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Wren Keemer
Mark Vincent
Criminal Justice 1010
4/14/18
Mental Illness in the Criminal Justice System

People with serious mental illness (SMI) in the prison system is a problem. Mental illness

in this instance includes major depressive disorder, bipolar disorder, and schizophrenia. This

paper will argue that the state should provide better ongoing mental health treatment for convicts

with mental illness instead of cycling them in and out of prisons. The majority of offenders with

serious mental illness were typically, male, younger, not married and less educated individuals

(Matejkowski, Lee, and Han p.16). “Those with bipolar disorder were also more likely to have a

criminal history than those with major depressive disorder” (Matejkowski, Lee, and Han p.16).

The criminal justice system is treating the symptoms and not the illness, by putting offenders in

prison instead of state mental hospitals and not getting them the help that they need. People with

SMI tend to have higher criminal justice involvement than the general population, which no one

fully understands (Matejkowski, Lee, and Han p.10).

In the 1950’s, the US had a peak number of about 559,000 people who were living in

state hospitals, and between the 1960’s and 1970’s that number went down significantly to about

200,000 residents (Slate p.341). Today it is down to 35,000 people, this is a 94% reduction in

state hospitals since the 1950’s (Slate p.341). Some researchers believe that deinstitutionalization

from state hospitals caused the criminalization and stigmatization of those who are mentally ill.

Because of the criminalization of people who are mentally ill, they are more likely to go

to prison and if there is no room in a state hospital, judges will send the mentally ill person to

prison instead of getting them the real help that they need (Ringhoff, Rapp, and Robst, p.2). “In

other words, police and judges would use criminal sanctions to deal with people with SMI
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(Ringhoff, Rapp, and Robst, p.3). As a result of being deinstitutionalized, many of the people

coming out of the state hospitals had inadequate housing and community support, therefore, they

became homeless, which in turn, created an unfair ruling of prison time if they were arrested

(Ringhoff, Rapp, and Robst, p.3).

Those with mental illness who do not have access to the right medications are more likely

to be homeless, more likely to be put into prison, and with certain mental illnesses, and without

the right medications are more likely to hurt someone (Slate, p.341). When Congress passed a

law refusing to pay for certain medications through Medicaid because they were too expensive, a

man who had Paranoid Schizophrenia for most of his life, but was taking medication and had not

had any issues with hurting anyone, was forced to take generic medication (Slate p.351). The

new medication had a different effect and he ended up murdering his mother because he thought

she was evil and was a part of the Kennedy assassination (Slate p.351). Fortunately he was later

institutionalized, and got the right medications, but he will now spend the rest of his life in a

mental hospital. If lawmakers were more concerned with the population’s health rather than

saving money, then maybe things like this would not happen.

Those who are in social work are neglectful with people in the criminal justice system.

There are not enough of them to do a worthwhile job of helping those with SMI in prison, they

lack the correct training that would help them, and the amount of adults with SMI have increased

“sevenfold” (Pettus-Davis p.3). A study with eleven participants with SMI reported on what it

was like to be in prison, three of them spoke about the prison staff as being “decent”, or

“alright”, another three reported that the staff, varied depending on the person. The majority said

that the staff was “abusive” and “manipulative” (Pope, Smith, Wisdom, Easter, and Pollock,
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p.449). Another report given by forty-three people that had been in prison reported that they had

increases of depression, anxiety, and suicidal thinking (Pope, et.al, p.450).

Even in the prisons, offenders with SMI are being treated poorly, either because prison

staff are not being trained on how to deal with offenders with SMI or they just do not want to

deal with them. There is not enough happening to help those people in the criminal justice

system because society, including prison staff and people in the social work community, just

want to write off offenders in general. Rates of serious mental illness (SMI) are higher in the

prison system than out in society. Not only do prisons provide insufficient mental health

treatment to the offenders in confinement, but also nobody seems to be trying to help them

before they are sent to prison (Pope, et. al, p.450). The amount of offenders that have mental

illness and are getting out of prison is continuing to rise (Pope, et al., p. 248). Effective

community return is difficult in particular with people who have mental illnesses because they

are more likely to be homeless, less likely to find a job, and often have a hard time finding

acceptable and suitable mental health treatment (Pope, et al., p. 249).

While there are programs to help ex-convicts with reentering society they are lacking in

most states and when they are doing well they are still not able to get the ex-convicts with

serious mental illness to go (Pope, et. al, p.451). Some ex-convicts getting out of prison who

have SMI, do not want to go to a halfway house because they want to take care of their families,

but then regret it later because they could not do as much for their families as they wanted to

because there mental illness prevented it (Pope, et. al, p.451). One of the problems with getting

ex-convicts with SMI to go to rehabilitation programs is that they want to do more than they

actually can and then later realize that it is too overwhelming. Moreover, not only do these

people have to cope with mental illness, they also have to cope with harsh treatment in prison.
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A study done by Pope, et al. (p.446), had a recruitment period in which 971 people with

serious mental illness were qualified for a larger study. Out of those 971 people only 77 granted

permission to be contacted and only 43 out of 56 met the additional standards that were required

for the study having reported that they have a history of being in prison and almost all of them

were involved with mental health services at the time of the interview (Pope, et al., p.446). Some

of these people have had a hard time getting out of the criminal justice system because once they

are in and have a mental illness, it is difficult not to go back to prison (Pope, et al., p.446). Once

they are in prison, they had a difficult time due to them not getting the correct treatment or any at

all.

The group of forty-three consisted of thirty-two males and eleven females and largely

consisted of self-identifying Black and Hispanic. According to Pope, et al. (p.447), the study

group recounted that they were sent to prison due to alcohol and drug related issues, assault,

loitering and trespassing. Within the prison system these “clients”, out of the forty-three, 3 said

that they had a “positive” experience with the jail and prison workers, saying that they were

“decent” or “all right”. Another 3 said that it depended on the person, whether the workers were

kind or not and 11 “clients” said that the prison workers were “abusive and manipulative” that

they “abused their authority” and that they refused to give the inmates their mail. (Pope, et al.,

p.447). According to Pope, et al. (p.447) the mental health professionals were few and far

between, the clients referred to them as being “unpredictable and uneven”, meaning, they did not

show up consistently.

While there are some states that have good rehabilitation programs, they do not go the

extra mile for those with serious mental illness. There just are not enough programs for ex-

convicts with SMI to get the help that they need, which include, getting on the medications that
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they need and giving them the right kind of therapy depending on what disorder they have. Some

of the ex-convicts with serious mental illness just did not have the support to get into the

programs that would help them rehabilitate and when they did they still had a hard time going, if

at all (Pope, et al., p.448). One man reported that he did not want to go to the housing that was

provided because that meant that he would have to live apart from his wife and children and he

wanted to support them, but could not because of his mental illness. He said that he regretted not

going because of that (Pope, et al., p.448). Some later said that they regretted not going and

doing the programs because they did not think that it would help (Pope, et al., p.449).

Much needs to be done to help people with serious mental illness who enter the criminal

justice system. The government needs to hire more people to talk to and help those that are in

prison with these issues, or providing preventative help so that they stay out of prison in the first

place. There are more people in the prison system than out in the community with serious mental

illnesses that are not getting the help that they need. Too many are being looked over in the

prisons and being treated insensitively because the staff does not know how to handle those kinds

of situations. The programs available to offenders after getting out of prison are lacking and need

to be more responsive toward people with mental illnesses and if that does not work, they need to

be sent to a hospital because most people with these mental illnesses will not choose to admit

themselves.

Works Cited
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Matejkowski, Jason, et al. "The Association between Criminal History and Mental Health

Service Use among People with Serious Mental Illness." Psychiatric Quarterly, vol. 85,

no. 1, Mar. 2014, pp. 9-24. EBSCOhost, doi:10.1007/s11126-013-9266-2.

Pettus-Davis, Carrie. "Reverse Social Work's Neglect of Adults Involved in the Criminal Justice

System: The Intersection and an Agenda." Social Work Research, vol. 36, no. 1, Mar.

2012, p. 3. EBSCOhost, doi:10.1093/swr/svs036.

Pope, Leah Gogel, et al. "Transitioning between Systems of Care: Missed Opportunities for

Engaging Adults with Serious Mental Illness and Criminal Justice Involvement."

Behavioral Sciences & the Law, vol. 31, no. 4, Jul/Aug2013, pp. 444-456. EBSCOhost,

doi:10.1002/bsl.2074.

Ringhoff, Daniel, et al. "The Criminalization Hypothesis: Practice and Policy Implications for

Persons with Serious Mental Illness in the Criminal Justice System." Best Practice in

Mental Health, vol. 8, no. 2, Dec. 2012, p. 1. EBSCOhost, libprox1.slcc.edu/login?

url=http://search.ebscohost.com/login.aspx?

direct=true&db=f6h&AN=85944023&site=eds-live.

Slate, Rison N. "Deinstitutionalization, Criminalization of Mental Illness, and the Principle of

Therapeutic Jurisprudence." Southern California Interdisciplinary Law Journal, vol. 26,

no. 2, Spring2017, pp. 341-356. EBSCOhost, libprox1.slcc.edu/login?

url=http://search.ebscohost.com/login.aspx?

direct=true&db=lgh&AN=123799180&site=eds-live.