By Jerry Mitchell
The Clarion Ledger
May 23, 2010
More than three times the number of people who suffer from mental illness are being held in jails and prisons these days instead of hospitals, a new study reveals. And a different study shows the number of mentally ill inmates committing suicide has doubled over the past 20 years.
“The sad fact is the deinstitutionalization of these supposedly god-awful psychiatric hospitals was made with the belief they would be placed in a better place,” said James Pavle, executive director of the Treatment Advocacy Center in Arlington, Va., which conducted the study on the mentally ill in jails and prisons. “But unfortunately, as the data shows, that better place has turned out to be jails and prisons, which are not better.”
What’s happening, Pavle said, is incarceration is replacing hospitalization. The odds of a seriously mentally ill individual being imprisoned rather than hospitalized are 3.2-to-1, the study determined.
Mississippi is much better than the national average at 1.8-to-1. States such as Arizona and Nevada have 10 times as many mentally ill individuals in prisons and jails than hospitals.
Pavle based the report on 2004-05 data, never before published, from the Department of Health and Human Services and the Bureau of Justice. In 1955, there was one psychiatric bed for every300 Americans, Pavle said. Now there is just one psychiatric bed for every 3,000 Americans, he said. “We’re not trying to suggest hospitalization is the only form of treatment, but it’s a very stark set of statistics.”
Past studies have put the number of mentally ill behind bars at between 15 and 20 percent of those incarcerated. Officials from the Mississippi Department of Corrections say about 14 percent of the 21,000 state inmates have been diagnosed with mental illness.
Hinds County Sheriff Malcolm McMillin estimated 85 percent of those behind bars suffer from mental problems, drug addiction and/or alcohol addiction. He said it’s a problem that law enforcement is inheriting that “nobody else wants to do anything about.”
Another sheriff, Donald Eslinger – who serves in Seminole County, Fla., and helped write the Treatment Advocacy Center study – noted that “people with mental illnesses who are incarcerated have high rates of victimization, assault and suicide.”
Wendy Bailey, of the state Department of Mental Health, said the agency is working to address such problems. For instance, a redesign of crisis intervention centers across the state should help with jail diversion, she said. The department has offered grants to the 15 community mental health centers to provide training to law enforcement officers on working with people with mental illness (not all centers took them).
Bailey said Timber Hills Mental Health Services and Region 8 Mental Health Services offer mobile crisis teams that will accompany and assist law enforcement in assessing for mental illness. This past year, state lawmakers passed legislation to develop crisis intervention teams across the state. A change also could come with how the judicial community handles the mentally ill.
Pine Belt Mental Healthcare Resources has received a grant for a mental health court, and Weems Community Mental Health Center in Meridian has applied for one.
Lindsay Hayes, project director for the National Center on Institutions and Alternatives, found in his report, “National Study of Jail Suicide: 20 Years Later,” that the rate of suicide has declined drastically in jails over the past two decades, but it is still three times higher than the general population.
Better awareness, better training and suicide prevention programs have helped lead to this decline, he said.
The study was conducted through a contract with the National Institute of Corrections and the U.S Department of Justice.
It identified 696 jail suicides across the U.S. in 2005 and 2006, with 612 deaths occurring in detention facilities and 84 in holding facilities. During that time, Mississippi had nine suicides in county jails and five in police department lockups. (According to the Mississippi Department of Corrections, five state inmates committed suicide during that time.)
Over the past 20 years, the number of mentally ill inmates who commit suicide has increased from 19 percent to 38 percent, according to the study. Hayes said he believes more than half the inmates who commit suicide have a mental illness. A 2002 study in Washington state found 77 percent of those who attempted suicide in jail were mentally ill.
“You ask any sheriff in Mississippi what their top five problems are, and I can guarantee you they will talk about dealing with the dramatic increase of the mentally ill coming into our jails,” he said.
Two decades ago, the jail suicide rate was nine greater than the general population. Today it is three or four times greater, Hayes said. “We’re much better at it than 20 years ago, but it’s still a high suicide rate compared to the community,” he said.
Training and vigilance can help make a difference, he said. “We have shown this is preventable. It’s challenging, but many of these suicides are preventable if we will commit ourselves to the task.”