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The Number of Mentally Ill in Prison

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An activity therapy room is seen at the Psychiatric Inpatient Program at San Quentin State Prison in San Quentin, California in December 2015. Credit: Stephen Lam

An activity therapy room is seen at the Psychiatric Inpatient Program at San Quentin State Prison in San Quentin, California in December 2015. Credit: Stephen Lam

As a clinical social worker in a prison in Michigan, I have seen firsthand how untreated mental illness needs have devastating consequences. It is also a symptom of a larger issue of the effect of untreated mental illness needs in the community.  According to Michigan’s Department of Corrections, 20% of all prisoners are in the mental health services program.  Using the most recent statistics on prison incarceration rates from 2013, slightly over 43,000 people were incarcerated, and 20 percent of prisoners in treatment equates to approximately 8500 prisoners having some type of diagnosed mental illness.

This figure is in stark contrast to a study done at the University of Michigan about mentally ill inmates which stated 65% of inmates in Michigan prisons have a mental illness and did not receive any treatment. The same study also put the number of mentally ill inmates at 30% of the total prison population versus the 20% reported by the Michigan Department of Corrections. It also reported male prisoners are less likely to receive treatment than female prisons.

The U of M study estimated that 77% of the 30% they believed to have a diagnosed mental illness were not receiving treatment which means only 23% of prisoners with a diagnosed mental illness is being treated. This does not necessarily mean the Department is failing to treat them or identify mentally ill inmates in the intake process. Inmates refusing treatment could also be a factor affecting outcomes. Inmates have the ability to say no to any form of treatment given if they are not a danger to themselves or others.

This study also looked at the involvement of mental illness as a factor in the crime the prisoner committed.  It was reported that 20% of the crimes committed were by a person who had a diagnosed mental illness with 65% of those people were not receiving any treatment for their mental illness prior to the crime being committed. I believe this issue was exacerbated when mental health facilities in the state of Michigan were closed down starting in the late 1980’s to 2003. These numbers do not address the issue of co-occurrence involving substance abuse, and the amount of drugs that enter prisons which is another serious problem.

Many people were forced back into the community where Medicaid funding did not keep the pace of the increase of mentally ill reintergrating back into the community.  As a result, people were not receiving treatment they needed and were forced to manage symptoms on their own. This caused other systems like the prisons to pick up the slack when a person with a mental illness committed a crime.

I am certainly not advocating for a return to state-run mental health facilities, but taxpayer money could be better spent on programs and even other levels of care in the community to stop the pipeline to prison for those suffering from mental illness.  The current budget in Michigan for the Department of Corrections is $1.9 billion dollars with $290 million allocated for health care of which mental health services are included with education spending at $13 billion dollars.

Michigan and other states need to create more mental health and drug courts to prevent mental ill individuals from being funnelled into prisons as a solution. Michigan has taken a step in the right direction and in 2013 10 mental health courts were designated in Michigan.

These courts have been reviewed by the Michigan State Court Administration and have found that they reduce prison recidivism rates.  As a social worker who attended one of these courts, the judges, attorneys, and probation officers involved have a greater understanding and empathy of the mental health needs of people in the criminal justice system.

Also, we also need more jail diversion programs as tool to provide relief for mental ill individuals getting in order for them to get the care they need to be productive. I had the privilege of working in a jail diversion program to divert people to services instead of keeping them in jail or prison. Only recently has the federal government started tracking data from many of these programs as well as working on uniform standards across the country.  Many states have different programs at the various levels which include intervention at the law enforcement level, at the court level, or after sentencing.

While I believe that people need to take responsibility for their crimes and poor choices, we should also take responsibility as a community to make sure those with serious needs get the help they need. Many of the prisoners I work with have significant trauma issues which is a contributing factor to complex problems.

Most importantly, we need to fund more programs and services for early childhood education to support families and identify issues early.  I know this will take significant amounts of money but a large majority of prisoners will return the community. Shouldn’t our money be spent in better ways?

Hi! My name is Laurie Eldred and I received a Master’s in Social Work and Public Administration from Grand Valley State University in Grand Rapids, Michigan in 2008. Since this time, I have worked for Ionia County Community Mental Health in Ionia, MI in programs serving adults with mental illness and substance abuse, and for the State of Michigan as a CPS worker for over 6 years. Currently, I am currently working as a clinical social worker for Michigan Department of Corrections and I started my own business; Eldred’s Clinical Services. The mission for my clinical practice is to transform people through compassionate therapy, clinical supervision, training, and consultation. I am married with 2 children and I am active with my local school district as well as my county human trafficking coalition.

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