Board of Trustees, Capital University, Columbus, Ohio

Author:Tom Hamilton
Position:Guilty Of Being Ill: Does The Punishment Fit The Crime?

I. Criminalization Of The Mentally Ill II. De-Institutionalization III. Trans-Institutionalization IV. The High Cost Of Incarceration IV. There Are Effective Alternatives V. Changes Are Needed


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Board of Trustees, Capital University, Columbus, Ohio.

The title of this paper is intentionally provocative to underscore the failure of society and mental health policy to provide adequate access and treatment for individuals with mental illness. As a result, a large number of adults and children are incarcerated simply because of the untreated symptoms of their illness.

My son has a serious and persistent mental illness. I have watched him struggle for eleven years to do the simple things in life that I take for granted. I have developed an enduring interest in the criminalization of those with a mental illness. At least to date, there but for the Grace of God goes my son.

I Criminalization Of The Mentally Ill

The United States has the largest incarcerated population in the world. One in every thirty-two adults was behind bars or on probation or parole at the beginning of this decade. According to the Bureau of Justice statistics, a record 6.6 million people are in our correctional system, with more than two million behind bars. Being the leading incarcerator is primarily the result of policy decisions and not rising crime rates.

There is a disproportionate representation of those with a serious mental illness relative to the general population. According to the Bureau of Justice, sixteen percent of all inmates report a mental illness or an overnight stay in a mental hospital. In addition, another fourteen percent reported having received mental health services at some point in the past.

It has been estimated that the occurrence of mental illness in prison could be at least five times greater than in the general population, and the gap is growing. The fastest-growing segment of the prison system is the female population and more than one in four incarcerated women have been identified as having a mental illness.

As large as these numbers are, they are believed to understate the problem because of under-reporting by those who do not want to reveal that they are ill, or because roughly fifty percent of the ill population lacks awareness of their illness. This overrepresentation in our prisons and jails is often referred to as the criminalization of those with a mental illness.

Those of us with an ill family member want criminals in jail, whether or not they have a mental illness. But for those whose crime is non-violent Page 1000 and is a result of the untreated symptoms of their illness, there is a much more humane and cost-effective treatment.

This issue constitutes one of the gravest social matters facing the country. Well-intentioned but ill-informed decisions and policies have led, for example, to the Los Angeles County Jail being the largest mental institution in the country; followed closely by the Cook County Jail in Chicago, Riker's Island in New York, and the Harris County Jail in Houston.

The French novelist, playwright, existentialist philosopher, and literary critic Jean Paul Sartre gives us a perspective from which to understand history. He suggests that comprehending past events is similar to looking out the rear window of a speeding vehicle. Objects passing close to you are a blur and difficult to clearly image. As they become more distant, they reach focus. Society's handling of those with a mental illness during the past half-century is now coming clearly into focus. These illnesses are common, yet treatable, but the general public's view of someone with a mental illness is fraught with myth and misunderstanding. Thanks to the knowledge and improved science flowing from research during the last decade, the nature of these illnesses is now much better understood.

One in five of us will experience diagnosable symptoms of a mental disorder in our lifetime. One in twenty will suffer symptoms so severe as to be disabled. As much as ten percent of all children experience serious mental health disorders.

These are real, diagnosable disorders, not character flaws or the result of personal weakness. They are more properly called neurobiological brain disorders (NBBD). Success rates for treating the symptoms of NBBD are as high or higher than other serious illnesses, with sixty- to eighty-percent efficacy rates or better. Much like diabetes, these disorders cannot yet be cured, but the symptoms can be controlled through treatment and therapy, and most individuals can...

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