry, with more and more facilities contracted out for operation by private corporations. The number of prison and jail beds has grown four-fold in the past quarter century, with 1.8 million people now incarcerated in the US, approximately 668 prisoners per 100,000 US residents.

According to the report, "Mentally ill offenders reported high rates of homelessness, unemployment, alcohol and drug abuse, and physical and sexual abuse prior to their current incarceration." 20.1 percent of mentally ill prisoners reported living on the street or in a shelter in the year prior to their arrest, while 8.8 percent of other inmates reported being homeless in this same period. 78.4 percent of mentally ill female state prison inmates reported physical and sexual abuse as opposed to 50.9 percent of other female prisoners; while 32.8 percent of mentally ill males in state prisons reported such abuse as opposed to 13.1 of the rest of the male prison population.

The mentally ill also do not receive the treatment they need once incarcerated. Only 60 percent of state prisoners requiring mental health treatment report receiving it, and only 40 percent of those in jail receive treatment. The nature of the treatment administered to these prisoners is not specified in the report.

While the nature of prisoners' mental illnesses is not examined in the Justice Department report, a 1991 study by the National Institute of Mental Health indicated that the lifetime rates for schizophrenia, major depression and bipolar disorder in the jail population were twice as high as among the general population—9.5 percent versus 4.5 percent. Such serious psychiatric disorders require the intervention of trained medical professionals with drug therapy and counseling, difficult or impossible to administer in a prison setting.

Those classified by the report as mentally ill were more likely to have committed a violent offense—52.9 percent of mentally ill inmates in state prison versus 46.1 percent of other state inmates. 28.4 percent of mentally ill probationers had committed a violent crime as opposed to 18.4 percent of other probationers. The National Institute of Mental Health suggests that "the mentally ill are more likely to be jailed at times when their symptoms are active; for example, they are more likely to be caught using illicit drugs at those times.”

Local jails in particular are ill-equipped to screen for mental illness or make referrals to mental hospitals. As a result, disturbed individuals brought to jails for minor crimes such as disorderly conduct, trespassing and petty theft are not diverted to the mental health system and end up being incarcerated instead of receiving the treatment they need.

Once incarcerated, the mentally ill remain imprisoned longer. They serve on average 15 months longer than other inmates. Disciplinary problems are more common among mentally ill inmates, which is most likely a result of their mental disorders and the lack of treatment they receive for them.

While the Supreme Court has ruled that the execution of the insane is unconstitutional, it has not banned the state killing of seriously mentally ill death row inmates. According to the Death Penalty Information Center, "As states push for more and quicker executions, the most mentally disturbed defendants often put up the least resistance."

On July 8 an appeals court halted the execution of Pernell Ford, a mentally ill man who had been scheduled to die in the state of Alabama's electric chair on July 9. Ford was convicted at the age of 18 of the stabbing deaths of two women during a 1983 burglary in Jacksonville, Alabama. A request for the stay of execution was filed over Ford's objections by his former attorney, Lajuana Davis, whom he had fired. He refused legal counsel at his trial, which included no opening statement, no objections and no cross-examination.

Pernell Ford is seriously mentally ill and has repeatedly tried to kill himself while on death row. He suffers from schizophrenia and depression and was first treated at a psychiatric clinic at the age of nine. At his sentencing he appeared in a white bed sheet and towels and asked that his murder victims be brought into the courtroom so they could be raised from the dead.

Ford's case is not an isolated one:

* In February of this year the state of Oklahoma executed Sean Sellers, who was convicted for a crime committed at age 16, despite evidence of a multiple-personality disorder.

* Also in February, Ohio executed Wilford Berry, who had been diagnosed with a severe schizoid personality disorder.

* James Rich was executed in North Carolina in March. He stated that he committed the murder for which he was convicted so that he would be put to death. He represented himself, waived his trials and appeals and fired his lawyers.

* California in May put to death Manual Babbitt, a highly disturbed Vietnam veteran suffering from post-traumatic stress syndrome.

* Stanley Faulder, a Canadian National who was not informed of his consular rights, was executed in the state of Texas last month. Faulder suffered diminished mental capacity as a result of a massive head injury received at a young age.