A Systematic Examination of the Influence of Indicators of Mental Illness on Deaths in the Texas Criminal Justice System

• Published date: 01 December 2023
• DOI: http://doi.org/10.1177/07340168221124459
• Author: Wendi Pollock,Deborah Sibila,Durant Frantzen,Fei Luo,Alex del Carmen
• Date: 01 December 2023
• Subject Matter: Articles

A Systematic Examination of

the Inf‌luence of Indicators of

Mental Illness on Deaths in the

Texas Criminal Justice System

Wendi Pollock

1

, Deborah Sibila

1

,

Durant Frantzen

2

, Fei Luo

3

,

and Alex del Carmen

4

Abstract

The publicized deaths of individuals such as Sandra Bland raise questions about whether, and how,

the American criminal justice system should handle individuals who display symptoms of mental ill-

nesses. The current study seeks to establish whether there is a stage in the criminal justice process

at which the presence of an indicator of a mental illness represents a particularly high risk of death

in custody. Using multilevel logistic regression and data on 10,667 civilian deaths that occurred in

the custody of criminal justice agencies across the state of Texas, from January 1st, 2005, through

October 30th, 2020, results suggest that indicators of mental illness represent the highest risk of

death when an individual is in the custody of police. At later stages in the criminal justice system

process, particularly jail and prison, indicators of a mental illness reduce the chances that someone

will die in custody. Policy implications are discussed.

Keywords

Race and crime/justice, gender and crime/justice, law enforcement, corrections, mental illness

Introduction

The publicized deaths of individuals such as Sandra Bland, Patrick Warren Sr., Janice

Dotson-Stephens, and Angelo Quinto raise questions about whether, and how, the American criminal

justice system should handle individuals who display symptoms of mental illnesses (Clarke, 2019;

Burke, 2021a; Burke, 2021b; Montgomery, 2019). While these cases illustrate the worst possible

outcome, the death of an individual, lawmakers and citizens are left to wonder if they represent a

1

Texas A&M University –Corpus Christi, Corpus Christi, TX, USA

2

Texas A&M University –San Antonio, San Antonio, TX, USA

3

Texas A&M International University, Laredo, TX, USA

4

Tarleton State University, Stephenville, TX, USA

Corresponding Author:

Wendi Pollock, Texas A&M University –Corpus Christi, 6300 Ocean Drive, Corpus Christi, TX 78412, USA.

Email: wendi.pollock@tamucc.edu

Article

Criminal Justice Review

2023, Vol. 48(4) 437-457

© 2022 Georgia State University

Article reuse guidelines:

sagepub.com/journals-permissions

DOI: 10.1177/07340168221124459

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larger pattern of deleterious interactions between those experiencing a mental health crisis and

employees of the American criminal justice (CJ) system.

There is supporting research that suggests that individuals with mental illnesses are often labeled

as “dangerous, unpredictable, incompetent, and unable to function in society”(Yanos, 2018, p. 4).

Movies, TV shows, and news media commonly misrepresent both mental illness and the people

who suffer from such illnesses (Stuart, 2006; Scarf, et al., 2020; “Stigma, prejudice, and discrimina-

tion…”, 2020). According to a U.S. study from 2006, half of all characters who were portrayed as

having a mental illness in prime-time programming, were also portrayed as being violent (Stuart,

2006). A more recent study in the Journal of the American Medical Association (JAMA) specif‌ically

notes that the 2019 f‌ilm Joker “continues the tradition of movies depicting individuals with mental

illness as violent”(Scarf, et al., 2020, p. 1). In addition to movies and television programming, celeb-

rities or political f‌igures have given misleading public statements about many aspects of mental

illness (LaPierre, 2012; Neill, 2005). For example, in 2012, the head of the NRA, Wayne

LaPierre, gave a speech in Washington D.C. in the wake of a mass shooting, in which he classif‌ied

people with mental illnesses as “genuine monsters –people so deranged, so evil, so possessed by

voices and driven by demons that no sane person can possibly ever comprehend them”(LaPierre,

2012, para. 9).

Given the prevalentand consistent application of negative labels to people who suffer from mental

illnesses, we are again left to wonder ifcriminal justice system personnelare affected by these stigmas

to the extent thatshowing symptoms of a mental illnessbecomes a risk factor for death in thecustody of

these actors. The current study seeks to examinethis question in more detail by analyzing10,667 civil-

ian deaths that occurred in the custody of criminal justice agencies across the state of Texas, from

January 1st, 2005, through October 30th, 2020. Texas is the second largest state in the United

States when ranked by population, at approximately 11 million people behind California, yet there

are approximately 16,000 more people in Texas jails and prisons, and 170,460 more people on proba-

tion and parole in Texas,compared to California. (“US states–ranked…”, 2021; “The facts…”, 2020).

In addition,for decades, a Texas statute has requiredlaw enforcement and correctionalagencies to f‌ile a

report within 30 daysof the death of an individual in their custody (TexasCode of Criminal Procedure,

2021). Accordingto the Texas Code of CriminalProcedure, “The director shallmake a good faith effort

to obtain all facts relevant to the death and include those facts in the report”(Texas Code of Criminal

Procedure, 2021). The custodial death reports were made publicly available on the Texas Attorney

General’s(AGs)off‌ice webpage in 2016 (“Custodial Death Report”, 2020), making Texas an ideal

place for an exploratory look at the effects of mental illness on deaths in custody.

Literature Review

Mental Illness in the Criminal Justice System

According to the National Institute of Mental Health (NIMH), almost one in f‌ive U.S. adults live with

mental illness (“Mental illness”, 2022). This, however, encompasses a wide range of illnesses that

include a broad array of symptoms and symptom severity. Accordingly, the NIMH further divides

the concept of “mental illness”into two broad categories known as “any mental illness or AMI”

and “serious mental illness or SMI”. AMI is def‌ined as a mental, behavioral, or emotional disorder

of any level of severity, while an SMI is a mental, behavioral, or emotional disorder “resulting in

serious functional impairment, which subsequently interferes with or limits one or more major life

activities”(“Mental illness”, 2022, para. 4). In 2020, approximately 21% of all U.S. adults had a dis-

order classif‌ied as AMI, while 5.6% of U.S. adults (14.2 million people) had a SMI. In addition,

almost 50% of juveniles between the ages of 13 and 18 had, at some point in their lives, a disorder

classif‌ied as AMI and approximately 22% of those had serious impairment (“Mental illness”, 2022).

438 Criminal Justice Review 48(4)