Orange is the New Psychiatric Hospital
Between 1960 and 1980, 80% of the long-term psychiatric beds in the U.S. were eliminated. We all applauded that as a productive move towards de-institutionalization and in supporting people with mental health problems in the community. The reality is that the state hospital of the 1960’s has been replaced with prison. Conservative research indicates that 25% of all prisoners have serious mental health problems; other estimates place it far higher. In fact, some prisons are now considered to be the largest providers of mental health services in their communities. The policy-driven change from mental health programs to prisons and corrections facilities has been dubbed “trans-institutionalization” by James Gilligan, a researcher in this area. What started out as de-institutionalization has clearly become re-institutionalization.
It’s time to take a serious look at what happens to people with mental health problems once they enter into correctional facilities. E. Fuller Torrey, MD, has written that isolation is the primary tool for control and segregation in prisons. A high number of inmates in solitary confinement have mental health problems according to Keramit Reiter, a Professor at the University of California-Irvine School of Law. Ms. Reiter places that number at 33%-50%. The data on prison suicides reports that 50% take place in isolation cells. The segregation of these individuals within the prison population further exposes them to the risk for suicide. Corrections officials keep asking for more segregation facilities.
With further cutbacks in public funding for mental health services likely to occur and changes expected to the Affordable Care Act (ACA) which could reduce mental health benefits we are going to experience more individuals with mental health problems entering into the correctional system. The very movement which was started to help people living in mental health institutions to live in the community has become the movement of housing them in the correctional institutions which are ill-equipped to meet their needs for treatment. People living with chronic mental health problems need housing, healthcare and access to treatment in the community. With those resources in place, they can avoid imprisonment and placement in institutions designed for punishment.