The Way I See It--Another Revolving Door

A small percentage of people have a mental illness, but a much larger percentage wind up in the legal system...in jail or prison.
   In Cobb County the jail averages about 2,100 inmates and about 600 of those have a mental illness, according to Nancy Bodiford of the Cobb jail.  She said that 27 percent is a subjective figure because there is a broad range of mental illness and some of those do not want to be identified as mentally ill.
  About five percent of the general population in Georgia  have a serious mental illness including schizophrenia, bipolar disorder and major depression, but 15 to 20 per cent of state prisoners have a major mental illness, according to the disabilities news web site of Patricia Bauer.
 Many of the mentally ill land in jails or prisons because of the difficulties obtaining treatment, according to a report by Human Rights Watch. Their web site, hrw.org, cited 16 per cent of inmates in U.S. prisons had a major mental illness in a recent survey.  In the general U.S. population, about five percent of the people have a serious mental illness.  Other reports indicate 15 to 20 per cent of those incarcerated have a mental illness, but if the full range of minor to major mental problems are included, that rate couild go much higher, perhaps to around 50 per cent.
  Mental health treatment varies from county to county, state to state. Mostly it depends on funding of programs for the mentally ill which usually comes from a combination of local, state and federal sources.   These funds often fall low on the priority list, especially in times like these with fewer funds raised by local, state and federal governments. 
  Meanwhile, Cobb County and Georgia are receiving additional funds for mental health, according to Todd Citron at the Cobb community mental health office. A settlement with the federal government related to placing too much emphasis on  hospitalization of mental ill patients will provide additional funds for community treatment programs through 2015.  This should improve current programs and provide new programs to treat the mentally ill in their communities.
  Recent decades have showed a major change in the way mentally ill are treated.  While there has been progress in medication and treatment programs, the availability of treatment programs often is less.   In the 1960s, a policy change nationwide pulled all except the most ill and dangerous of the mentally ill out of state hospitals and returned them to their local communities. 
  At the same time, local community programs often have not been able to keep the patients or former patients in programs.  Many of the mentally ill then and now fall through social safety nets meant to protect them.
  Hospitalization keeps mentally ill patients only long enough so they are not a danger to themselves or others, but not long enough to get them stable enough to function.  At the same time outpatient programs often have such strict attendance policies that patients are unable to sit still long enough to stay in group treatment sessions.
  This combination of problems leaves one area left for mentally ill patients when they get into trouble even if it occurs when they are sick.  That is the criminal justice system, the courts and jail or prison.
  In the most simple observation, it appears that the result is from warehousing the mentally ill in state hospitals to warehousing them in prisons.
  Even though jails and prisons have facilities for the mentally ill, they often lack treatment other than medication.  Frequently they are over medicated because they can be difficult and misunderstood by staff who frequently have little training or few people trained to deal with mental health. 
  Some family members who have had friends or relatives in Cobb County jail report that other than medication, they receive little treatment and little input even if it is an immediate family member.  While family members are told the inmate will receive the medication his private psychiatrist ordered, this may not happen, especially if it is a new or expensive medication.
  One source reported they offered to provide the medication for their son, but the the jail staff refused to allow it.  The source said telephone calls to the jail psychiatrist were not returned and they were told he had no contact with family members.
  With only a few mental health courts in Georgia and not enough treatment inside or outside legal system improving their situation, a mental health patient faces another revolving door.  Without intensive treatment, another stint in jail or prison is often ahead for the mentally ill.
  The combination of a lack of available treatment and their likelihood to become unruly or violent due to the mental illness makes them a prime prospect for the criminal justice system.  Add in the homeless mentally ill and the prospects become worse.