NC justice system failing mentally ill inmates
In recent years, North Carolina’s Justice System regarding its mentally ill population has gained negative attention nationwide. Reports reveal what can only be described as a failing approach to an already crumbling system. Worse still, the findings indicate the expensive current practices that fail to reduce recidivism rates are actually costing Carolina taxpayers more than a comparable system that would focus on providing adequate treatment and reducing arrest rates.
One might expect the lack of effective programs provided to equal a cut in costs, but it appears just the opposite is true. A study published in the online journal Psychiatric Services (May 2013) conducted by NC State professor Sarah Desmarais analyzing mental health treatment and corresponding arrest rates and costs, found mentally ill individuals that were arrested and denied adequate treatment cost the government approximately $95,000, an almost $30,000 jump from the reported $68,000 that it cost when arrest was avoided and replaced by more effective treatments. The consequences of North Carolina’s overcrowded prisons and jails was exacerbated when Dorthea Dix Hospital, offering psychiatric treatment to patients since 1856, closed in 2012, as documented in Treatment Advocacy Center’s “No Room at the Inn”, despite objections from many mental health advocates including Representative Deborah Ross. The report held that in 2008, they found North Carolina had only 17.1 beds per 100,000 population, which illustrated a severe shortage from the considered minimum of 50 beds per 100,000. The hospital’s closing created an additional 200 bed shortage, the report claimed. Consider the consequences TAC lists associated with the lack of psychiatric services:
• Law enforcement agencies are routinely tied up with service calls, transportation, and security surrounding psychiatric crises that deserve medical attention.
• Public hospital emergency departments are so overcrowded, patients often wait weeks for psychiatric treatment and some are released without ever receiving treatment.
• The homeless population has increased significantly.
• Jails and prisons are used to house mentally ill inmates and being touted the new psychiatric hospitals. Along these same lines, it is estimated that there are 10 times more mentally ill inmates than there are mentally ill patients being treated by hospitals.
• Arrest-related deaths, along with certain violent crimes, show increase associated with lower-state hospital funding.
• Inmates who receive mental health treatment have been shown to avoid future costly legal problems, including re-incarceration.
The Treatment Advocacy Center recently stated “There is probably no state where mental health services have deteriorated as much as they have in North Carolina over the last decade. The efforts to privatize the system have been a disaster...”
Almost everyone in the field of mental health advocacy, including not only the Treatment Advocacy Center, but reports released by the National Alliance for Mental Illness, as well as the American Civil Liberties Union agree relatively simple measures such as providing medication, counseling, alternative diversion options, careful intake screening, additional necessary assessments and qualified staff would better serve the mentally ill population, reduce costs for taxpayers, and result in reduction of re-arrests. The North Carolina Department of Correctional Services gives jail and prison personnel the right to involuntary administration of medication to mentally ill inmates and North Carolina law requires coordination of services between the state’s psychiatric facilities for inmates and the prisons and jails they return to once released, as found in the policy and procedure manual. The DOC also mandates training of certified personnel to identify inmates posing mental health concerns.
Unfortunately the mandates and permissions granted are not guaranteeing that inmates receive the care they are entitled to while in custody. Prisons and jails are substituting medical treatment for mentally ill citizens, who may lack the ability to advocate for themselves. Our tax dollars continue to be wasted on a system that fails to offer adequate treatment, denies inmates civil rights, and refuses the possibility of affordable solutions.
Melissa Crowley is an educator, writer, and advocate for social justice.